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  • 101.
    Edell-Gustafsson, Ulla
    et al.
    Linköping University, Department of Medical and Health Sciences, Nursing Science. Linköping University, Faculty of Health Sciences.
    Angelhoff, Charlotte
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Johnsson, Ewa
    Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Karlsson, Jenny
    Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Mörelius, Evalotte
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Centre of Paediatrics and Gynecology and Obstetrics, Department of Paediatrics in Linköping.
    Parents’ perceptions of sleeping in a neonatal intensive care unit2013Conference paper (Other academic)
    Abstract [en]

    Introduction

    Sleep is important for mental and emotional health. For parents staying in the hospital with their preterm and/or sick infant, lack of sleep may affect their ability to handle the situation, supporting their infant, and participate in decision-making. Moreover, when a child is born preterm, parents may experience stress that potentially affects their ability to interact and bond with the infant.

     

    Purpose

    To describe parents’ perceptions of what it is like to sleep in a neonatal intensive care unit (NICU) in a room nearby or in the same room as their infant.

     

    Material

    Twelve parents (eight mothers and four fathers) of infants born between week 29 and 36, in three different hospitals, were included. Eight of the parents slept in the same room as their infants and four parents slept in parents’ rooms in the NICU.  

     

    Methods

    Parents were interviewed with open-ended questions. Data was analysed with a phenomenographic method according to Marton and Both.

     

    Results

    Five descriptive categories in the phenomenon of parents’ perception of how it is to sleep  in a NICU  were  identified; Transition to parenthood, How parents perceive and manage their tiredness, A feeling of being out of control, Different forms of support and Environment.

     

    Conclusions

    Parents in the NICU are vulnerable, in a stressful situation, with an infant in need of neonatal intensive care. At the same time they are going through a complicated transition to parenthood. Hence sleep is important for the parents in several aspects, and NICU staff needs to acknowledge and promote parents’ sleep. 

  • 102.
    Edéll-Gustafsson, Ulla
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Angelhoff, Charlotte
    Department of Social and Welfare Studies, Faculty of Health Sciences, Linköping University, Norrköping, Sweden.
    Johnsson, Ewa
    Department of Pediatrics, County Council of Östergötland, Linköping, Sweden.
    Karlsson, Jenny
    Department of Pediatrics, County Council of Östergötland, Linköping, Sweden.
    Mörelius, Evalotte
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Medicine and Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Paediatrics in Linköping. Department of Social and Welfare Studies, Faculty of Health Sciences, Linköping University, Norrköping, Sweden.
    Hindering and buffering factors for parental sleep in neonatal care: A phenomenographic study2015Conference paper (Other academic)
    Abstract [en]

    Aims and objectives

    To explore and describe how parents of preterm and/or sick infants in neonatal care perceive their sleep.

    Background

    Parents experience many stressful situations when their newborn infant is preterm and/or sick. This affects bonding. By developing more family-centred care units with single-family rooms, parents are given the opportunity to stay and care for their newborn infant(s) 24 hours a day. Lack of sleep may affect new parents' ability to cope with the many challenges they face on a daily basis.

    Design

    A phenomenographic study with an inductive and exploratory design.

    Methods

    Semi-structured interviews were conducted with twelve parents of infants in neonatal care between January–March 2012. To describe variations in perception of the phenomenon, data were analysed using phenomenography.

    Findings

    Four descriptive categories were identified within the phenomenon sleep in parents of preterm and/or sick infants in neonatal care: impact of stress on sleep; how the environment affects sleep; keeping the family together improves sleep; and, how parents manage and prevent tiredness.

    Conclusion

    Anxiety, uncertainty and powerlessness have a negative influence on sleep. This can be decreased by continuous information, guidance and practical support. Skin-to-skin care was perceived as a stress-reducing factor that improved relaxation and sleep and should be encouraged by the nurse. The parents also mentioned the importance of being together. Having a private place where they could relax and take care of themselves and their newborn infant improved sleep. It was also desirable to involve older siblings in order to decrease feelings of loneliness, sadness and isolation.

    Relevance for clinical practice

    Improved parental sleep in neonatal care may help the families cope with the situation and facilitate problem-solving, emotional regulation and the transition to parenthood.

  • 103.
    Edéll-Gustafsson, Ulla
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Angelhoff, Charlotte
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care.
    Johnsson, Ewa
    Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Paediatrics in Linköping.
    Karlsson, Jenny
    Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Paediatrics in Linköping.
    Mörelius, Evalotte
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences. Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Paediatrics in Linköping.
    Hindering and buffering factors for parental sleep in neonatal care. A phenomenographic study2015In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 24, no 5-6, p. 717-727Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES:

    To explore and describe how parents of preterm and/or sick infants in neonatal care perceive their sleep.

    BACKGROUND:

    Parents experience many stressful situations when their newborn infant is preterm and/or sick. This affects bonding. By developing more family-centred care units with single-family rooms, parents are given the opportunity to stay and care for their newborn infant(s) 24 hours a day. Lack of sleep may affect new parents' ability to cope with the many challenges they face on a daily basis.

    DESIGN:

    A phenomenographic study with an inductive and exploratory design.

    METHODS:

    Semi-structured interviews were conducted with twelve parents of infants in neonatal care between January-March 2012. To describe variations in perception of the phenomenon, data were analysed using phenomenography.

    FINDINGS:

    Four descriptive categories were identified within the phenomenon sleep in parents of preterm and/or sick infants in neonatal care: impact of stress on sleep; how the environment affects sleep; keeping the family together improves sleep; and, how parents manage and prevent tiredness.

    CONCLUSION:

    Anxiety, uncertainty and powerlessness have a negative influence on sleep. This can be decreased by continuous information, guidance and practical support. Skin-to-skin care was perceived as a stress-reducing factor that improved relaxation and sleep and should be encouraged by the nurse. The parents also mentioned the importance of being together. Having a private place where they could relax and take care of themselves and their newborn infant improved sleep. It was also desirable to involve older siblings in order to decrease feelings of loneliness, sadness and isolation.

    RELEVANCE FOR CLINICAL PRACTICE:

    Improved parental sleep in neonatal care may help the families cope with the situation and facilitate problem-solving, emotional regulation and the transition to parenthood.

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  • 104.
    Edéll-Gustafsson, Ulla
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Angelhoff, Charlotte
    Johnsson, Ewa
    Karlsson, Jenny
    Mörelius, Evalotte
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Medicine and Health Sciences.
    Parents' perceptions of sleepin in a neonatal intensive care unit2013Conference paper (Refereed)
  • 105.
    Edéll-Gustfsson, Ulla
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences.
    Angelhoff, Charlotte
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Johnsson, Ewa
    Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Paediatrics in Linköping.
    Karlsson, Jenny
    Region Östergötland, Center of Paediatrics and Gynaecology and Obstetrics, Department of Paediatrics in Linköping.
    Mörelius, Eva-Lotta
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Paediatrics in Linköping.
    Hindering and buffering factors for parental sleep in neonatal care.: A phenomenographic study2015In: Disability, Chronic Disease and Human Development / [ed] Joav Merrick, Nova Science Publishers, Inc., 2015, no 5-6Conference paper (Other academic)
    Abstract [en]

    Background

    Parents experience many stressful situations when their newborn infant is preterm and/or sick. This affects bonding. By developing more family-centered care units with single-family rooms, parents are given the opportunity to stay and care for their newborn infant(s) twenty-four hours a day. Lack of sleep may affect the new parents’ ability to handle the situation.

    Aim

    To explore and describe how parents of preterm and/or sick infants in neonatal care perceive their sleep.

    Methods This is a phenomenographic study with an inductive, exploratory design. Semi-structured interviews were conducted with twelve parents of infants in neonatal care. Data was analysed to describe variations of the phenomenon.

    Findings

    Four descriptive categories were identified within the phenomenon sleep in parents of preterm and/or sick infants in neonatal care; Impact of stress on sleep, How the environment affects sleep, Keeping the family together improves sleep, and How parents manage and prevent tiredness.

    Conclusion

    Anxiety, uncertainty and powerlessness have a negative influence on sleep. This can be decreased by continuous information, guidance, and practical support. Skin-to-skin-care is an important source for recovery, relaxation and sleep, and should be encouraged by the nurse. The parents also mentioned the importance of being together. To have a private place where they could relax and take care of themselves and their newborn infant improved sleep. It was also desirable to involve older siblings in order to decrease feelings of loneliness, sadness and isolation. Improved parental sleep in the neonatal care may help the families to cope with the situation, and facilitate problem-solving, emotional regulation, and the transition to parenthood.

  • 106.
    Ehrenfors, Rita
    et al.
    Karolinska Institutet, Huddinge, Sweden.
    Borell, Lena
    Karolinska Institutet, Huddinge, Sweden.
    Hemmingsson, Helena
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Assesments used in school-aged children with acquired brain injury - Linking to the international classification of functioning, disability and health2012In: Brain Injury, ISSN 0269-9052, E-ISSN 1362-301X, Vol. 26, no 4-5, p. 502-502Article in journal (Refereed)
    Abstract [en]

    Objectives: The aim was to examine widely used assessments within rehabilitation of school-aged children with acquired brain injury (ABI) with the International Classification of Functioning, Disability and Helath (ICF) as a framework.

    Methods: A multicentre survey identified the assessments most widely used in the rehabilitation of school-aged children with ABI in Sweden. The aims of these assessments were linked to the ICF according to previously published linking rules for clinical assessments.

    Results: Thirty out of 43 widely used assessments were linked to body functions. The remaining assessments were linked to activities and participation, with no assessments being linked to environmental factors. Many categories within activities and participation were missing, whereas some categories within body functions were covered by numerous assessments.

    Conclusions: The widely used assessments within paediatic brain injury rehabilítation do not cover essential aspects of functioning and disability. Specificially, assessments focusing on many crucial categories of activities and participation, and all categories within environmental factors were missing. A better understanding of school-aged children's health and disability might be achieved by using the ICF to identify a set of assessments, illuminating body functions, activities and participation and environmental factors.

     

  • 107.
    Ekbladh, Elin
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Interventioner för att påverka sjukfrånvaro - en analys av tillvägagångssätt.2005In: Socialmedicinsk Tidskrift, ISSN 0037-833X, no 3, p. 210-222Article in journal (Other academic)
    Abstract [en]

    Interventions used to impact sick leave

    -          An analysis of approaches

    This review concerns intervention research published during the 21st century where the purpose of the interventions was to impact sick leave in work life. The aim of this review was to create a systematic chart of interventions published in scientific journals during the period mentioned above. A second aim was to analyze the procedures in the papers and their overall goal concerning their interventions for papers published in year 2003. The papers were analyzed through Blake and Moutons’ model of intervention approaches. The review resulted in 60 scientific papers with intervention research concerning sick leave. During year 2003, 17 papers were published concerning this topic, which was the most during any year in the 21st century.  The intervention approach that was most common was the “ prescriptive interventions” (n=11). One explanation for this could be that many of the interventions (n=7) were carried out in a health care arena that has a long tradition of an expert authority relation towards the client. Twelve of the papers described disease prevention interventions and five described health promotion interventions. None of the 17 papers had a qualitative approach, which is noteworthy since it has been recommended that a combination of quantitative and qualitative approaches is the best method in intervention evaluation.

