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  • 151.
    Liedberg, Gunilla
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Björk, Mathilda
    Avd. för rehabilitering, HHJ, Hälsohögskolan, Högskolan i Jönköping.
    Interventions at work in fibromyalgia (FM) using the time geographic diary method.2010Conference paper (Other academic)
  • 152.
    Liedberg, Gunilla
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Björk, Mathilda
    Hälsohögskolan, Jönköping.
    Interventions at work using the time-geographic diary method in women with fibromyalgia2010Conference paper (Refereed)
  • 153.
    Liedberg, Gunilla
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Björk, Mathilda
    Hälsohögskolan, Jönköpings universitet.
    Hensing, Gunnel
    Sahlgrenska akademin, Göteborgs universitet.
    Occupational therapists’ perceptions of gender – A focus group study2012Conference paper (Other academic)
    Abstract [en]

    'Doing gender' in encounters with clients has been investigated previously in social science, but has not been explicitly researched from an occupational therapy perspective.The aim was to describe how occupational therapists perceive gender, and its importance for occupational therapy and daily work.The material was based on four focus group interviews that included 17 occupational therapists. The analysis showed two emerging themes: 'The concept of gender is tacit in occupational therapy' and 'Client encounters'. The first theme was for instance built up of the 'Client-centred approach', and 'Values'. The second theme consisted of 'Communication', 'Assessment' and 'Interventions'. Occupational therapists were unaware of the possibility that they were 'doing gender' in their encounters with clients. Implications of these findings for education and practice should include the gender perspective and its consequences for our clients, which could increase the awareness, and its relevance for health in bothmen and women.

  • 154.
    Liedberg, Gunilla
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Eddy, Linda
    College of Nursing, Washington State University, Vancouver, USA.
    Burckhardt, Carol
    Division of Arthritis and Rheumatic Diseases, Oregon Health and Science University, Portland, USA.
    Validity testing of the Quality of Life Scale, Swedish Version: Focus Group Interviews of Women with Fibromyalgia2012In: Occupational Therapy International, ISSN 0966-7903, E-ISSN 1557-0703, Vol. 19, no 4, p. 165-175Article in journal (Refereed)
    Abstract [en]

    Focus group interviews were used to examine validity of the Quality of Life Scale, Swedish version (QOLS-S) for use with women with fibromyalgia. Five interviews with 18 women with fibromyalgia were completed. The opening question was “What does quality of life mean to you?” Later, participants were asked to respond to questions about the specific domains and items in the QOLS-S. The transcribed interviews were analysed, and categories were identified. Opinions concerning domains and items in the QOLS-S were linked to domains of the QOLS-S. Four categories emerged from the opening question: finances, to be an active person and participate in society, relations with others, and health. Overall, the women's perceptions of quality of life were congruent with the domains of QOLS-S. However, further attention should be given to the translation of certain items and apparent overlaps in some items indicate that they can be combined. Also, the instrument needs to be scrutinized from a cultural perspective because some items in the “social, community and civic activities” domain were not endorsed by the participants.

  • 155.
    Liedberg, Gunilla
    et al.
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Hensing, Gunnel
    Sahlgrenska akademin, Göteborg.
    Occupational Therapists Students’ choice of client activities – does patients’ gender matter?2012Conference paper (Other academic)
  • 156.
    Liedberg, Gunilla
    et al.
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care.
    Jacobsen, Klara
    Sör-Trondelag University College, Norway.
    Magnus, Eva
    Sör-Trondelag University College, Norway.
    Bendixen, Hans Jörgen
    Copenhagen University hospital, Denmark.
    la Cour, Karen
    Institute of public Health, University of Southern Denmark.
    Kroksmark, Ulla
    University og Gothenburg, Sweden.
    Time Geographic Method: Promising use in rehabilitation and health promotionConference paper (Refereed)
  • 157.
    Liedberg, Gunilla
    et al.
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Lindh Falk, Annika
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Implementering av ett genusperspektiv på ett arbetsterapeutprogram2011Conference paper (Other academic)
    Abstract [sv]

    Bakgrund: Det är viktigt att utbildning också genomsyras av ett genusperspektiv. Kvinnor och män formas genom sin livscykel av kultur, samhälle och interaktioner mellan människor enligt genussystemet. Detta påverkar mäns och kvinnors livsstil och levnadsförhållanden och därmed också hälsa, livskvalitet och dagliga aktiviteter. De gränser som genus sätter för män och kvinnor förhandlas på tre nivåer; individuell, organisatorisk och samhällsnivå. Som en följd av detta förstås att möten inom hälso- och sjukvården också är situationer där genus konstrueras. Begreppet ”konstruera genus” baseras på en förståelse av genusbegreppet som en social konstruktion, inte enbart som biologiskt kön definierat av naturen och förutbestämd till specifika beteenden som en konsekvens av biologin.

    Syfte:  Att implementera ett genusperspektiv på Arbetsterapeutprogrammet.

    Metod: En utsedd person ansvarig för implementeringen har gått igenom bl a referenslitteratur, föreläsningar och examinationer. Förslag till föreläsningar, seminarier och examinationer har framkommit. Diskussionsseminarier bland personalen har också genomförts.

    Resultat: Begreppet genus är tydliggjort i kursplaner med hjälp av specifika lärandemål och examinationer. Frågor om kön och genus är inkluderade i programutvärderingen.

    Diskussion: Trots det klientcentrerade arbetssättet inom arbetsterapi leder inte detta automatiskt till ett genusmedvetet förhållningssätt vid möten med klienter. Ett medvetet förhållningssätt resulterar i att båda könen får behandling utifrån sina specifika behov och att arbetsterapeuten kan bortse från egna värderingar/traditionella könsroller. Forsknings- och utbildningsinsatser behövs för att öka kunskapen om genus inom arbetsterapi.

  • 158.
    Liedberg, Gunilla Margareta
    et al.
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Lindh Falk, Annika
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Implementation of a gender perspective at an occupational therapy programme2010Conference paper (Refereed)
  • 159.
    Liedberg, Gunilla
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Mårtensson, Lena
    Institutionen för neurovetenskap och fysiologi, Göteborgs universitet.
    Forskning i praxis: Arbetsterapeutisk forskning om långvarig smärta2010In: Tidskriften Arbetsterapeuten, ISSN 0345-0988, no 8, p. 1-4Article, review/survey (Other academic)
  • 160.
    Liljekvist, Amanda
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy.
    Westling, Kajsa
    Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy.
    Hundförares uppfattning om att använda hund som medel i grundskolan i relation till görande och delaktighet i skolaktivitet2019Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [sv]

    Elever med särskilda behov känner sig ofta mindre delaktiga i skolaktivitet än andra elever på grund av att de behöver stöd i skolan. Att använda hund som medel i skolan kan vara ett komplement i undervisningen och en hunds närvaro i skolan har tidigare visat på positiva effekter på bl.a. elevers lärande och attityd gentemot skolan. Syftet med studien var att beskriva hur hundförare uppfattar att hund som medel i grundskolan påverkar möjligheten till görande och delaktighet i skolaktivitet för elever med särskilda behov. Tio intervjuer med hundförare som arbetar med hund som medel i grundskolan genomfördes. En intervjuguide utformades med stöd från teorier om görande och delaktighet i skolaktivitet. Resultatet visade att hundförarna uppfattade att hunden kan motivera och stödja elever i skolaktiveter. Ett nyckelfynd var att hunden uppfattades kunna göra skolaktiviteter mer lustfyllda, vilket ökade deltagandet i skolaktiviteter. Resultatet tyder på att möjligheten till görande och delaktighet i skolaktivitet påverkas för elever med särskilda behov genom att bl.a. skapa ett mer frivilligt görande, en känsla av grupptillhörighet och påverka uppfattningen om det egna görandet i skolaktiviteter. Det finns ett behov av vidare forskning kring effekten av att använda hund som medel i grundskolan samt hur elever med särskilda behov upplever och hur lärare uppfattar att hunden påverkar görandet och delaktigheten i skolaktivitet. 