  • 108.
    Ekbladh, Elin
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    "Return to Work - the Predictive Validity of the Assessment Instrument Worker Role Interview"2010Conference paper (Refereed)
    Abstract [en]

    "Return to Work - the Predictive Validity of the Assessment Instrument Worker Role Interview"

     

    Introduction: Long-term sick-listing entails great costs for the society and suffering for the individual. As rehabilitation could decrease these costs, valid and reliable methods are then required for assessing work ability and identifying individual rehabilitation needs. There is a need to develop and investigate the validity of work-related assessments tools and in particular assessments concerned with psychosocial aspects in relation to return to work.

    Objectives: The aims of this study were to investigate if and how the Worker Role Interview (WRI) can predict return to work and how the predictive validity of the WRI for return to work changes over a period of two years.

    Methods: WRI is an assessment tool designed to identify psychosocial and environmental factors which influence a person’s ability to return to work. Fifty three long-term sick-listed people constituted the study group. Differences in WRI ratings and the ability of WRI to correctly predict whether these people would fall into the working or non-working groups at 6, 12 and 24 month follow-ups were tested by Mann–Whitney test and logistic regression respectively

    Results: The item ‘Expectation of job success’ which concerns the person’s belief in their abilities in relation to return to work emerged as an important predictive factor for return to work in all statistical analyses. Eight of 16 items in WRI were rated differently between the working or non-working groups at one or more of the three follow-ups. The regression models based on the WRI ratings had an overall correct prediction rate ranging from 81% to 96% between the follow-ups.

    Conclusion and contribution to practice and evidence base of occupational therapy: The WRI assessment contains items which predict return to work. This implies that the WRI is a useful tool for occupational therapist working with vocational rehabilitation for identifying individual rehabilitation needs for people who are sick-listed.

  • 109. Order onlineBuy this publication >>
    Ekbladh, Elin
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Return to Work: Assessment of Subjective Psychosocial and Environmental Factors2008Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Introduction: In Swedish society the sick-leave rate is high and a better understanding is required of the factors that facilitate return to work. In the return to work process, assessments of peoples’ work ability play an important role. However, the lack of usable, valid, reliable, and theoretically sound assessment instruments for assessing work ability is a concern. Credible and theoretically sound assessment methods for assessing clients’ work ability strengthen the possibilities for making valid interpretations and obtaining important information for composing further intervention strategies which can guide suitable interventions in the process of returning to work. Such interventions need multi-professional expertise. In this area occupational therapists can offer valuable contribution. In the overall assessment of work ability the unique individual’s subjective perception of the situation needs to be considered since this has been found greatly relevant for return to work. The Worker Role Interview (WRI) and the Work Environment Impact Scale (WEIS) are two work-related interview assessment instruments that have been developed to assess subjective psychosocial and environmental factors of work ability. The WRI and the WEIS have been primarily tested for reliability and validity and are theoretically founded in the Model of Human Occupation (MOHO), which is an occupation-focused model addressing psychosocial factors. They have been adapted and translated to Swedish and are used among Swedish occupational therapists working with clients experiencing work-related problems.

    Aim: The overall aim of this thesis was to evaluate the usefulness of the assessment instruments the Worker Role Interview and the Work Environment Impact Scale for identifying psychosocial and environmental rehabilitation needs essential for returning to work.

    Methods: Five empirical studies were performed, all of which were analysed quantitatively, with the exception of study IV in which both qualitative and quantitative analysing methods were used. Studies I, III and IV were cross-sectional while studies II and V were two-year longitudinal studies. In study I, data were collected by a questionnaire, in studies II, III and V the primary data constituted of ratings on the WRI items. In study IV the primary data were ratings of the WEIS items and the written notes beside the rating on each item.

    Results: In study I, theoretical approaches and professional models that influenced psychiatric care and psychiatric occupational therapy practice among occupational therapists in Sweden was investigated. The most common approach in psychiatric care was the psychosocial approach, and the practice model which was most often used was the Model of Human Occupation. The results indicated that the psychosocial approach and the Model of Human Occupation seemed applicable in occupational therapy, motivating further use of that model. However, it was also found that occupational therapists in psychiatric care used professional practice models to a rather low extent. One way to enhance the application of theory into practice is the use of theory- based assessment instruments. Consequently, the Model of Human Occupation- based assessment instruments, the WRI and the WEIS, have been evaluated and used in the other studies in the present thesis The value of the WRI for predicting return to work after long term sick-leave was investigated in studies II and V. The content area in the WRI with best overall predictive validity for return to work was ‘Personal causation’. Its items focus on the individual’s motivation for return to work in relation to the individual’s feeling of competence and effectiveness in doing work tasks and facing challenges at work. The two WRI items which best predicted whether the participants would be in the working or the non-working groups at the two-year follow up were ‘Expectations of job success’, which concerns beliefs in personal abilities in relation to returning to work, and the item ‘Daily routines’ which concerns the individual’s routines and organisation of time outside work. These results suggest that knowledge about how to strengthen the person’s belief in his or her abilities, how routines impact occupational performance, and how to support the individual in structuring his or her daily doings are needed in interventions aiming at supporting the individual to return to work.

    In study III the construct validity of the WRI was investigated in an international study. All the WRI items except those related to the environment area seemed to capture the intended construct of the WRI, namely psychosocial ability for return to work. The construct of the WRI seems to be stable and valid across different countries and populations, and the WRI showed an ability to separate clients into three distinct levels of psychosocial ability for return to work.

    In study IV the impact of the work environment was investigated by using the WEIS among people with experiences of sick-leave. Social interactions at work and the meaning of the work had the most supportive impact and different work demands and the rewards received for the work were perceived as most interfering with work performance, well-being, and satisfaction.

    Conclusion: The WRI seems to be suitable for estimating psychosocial work ability. In addition it contains items which can predict return to work up to two years after the assessment is conducted. The use of the WEIS revealed supportive and interfering factors for work performance, well-being, and satisfaction among people with experiences of long term sick-leave. The interview format of the WRI and the WEIS seems valuable since it provides comprehensive information which can contribute to the planning of rehabilitation interventions for the unique client. Thus, the WRI and the WEIS, which are theoretically founded in the Model of Human Ocupation are juged to be useful for identifying psychosocial and environmental rehabilitation needs in order to support the individual in returning to work after sick-leave.

    List of papers
    1. Practice models in Swedish psychiatric occupational therapy
    Open this publication in new window or tab >>Practice models in Swedish psychiatric occupational therapy
    2000 (English)In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, Vol. 7, no 3, p. 107-113Article in journal (Refereed) Published
    Abstract [en]

    In clinical settings, occupational therapists need models both from their own field, occupational therapy, and from other fields in order to offer the clients adequate treatment. It is unknown which theoretical approaches and practice models influence Swedish occupational therapists' daily work. In this study a questionnaire (n=334) was used to investigate approaches and models used in Swedish psychiatric care service and in psychiatric occupational therapy service. The results showed that the psychosocial approach influenced both psychiatric care and psychiatric occupational therapy most. The most frequently used practice model was the Model of Human Occupation. However, 75% of the respondents did not identify theoretical thinking based on models from their own field behind their actions. Many practitioners seemed to use knowledge developed by other disciplines more often. Years of clinical experience in the profession or education did not seem to have any impact on the ability to identify the practice models that were used. The results indicate that education in occupational therapy must emphasize knowledge in its own field more than has been done up to now.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-13268 (URN)10.1080/110381200300006050 (DOI)
    Available from: 2008-05-07 Created: 2008-05-07
    2. The Worker Role Interview: Preliminary data on the predictive validity of return to work of clients after an insurance medicine investigation
    Open this publication in new window or tab >>The Worker Role Interview: Preliminary data on the predictive validity of return to work of clients after an insurance medicine investigation
    2004 (English)In: Journal of Occupational Rehabilitation, ISSN 1053-0487, Vol. 14, no 2, p. 131-141Article in journal (Refereed) Published
    Abstract [en]

    The aim was to investigate the predictive validity of the Worker Role Interview (WRI) for return to work at a 2-year follow-up of clients who attended an insurance medicine investigation center. The WRI identifies psychosocial and environmental factors that influence a person's abilities to return to work. Forty-eight of 202 consecutively selected clients constituted the study group. The Mann–Whitney U test was used to test the statistically significant differences in WRI ratings between those who were working (n=6) and those who were not (n=42) 2 years after their investigations. Five of the 17 items in WRI had a tentative predictive validity of return to work. The content area personal causation in WRI, had the best predictive validity. The results emphasize the importance of considering the unique individual's beliefs and expectations of his/her effectiveness at work when assessing clients' work ability and planning for further rehabilitation.

    Keywords
    prediction, return to work, assessment, psychosocial, sick leave, insurance medicine
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-13269 (URN)10.1023/B:JOOR.0000018329.79751.09 (DOI)
    Note
    Original Publication: Elin Ekbladh, Lena Haglund and Lars-Håkan Thorell, The Worker Role Interview: Preliminary data on the predictive validity of return to work of clients after an insurance medicine investigation, 2004, Journal of Occupational Rehabilitation, (14), 2, 131-141. http://dx.doi.org/10.1023/B:JOOR.0000018329.79751.09 Copyright: Springer http://www.springerlink.com/ Available from: 2008-05-07 Created: 2008-05-07 Last updated: 2010-12-06
    3. Psychometric properties of the Worker Role Interview
    Open this publication in new window or tab >>Psychometric properties of the Worker Role Interview
    Show others...
    2006 (English)In: Work, ISSN 1051-9815, Vol. 27, no 3, p. 313-318Article in journal (Refereed) Published
    Abstract [en]

    Objectives. This study examined the psychometric properties of the rating scale of the Worker Role Interview (WRI). The study also asked whether the scale's items formed a valid measure of the construct, psychosocial capacity for work, and whether they were targeted to and could effectively discriminate between persons at different levels of psychosocial ability for work.

    Method of study. Data were collected from 21 raters on 440 participants from the United States, Sweden and Iceland. A many-faceted Rasch model was used to analyze the data.

    Results. Most items of the scale worked effectively to measure the underlying construct for which the WRI was designed. In addition, the items were ordered from least to more of the underlying construct as expected. The scale validly measured 90.23% of the participants, who varied by nationality, culture, age and diagnostic status. The scale's items distinguished participants into approximately three different strata and were appropriately targeted to the participants. Seventeen of the 21 raters used scale in a valid manner.

    Conclusions. The WRI scale and items are valid across ages, diagnoses, and culture and effectively measure a wide range of persons.

    Keywords
    Assessment, worker role, model of human occupation
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-13270 (URN)
    Available from: 2008-05-07 Created: 2008-05-07 Last updated: 2009-05-14
    4. Perceptions of the work environment among people with experience of long term sick leave
    Open this publication in new window or tab >>Perceptions of the work environment among people with experience of long term sick leave
    2010 (English)In: WORK-A JOURNAL OF PREVENTION ASSESSMENT and REHABILITATION, ISSN 1051-9815, Vol. 35, no 2, p. 125-136Article in journal (Refereed) Published
    Abstract [en]

    Purpose: The aims were to describe and analyze how people with experience of long term sick leave perceive that factors in their work environment support or interfere with work performance, satisfaction, and well-being. Method: The 53 participants were interviewed with the Work Environment Impact Scale (WEIS). The WEIS ratings and belonging notes were analyzed by descriptive statistics and qualitative analysis respectively. Differences in WEIS ratings between; women and men; participants with somatic and mental diseases; and participants working and on full-time sick leave were tested. Results: The most supportive factors concerned social interactions at work, and the value and meaning of work. The factors perceived as most interfering concerned work demands and rewards. The social relations at work were perceived as more supportive by the working group than by those on full-time sick leave. The participants with somatic diseases perceived physical work factors as more interfering than did participants with mental diseases, who in turn perceived the value and meaning of work as more interfering. Conclusion: Knowledge about the interaction between the worker and the work environment could reveal useful information about the complex phenomenon of reducing sick leave. The WEIS seems useful in providing information about how alterations and accommodations in the work environment could support individual workers.

    Keywords
    Psychosocial, assessment, WEIS, well-being, RTW, occupational therapy
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-54491 (URN)10.3233/WOR-2010-0964 (DOI)000275284100003 ()
    Note
    Original Publication: Elin Ekbladh, Lars-Håkan Thorell and Lena Haglund, Perceptions of the work environment among people with experience of long term sick leave, 2010, WORK-A JOURNAL OF PREVENTION ASSESSMENT and REHABILITATION, (35), 2, 125-136. http://dx.doi.org/10.3233/WOR-2010-0964 Copyright: IOS Press http://www.iospress.nl/ Available from: 2010-03-19 Created: 2010-03-19 Last updated: 2010-12-06
    5. Return to work: the predictive value of the Worker Role Interview (WRI) over two years
    Open this publication in new window or tab >>Return to work: the predictive value of the Worker Role Interview (WRI) over two years
    2010 (English)In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 35, no 2, p. 163-172Article in journal (Refereed) Published
    Abstract [en]

    Worker Role Interview (WRI) is an assessment tool designed to identify psychosocial and environmental factors which influence a persons ability to return to work. The purpose of this study was to investigate if the Worker Role Interview (WRI) can predict return to work over a period of two years. Fifty three long-term sick-listed people were interviewed and rated with the WRI. Differences in ratings and the ability of WRI to correctly predict whether these people would fall into the working or non-working groups at 6, 12 and 24 month follow-ups were tested by Mann-Whitney test and logistic regression respectively. Eight of 17 items in WRI were rated differently between the groups at one or more of the follow-ups. The regression models based on the WRI ratings had an overall correct prediction rate ranging from 81% to 96%. Expectation of job success which concerns the persons belief in abilities in relation to return to work emerged as an important predictive factor for return to work in all statistical analyses. The WRI assessment contains items that could predict return to work. This implies that the WRI could be a useful tool in vocational rehabilitation for identifying individual rehabilitation needs.

    Keywords
    assessment, motivation, psychosocial, RTW, sick-leave, work ability, vocational rehabilitation, occupational therapy, Model of Human Occupation, Bedömningsinstrument, arbetsförmåga, arbetsterapi, sjukfrånvaro, Model of Human Occupation
    National Category
    Medical and Health Sciences Occupational Therapy
    Identifiers
    urn:nbn:se:liu:diva-13272 (URN)10.3233/WOR-2010-0968 (DOI)000275284100007 ()
    Available from: 2008-05-07 Created: 2008-05-07 Last updated: 2017-12-13
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  • 110.
    Ekbladh, Elin
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    ÅTERGÅNG TILL ARBETE: Bedömning av subjektiva psykosociala och miljömässiga faktorer2009In: AT-forum, Förbundet Sveriges Arbetsterapeuter, Stockholmsmässan, 6-7 maj 2009, Stockholm: FSA , 2009Conference paper (Refereed)
    Abstract [sv]

    Återgång till arbete-

    bedömning av subjektiva psykosociala och miljömässiga faktorer

     

    Bakgrund: Bristen på valida, reliabla och teoretiskt förankrade bedömningsinstrument för bedömning av arbetsförmåga är ett bekymmer eftersom tillförlitliga bedömningar är en förutsättning för utformning och genomförande av adekvata interventioner i syfte att stödja återgång i arbete. Worker Role Interview (WRI) och Work Environment Impact Scale (WEIS) är två arbetsrelaterade intervjuinstrument, som har utvecklats i syfte att bedöma subjektiva psykosociala och miljömässiga faktorers påverkan på arbetsförmåga.

     

    Syfte: Det övergripande syftet med avhandlingsarbetet har varit att undersöka WRI och WEIS användbarhet för identifiering av psykosociala och miljömässiga rehabiliteringsbehov av betydelse för återgång i arbete.

     

    Metod: Avhandlingen består av fem empiriska studier. Samtliga studier har bearbetats kvantitativt och i en av studierna har även kvalitativ bearbetning genomförts. Tre studier är tvärsnittsstudier och två studier är två års longitudinella studier.

     

    Resultat: WRI är användbart för bedömning av psykosociala faktorers påverkan på arbetsförmågan. I WRI ingår flera variabler som kan predicera återgång till arbete upp till två år efter genomförd bedömning. WEIS är användbart för att identifiera arbetsmiljöfaktorer som stödjer respektive hindrar personers välbefinnande och utförande av arbete.

     

    Konklusion: Den information som WRI- och WEIS-intervjuer genererar är värdefull, då den kan utgöra en viktig grund för planering av individspecifika rehabiliteringsinsatser. Bedömningsinstrumenten WRI och WEIS med teoretisk förankring i Model of Human Occupation är användbara för att identifiera psykosociala och miljömässiga rehabiliteringsbehov i syfte att stödja personer i processen åter till arbete efter sjukskrivning.

  • 111.
    Ekbladh, Elin
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Fan, Chia-Wei
    University of Illinois at Chicago.
    Sandqvist, Jan
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Hemmingsson, Helena
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Taylor, Renée
    University of Illinois at Chicago.
    Work environment impact scale: Testing the psychometric properties of the Swedish version2014In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 47, no 2, p. 213-219Article in journal (Refereed)
    Abstract [en]

    The Work Environment Impact Scale (WEIS) is an assessment that focuses on the fit between a person and his or her work environment. It is based on Kielhofner’s Model of Human Occupation and designed to gather information on how clients experience their work environment.

    The aim of this study was to examine the psychometric properties of the Swedish version of the WEIS assessment instrument.

    In total, 95 ratings on the 17-item WEIS were obtained from a sample of clients with experience of sick leave due to different medical conditions. Rasch analysis was used to analyze the data. 

    Overall, the WEIS items together cohered to form a single construct of increasingly challenging work environmental factors. The hierarchical ordering of the items along the continuum followed a logical and expected pattern, and the participants were validly measured by the scale. The three occupational therapists serving as raters validly used the scale, but demonstrated a relatively high rater separation index, indicating differences in rater severity.  

    The findings provide evidence that the Swedish version of the WEIS is a psychometrically sound assessment across diagnoses and occupations, which can provide valuable information about experiences of work environment challenges.

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  • 112.
    Ekbladh, Elin
    et al.
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Haglund, Lena
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Work Environment Impact Scale, svensk version 3: Användarmanual för WEIS-S2010Other (Other (popular science, discussion, etc.))
    Abstract [sv]

    Manual för Work Environment Impact Scale (WEIS)

    Den här manualen är tänkt att vara ett stöd för användare av WEIS. Bedömningsinstrumentet WEIS består av en semistrukturerad intervju och en fyrgradig skattningsskala. Intervjun är utformad för att erhålla information om hur personer upplever sin arbetsmiljö. Genom WEIS intervjun erhålls information om hur personen uppfattar att psykosociala och fysiska faktorer i personens unika arbetsmiljö påverkar personens känsla av tillfredställelse och välbefinnande vid utförande av arbete. Vid WEIS intervjun efterfrågas information om hur en given arbetsmiljö påverkar den enskilde personen. Model of Human Occupation (MOHO) utgör den teoretiska grunden till WEIS.

    WEIS kan användas för att identifiera arbetslivsinriktade rehabiliteringsbehov och som en del i bedömning av en persons arbetsförmåga.  För att få en så rik och mångsidig bild som möjligt av personen bör WEIS bedömningar kompletteras med andra bedömningar och bedömningsmetoder. Denna tredje svenska upplaga av WEIS kan användas för personer som är sjukskrivna och som har en anställning samt för personer som är i arbete eller utför arbetsliknande uppgifter i någon form av arbetsmiljö.

  • 113.
    Ekbladh, Elin
    et al.
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Haglund, Lena
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Worker Role Interview, svensk version 3: Användarmanual WRI-S2007Other (Other (popular science, discussion, etc.))
    Abstract [sv]

    Manual för  the Worker Role Interview (WRI)

    WRI är ett bedömningsinstrument med en semistrukturerad intervju och en fyrgradig skattningsskala. Syftet med intervjun är att identifiera hur psykosociala och miljömässiga faktorer påverkar personers möjligheter att vara kvar i, återgå till eller skaffa ett arbete. Genom WRI intervjun erhålls information om personens tidigare och nuvarande arbetssituation, personens livssituation i relation till att ha en arbetsroll och hur personen ser på sin framtida arbetssituation. Den teoretiska grunden för WRI är Model of Human Occupation. WRI kan användas som en komponent vid bedömning av en persons arbetsförmåga. WRI kan också användas för att identifiera arbetslivsinriktade rehabiliteringsbehov. För att få en så rik och mångsidig bild som möjligt av personen bör WRI bedömningen kompletteras med andra bedömningar och bedömningsmetoder. Det här är den tredje reviderade upplagan av den svenska versionen av WRI.

  • 114.
    Ekbladh, Elin
    et al.
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Haglund, Lena
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Thorell, Lars-Håkan
    Linköping University, Department of Clinical and Experimental Medicine, Psychiatry . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Psychiatry.
    The Worker Role Interview: Preliminary data on the predictive validity of return to work of clients after an insurance medicine investigation2004In: Journal of Occupational Rehabilitation, ISSN 1053-0487, Vol. 14, no 2, p. 131-141Article in journal (Refereed)
    Abstract [en]

    The aim was to investigate the predictive validity of the Worker Role Interview (WRI) for return to work at a 2-year follow-up of clients who attended an insurance medicine investigation center. The WRI identifies psychosocial and environmental factors that influence a person's abilities to return to work. Forty-eight of 202 consecutively selected clients constituted the study group. The Mann–Whitney U test was used to test the statistically significant differences in WRI ratings between those who were working (n=6) and those who were not (n=42) 2 years after their investigations. Five of the 17 items in WRI had a tentative predictive validity of return to work. The content area personal causation in WRI, had the best predictive validity. The results emphasize the importance of considering the unique individual's beliefs and expectations of his/her effectiveness at work when assessing clients' work ability and planning for further rehabilitation.

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  • 115.
    Ekbladh, Elin
    et al.
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Lang, Bibi
    Arbetsförmedlingen.
    Rothman, Henning
    Arbetsförmedlingen.
    Sandqvist, Jan
    Linköping University, Department of Social and Welfare Studies. Linköping University, Faculty of Health Sciences.
    Bedömningav arbetsförmåga – instrument och metod med praktiskt  exempel från Arbetsförmedlingen2011Conference paper (Refereed)
  • 116.
    Ekbladh, Elin
    et al.
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Sandqvist, Jan
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Assessing work ability2009In: Nordic Occupational Therapy Forum, Helsinki, Finland: Vocational assessment, 2009Conference paper (Other academic)
  • 117.
    Ekbladh, Elin
    et al.
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Sandqvist, Jan
    Linköping University, Department of Social and Welfare Studies. Linköping University, Faculty of Health Sciences.
    Experiences of how psychosocial factors influence work ability for people with common mental disorders.2012Conference paper (Refereed)
  • 118.
    Ekbladh, Elin
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Medicine and Health Sciences.
    Sandqvist, Jan
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Medicine and Health Sciences.
    Psychosocial Factors’ Influence on Work Ability of People Experiencing Sick Leave Resulting From Common Mental Disorders2015In: Occupational Therapy in Mental Health, ISSN 0164-212X, E-ISSN 1541-3101, Vol. 31, no 3, p. 283-297Article in journal (Refereed)
    Abstract [en]

    A description of how people with the experience of long-term sick leave resulting from common mental disorders perceive that psychosocial factors influence their work ability. The Worker Role Interview was conducted with 14 informants and analyzed using qualitative content analysis. The informants believed in their future work ability. Most had had to adjust their habits and routines to manage their working and private lives in relation to their mental health problems. Occupational therapists need more knowledge about how to strengthen clients' beliefs in their occupational abilities and how to organize their daily activities in a balanced fashion.