  • 161.
    Lindh Falk, Annika
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Liedberg, Gunilla
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Arts and Sciences.
    Arbetsterapi och genus i utbildning och yrkesliv2010Conference paper (Other academic)
  • 162.
    Lundblad, Fanny
    et al.
    Linköping University, Department of Social and Welfare Studies.
    Karlsson, Anna
    Arbetsterapeutens erfarenheter av arbete med teknikstöd i skolan för elever med kognitiva funktionsnedsättningar: En kvalitativ intervjustudie2018Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Students with cognitive disabilities often have reduced executive skills. It is not known exactly how many students with cognitive disabilities there are in schools and therefore they do not always receive the support they need. Lack of support can lead to reduced participation in school activities. The study therefore aims to describe how occupational therapists work with assistive technology to promote participation in school activities for students with cognitive disabilities. This is an empirical study whose research method is the qualitative interview. The participants were registered occupational therapists working at schools around Sweden. The results present three main themes describing the occupational therapist’s working process for designing assistive technology. Assistive technology can be high or low tech, and may prevent or compensate for difficulties. By tutoring school staff, the occupational therapists can get support in their work on assistive technology. The challenges faced by the occupational therapists in their work are the teachers' attitude towards and knowledge of assistive technology, which affect the collaboration with therapists on assistive technology. The conclusion is that since occupational therapists are still becoming established in schools, their work on assistive technology is affected. Had occupational therapy already been established in schools, their work with assistive technology would have received further support from the politic and economic environment, as well as other professionals in school.

  • 163. Lundén, Johannes
    et al.
    Smeds, Mika
    Kåhlin, Ida
    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.
    Jämlik arbetsterapi - inte utan kulturell kompetens2013In: Arbetsterapeuten, ISSN 0345-0988, no 5, p. 26-27Article in journal (Other (popular science, discussion, etc.))
    Abstract [sv]

    Vårt samhälle är i dag mer kulturellt heterogent än någonsin. Samtidigt ser vi allt större klyftor mellan olika grupper gällande hälsa och livskvalitet. Jämlik arbetsterapi är därför ett viktigt begrepp i vår yrkesutövning. Men då krävs kulturell kompetens hos arbetsterapeuterna.

  • 164.
    Mahrs Träff, Annsfie
    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.
    Perceptions of the concept of physical activity among older people and staff in residential homes2014Conference paper (Other academic)
    Abstract [en]

    This presentation aims to present parts of my doctoral work focusing on the ability and desire to be physically active when you live in a residential home for the elderly. The aim for this part of the study was to identify and describe variations in perceptions of the concept for “physical activity”.Physical activity is described as positive and important for all people. My thesis is to investigate how people are interested in, and able to, maintaining physical activities even though they often have significant disabilities. And also to investigate how older people in residential homes are experiencing opportunities for physical activity and how their physical environment affects these opportunities.The part of my studies that will be presented have a phenomenografic approach was used to analyze semistructurated interviews with elderly people living on residential homes and with staff. This took place in four residential homes in two municipalities in Sweden.The interviews show that the older people often describes physical activity in one way when asked about what the concept of physical activity means to them and sometimes also states that physical activity is something that they do not perform. Later in the interview the very same person can describe the activities of a physical nature which they do in everyday life, for example to walk. A number of staff do describe that physically activity is one thing when it comes to themselves, but something else when it comes to the older people.To have different perceptions of a central concept can affect both hopes and expectations.

  • 165.
    Malmlund, Malin
    et al.
    Linköping University, Department of Social and Welfare Studies.
    Jaderi, Shilan
    Linköping University, Department of Social and Welfare Studies.
    Arbetsterapeuters kunskaper och erfarenheter av sitt arbete med bostadsanpassningsärenden: En kvalitativ studie2015Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    As people live longer and the age structure changes, society has carried through an initiative to allow older people to live at home as long as possible, the so-called principle remaining living at home. The consequence is that health care related activities have increased in the home where housing adaptation is an initiative that enables remain living at home longer. To get a home modification requires that an occupational therapist, or other expert, certify that the need exists by assessing the person's disability related to that constitutes a barrier to occupational performance. The purpose of this study is to describe occupational therapists knowledge and experience of its role in the home modification process and how the occupational therapist involves the client in this process. Ten occupational therapists with at least two years of work experience in the field of home modifications were interviewed through semi-structured interviews. The result highlights the occupational therapist has different roles towards the client and home adaptation unit. The result also highlights the ethical dilemmas and the importance of the practice-based knowledge. Furthermore, a clearer process description and increased scientific basis would contribute to a more equitable care for the client, where both science and proven experience in use.

  • 166.
    Margot-Cattin, Isabel
    et al.
    Univ Appl Sci and Arts Western Switzerland, Switzerland; Karolinska Inst, Sweden; Karolinska Inst, Sweden.
    Kuhne, Nicolas
    HES SO, Switzerland.
    Kottorp, Anders
    Malmo Univ, Sweden.
    Cutchin, Malcolm
    Wayne State Univ, MI USA.
    Öhman, Annika
    Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy. Linköping University, Faculty of Medicine and Health Sciences.
    Nygard, Louise
    Karolinska Inst, Sweden.
    Development of a Questionnaire to Evaluate Out-of-Home Participation for People With Dementia2019In: American Journal of Occupational Therapy, ISSN 0272-9490, E-ISSN 1943-7676, Vol. 73, no 1, article id 7301205030Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE. We describe the development of a questionnaire, Participation in Activities and Places Outside Home (ACT-OUT). for older adults with cognitive impairment and align it to people with mild- to moderate-stage dementia. METHOD. ACT-OUT was developed in a cross-cultural collaboration in combination with three rounds of cognitive interviews in Switzerland with 26 older adults without cognitive impairment and five older adults with dementia. Qualitative data from the interviews were analyzed using a constant comparison approach. RESULTS. The final ACT-OUT Version 1.0 consists of three parts: (1) questions targeting places older adults visit: (2) questions on aspects influencing participation , such as transportation. familiarity, and risk perception: and (3) questions on perception of self. CONCLUSION. The development of an instrument such as ACT-OUT is more a cyclical than a linear process. This study is a first step toward a more systematic evaluation of out-of-home participation among older adults with and without dementia.