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  • 119.
    Ekbladh, Elin
    et al.
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Sandqvist, Jan
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Theory based assessment of work ability2009In: Finnish occupational therapists national conference, Suomen Toimintaterapeuttiliitto ry, September, 2009, Helsinki, Finland: TOI , 2009Conference paper (Refereed)
    Abstract [en]

    Theory based assessment of work ability

     

    In the return to work process, assessments of peoples’ work ability play an important role. Credible and theoretically sound assessment methods for assessing clients’ work ability strengthen the possibilities for making valid interpretations which can guide suitable interventions in the process of returning to work. In this area occupational therapists can offer valuable contribution.

     

    A single assessment instrument generally does not address all the multiple factors involved in a client’s work ability. Therefore, assessors should use several instruments in combination. Four instruments frequently used in vocational rehabilitation are:

    • The Assessment of Work Characteristics (AWC) is an observation instrument that describes the extent to which a client has to use different working skills to perform a work task in an efficient and appropriate way.
    • The Assessment of Work Performance (AWP) assesses a client’s observable (working) skills during work performance, i.e. it assesses how efficient and appropriate the client performs a work activity.
    • The Worker Role Interview (WRI) is an interview instrument that focuses on how psychosocial and environmental factors influence a client’s ability to return to work.
    • The Work Environment Impact Scale (WEIS) is an interview instrument that describes how clients experience their work environment.

     

    The instruments AWC, AWP, WEIS and WRI  are all based on The Model of Human Occupation (MOHO). MOHO is a theoretical framework that explains the meaning and importance of activities for human beings and offers a conceptual framework for the description of human occupation. Assessment instruments based on theoretical models have the advantage that they create conditions that are conducive to valid interpretations of assessment results and yield intervention strategies.

     

    Ongoing and future research will focus on further psychometric evaluation and studies of how and with what results the above instruments could be combined with each other.

  • 120.
    Ekbladh, Elin
    et al.
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Thorell, Lars-Håkan
    Linköping University, Department of Clinical and Experimental Medicine, Psychiatry . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Psychiatry.
    Haglund, Lena
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Perceptions of the work environment among people with experience of long term sick leave2010In: WORK-A JOURNAL OF PREVENTION ASSESSMENT and REHABILITATION, ISSN 1051-9815, Vol. 35, no 2, p. 125-136Article in journal (Refereed)
    Abstract [en]

    Purpose: The aims were to describe and analyze how people with experience of long term sick leave perceive that factors in their work environment support or interfere with work performance, satisfaction, and well-being. Method: The 53 participants were interviewed with the Work Environment Impact Scale (WEIS). The WEIS ratings and belonging notes were analyzed by descriptive statistics and qualitative analysis respectively. Differences in WEIS ratings between; women and men; participants with somatic and mental diseases; and participants working and on full-time sick leave were tested. Results: The most supportive factors concerned social interactions at work, and the value and meaning of work. The factors perceived as most interfering concerned work demands and rewards. The social relations at work were perceived as more supportive by the working group than by those on full-time sick leave. The participants with somatic diseases perceived physical work factors as more interfering than did participants with mental diseases, who in turn perceived the value and meaning of work as more interfering. Conclusion: Knowledge about the interaction between the worker and the work environment could reveal useful information about the complex phenomenon of reducing sick leave. The WEIS seems useful in providing information about how alterations and accommodations in the work environment could support individual workers.

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  • 121.
    Ekbladh, Elin
    et al.
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Thorell, Lars-Håkan
    Linköping University, Department of Clinical and Experimental Medicine, Psychiatry . Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Psychiatry.
    Haglund, Lena
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Return to work: the predictive value of the Worker Role Interview (WRI) over two years2010In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 35, no 2, p. 163-172Article in journal (Refereed)
    Abstract [en]

    Worker Role Interview (WRI) is an assessment tool designed to identify psychosocial and environmental factors which influence a persons ability to return to work. The purpose of this study was to investigate if the Worker Role Interview (WRI) can predict return to work over a period of two years. Fifty three long-term sick-listed people were interviewed and rated with the WRI. Differences in ratings and the ability of WRI to correctly predict whether these people would fall into the working or non-working groups at 6, 12 and 24 month follow-ups were tested by Mann-Whitney test and logistic regression respectively. Eight of 17 items in WRI were rated differently between the groups at one or more of the follow-ups. The regression models based on the WRI ratings had an overall correct prediction rate ranging from 81% to 96%. Expectation of job success which concerns the persons belief in abilities in relation to return to work emerged as an important predictive factor for return to work in all statistical analyses. The WRI assessment contains items that could predict return to work. This implies that the WRI could be a useful tool in vocational rehabilitation for identifying individual rehabilitation needs.

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  • 122.
    Ekdahl, Anne
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Geriatric Medicine.
    How to promote better care of elderly patients with multi-morbidity in Europe: A Swedish example2012In: EUROPEAN GERIATRIC MEDICINE, ISSN 1878-7649, Vol. 3, no 2, p. 103-106Article in journal (Refereed)
    Abstract [en]

    How to improve the care of elderly patients with multi-morbidity, regardless of borders between medical specialities and professions, starting from the patients point of view and ending with a powerful policy document with impact on the political system. A document written by the Swedish Association of Geriatric Medicine, the Swedish Association of General Practice and the Swedish Association of Internal Medicine.

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  • 123.
    Ekdahl, Anne
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Geriatric Medicine in Linköping.
    The organisation of hospitals and the remuneration systems are not adapted to frail old patients giving them bad quality of care and the staff feelings of guilt and frustration2014In: European Geriatric Medicine, ISSN 1878-7649, E-ISSN 1878-7657, Vol. 5, no 1, p. 35-38Article in journal (Refereed)
    Abstract [en]

    Background: In the coming half-century, the population of old people will increase, especially in the oldest age groups. Therefore, the prevalence of multiple chronic conditions, and consequently, the need of health care including care in hospital, is rising. Materials and methods: This article includes results from three mainly qualitative articles (interviews with frail old people, physicians, and an observational study in acute medical wards) and a cross-sectional survey of newly discharged elderly patients. Results: Health care does not take a holistic approach to patients with more complex diseases, such as frail old people. The remuneration system rewards high production of care in terms of numbers of investigations and operations, turnover of hospital beds, and easy accessibility to care. Frail old people do not feel welcome in hospital, with their complex diseases and a need of more time to recover. The staff providing care feels frustrated, and often guilty when taking care of old people. Discussion and conclusion: To improve quality of care of frail elderly, a model is suggested with the following main components: more hospital wards which can address the patients whole situation medically, functionally, and psychologically, i.e comprehensive geriatric assessment (CGA). Better identification of frail elderly people is necessary, together with a change in remuneration system, with a focus on the patients functional status and quality of life. More training in geriatrics is required for staff to feel confident when treating frail old people.

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  • 124.
    Ekdahl, Anne
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in East Östergötland, Department of Geriatric Medicine in Norrköping.
    Andersson, Lars
    Linköping University, Department of Social and Welfare Studies, NISAL - National Institute for the Study of Ageing and Later Life. Linköping University, Faculty of Arts and Sciences.
    Friedrichsen, Maria
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in East Östergötland, Center of Palliative Care.
    They do what they think is the best for me: Frail elderly patients' preferences for participation in their care during hospitalization.2010In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 80, no 2, p. 233-240Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To deepen the knowledge of frail elderly patients' preferences for participation in medical decision making during hospitalization. METHODS: Qualitative study using content analysis of semi-structured interviews.

    RESULTS: Patient participation to frail elderly means information, not the wish to take part in decisions about their medical treatments. They view the hospital care system as an institution of power with which they cannot argue. Participation is complicated by barriers such as the numerous persons involved in their care who do not know them and their preferences, differing treatment strategies among doctors, fast patient turnover in hospitals, stressed personnel and linguistic problems due to doctors not always speaking the patient's own language.

    CONCLUSION: The results of the study show that, to frail elderly patients, participation in medical decision making is primarily a question of good communication and information, not participation in decisions about medical treatments.

    PRACTICE IMPLICATIONS: More time should be given to thorough information and as few people as possible should be involved in the care of frail elderly. Linguistic problems should be identified to make it possible to take the necessary precautions to prevent negative impact on patient participation.

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  • 125.
    Ekdahl, Anne W
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in East Östergötland, Department of Geriatric Medicine in Norrköping.
    Andersson, Lars
    Linköping University, Department of Social and Welfare Studies, NISAL - National Institute for the Study of Ageing and Later Life. Linköping University, Faculty of Arts and Sciences.
    Wiréhn, Ann-Britt
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in West Östergötland, Research & Development Unit in Local Health Care.
    Friedrichsen, Maria
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in East Östergötland, Center of Palliative Care.
    Are elderly people with co-morbidities involved adequately in medical decision making when hospitalised?: A cross-sectional survey2011In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 11, no 46Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    Medical decision making has long been in focus, but little is known of the preferences and conditions for elderly people with co-morbidities to participate in medical decision making. The main objective of the present study was to investigate the preferred and the actual degree of control, i.e. the role elderly people with co-morbidities wish to assume and actually had with regard to information and participation in medical decision making during their last stay in hospital.This study was a cross-sectional survey including three Swedish hospitals with acute admittance. The participants were patients aged 75 years and above with three or more diagnoses according to the International Classification of Diseases (ICD-10) and three or more hospitalisations during the last year.

    METHODS:

    We used a questionnaire combined with a telephone interview, using the Control Preference Scale to measure each participant's preferred and actual role in medical decision making during their last stay in hospital. Additional questions were asked about barriers to participation in decision making and preferred information seeking role. The results are presented with descriptive statistics with kappa weights.

    RESULTS:

    Of the 297 elderly patients identified, 52.5% responded (n = 156, 46.5% male). Mean age was 83.1 years. Of the respondents, 42 of 153 patients said that they were not asked for their opinion (i.e. no shared decision making). Among the other 111 patients, 49 had their exact preferred level of participation, 37 had less participation than they would have preferred, and 23 had more responsibility than they would have preferred. Kappa statistics showed a moderate agreement between preferred and actual role (κw = 0.57; 95% CI: 0.45-0.69). Most patients wanted to be given more information without having to ask. There was no correlation between age, gender, or education and preferred role. 35% of the patients agreed that they experienced some of the various barriers to decision making that they were asked about: 1) the severity of their illness, 2) doctors with different treatment strategies, 3) difficulty understanding the medical information, and 4) difficulty understanding doctors who did not speak the patient's own language.

    CONCLUSIONS:

    Physicians are not fully responsive to patient preferences regarding either the degree of communication or the patient's participation in decision making. Barriers to participation can be a problem, and should be taken into account more often when dealing with hospitalised elderly people.

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  • 126.
    Ekdahl, Anne W
    et al.
    Region Östergötland, Local Health Care Services in Central Östergötland, Department of Geriatric Medicine in Linköping. Linköping University, Faculty of Medicine and Health Sciences. Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm.
    Wirehn, Ann-Britt
    Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Medicine and Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in West Östergötland, Research & Development Unit in Local Health Care.
    Alwin, Jenny
    Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Health Sciences.
    Jaarsma, Tiny
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Medicine and Health Sciences.
    Unosson, Mitra
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Medicine and Health Sciences.
    Husberg, Magnus
    Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Medicine and Health Sciences.
    Eckerblad, Jeanette
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Medicine and Health Sciences.
    Milberg, Anna
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences. Region Östergötland, Local Health Care Services in East Östergötland, Department of Advanced Home Care in Norrköping. Region Östergötland, Local Health Care Services in East Östergötland, Center of Palliative Care.
    Krevers, Barbro
    Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Medicine and Health Sciences.
    Carlsson, Per
    Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Medicine and Health Sciences.
    Costs and Effects of an Ambulatory Geriatric Unit (the AGe-FIT Study): A Randomized Controlled Trial2015In: Journal of the American Medical Directors Association, ISSN 1538-9375, Vol. 16, no 6, p. 497-503Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To examine costs and effects of care based on comprehensive geriatric assessment (CGA) provided by an ambulatory geriatric care unit (AGU) in addition to usual care.

    DESIGN: Assessor-blinded, single-center randomized controlled trial.

    SETTING: AGU in an acute hospital in southeastern Sweden.

    PARTICIPANTS: Community-dwelling individuals aged 75 years or older who had received inpatient hospital care 3 or more times in the past 12 months and had 3 or more concomitant medical diagnoses were eligible for study inclusion and randomized to the intervention group (IG; n = 208) or control group (CG; n = 174). Mean age (SD) was 82.5 (4.9) years.

    INTERVENTION: Participants in the IG received CGA-based care at the AGU in addition to usual care.

    OUTCOME MEASURES: The primary outcome was number of hospitalizations. Secondary outcomes were days in hospital and nursing home, mortality, cost of public health and social care, participant' sense of security in care, and health-related quality of life (HRQoL).

    RESULTS: Baseline characteristics did not differ between groups. The number of hospitalizations did not differ between the IG (2.1) and CG (2.4), but the number of inpatient days was lower in the IG (11.1 vs 15.2; P = .035). The IG showed trends of reduced mortality (hazard ratio 1.51; 95% confidence interval [CI] 0.988-2.310; P = .057) and an increased sense of security in care interaction. No difference in HRQoL was observed. Costs for the IG and CG were 33,371£ (39,947£) and 30,490£ (31,568£; P = .432).

    CONCLUSIONS AND RELEVANCE: This study of CGA-based care was performed in an ambulatory care setting, in contrast to the greater part of studies of the effects of CGA, which have been conducted in hospital settings. This study confirms the superiority of this type of care to elderly people in terms of days in hospital and sense of security in care interaction and that a shift to more accessible care for older people with multimorbidity is possible without increasing costs. This study can aid the planning of future interventions for older people.

    TRIAL REGISTRATION: clinicaltrials.gov identifier: NCT01446757.

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  • 127.
    Eliasson, Ann-Christin
    et al.
    Institutionen för kvinnor och barns hälsa, Karolinska institutet.
    Lidström, HeleneLinköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Medicine and Health Sciences.Peny-Dahlstrand, MarieInstitutionen för neurovetenskap och fysiologi, Sahlgrenska akademien, Göteborgs universitet.
    Arbetsterapi för barn och ungdom2016Collection (editor) (Other academic)
    Abstract [sv]

    I Arbetsterapi för barn och ungdom har 28 ledande experter inom arbetsterapi bidragit med gedigen kunskap och klinisk erfarenhet av barn och ungdom med funktionsnedsättningar.

    I boken finns ett tydligt fokus på aktiviteter i barnens vardag men även i förhållande till hälsa, samhälle och transition från barn till vuxenlivet. Arbetsterapi för barn och ungdom tar även upp aktiviteter kring lek, skola och fritid samt hur barn lär sig nya aktiviteter, och hur de kan träna och kompensera för nedsatt funktion. Kommunikation, kognitivt stöd och förmågan att använda sina händer behandlas också. 


    Boken representerar forskningsläget för svensk arbetsterapi inom området barn och ungdom. Den visar att det finns en bredd i den pågående forskningen men också att det behövs mer kunskap. 

    Arbetsterapi för barn och ungdom riktar sig till arbetsterapeuter inom grundutbildning och fortbildning samt till verksamma arbetsterapeuter och andra yrkesgrupper som möter funktionsnedsatta barn och ungdomar.

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  • 128.
    Engstrand, Christina
    et al.
    Östergötlands Läns Landsting, Reconstruction Centre, Department of Plastic Surgery, Hand surgery UHL.
    Boren, Linda
    Östergötlands Läns Landsting, Reconstruction Centre, Department of Plastic Surgery, Hand surgery UHL.
    Liedberg, Gunilla
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Evaluation of Activity Limitation and Digital Extension in Dupuytrens Contracture Three Months after Fasciectomy and Hand Therapy Interventions2009In: Journal of Hand Therapy, ISSN 0894-1130, E-ISSN 1545-004X, JOURNAL OF HAND THERAPY, Vol. 22, no 1, p. 21-26Article in journal (Refereed)
    Abstract [en]

    Background: Working while exposed to motions, physically and psychologically affects a person. Traditionally, motion sickness symptom reduction has implied use of medication, which can lead to detrimental effects on performance. Non-pharmaceutical strategies, in turn, often require cognitive and perceptual attention. Hence, for people working in high demand environments where it is impossible to reallocate focus of attention, other strategies are called upon. The aim of the study was to investigate possible impact of a mitigation strategy on perceived motion sickness and psychophysiological responses, based on an artificial sound horizon compared with a non-positioned sound source.

    Methods: Twenty-three healthy subjects were seated on a motion platform in an artificial sound horizon or in non-positioned sound, in random order with one week interval between the trials. Perceived motion sickness (Mal), maximum duration of exposure (ST), skin conductance, blood volume pulse, temperature, respiration rate, eye movements and heart rate were measured continuously throughout the trials.

    Results: Mal scores increased over time in both sound conditions, but the artificial sound horizon, applied as a mitigation strategy for perceived motion sickness, showed no significant effect on Mal scores or ST. The number of fixations increased with time in the non-positioned sound condition. Moreover, fixation time was longer in the non-positioned sound condition compared with sound horizon, indicating that the subjects used more time to fixate and, hence, assumingly made fewer saccades.

    Conclusion: A subliminally presented artificial sound horizon did not significantly affect perceived motion sickness, psychophysiological variables or the time the subjects endured the motion sickness triggering stimuli. The number of fixations and fixation times increased over time in the non-positioned sound condition.

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  • 129.
    Erichsén, Eva
    et al.
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care.
    Hadd Danielsson, Elisabeth
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care.
    Friedrichsen, Maria
    Linköping University, Faculty of Health Sciences. Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Östergötlands Läns Landsting, Local Health Care Services in East Östergötland, Department of Geriatrics and Hospital based homecare VHN.
    A phenomenological study of nurse´s understanding of honesty in palliative care2010In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 17, no 1, p. 39-50Article in journal (Other academic)
    Abstract [en]

    Honesty is essential for the care of seriously ill and dying patients. The current study aimed to describe how

    nurses experience honesty in their work with patients receiving palliative care at home. The interviews in

    this phenomenological study were conducted with 16 nurses working with children and adults in palliative

    home-based care. Three categories emerged from analyses of the interviews: the meaning of honesty, the

    reason for being honest and, finally, moral conflict when dealing with honesty. The essence of these

    descriptions was that honesty is seen as a virtue, a good quality that a nurse should have. The nurses’ ethical

    standpoint was shown in the moral character they show in their work and in their intention to do good. This

    study could help nurses to identify different ways of looking at honesty to promote more consciousness and

    openness in ethical discussions between colleagues and other staff members.

  • 130.
    Erichsén, Eva
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in East Östergötland, Department of Advanced Home Care in Norrköping. Region Östergötland, Local Health Care Services in East Östergötland, Center of Palliative Care.
    Milberg, Anna
    Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in East Östergötland, Center of Palliative Care. Region Östergötland, Local Health Care Services in East Östergötland, Department of Advanced Home Care in Norrköping.
    Jaarsma, Tiny
    Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Friedrichsen, Maria
    Region Östergötland, Local Health Care Services in East Östergötland, Center of Palliative Care. Linköping University, Department of Social and Welfare Studies, Division of Nursing Science. Linköping University, Faculty of Medicine and Health Sciences.
    Constipation in specialized palliative care: factors related to constipation when applying different definitions2016In: Supportive Care in Cancer, ISSN 0941-4355, E-ISSN 1433-7339, Vol. 24, no 2, p. 691-698Article in journal (Refereed)
    Abstract [en]

    CONTEXT:

    For patients in palliative care, constipation is primarily a result of opioid treatment. Impacts from other factors related to constipation in palliative care are rarely studied.

    OBJECTIVES:

    The aim was to identify factors related to constipation in patients in palliative care, and then to compare these factors between patients with different types of constipation and patients without constipation.

    METHODS:

    Cross-sectional data on constipation was collected with a 26-item questionnaire from 485 patients in 38 specialist palliative care units in Sweden. Three different constipation groups were used; MC ONLY, PC ONLY, and MC & PC. Logistic regression analyses were used to calculate odds ratios.

    RESULTS:

    Patients with <3 defecations/week, MC ONLY, (n = 36) had higher odds of being hospitalized, bed-restricted, in need of personal assistance for toilet visits, and of having a poor fluid intake. Patients with the perception of being constipated, PC ONLY, (n = 93) had higher odds of having poor appetite, hemorrhoids, hard stool, more opioid treatment, less laxative treatment and of being more dissatisfied with constipation information. Patients with both <3 defecations/week and a perception of being constipated, MC & PC, (n = 78) had higher odds of having cancer- disease.

    CONCLUSION:

    There were several significant factors related to constipation with higher odds than opioid- treatment, for patients in palliative care, such as; hard stool, cancer diagnosis, dissatisfaction with information, low fluid intake, hemorrhoids, bed restriction, hospitalization, and need of personal assistance for toilet visits.

  • 131.
    Erichsén, Eva
    et al.
    Linköping University, Department of Social and Welfare Studies. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in East Östergötland, Department of Advanced Home Care in Norrköping. Region Östergötland, Local Health Care Services in East Östergötland, Center of Palliative Care.
    Milberg, Anna
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Advanced Home Care in Linköping. Region Östergötland, Local Health Care Services in East Östergötland, Center of Palliative Care.
    Jaarsma, Tiny
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Friedrichsen, Maria
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences. Region Östergötland, Local Health Care Services in East Östergötland, Department of Advanced Home Care in Norrköping. Region Östergötland, Local Health Care Services in East Östergötland, Center of Palliative Care.
    Constipation in specialized palliative care: prevalence, definition and patient perceived symptom distress2015In: Journal of Palliative Medicine, ISSN 1096-6218, E-ISSN 1557-7740, Vol. 18, no 7, p. 585-592Article in journal (Refereed)
    Abstract [en]

    Context: The prevalence of constipation among patients in palliative care has varied in prior research, from 18-90 %, depending on different study factors.

    Objectives: The aim of this study was to describe and explore the prevalence and symptom distress of constipation, using different definitions of constipation, in patients admitted to specialized palliative care settings.