  • 167.
    Markozannes, Georgios
    et al.
    Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, University Campus, 45110, Ioannina, Greece.
    Aretouli, Eleni
    Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece.
    Rintou, Evangelia
    Department of Psychiatry, University of Ioannina School of Medicine, University Campus, 45110, Ioannina, Greece.
    Dragioti, Elena
    Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, University Campus, 45110, Ioannina, Greece.
    Damigos, Dimitrios
    Department of Psychiatry, University of Ioannina School of Medicine, University Campus, 45110, Ioannina, Greece.
    Ntzani, Evangelia
    Center for Evidence Synthesis in Health, Department of Health Services, Policy and Practice, School of Public Health, Brown University, Providence, Rhode Island, 02903, USA. Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, University Campus, 45110, Ioannina, Greece .
    Evangelou, Evangelos
    Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, University Campus, 45110, Ioannina, Greece. Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, SW7 2AZ, UK..
    Tsilidis, Konstantinos K
    Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, University Campus, 45110, Ioannina, Greece. Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, SW7 2AZ, UK..
    An umbrella review of the literature on the effectiveness of psychological interventions for pain reduction.2017In: BMC Psychology, E-ISSN 2050-7283, Vol. 5, no 1, article id 31Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Psychological interventions are widely implemented for pain management and treatment, but their reported effectiveness shows considerable variation and there is elevated likelihood for bias.

    METHODS: We summarized the strength of evidence and extent of potential biases in the published literature of psychological interventions for pain treatment using a range of criteria, including the statistical significance of the random effects summary estimate and of the largest study of each meta-analysis, number of participants, 95% prediction intervals, between-study heterogeneity, small-study effects and excess significance bias.

    RESULTS: Thirty-eight publications were identified, investigating 150 associations between several psychological interventions and 29 different types of pain. Of the 141 associations based on only randomized controlled trials, none presented strong or highly suggestive evidence by satisfying all the aforementioned criteria. The effect of psychological interventions on reducing cancer pain severity, pain in patients with arthritis, osteoarthritis, rheumatoid arthritis, breast cancer, fibromyalgia, irritable bowel syndrome, self-reported needle-related pain in children/adolescents or with chronic musculoskeletal pain, chronic non-headache pain and chronic pain in general were supported by suggestive evidence.

    CONCLUSIONS: The present findings reveal the lack of strong supporting empirical evidence for the effectiveness of psychological treatments for pain management and highlight the need to further evaluate the established approach of psychological interventions to ameliorate pain.

  • 168.
    McAuliffe, Tomomi
    et al.
    School of Occupational Therapy, Social Work and Speech Pathology, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia; School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Queensland, Brisbane, Australia.
    Thomas, Yvonne
    Allied Health and Social Sciences, Institute of Health and Society, University of Worcester, Worcester, UK.
    Vaz, Sharmila
    School of Occupational Therapy, Social Work and Speech Pathology, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia.
    Falkmer, Torbjörn
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Pain and Rehabilitation Center. School of Occupational Therapy, Social Work and Speech Pathology, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia.
    Cordier, Reinie
    School of Occupational Therapy, Social Work and Speech Pathology, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia.
    The experiences of mothers of children with autism spectrum disorder: Managing family routines and mothers health and wellbeing2019In: Australian Occupational Therapy Journal, ISSN 0045-0766, E-ISSN 1440-1630, Vol. 66, no 1, p. 68-76Article in journal (Refereed)
    Abstract [en]

    Background/aim

    Families of children with autism spectrum disorder (ASD) use family routines to provide predictability and structure to support occupational engagement of their family members. Mothers assume the major role to orchestrate occupations in constructing family routines, which may impact their health and wellbeing. However, the experiences of mothers in managing family routines and their health and wellbeing have not been the main focus in previous research. Thus, this study explored the experiences of mothers of children with ASD in managing family routines and their perceptions of the impact of family routines on their health and wellbeing.

    Methods

    An interpretive phenomenological approach was used. Twenty mothers of children with ASD, aged between 28 and 56 years, participated in semi‐structured interviews. Data were transcribed verbatim and each transcript was analysed.

    Results

    Five themes that summarise mothers’ perceptions towards health and wellbeing when managing family routines emerged: (i) Keeping on track keeping healthy; (ii) My life is busy, because I do everything for everyone else; (iii) Keeping on track all the time is tiring or frustrating; (iv) Looking after my family by looking after myself; and (v) I am not perfect and it is OK.

    Conclusion

    This study highlighted the substantial efforts required in constructing family routines that may be at the cost of mothers’ health and wellbeing. However, mothers may be able to cope with everyday demands in managing family routines by changing their perspectives. By integrating ‘me‐time’ activities in family routines, mothers may be able to support their own health and wellbeing. Mothers’ values and needs are reflected in family routines; hence, thorough understanding of family routines may be a key to support mothers’ occupational engagement.

  • 169.
    Månsson Lexell, Eva
    et al.
    Arbetsterapi och aktivitetsvetenskap, Lunds Universitet.
    Haglund, Lena
    Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy. Linköping University, Faculty of Medicine and Health Sciences.
    Arbetsterapeuters uppfattning av användbarheten av svenska Fatigue Management Programmet för personer med Multipel skleros2019Conference paper (Refereed)
    Abstract [sv]

    Fatigue är vanligt förekommande hos personer med Multipel skleros (MS) och MS-fatigue har ofta en negativ inverkan på personernas möjligheter att utföra och vara delaktig i vardagens olika aktiviteter. Fatigue Management (FM) programmet är en arbetsterapeutisk intervention som syftar till att deltagarna lär sig strategier för att kunna hantera MS-fatigue i vardagen. Programmet använder sig av self-management metodik under genomförandet och rekommenderas av Socialstyrelsen i de nationella riktlinjerna för MS. Syftet var att undersöka svenska arbetsterapeuters uppfattning av användbarheten av den svenska översättningen av programmet med klienter med MS.

    Metod/Tillvägagångssätt* En mixad metod användes tillsammans med åtta arbetsterapeuter som initialt deltog i en workshop och sedan genomförde FM programmet med MS-klienter. Därefter fyllde de i en enkät innan de deltog i fokusgrupps intervjuer där fokus var på användbarheten av programmet.

    Resultat/Preliminärt resultat* Varje arbetsterapeut genomförde programmet i sin helhet en gång med 5-9 MS-klienter. Överlag var arbetsterapeuterna nöjda med innehållet i programmet och de följde programmets struktur under genomförandet. Mindre förändringar föreslogs särskilt i relation till hur kognitiv fatigue kan hanteras. De diskuterade även utmaningar gällande att använda self-management metodik där arbetsterapeuten har en annan roll än den traditionella som expert.

    Slutsats/Praktisk tillämpning* FM programmet visade sig vara användbart i Sverige men arbetsterapeuter som vill erbjuda programmet bör först delta i en kortare workshop där programmets innehåll och struktur diskuteras såväl som dess underliggande teorier. Framtida studier bör fokusera på större interventionsstudier som utvärderar effekterna av programmet.