    Methods: Data was collected in a cross-sectional survey from 485 patients in 38 palliative care units in Sweden. Variables were analyzed using logistic regression and summarized as odds ratio (OR).

    Result: The prevalence of constipation varied between 7 – 43 %, depending on the definition used. Two constipation- groups were found: (i) Medical constipation- group (MCG; ≤ 3 defecations/week n=114; 23%); (ii) Perceived constipation- group (PCG; Patients with a perception of being constipated the last two weeks; n= 171; 35%). Three sub-groups emerged: patients with (a) only medical constipation (7 %), (b) only perceived constipation (19 %), and (c) with both medical and perceived constipation (16%). There were no differences in symptom severity between groups; 71% of all constipated patients had severe constipation.

    Conclusion: The prevalence of constipation may differ, depending on the definition used and how constipation is assessed. In this study we found two main groups and three sub-groups, analyzed from the definitions of frequency of bowel movements and experience of being constipated. To be able to identify constipation, the patients’ definition has to be further explored and assessed.

  • 132.
    Ericsson, Iréne
    et al.
    Jönköping University, Sweden.
    Hellström, Ingrid
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Kjellström, Sofia
    Jönköping University, Sweden.
    Sliding interactions: An ethnography about how person with dementia interacts in special housing for elderly2011In: Dementia, ISSN 1471-3012, E-ISSN 1741-2684, Vol. 10, no 4, p. 523-538Article in journal (Refereed)
    Abstract [en]

    This ethnography describes how persons with dementia interact with cognitively intact persons in housing with care for the elderly. The results, drawing upon 31 observation sessions and nine interviews, are described under the following themes, which were interpreted from the standpoint of social interaction theory: interaction with expression of satisfaction, disorientation, and dissociation. Interaction provided satisfaction, but did not always reflect a positive experience. Awareness in persons with dementia seemed to be greater than others perceived and, as a result, interaction was adversely affected by frequent well-intentioned corrections and comments. Participation in interaction can be encouraged and feelings of indignation avoided  by assuming that persons with dementia are aware of their situation and how others behave toward them. Sensitivity is required to interpret individuals' expressions of desire not to participate, while simultaneously it is important to try to interpret why they want to refrain.

  • 133.
    Ericsson, Iréne
    et al.
    Jönköping University, Sweden.
    Kjellström, Sofia
    Jönköping University, Sweden.
    Hellström, Ingrid
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Creating relationships with persons with moderate to severe dementia2013In: Dementia, ISSN 1471-3012, E-ISSN 1741-2684, Vol. 12, no 1, p. 63-79Article in journal (Refereed)
    Abstract [en]

    The study describes how relationships are created with persons with moderate to severe dementia. The material comprises 24 video sequences of Relational Time (RT) sessions, 24 interviews with persons with dementia and eight interviews with professional caregivers. The study method was Constructivist Grounded Theory. The categories of 'Assigning time', 'Establishing security and trust' and 'Communicating equality' were strategies for arriving at the core category, 'Opening up', which was the process that led to creating relationships. Both parties had to contribute to create a relationship; the professional caregiver controlled the process, but the person with dementia permitted the caregiver's overtures and opened up, thus making the relationship possible. Interpersonal relationships are significant to enhancing the well-being of persons with dementia. Small measures like RT that do not require major resources can open paths to creating relationships.

  • 134.
    Eriksson, Helene
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Andersson, Gisela
    Östergötlands Läns Landsting, Local Health Care Services in East Östergötland, Department of Advanced Home Care in Norrköping.
    Olsson, Louise
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Milberg, Anna
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Advanced Home Care in Linköping. Östergötlands Läns Landsting, Local Health Care Services in East Östergötland, Center of Palliative Care.
    Friedrichsen, Maria
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in East Östergötland, Center of Palliative Care.
    Ethical Dilemmas Around the Dying Patient With Stroke: A Qualitative Interview Study With Team Members on Stroke Units in Sweden2014In: Journal of Neuroscience Nursing, ISSN 0888-0395, E-ISSN 1945-2810, Vol. 46, no 3, p. 162-170Article in journal (Refereed)
    Abstract [en]

    In Sweden, individuals affected by severe stroke are treated in specialized stroke units. In these units, patients are attended by a multiprofessional team with a focus on care in the acute phase of stroke, rehabilitation phase, and palliative phase. Caring for patients with such a large variety in condition and symptoms might be an extra challenge for the team. Today, there is a lack of knowledge in team experiences of the dilemmas that appear and the consequences that emerge. Therefore, the purpose of this article was to study ethical dilemmas, different approaches, and what consequences they had among healthcare professionals working with the dying patients with stroke in acute stroke units. Forty-one healthcare professionals working in a stroke team were interviewed either in focus groups or individually. The data were transcribed verbatim and analyzed using content analysis. The ethical dilemmas that appeared were depending on nondecisions about palliative care or discontinuation of treatments. The lack of decision made the team members act based on their own individual skills, because of the absence of common communication tools. When a decision was made, the healthcare professionals had problems holding to the decision. The devised and applied plans could be revalued, which was described as a setback to nondecisions again. The underlying problem and theme was communication barriers, a consequence related to the absence of common skills and consensus among the value system. This study highlights the importance of palliative care knowledge and skills, even for patients experiencing severe stroke. To make a decision and to hold on to that is a presupposition in creating a credible care plan. However, implementing a common set of values based on palliative care with symptom control and quality of life might minimize the risk of the communication barrier that may arise and increases the ability to create a healthcare that is meaningful and dignified.

  • 135.
    Eriksson, Henrik
    et al.
    Mälardalens University, Eskilstuna, Sweden.
    Sandberg, Jonas
    Jönköping University, Sweden; Ersta Sköndal university college and Ersta hospice clinic, Stockholm, Sweden.
    Hellström, Ingrid
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Experiences of long-term home care as an informal caregiver to a spouse: gendered meanings in everyday life for female carers2013In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 8, no 2, p. 159-165Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES: In this article, we explore the gender aspects of long-term caregiving from the perspective of women providing home care for a spouse suffering from dementia.

    BACKGROUND: One of the most common circumstances in which a woman gradually steps into a long-term caregiver role at home involves caring for a spouse suffering from dementia. Little attention has been paid to examining the experiences and motivations of such caregivers from a feminist perspective.

    METHODS: Twelve women, all of whom were informal caregivers to a partner suffering from dementia, were interviewed on the following themes: the home, their partner's disease, everyday life, their relationship and autonomy. The results of these interviews were analysed in relation to gender identity and social power structures using a feminist perspective.

    RESULTS: The findings of this study show that the informants frequently reflected on their caregiving activities in terms of both general and heteronormative expectations. The results suggest that the process of heteropolarisation in these cases can be an understood as a consequence of both the spouse's illness and the resulting caring duties. Also, the results suggest that the act of caring leads to introspections concerning perceived 'shortcomings' as a caregiver. Finally, the results indicate that it is important to recognise when the need for support in day-to-day caring is downplayed.

    CONCLUSIONS: Women view their caregiving role and responsibilities as paramount; their other duties, including caring for themselves, are deemed less important. We stress that the intense commitment and responsibilities that women experience in their day-to-day caring must be acknowledged and that it is important for healthcare professionals to find mechanisms for providing choices for female caregivers without neglecting their moral concerns.

    IMPLICATIONS FOR PRACTICE: Female carers face difficulties in always living up to gendered standards and this need to be considered when evaluating policies and practices for family carers.

  • 136.
    Ernersson, Åsa
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Hollman Frisman, Gunilla
    Linköping University, Department of Medical and Health Sciences, Division of Nursing Science. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Gastroentorology.
    Löfgren, U-A
    Berggren, B
    Lindström, Torbjörn
    Linköping University, Department of Medical and Health Sciences, Division of Cardiovascular Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Center, Department of Endocrinology.
    Fear of hypoglycaemia and empowerment in patients with type 1 diabetes2012Conference paper (Other academic)
  • 137.
    Falklöf, Ingrid
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Arts and Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Psychiatry.
    Haglund, Lena
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Arts and Sciences.
    Daily occupations and adaptation to daily life described by women suffering from borderline personally disorder2010In: Occupational Therapy in Mental Health, ISSN 0164-212X, E-ISSN 1541-3101, Vol. 26, no 4, p. 354-374Article in journal (Refereed)
    Abstract [en]

    Clients suffering from Borderline Personality Disorder have significant impairments in relation to health. Despite this, their occupational status is rarely described. The aim of this study was to examine how women with Borderline Personality Disorder describe their daily occupations and adaptation to daily life. The study included nine participants. The data were collected using a semi-structured interview and were analyzed using content analysis.

    Theme: Having few organized daily activities and poor personal causation prevent changes in adaptation to daily life. Two categories: performance and self-image, and four subcategories: competent or incompetent to perform, positive self-image, and lack of self-image were identified.

  • 138.
    Fan, Chia-Wei
    et al.
    University of Illinois, IL USA .
    Taylor, Renee R.
    University of Illinois, IL USA .
    Ekbladh, Elin
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Hemmingsson, Helena
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Sandqvist, Jan
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Evaluating the Psychometric Properties of a Clinical Vocational Rehabilitation Outcome Measurement: The Assessment of Work Performance (AWP)2013In: OTJR (Thorofare, N.J.), ISSN 1539-4492, E-ISSN 1938-2383, Vol. 33, no 3, p. 125-133Article in journal (Refereed)
    Abstract [en]

    This study examined the validity and reliability of the Assessment of Work Performance (AWP) using Rasch analysis. The AWP was administered to 365 clients with a variety of work-related problems. Rasch analysis and principal component analysis were used to examine the appropriateness of the rating scales and unidimensionality of AWP items. The person-response validity, internal consistency, targeting appropriateness, and differential item function were also analyzed. The Rasch analysis confirmed the 4-point rating scale, and the item set met the criteria of unidimensionality. The AWP exhibited satisfactory person-response validity and internal consistency. Among the three subdomains, the targeting of item-difficulty was sufficient in the motor skills and process skills subdomains. Differential item functioning was found across gender and diagnoses. This study presented evidence to support that the AWP functioned as a reliable and valid assessment in assessing work performance.

  • 139.
    Faresjö, Åshild
    et al.
    Linköping University, Department of Medicine and Health Sciences, Division of Preventive and Social Medicine and Public Health Science. Linköping University, Faculty of Health Sciences.
    Johansson, Saga
    Astra Zeneca R&D, Mölndal .
    Faresjö, Tomas
    Linköping University, Department of Medicine and Health Sciences, General Practice. Linköping University, Faculty of Health Sciences.
    Roos, Susanne
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Hallert, Claes
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in the East of Östergötland, Department of Internal Medicine VHN.
    Sex differences in dietary coping with gastrointestinal symptoms2010In: EUROPEAN JOURNAL OF GASTROENTEROLOGY and HEPATOLOGY, ISSN 0954-691X, Vol. 22, no 3, p. 327-333Article in journal (Refereed)
    Abstract [en]

    Aim Nutritional changes are often considered first-line treatment in public health diseases that apply to many gastrointestinal (GI) disorders, as different food and beverages may modulate GI motor and sensory functions, and may provoke GI symptoms. The aim of this study was to examine dietary coping and possible changes in food and beverage intake in relation to GI symptoms reported by identified irritable bowel syndrome (IBS) patients compared with healthy controls, and whether any sex differences were observed in these respects. Methods A population-based case-control design was used. Three primary healthcare centres were selected in the city of Linko ping in Sweden. The IBS patients were recruited from the studied primary healthcare centers on the basis of diagnoses from computerized medical records. The controls were randomly selected from the general population in the same region. A questionnaire was used with specific questions about self-reported food and beverage increase or decrease of GI symptoms and self-reported changes in dietary habits. Results Female IBS patients seem to be more willing to change dietary habits because of their GI problems than men. Effects of these nutritional behaviour changes were reported for almost all participants that had made dietary adjustments. Fatty food, certain vegetables, dairy products and eggs were significantly more reported to cause GI complaints among IBS patients compared with their controls. Conclusion Female IBS patients reported more changes in their dietary habits because of GI problems than men with the disease. The majority of both women and men who changed their dietary habits because of GI problems experienced improvement in their symptoms.