  • 170.
    Månsson Lexell, Eva
    et al.
    Lund University, Lund, Sweden.
    Haglund, Lena
    Linköping University, Department of Social and Welfare Studies. Linköping University, Faculty of Medicine and Health Sciences.
    Packer, Tanya
    Dalhousie University, Nova Scotia, Canada.
    Fatigue Management -  en sex-veckorskurs där deltagarna lär sig hantera fatigue2017Conference paper (Other academic)
  • 171.
    Månsson Lexell, Eva
    et al.
    Lund University, Lund, Sweden / Skåne University Hospital, Lund-Malmö, Sweden.
    Packer, Tanya
    Dalhousie University, Halifax, Canada.
    Haglund, Lena
    Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy. Linköping University, Faculty of Medicine and Health Sciences.
    The Fatigue Management Program for people with multiple sclerosis: A feasibility study among Swedish occupational therapists2018Conference paper (Refereed)
    Abstract [en]

    Introduction: Around 80% of all people with multiple sclerosis (MS) experience MS-fatigue, significantly impacting everyday occupational performance. The Fatigue Management course (FMC) is an evidence-based occupational therapy intervention that provides people with tools to manage and overcome fatigue. Based on self-management science, participants take an active role in setting goals and learning problem-solving techniques that can be generalized to other occupations. The recently released MS guidelines in Sweden, cite this as best practice, even though no Swedish translation exists. Thus, the ecological validity of the course in a Swedish context is unclear.

    Objectives: To translate the FMC manual into Swedish, and to investigate its feasibility for people with MS in Sweden.Method: We used a mixed-methods design. Eight occupational therapists tested the FMC and then completed a questionnaire and participated in focus group interviews.

    Results: Each therapists conducted one course with 5-9 MS-participants (total=48 MS-participants). Overall, therapists were satisfied with the content in the manual, and only minor improvements of the layout were needed. Discussions revealed how therapists who thoroughly read the manual in advance, experienced less implementation problems. Difficulties implementing self-management strategies rather than the traditional role of an expert were discussed.

    Conclusions: The FMC course is feasible in a Swedish context. Future studies should focus on larger intervention studies that evaluate course effects on fatigue, occupational performance and engagement in occupations.

  • 172.
    Mårtensson, Lena
    et al.
    Göteborgs universitet, Sweden.
    Liedberg, Gunilla
    Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy. Linköping University, Faculty of Medicine and Health Sciences.
    Occupational life trajectories in the context of chronic pain and immigration2016In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 23, no 5, p. 383-390Article in journal (Refereed)
    Abstract [en]

    Background Persons with chronic pain report a range of occupational problems. The specific health needs of immigrants are judged to be poorly understood, and health systems are not prepared to respond adequately. Being an immigrant is regarded as a risk factor for the progression of chronic widespread pain into a state of disability. Objectives To explore occupational life trajectories among immigrant women with chronic pain. Material and methods A qualitative content analysis was used to capture the latent meaning of experiences in individual interviews of eight women with immigrant background and chronic pain. Results An overarching theme, 'making the best of a conditional situation', representing the women's occupational life trajectories, covers the content of two categories: 'being controlled', including affected self-perception, social relations, and future prospects, and 'trying to deal with challenges', comprising a focus on resources, having trust in one's own judgements and getting help from others. Conclusion and significance The experiences demonstrate an occupational life controlled by internal and external factors and may be understood as a disrupted occupational life trajectory. This knowledge may be helpful to occupational therapists supporting immigrant women's attempts to regain a structured life despite the constant presence of pain.

  • 173.
    Müssener, Ulrika
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Bendtsen, Marcus
    Linköping University, Department of Computer and Information Science, Database and information techniques. Linköping University, Faculty of Science & Engineering.
    Mccambridge, James
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. University of York, England.
    Bendtsen, Preben
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in West Östergötland, Department of Medical Specialist in Motala.
    User satisfaction with the structure and content of the NEXit intervention, a text messaging-based smoking cessation programme2016In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 16, article id 1179Article in journal (Refereed)
    Abstract [en]

    Background: Smoking is still the leading cause of preventable ill health and death. There is a limited amount of evidence for effective smoking cessation interventions among young people. To address this, a text messaging-based smoking cessation programme, the NEXit intervention, was developed. Short-term effectiveness, measured immediately after the 12-week intervention revealed that 26% of smokers in the intervention group had prolonged abstinence compared with 15% in the control group. The present study was performed to explore the users experiences of the structure and content of the intervention in order to further develop the intervention. Methods: Students participating in the main NEXit randomized controlled trial were invited to grade their experiences of the structure and content of the intervention after having completed follow-up. The participants received an e-mail with an electronic link to a short questionnaire. Descriptive analysis of the distribution of the responses to the questionnaire was performed. Free-text comments to 14 questions were analysed. Results: The response rate for the user feedback questionnaire was 35% (n = 289/827) and 428 free-text comments were collected. The first motivational phase of the intervention was appreciated by 55% (158/289) of the participants. Most participants wanted to quit smoking immediately and only 124/289 (43%) agreed to have to decide a quit-date in the future. Most participants 199/289 (69%) found the content of the messages in the core programme to be very good or good, and the variability between content types was appreciated by 78% (224/289). Only 34% (97/289) of the participants thought that all or nearly all messages were valuable, and some mentioned that it was not really the content that mattered, but that the messages served as a reminder about the decision to quit smoking. Conclusions: The programme was largely perceived satisfactory in most aspects concerning structure and content by young people and most participants stated that they would recommend it to a friend who wants to quit smoking. The motivational phase might be worth shortening and the number of messages around the quit date itself reduced. Shorter messages seemed to be more acceptable.

  • 174.
    Niklasson, Emma
    et al.
    Linköping University, Department of Social and Welfare Studies.
    Smålander, Sofia
    Linköping University, Department of Social and Welfare Studies.
    Användning av djur inom arbetsterapi: En systematisk litteraturstudie2011Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Occupational Therapy aims at assisting clients in the performance of occupations. Animals have a positive effect on humans’ physical, mental and social functions that can increase the individuals’ occupational ability, which is a prerequisite for occupational performance. The aim was to describe research regarding the relation between animals and occupational therapy and the impact the animals have on individuals’ occupational lives. The method was a systematic literature search, conducted with 14 selected words in seven databases, and this resulted in 15 articles for analysis. In the result, animal ownership and animal-assisted therapy were identified as areas of research. Dogs were the most common animals for ownership and therapy, followed by cats and horses. Persons who performed occupations with animals had a variety of diagnosis and performed them in all occupational areas. The most common disability for animal owners were physical and for therapy clients psychiatric. Occupations were conducted primarily in home and community environments. The authors concluded that there is a possibility of implementing occupational therapy with animals in Sweden, but there may be factors that can complicate the process. A solution for implementation would be that the occupational therapist works with animals/pets in the clients’ home and community environment.