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  • 140.
    Feijo, Maria Karolina
    et al.
    University of Federal Rio Grande do Sul, Brazil .
    Avila, Christiane Wahast
    University of Federal Rio Grande do Sul, Brazil .
    de Souza, Emiliane Nogueira
    University of Federal Ciencias Saude Porto Alegre, Brazil .
    Jaarsma, Tiny
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Rabelo, Eneida Rejane
    University of Federal Rio Grande do Sul, Brazil .
    Cross-cultural adaptation and validation of the European Heart Failure Self-care Behavior Scale for Brazilian Portuguese2012In: Revista Latino-Americana de Enfermagem, ISSN 0104-1169, Vol. 20, no 5, p. 988-996Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE:

    To adapt and validate a Brazilian Portuguese version of the European Heart Failure Self-Care Behavior Scale.

    METHODS:

    The cross-cultural adaptation (translation, synthesis, back-translation, expert committee review, and pretesting) and validation (assessment of face validity, content validity, and internal consistency reliability) were carried out in accordance with the literature. The European Heart Failure Self-Care Behavior Scale assesses key components of self-care: recognition of the signs and symptoms of decompensated heart failure (HF) and decision-making when these signs and symptoms arise. It comprises 12 items (range 12-60, where lower scores indicate better self-care).

    RESULTS:

    The sample comprised 124 HF patients with a mean age of 62.3 ± 12 years. The Cronbach's Alpha internal consistency was 0.70 and the intraclass correlation coefficient for reproducibility was 0.87.

    CONCLUSION:

    Face and content validity, internal consistency and reproducibility have lended validity and reliability for the use of the instrument in Brazil.

  • 141. Feijó, Maria Karolina
    et al.
    Ávila, Christiane Wahast
    de Souza, Emiliane Nogueira
    Jaarsma, Tiny
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Rabelo, Eneida Rejane
    Cross-cultural adaptation and validation of the European Heart Failure Self-Care Behavior Scale for Brazilian Portuguese.2012In: Revista Latino-Americana de Enfermagem, ISSN 0104-1169, E-ISSN 1518-8345, Vol. 20, no 5, p. 988-996Article in journal (Refereed)
    Abstract [es]

    OBJECTIVE: To adapt and validate a Brazilian Portuguese version of the European Heart Failure Self-Care Behavior Scale.

    METHODS: The cross-cultural adaptation (translation, synthesis, back-translation, expert committee review, and pretesting) and validation (assessment of face validity, content validity, and internal consistency reliability) were carried out in accordance with the literature. The European Heart Failure Self-Care Behavior Scale assesses key components of self-care: recognition of the signs and symptoms of decompensated heart failure (HF) and decision-making when these signs and symptoms arise. It comprises 12 items (range 12-60, where lower scores indicate better self-care).

    RESULTS: The sample comprised 124 HF patients with a mean age of 62.3 ± 12 years. The Cronbach's Alpha internal consistency was 0.70 and the intraclass correlation coefficient for reproducibility was 0.87.

    CONCLUSION: Face and content validity, internal consistency and reproducibility have lended validity and reliability for the use of the instrument in Brazil.

  • 142.
    Forsner, Maria
    et al.
    Högskolan Dalarna.
    Mörelius, Evalotte
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center of Paediatrics and Gynaecology and Obstetrics, Department of Paediatrics in Linköping.
    Läkemedelshantering för barn2013In: Kvalitetsindikatorer inom omvårdnad / [ed] Ewa Idvall, Stockholm: Gothia Förlag AB, 2013, 6, p. 62-66Chapter in book (Other academic)
  • 143.
    Forsyth, Kirsty
    et al.
    Queen Margaret University College, Edinburgh, Scotland, UK.
    Braveman, Brent
    University of Illinois at Chicago, Chicago, IL, USA.
    Ekbladh, Elin
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Kielhofner, Gary
    University of Illinois at Chicago, Chicago, IL, USA.
    Haglund, Lena
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Fenger, Kristjana
    Occupational Therapy Program, University of Akureyi, Akureyi, Iceland.
    Keller, Jessica
    Queen Margaret University College, Edinburgh, Scotland, UK.
    Psychometric properties of the Worker Role Interview2006In: Work, ISSN 1051-9815, Vol. 27, no 3, p. 313-318Article in journal (Refereed)
    Abstract [en]

    Objectives. This study examined the psychometric properties of the rating scale of the Worker Role Interview (WRI). The study also asked whether the scale's items formed a valid measure of the construct, psychosocial capacity for work, and whether they were targeted to and could effectively discriminate between persons at different levels of psychosocial ability for work.

    Method of study. Data were collected from 21 raters on 440 participants from the United States, Sweden and Iceland. A many-faceted Rasch model was used to analyze the data.

    Results. Most items of the scale worked effectively to measure the underlying construct for which the WRI was designed. In addition, the items were ordered from least to more of the underlying construct as expected. The scale validly measured 90.23% of the participants, who varied by nationality, culture, age and diagnostic status. The scale's items distinguished participants into approximately three different strata and were appropriately targeted to the participants. Seventeen of the 21 raters used scale in a valid manner.

    Conclusions. The WRI scale and items are valid across ages, diagnoses, and culture and effectively measure a wide range of persons.

  • 144.
    Forsyth, Kirsty
    et al.
    Queen Margaret University College, Edinburgh, Scotland.
    Deshpande, Shilpa
    Kielhofner, Gary
    University of Illinois at Chicago.
    Henriksson, Chris
    Haglund, Lena
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Olson, Linda
    Rusch University, Chicago.
    Skinner, Sarah
    University of Illinois Medical Center at Chicago .
    Kulkarni, Supriya
    The Occupational Circumstances Assessment Interview and Rating Scale Version 4.0, 20052005Book (Other academic)
    Abstract [en]

    The OCAIRS provides a structure for gathering, analyzing, and reporting data on the extent and nature of an individual's occupational participation. It can be used with a wide range of clients, and would be appropriate for any adolescent or adult client who has the cognitive and emotional ability to participate in an interview. The OCAIRS provides a structured and theoretically based means of developing interview skills in evaluation and treatment.

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  • 145.
    Frid, Marianne
    et al.
    Karolinska University Hospital.
    Strang, Peter
    Karolinska University Hospital.
    Friedrichsen, Maria
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in East Östergötland, Department of Geriatrics and Hospital based homecare VHN.
    Johansson, Karin
    Lund .
    lower limb lymphedema: experiences and perceptions of cancer patients in the late palliative stage2006In: Journal of Palliative Care, ISSN 0825-8597, Vol. 22, no 1Article in journal (Refereed)
  • 146. Order onlineBuy this publication >>
    Friedrichsen, Maria
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in East Östergötland, Department of LAH/Linnéa.
    Crossing the border: Different ways cancer patients, family members and physicians experience information in the transition to the late palliative phase2002Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Information in the transition to the late palliative phase is not a well-studied area, especially not from the perspective of patients and family members. The aim of this thesis was to describe how cancer patients, family members and physicians experience information during the transition from a curative or early palliative phase to a late palliative phase, i.e. when tumour-specific treatment could not be offered. Cancer patients (n=30) admitted to palliative hospital based home care, family members (n=20) of cancer patients, and physicians (n=30) working with cancer patients in different settings were included in order to create a maximum variation sampling.

    Tape-recorded, semi-structured interviews and qualitative, phenomenographic analyses were done in all the studies.

    Patients described the physician as an expert (study I), an important person during this event, despite characterising him/her in different ways ranging from the empathetic professional to the rough and ready expert. Their relationship with the physician was also stressed. Their own resources, i.e. a sense of well being, a sense of security and individual strength, and their previous knowledge, were important components regarding their ability to take part in the communication (study II). Patients interpret words and phrases carefully and can perceive them as forewarnings, as being emotionally trying, and as fortifying and strengthening (study III). The overall message could be interpreted as either focused on quality if life, on treatment or on death and threat.

    Family members wanted to protect the patient during this period and could be very active and prominent in their protective role (study IV). However, other family members described themselves as being in the background more or less involuntarily. Family members also felt that there were expectations regarding their behaviour, either that they should take over in terms of communication, or that they should restrict their participation. When giving information, the physicians had a clear goal - to make the patient understand while being as considerate toward the patient as possible. However, the strategies for reaching this goal differed and included: explaining and convincing, softening the impact and vaguely suggesting, preparing and adapting. Some physicians had a main strategy while others mixed different strategies depending on the context.

    The experience of receiving and providing information about discontinuing tumour specific treatment is like crossing a border, where patients experience the behaviour of the physician and the words they express of great significance. Family members assume the role of protectors. Physicians use different strategies in order to help patients cross the border.

    List of papers
    1. Breaking bad news in the transition from curative to palliative cancer care-patient's view of the doctor giving the information
    Open this publication in new window or tab >>Breaking bad news in the transition from curative to palliative cancer care-patient's view of the doctor giving the information
    2000 (English)In: Supportive Care in Cancer, ISSN 0941-4355, Vol. 8, no 6, p. 472-478Article in journal (Refereed) Published
    Abstract [en]

    In the transition from curative to palliative cancer care, communication is of special importance. The aim of this study was to explore how patients with a disseminated cancer disease experienced the information about their incurable state, focusing on the physician. The persons taking part were 30 patients admitted to a hospital-based home care unit in Sweden. Semi-structured interviews were conducted and analysed using a qualitative method. All patients described their doctors as experts, despite different qualities. Six subcategories were identified: (1) the inexperienced messenger, (2) the emotionally burdened, (3) the rough and ready expert (4) the benevolent but tactless expert, (5) the "distanced" doctor and (6), the empathic professional. The relationship was described as very important to the patients' capacity to handle the information and was felt to have been built up during earlier meetings. The relationship was described in four subcategories: personal between well-acquainted individuals, impersonal between unacquainted individuals, personal between unacquainted individuals and impersonal between well-acquainted individuals. Both the character of the physician and his or her ability to create personal relationships influence patients' capacity to cope with this specific situation. Education and guidance are needed both in clinical practice and in medical schools.

    Keywords
    Doctor - patient communication, Palliative care, Behaviour, Patient's opinion
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-13723 (URN)10.1007/s005200000147 (DOI)
    Available from: 2002-05-24 Created: 2002-05-24 Last updated: 2015-06-10
    2. Cancer patients' perceptions of their own participation and own resources after receiving information about discontinuation of active tumour treatment
    Open this publication in new window or tab >>Cancer patients' perceptions of their own participation and own resources after receiving information about discontinuation of active tumour treatment
    2000 (English)In: Acta Oncologica, ISSN 0001-6381, Vol. 39, no 8, p. 919-925Article in journal (Refereed) Published
    Abstract [en]

    The focus of most studies on informational needs has been on primary cancer diagnosis. The aim of this study was to explore how cancer patients in a palliative care setting perceived their own participation and resources after receiving information about the discontinuation of active tumour treatment. Thirty cancer patients admitted to a hospital-based home-care unit participated in the study. Semi-structured interviews were conducted and analysed using a phenomenographic method. The patients described their own participation as being either verbally passive or active, in order to receive more information or to avoid information. Furthermore, previous knowledge, at different levels, was described as important: 1) Unsuspecting naive, 2) apprehensive suspicious, 3) well prepared. Patients' own resources included a sense of wellbeing, a sense of security and individual strength. In conclusion, patients' previous knowledge and own resources are important components for their capacity to take part in the dialogue when receiving information.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-13724 (URN)10.1080/02841860050215882 (DOI)
    Available from: 2002-05-24 Created: 2002-05-24 Last updated: 2015-06-10
    3. Cancer patients' interpretations of verbal expressions when given information about ending cancer treatment
    Open this publication in new window or tab >>Cancer patients' interpretations of verbal expressions when given information about ending cancer treatment
    2002 (English)In: Palliative Medicine, ISSN 0269-2163, Vol. 16, no 4, p. 323-330Article in journal (Refereed) Published
    Abstract [en]

    BACKGROUND: Cancer patients' interpretations of the meaning of words used when given bad news are not well studied in medical settings. The aim of this study was to ascertain what significance verbal expressions had for cancer patients when they were given information about ending active tumour treatment, and what message they felt they received.

    METHODS: Tape-recorded semi-structured interviews were performed and analysed using a qualitative phenomenographical approach.

    RESULTS: Thirty patients with incurable cancer admitted to hospital-based home care unit in Sweden participated. Three main categories about the significance of words emerged: 1) words could indicate indirect warnings as being forewarnings, evasive or ambiguous; 2) words could also be perceived as emotionally trying, as threats or abandoning; 3) other words were fortifying and strengthened the patient in this situation. The overall message given during the information could be interpreted differently: either focused on treatment, on quality of life, or on threat and death.

    CONCLUSION: The understanding of the significance of words to tailor the information to patients helps the physician to use forewarnings and fortifying words and to identify and avoid the use of threatening words.

    Keywords
    communication, neoplasms, palliative care, patient perception, phenomenography
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-13725 (URN)10.1191/0269216302pm543oa (DOI)
    Available from: 2002-05-24 Created: 2002-05-24 Last updated: 2015-06-10
    4. Receiving bad news- experiences of family members
    Open this publication in new window or tab >>Receiving bad news- experiences of family members
    2001 (English)In: Journal of Palliative Care, ISSN 0825-8597, Vol. 17, no 4, p. 241-247Article in journal (Refereed) Published
    Abstract [en]

    Little is known about how next-of-kin experience receiving bad news. The aim of this study was to explore the experiences of family members when receiving information about ending tumour treatment, with a focus on their role in this context.

    METHODS: Semi-structured interviews were performed and analyzed using a qualitative phenomenographic method.

    RESULTS: Twenty family members of patients with incurable progressive cancer admitted to hospital-based home care were included in the study. Data showed that family members want to protect, represent, or act on behalf of the patient. Some described themselves as assuming prominent roles: the demander-of-truth role, the secret-keeper role, and the controller role. Others assumed more passive roles: the surrendering role, the considerate listener role, and the excluded outsider role.

    CONCLUSION: This study has revealed possible-explanations as to why family members are dissatisfied with information. The results of this study may help doctors in clinical practice recognize the different types of behaviour family members exhibit when receiving bad news.

    Place, publisher, year, edition, pages
    Montreal, Canada: Centre for Bioethics, 2001
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-13726 (URN)000173319900004 ()
    Available from: 2002-05-24 Created: 2002-05-24 Last updated: 2017-12-13
    5. Doctors' strategies when breaking bad news to terminally ill cancer patients
    Open this publication in new window or tab >>Doctors' strategies when breaking bad news to terminally ill cancer patients
    2003 (English)In: Journal of Palliative Medicine, ISSN 1096-6218, Vol. 6, no 4, p. 565-574Article in journal (Refereed) Published
    Abstract [en]

    Breaking bad news to patients with a terminal disease is a difficult task for physicians. The aim of this study was to study how doctors perceive their strategies when giving information to cancer patients about discontinuing active tumour treatment. Thirty doctors with different demographic characteristics working with patients with cancer in Sweden participated. Semistructured interviews were conducted and analyzed using a qualitative phenomenographic method. The goal when giving this information was described as making the patient understands while being as considerate as possible. However, the strategies for reaching this goal were different: (1) explaining and convincing information, (i.e., giving a long explanation about why treatment has to be discontinued); (2) softening the impact of the information, with the doctor recommending discontinuation of treatment; (3) and preparing either the patient or the physician himself/herself for the information; (4) adapting or tailoring the information to the patient, with the doctor actively seeking knowledge about the patient in order to be able to adapt the information to the patient's level, or with the doctor briefly describing the situation and then remaining silent, allowing room for the patient's reactions and questions (i.e., letting the patient take an active part). When giving information, the doctors' goal was to make patients understand, but the strategies differed depending on the context.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-13727 (URN)10.1089/109662103768253678 (DOI)
    Available from: 2002-05-24 Created: 2002-05-24 Last updated: 2015-06-10
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  • 147.
    Friedrichsen, Maria
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in East Östergötland, Center of Palliative Care.
    Språkets och samtalets betydelse2013In: Palliativ vård: begrepp och perspektiv i teori och praktik / [ed] Birgitta Andershed, Britt-Marie Ternestedt, Cecilia Håkanson, Lund: Studentlitteratur, 2013, 1, p. 431-439Chapter in book (Other (popular science, discussion, etc.))
  • 148.
    Friedrichsen, Maria
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in East Östergötland, Center of Palliative Care.
    Hajradinovic, Yvonne
    Östergötlands Läns Landsting, Local Health Care Services in East Östergötland, Center of Palliative Care.
    Jakobsson, Maria
    Östergötlands Läns Landsting, Local Health Care Services in East Östergötland, Center of Palliative Care.
    Sundberg, Lars
    Östergötlands Läns Landsting, Local Health Care Services in East Östergötland, Center of Palliative Care.
    Axmacher Jonsson, Monica
    Östergötlands Läns Landsting, Local Health Care Services in East Östergötland, Center of Palliative Care.
    Milberg, Anna
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Advanced Home Care in Linköping. Östergötlands Läns Landsting, Local Health Care Services in East Östergötland, Center of Palliative Care.
    Prolonged grievers: A qualitative evaluation of a support group intervention2014In: Palliative & Supportive Care, ISSN 1478-9515, E-ISSN 1478-9523, Vol. 12, no 4, p. 299-308Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of this project was to study prolonged grievers psychosocial processes and experience during participation in a group intervention and 6–8 weeks after discontinuation. The intervention in this study was a group therapy with the aim of getting in contact with their pain and loss and confronting and working with this loss.

    Methods: Data was collected by using diaries and tape-recorded interviews, analyzed with grounded theory. The participants were 11 females between the ages of 33 and 71.

    Results: The main process that was found in the qualitative data was: Ambivalence when struggling and learning through work and rest towards a balance. Sub-processes were: To share and be confirmed in the group through sense of cohesion; To dare/venture to discover problems and solutions; To react when you get emotionally involved, and to compare and discover.

    Significance of results: This study gives insight into prolonged grievers' thinking, which is valuable knowledge. Rather than assuming that all individuals suffering from prolonged grief need the same treatment, we suggest that there should be a range of different therapies.

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  • 149.
    Friedrichsen, Maria
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in East Östergötland, Center of Palliative Care. Vrinnevi Hospital, Sweden .
    Heedman, Per-Anders
    Vrinnevi Hospital, Sweden .
    Astradsson, Eva
    Vrinnevi Hospital, Sweden .
    Jakobsson, Maria
    Vrinnevi Hospital, Sweden .
    Milberg, Anna
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in East Östergötland, Center of Palliative Care. Region Östergötland, Local Health Care Services in East Östergötland, Department of Advanced Home Care in Norrköping. Vrinnevi Hospital, Sweden .
    Does a Half-Day Course about Palliative Care Matter? A Quantitative and Qualitative Evaluation among Health Care Practitioners2013In: Journal of Palliative Medicine, ISSN 1096-6218, E-ISSN 1557-7740, Vol. 16, no 5, p. 496-501Article in journal (Refereed)
    Abstract [en]

    Background: To date there has been a paucity of research examining whether a course in palliative care influences the clinical work. Therefore a half-day course was started for different professionals. less thanbrgreater than less thanbrgreater thanObjectives: The aims of this study were to quantitatively and qualitatively explore professionals experience of the usefulness and importance of such a course. less thanbrgreater than less thanbrgreater thanDesign: An evaluation study was used with two measurement points in the quantitative part; qualitative focus group interviews were conducted three times. less thanbrgreater than less thanbrgreater thanSetting and Subjects: Data was collected in Sweden through structured and open-ended questions (n = 355) and in focus group discussions (n = 40). less thanbrgreater than less thanbrgreater thanResults: The majority of participants were allied professionals (86%). Course evaluation immediately after the intervention showed high scores. At three months, 78% of the 86 participants who had cared for a dying patient since the course claimed that the course had been useful in their work. In addition, there were improvements regarding symptom management (37%), support to family members (36%), more frequent break point conversations (31%), and improved cooperation in the teams (26%). The qualitative analysis showed that the course made participants start to compare their own working experiences with the new knowledge. When returning to work, the participants feel strengthened by the the newly acquired knowledge, but the will to improve the care also led to frustration, as some of the participants described that they wanted to change routines in the care of the dying, but felt hindered. less thanbrgreater than less thanbrgreater thanConclusion: The course was appreciated and useful in the professionals work, but it also created problems.

  • 150.
    Friedrichsen, Maria
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in East Östergötland, Department of LAH/Linnéa.
    Lindholm, Ann
    Stockholms sjukhem.
    Milberg, Anna
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Advanced Home Care in Linköping. Östergötlands Läns Landsting, Local Health Care Services in East Östergötland, Center of Palliative Care.
    Experiences of truth disclosure in terminally ill cancer patients in palliative home care2011In: Palliative & Supportive Care, ISSN 1478-9515, E-ISSN 1478-9523, Vol. 9, no 2, p. 173-180Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of this study was to explore the experiences and preferences of terminally ill cancer patients regarding truth telling in the communication of poor prognoses.

    Method: We recorded and transcribed interviews with 45 patients who knew their cancer was terminal, and analyzed their responses hermeneutically.

    Results: Patients identified three different modes of truth: (1) the absolute objective truth that they are dying; (2) the partial truth about their condition including some facts but not all of the details; and (3) the desired truth, originating in the patient's own beliefs about a healthy or better life. Coping strategies were related to patients’ preferred mode of truth: (1) facing the truth in order to take action; (2) facing some parts of the truth in order to maintain hope; and (3) hovering between facing and avoiding the truth. In their struggle for existential survival, patients used different coping strategies, changing from one to another depending upon the circumstances.

    Significance of results: Varying use of different coping strategies impacts on patient preferences concerning communication about bad news with their doctors. Truth-telling entails more than merely providing information related to the forthcoming death. It also concerns how physicians or other healthcare staff can support the patient's existential survival by fine-tuning the communication of “truth” according to the individuals’ preferences.

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    Truth disclosure
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