  • 175.
    Nygård, Louise
    et al.
    Karolinska Institutet.
    Öhman, Annika
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Department of Social and Welfare Studies, NISAL - National Institute for the Study of Ageing and Later Life. Linköping University, Faculty of Medicine and Health Sciences.
    Managing changes in everyday occupations: the experience of persons with Alzheimer's disease.2002In: OTJR (Thorofare, N.J.), ISSN 1539-4492, E-ISSN 1938-2383, Vol. 22, no 2, p. 70-81Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to uncover how people with dementia respond to the problems and changes they experience in everyday occupations. Seven participants with dementia were included. Data were collected by means of repeated interviews and observations that focused on the person's experiences of competence and management in everyday occupations. The analysis was carried out from within a phenomenological perspective and resulted in a structure describing management strategies. It was concluded that the participants used a wide variety of strategies. Some strategies were directed toward managing the altered conditions caused by the disease while others served the purpose of responding to the occupational problems of everyday life. The latter strategies were of three types based mainly on environment, habituation, and cognition. Overall, the implicit and explicit cognitive awareness underpinning many strategies seems to call for great caution when assuming that people with dementia soon lose their awareness of disability.

  • 176.
    Peny-Dahlstrand, Marie
    et al.
    Institutionen för neurovetenskap och fysiologi, Sahlgrenska akademin, Göteborgs universitet.
    Lidström, Helene
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Medicine and Health Sciences.
    Eliasson, Ann-Christin
    Institutionen för kvinnor och barns hälsa, Karolinska institutet.
    Framtidens arbetsterapi2016In: Arbetsterapi för barn och ungdom / [ed] Ann-Christin Eliasson, Helene Lidström, Marie Peny-Dahlstrand, Lund: Studentlitteratur AB, 2016, 1, p. 333-336Chapter in book (Other academic)
  • 177.
    Persson, Jan
    et al.
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Health Sciences.
    Andrich, Renzo
    SIVA, Milano, Italy.
    Van Beekum, Taeke
    TNO-PG, Leiden, The Netherlands.
    Brodin, Håkan
    TNO-PG, Leiden, The Netherlands.
    Lorentsen, Öivind
    Rehab-Nor A/S, Norway.
    Wessels, Roelof
    iRv, Hoensbroek, The Netherlands.
    de Witte, Luc
    iRv, Hoensbroek, The Netherlands.
    Preference based assessment of the quality of life of disabled persons2002In: Technology and disability, ISSN 1055-4181, Vol. 14, no 3, p. 119-124Article in journal (Refereed)
    Abstract [en]

    A new method for assessing preference based outcome measures in rehabilitation with assistive devices is reported. The method uses a standard utility instrument, the EuroQol, with complementary items on mobility and social relationships. In addition, a problem solving scale (PIRS) is introduced. Validation has been carried out in a multicenter study of mobility, hearing and communication devices. Utilities and problem solving scores covary strongly for mobility interventions but not for those dealing with communication. So far it is not explained whether the investigated communication interventions result in moderate utility gain only, or whether there is a bias in the corresponding utility scores. Further research on this has been started. The issue of deriving utility weights for the PIRS has also been started. We recommend the described method to be used for cost-utility analyses of rehabilitation measures for disabled persons.

  • 178.
    Pettersson, Kristina
    et al.
    Östergötlands Läns Landsting.
    Kjellberg, Anette
    Linköping University. Linköping University, Department of Social and Welfare Studies. Linköping University, Department of Social and Welfare Studies, Health, Activity, Care.
    Aktivitetsproblem inom området kommunikation för personer med neurologisk funktionsnedsättningConference paper (Refereed)
  • 179.
    Pohl, Petra
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Activity and Health. Univ Gothenburg, Sweden.
    Carlsson, Gunnel
    Univ Gothenburg, Sweden.
    Kall, Lina Bunketorp
    Sahlgrenska Univ Hosp Molndal, Sweden; Univ Gothenburg, Sweden.
    Nilsson, Michael
    Univ Gothenburg, Sweden; Univ Newcastle, Australia.
    Blomstrand, Christian
    Univ Gothenburg, Sweden.
    A qualitative exploration of post-acute stroke participants experiences of a multimodal intervention incorporating horseback riding2018In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 13, no 9, article id e0203933Article in journal (Refereed)
    Abstract [en]

    Background Multimodal rehabilitation interventions delivered in late phase of stroke recovery involve physical (motor and sensory), social, and cognitively challenging activities. Horseback riding can be incorporated within such interventions, leading to meaningful long-term improvements when applied to individuals with moderate levels of disability. There is a lack of research illuminating stroke survivors experiences and perceptions of horseback riding in the context of multimodal interventions. Aim To explore stroke survivors experiences of participation in a multimodal group-based intervention that included horseback riding. Methods An explorative interview study was conducted with individual face-to-face interviews performed on a single occasion, utilising a semi-structured interview guide. Eighteen participants were purposively selected from a larger trial (mean age 62, 12 men, 6 women) within four weeks after treatment completion. The interview duration was between 17 and 50 minutes. The data was analysed using a qualitative content analysis method. Findings Four broad themes were identified from the analysis. These themes were: transformative experiences; human-horse interaction; togetherness and belonging; and the all-in-one solution. Interacting with the horse and peers had a profound emotional impact on the participants. The participants also reported having learned new skills, increased self-efficacy and self-esteem, and improvements in balance and gait, all of which could be transferred to everyday life. The horse itself played a central role, but other components, such as the other group members, the instructors, and the challenging tasks on the horseback, were also important. Conclusion A multimodal rehabilitation intervention that includes horseback riding may provide stroke survivors in a late phase of recovery with rich pleasurable experiences that may have life-changing and profound impacts on their emotional and physical state.

  • 180.
    Pohl, Petra
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Physiotherapy. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Activity and Health. Univ Gothenburg, Sweden.
    Carlsson, Gunnel
    Univ Gothenburg, Sweden.
    Kall, Lina Bunketorp
    Sahlgrenska Univ Hosp Molndal, Sweden; Univ Gothenburg, Sweden.
    Nilsson, Michael
    Univ Gothenburg, Sweden; Univ Newcastle, Australia.
    Blomstrand, Christian
    Univ Gothenburg, Sweden.
    Experiences from a multimodal rhythm and music-based rehabilitation program in late phase of stroke recovery - A qualitative study2018In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 13, no 9, article id e0204215Article in journal (Refereed)
    Abstract [en]

    Background Rehabilitative stroke interventions based on principles of multimodal stimulation have the potential to profoundly affect neuroplastic processes beyond the sub-acute phase. In order to identify important core mechanisms, there is a need to explore how interventions that combine physical, social, sensory, and cognitively challenging activities are perceived and experienced by the participants. This qualitative study, based on an interpretive interactionist perspective, explored the experiences of stroke survivors who participated in a group-based multimodal rehabilitation program based on rhythm and music. Methods and findings Within four weeks after completion of the multimodal rehabilitation program, face-to-face semi-structured interviews were conducted on a single occasion with 15 purposively selected individuals (mean age 65, 8 men, 7 women). The interview duration was between 13 and 44 minutes. Qualitative content analysis with an inductive approach was used to analyze data. Three categories were identified, each containing several sub-categories: To be intellectually challenged (energy-consuming activity and coordinating multiple input and output), Perceived therapeutic benefits (motor skills, cognitive skills, emotional and psychological responses), and Pros and cons with social integration (fellowship, competing with others, and instructor characteristics). From these categories, an overall theme was derived: The multifaceted layers of multimodal stimulation. Enjoying music, being part of a group with peers, a skilled instructor, and being able to manage the challenging movements, were related to positive experiences. In contrast, negative experiences were associated with not being able to perform the exercises, and with group members who dominated the conversational space. Conclusion This study shows that access to a multimodal rehabilitation program with rhythm and music as operating ingredients may contribute to positive experiences for many individuals in a late phase after stroke in terms of motor, cognitive, as well as emotional enhancements. Important components were the music, the social interaction, the challenging exercises, and the skilled instructor.

  • 181.
    Pooremamali, Parvin
    et al.
    Linköping University, Department of Social and Welfare Studies. Linköping University, Faculty of Arts and Sciences.
    Morville, Anne-Le
    Metropolitan University of Coll, Denmark.
    Eklund, Mona
    Lund University, Sweden.
    Barriers to continuity in the pathway toward occupational engagement among ethnic minorities with mental illness2017In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 24, no 4, p. 259-268Article in journal (Refereed)
    Abstract [en]

    Ethnic minorities have particular needs and difficulties in terms of support for meaningful occupations, lack of access to and use of occupation-based rehabilitation services. They are not established in the labour market and are seldom in paid employment. This study aimed to investigate how mentally ill ethnic minority clients experience, feel and think about participation in occupation-based rehabilitation, and potential barriers they might encounter. Nine participants experiencing mental illness and receiving occupation-based rehabilitation were interviewed. Grounded theory methods were used in order to collect and analyze data. One core category, barriers for a continuous path towards enriched and meaningful occupation described the participants experiences of a variety of barriers related to personal, occupational and system factors that hindered participation in occupation-based rehabilitation and influenced their need for occupational development and growth. The core category was composed of; personal-related barriers, occupational-related barriers, and system-related barriers as well as six related sub-categories. These barriers interacted continually across time and space in ways that increased the participants sense of occupational deprivation and alienation. The findings also suggested that the issues of paid employment for ethnic minorities with mental illness should feature on the agenda of local, regional and state politicians and professionals involved in occupational rehabilitation.

  • 182.
    Praetorius Holmgren, Angelica
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy.
    Thörnqvist, Anna
    Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy.
    Äldre individer som bor på särskilda boenden och deras upplevelse av att utföra fritidsaktiviteter: - En kvalitativ studie2017Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Aging usually results in physical and/or cognitive impairments that affect older individuals’ ability to perform leisure activities. It is important to create the possibility for leisure activities for individuals in residential care since such activities have been proven to have a positive effect on both physical and psychosocial health. The meaning of leisure activities is individual and depends on how far the individual experiences the activity to bring joy and well-being. The aim of this study is to describe how older individuals in residential care perceive the performance of their leisure activities. To achieve the aim, a qualitative method and semi-structured interview were used to collect data. Nine individuals participated and the interviews took place in a residential care setting. Malterud (2014) four steps were used to analyze the material and to develop the result. The results show that older individuals living in residential care want to perform additional leisure activities to those that are offered but are limited by various factors such as physical disabilities or being in need of support from people around them, especially staff and relatives. The study shows that older individuals need support from people around them to perform leisure activities.

  • 183.
    Rike, Per-Ola
    et al.
    Sunnaas Rehabil Hosp, Norway.
    Johansen, Hans J.
    Stavern Rehabil Hosp, Norway.
    Ulleberg, Pal
    Univ Oslo, Norway.
    Lundqvist, Anna
    Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Rehabilitation Medicine.
    Schanke, Anne-Kristine
    Sunnaas Rehabil Hosp, Norway; Univ Oslo, Norway.
    Exploring associations between self-regulatory mechanisms and neuropsychological functioning and driver behaviour after brain injury2018In: Neuropsychological rehabilitation (Print), ISSN 0960-2011, E-ISSN 1464-0694, Vol. 28, no 3, p. 466-490Article in journal (Refereed)
    Abstract [en]

    The objective of this prospective one-year follow-up study was to explore the associations between self-regulatory mechanisms and neuropsychological tests as well as baseline and follow-up ratings of driver behaviour. The participants were a cohort of subjects with stroke and traumatic brain injury (TBI) who were found fit to drive after a multi-disciplinary driver assessment (baseline). Baseline measures included neuropsychological tests and ratings of self-regulatory mechanisms, i.e., executive functions (Behavior Rating Inventory of Executive Function-Adult Version; BRIEF-A) and impulsive personality traits (UPPS Impulsive Behavior Scale). The participants rated pre-injury driving behaviour on the Driver Behaviour Qestionnaire (DBQ) retrospectively at baseline and after one year of post-injury driving (follow-up). Better performance on neuropsychological tests was significantly associated with more post-injury DBQ Violations. The BRIEF-A main indexes were significantly associated with baseline and follow-up ratings of DBQ Mistakes and follow-up DBQ Inattention. UPPS (lack of) Perseverance was significantly associated with baseline DBQ Inattention, whereas UPPS Urgency was significantly associated with baseline DBQ Inexperience and post-injury DBQ Mistakes. There were no significant changes in DBQ ratings from baseline (pre-injury) to follow-up (post-injury). It was concluded that neuropsychological functioning and self-regulatory mechanisms are related to driver behaviour. Some aspects of driver behaviour do not necessarily change after brain injury, reflecting the influence of premorbid driving behaviour or impaired awareness of deficits on post-injury driving behaviour. Further evidence is required to predict the role of self-regulatory mechanisms on driver behaviour and crashes or near misses.

  • 184.
    Rosenberg, Catarina
    et al.
    Linköping University, Department of Social and Welfare Studies.
    Svan, Matilda
    Linköping University, Department of Social and Welfare Studies.
    Hur konsulter i bemanningsbranschen arbetande inom lager, verkstad och industri uppfattar sin arbetsmiljö2008Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    The Swedish employment agency industry is expanding. Working as a consultant implies constant adjustments to new environments. The work environment consists of physical and psychosocial factors. Today, psychosocial problems in the work environment are more complex than in the 1990s. The aim of the study is to examine how people working in an employment agency that provides staff for warehouse, workshops and industries, perceive that their physical– and psychosocial work environment affects work performance and wellbeing at work and whether demographical factors influence how the work environment is perceived. The study is a crosssectional study, and the assessment tool Work Environment Impact Scale (WEIS) has been applied. In the study 30 consultants in an employment agency industry were interviewed. The result shows that environmental factors perceived as most supportive of work performance and wellbeing at work were ”Work group membership”, ”Interaction with others” and ”Work role standards”. The environmental factors of work that were perceived as most limiting of work performance, satisfaction, and wellbeing at work were “Task demands”, “Rewards” and “Supervisor interaction”. In conclusion, fellowship with others - co-workers as well as customers - was shown to be the most supportive environmental factor. The limiting factors were mainly failing leadership from the employment agency's superior, and lack of support and display of appreciation towards the consultants.

  • 185.
    Rustner, Birgitta
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Rehabilitation Medicine.
    Wressle, Ewa
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Acute Internal Medicine and Geriatrics.
    Samuelsson, Kersti
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Rehabilitation Medicine.
    Results from a cognitive group rehabilitation programme from an occupational performance perspective2016In: British Journal of Occupational Therapy, ISSN 0308-0226, E-ISSN 1477-6006, Vol. 79, no 12, p. 734-741Article in journal (Refereed)
    Abstract [en]

    Introduction: The Canadian Occupational Performance Measure (COPM) was used for treatment planning and to evaluate the effect of a cognitive group rehabilitation programme. The aim was to identify occupational performance problems defined as important and to analyse the outcome, and to link those problems to the International Classification of Functioning, Disability and Health (ICF) core set for traumatic brain injury and stroke.

    Method: A retrospective design was used, including an analysis of COPM data recorded before and two months after the programme. COPM data from 124 clients were linked to the ICF core sets.

    Results: A clinically important difference of 2 COPM scores was reached in 32% of the clients for occupational performance and in 47% for satisfaction with occupational performance. A majority of the problems identified (62%) were classified within the activities and participation component in the ICF, and 38% in body functions. All occupational performance problems could be linked to the ICF; just one of the 36 categories (caring for household objects) was not found in any of the ICF core sets.

    Conclusion: By linking the COPM data to the core sets, occupational therapists can be confident in addressing the typical problems of the group of clients identified.

  • 186.
    Ryd, Charlotta
    et al.
    Karolinska Inst, Sweden.
    Malinowsky, Camilla
    Karolinska Inst, Sweden.
    Öhman, Annika
    Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy. Linköping University, Faculty of Medicine and Health Sciences.
    Kottorp, Anders
    Malmo Univ, Sweden.
    Nygard, Louise
    Karolinska Inst, Sweden.
    Older adults experiences of daily life occupations as everyday technology changes2018In: British Journal of Occupational Therapy, ISSN 0308-0226, E-ISSN 1477-6006, Vol. 81, no 10, p. 601-608Article in journal (Refereed)
    Abstract [en]

    Introduction Knowledge is lacking of how technological development has affected occupational engagement and performance. Changes in the environment, for example, new technology, are likely to create changes in the dynamics of occupations and exploring this among older adults is especially important. This study aimed to explore what can drive and hinder the incorporation of everyday technology into occupations and how new technology affects occupational engagement and performance among older adults. Method A constructivist grounded theory methodology was applied. Data were collected by individual interviews with six women and five men between the ages of 67 and 92 years old. Participants also varied as regards their cognitive function and living conditions. Results The findings concerned the match between technology and the participants perceptions of occupational purposes, needs of control and safety, and the kind of technology user they strived to be. A good match was a driving force for technology usage and satisfaction with the altered occupations and vice versa. Conclusion Occupational engagement and performance in relation to technology use can be facilitated, which is useful knowledge for stakeholders developing and implementing new technology, as well as those who encounter older adults with the needs or desire to use technology in their daily occupations.

  • 187.
    Ryd, Charlotta
    et al.
    Karolinska Institute, Sweden.
    Nygard, Louise
    Karolinska Institute, Sweden.
    Malinowsky, Camilla
    Karolinska Institute, Sweden.
    Öhman, Annika
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences. Linköping University, NISAL - National Institute for the Study of Ageing and Later Life.
    Kottorp, Anders
    Karolinska Institute, Sweden; Zurich University of Appl Science, Switzerland.
    Associations between performance of activities of daily living and everyday technology use among older adults with mild stage Alzheimers disease or mild cognitive impairment2015In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 22, no 1, p. 33-42Article in journal (Refereed)
    Abstract [en]

    Background: The use of everyday technology (ET) is important for many activities in daily life (ADL) and can be especially challenging for older adults with cognitive impairments. Objective: The aim was to explore associations between ADL performance and perceived ability to use ET among older adults with mild stage Alzheimers disease (AD) and mild cognitive impairment (MCI). ADL motor and process ability, and ability to use ET were also compared between the groups. Methods: Participants with AD (n = 39) and MCI (n = 28) were included. Associations and group differences were explored with nonparametric statistics. Results: Significant correlations were found between ADL process ability and ET use in both groups (R-s = 0.44 and 0.32, p less than 0.05), but for ADL motor ability and ET use, correlations were only found in the MCI group (R-s = 0.51, p less than 0.01). The MCI group had significantly higher measures of ADL process ability (p less than 0.001) and ET use (p less than 0.05). Conclusion: ADL performance ability and perceived ability to use ET are important to consider in evaluations of older adults with cognitive impairments. Group differences indicate that measures of ADL performance ability and ET use are sensitive enough to discriminate the MCI group from the AD group with individually overlapping measures.

  • 188.
    Salomonsson, Johan
    et al.
    Linköping University, Department of Social and Welfare Studies.
    Lundqvist, Maria
    Linköping University, Department of Social and Welfare Studies.
    Instrument för bedömning av arbetsförmåga: En systematisk litteraturstudie2009Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
    Abstract [en]

    Being active and able to perform one’s work is of central importance to an individual’s health and wellbeing. Work capacity is a complex concept that is described as multidimensional. When assessing an individual’s work capacity, it is of great importance to use reliable methods designed to help the individual with his continuing rehabilitation. The purpose of this study was to identify existing assessment instruments for measuring work capacity in different ways, considering for example: the purpose of the instrument, the method for data collection, and the psychometric properties tested for the instrument. A systematic literature review was performed by searching the following databases; PubMed, CINAHL, Scopus, and OT-seeker.  The search resulted in ten articles. A complementary manual search was conducted, producing six additional articles. The contents of the 16 articles identified seven instruments, all of which measured an individual's work capacity in different ways. The majority of the instruments had a clear purpose, were anchored in a theoretical basis, and were tested on different psychometric properties. The authors found that the concept of work capacity has no single definition and is a complex concept. The discussion suggests the combined use of various instruments that emerged in the study to clarify and assist in the assessment of an individual’s work capacity.

  • 189.
    Samuelsson, Kersti
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of Rehabilitation Medicine UHL.
    Björk, Maarit
    Linköping University, Department of Clinical and Experimental Medicine, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of Rehabilitation Medicine UHL.
    Erdugan, Ann-Marie
    Linköping University, Department of Clinical and Experimental Medicine, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of Rehabilitation Medicine UHL.
    Hansson, Anna-Karin
    Linköping University, Department of Clinical and Experimental Medicine, Rehabilitation Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Reconstruction Centre, Department of Rehabilitation Medicine UHL.
    Rustner, Birgitta
    Östergötlands Läns Landsting, Reconstruction Centre, Department of Rehabilitation Medicine UHL.
    The effect of shaped wheelchair cushion and lumbar supports on under-seat pressure, comfort, and pelvic rotation.2009In: Disability and Rehabilitation: Assistive Technology, ISSN 1748-3107, E-ISSN 1748-3115, Vol. 4, no 5, p. 329-336Article in journal (Refereed)
    Abstract [en]

    AIM: A wheelchair seat and position help clients perform daily activities. The comfort of the wheelchair can encourage clients to participate in daily activities and can help prevent future complications. PURPOSE: This study evaluates how a shaped seat-cushion and two different back supports affect under-seat pressure, comfort, and pelvic rotation. METHOD: Thirty healthy subjects were tested using two differently equipped manual wheelchairs. One wheelchair had a Velcro adjustable back seat and a plane seat-cushion. The other wheelchair had a non-adjustable sling-back seat and a plane cushion. The second wheelchair was also equipped with a shaped cushion and/or a detachable lumbar support. Under-seat pressure, estimated comfort, and pelvic rotation were measured after 10 min in each wheelchair outfit. RESULTS: Peak pressure increased with the shaped cushion compared to the plane cushion. No significant difference in estimated comfort was found. Pelvic posterior-rotation was reduced with the adjustable or detachable back-support irrespective of the shape of the seat cushion. CONCLUSIONS: To support a neutral pelvic position and spinal curvature, a combination of a shaped cushion and a marked lumbar support is most effective.

  • 190.
    Samuelsson, Kersti
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Rehabilitation Medicine.
    Modig-Arding, Ingalill
    Region Östergötland, Anaesthetics, Operations and Specialty Surgery Center, Department of Rehabilitation Medicine.
    Wressle, Ewa
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Acute Internal Medicine and Geriatrics.
    Driving after an injury or disease affecting the brain: an analysis of clinical data2018In: British Journal of Occupational Therapy, ISSN 0308-0226, E-ISSN 1477-6006, Vol. 81, no 7, p. 376-383Article in journal (Refereed)
    Abstract [en]

    Introduction: Traffic safety may be affected if a licence holder has experienced illness or injury that may have an impact on cognition. Occupational therapists are involved in assessing cognitive functions that might affect a patients ability to drive a car using different evaluation tools in different countries and settings. The aim of this study was to look at the predictive value of some of the assessment tools available to occupational therapists for making judgements about resuming driving after cognitive impairment due to brain trauma or disease. Method: A retrospective study based on clinical data from 204 patients referred to a specialist department for recommendations on ability to drive after brain injury or disease. All patients underwent three assessments: stroke drivers screening assessment, useful field of view and simulated driving skill. In addition, an on-road assessment was added in 76% of the sample. Results: Useful field of view had the highest sensitivity (78%) and, combined with the results from the simulator, the sensitivity was 87 degrees/o. The specificity for the two methods was 55%. Conclusion: The results from useful field of view and a simulator test combined best predicted the final recommendation from the multi-professional team discussion on which clients should be recommended not to resume driving.

  • 191.
    Samuelsson, Kersti
    et al.
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Rehabilitation Medicine.
    Wressle, Ewa
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuroscience. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Department of Geriatric Medicine in Linköping.
    Powered wheelchairs and scooters for outdoor mobility: a pilot study on costs and benefits2014In: Disability and Rehabilitation: Assistive Technology, ISSN 1748-3107, E-ISSN 1748-3115, Vol. 9, no 4, p. 330-334Article in journal (Refereed)
    Abstract [en]

    Purpose: This study evaluates the effect of electric powered wheelchairs/scooters (PWC/S) on occupational performance, social participation, health, and life satisfaction. In addition, this study estimates the costs and benefits of PWC/S and describes users’ experiences with the delivery process.

    Methods: This prospective study has a before-and-after design. Postal questionnaires were sent to 24 first-time PWC/S users before delivery of the PWC/S and four months after delivery. The participants used their PWC/S for outdoor mobility.

    Results: PWC/S improved the users’ daily lives, their ability to engage in mobility-related activities, and their social participation. For a majority of the users, estimated independence, feelings of safety, and self-esteem increased although overall health and life satisfaction were not significantly affected. All users thought that the therapist had considered their needs during the providing process. Most participants (73%) were satisfied with their device at follow-up. For the 12 users who reported no change in health status between measures, the mean societal savings based on calculated costs for assistance was € 6 227 per person per year.

    Conclusions: PWC/S seems to improve occupational performance, social participation, and life satisfaction for users. Moreover, these improvements seem to have an economic advantage for both users and society.

  • 192.
    Samuelsson, Kersti
    et al.
    Östergötlands Läns Landsting, Anaesthetics, Operations and Specialty Surgery Center, Department of Rehabilitation Medicine. Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Medicine and Health Sciences.
    Wressle, Ewa
    Linköping University, Department of Clinical and Experimental Medicine, Division of Neuro and Inflammation Science. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Local Health Care Services in Central Östergötland, Department of Geriatric Medicine in Linköping.
    Turning evidence into practice: Barriers to research use among occupational therapists2015In: British Journal of Occupational Therapy, ISSN 0308-0226, E-ISSN 1477-6006, Vol. 78, no 3, p. 175-181Article in journal (Refereed)
    Abstract [en]

    Introduction: Research has demonstrated that occupational therapists generally have a positive attitude regarding the use of evidence in their daily practice and decision-making. In addition, occupational therapists are expected to implement evidencebased practice, which is often understood as equivalent to research. However, evidence-based practice might be difficult to reconcile with occupational therapy from a client-centred focus. This study examines what occupational therapists perceive as barriers to research use and discusses the challenge of clinical implementation.

    Method: This study uses a descriptive cross-sectional design. The Barriers to Research Utilization Scale questionnaire was mailed to 807 randomly selected Swedish occupational therapists. The response rate was 59%.

    Findings: The occupational therapists identified three main barriers to the use of research: insufficient facilities (82%); lack of time to read research (77%); difficulty understanding statistical analyses (75%). Degree of education was shown to affect results; occupational therapists with higher education levels indicated a higher use of research.

    Conclusion: Implementing research in clinical practice is a challenge. Occupational therapists are interested but they lack the optimal prerequisites and time.

  • 193.
    Sandell, Caroline
    et al.
    Östergötlands Läns Landsting.
    Kjellberg, Anette
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Taylor, Renee
    Linköping University, Department of Social and Welfare Studies, Division of Health, Activity and Care. Linköping University, Faculty of Health Sciences.
    Participating in diagnostic experience: Adults with neuropsychiatric disorders2013In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 20, no 2, p. 136-142Article in journal (Refereed)
    Abstract [en]

    Knowledge regarding neuropsychiatric disabilities has increased in recent years, resulting in an increasing number of adults requesting neuropsychiatric evaluation. The aim of this qualitative study was to describe adult clients' experiences of participating actively in a supportive assessment process in which they received a diagnosis of either autism spectrum disorder (ASD) and/or attention-deficit hyperactivity disorder (ADHD) and then received follow-up counselling, guidance, and compensatory resources that were immediate and directly integrated into the diagnostic experience. The Occupational Performance History Interview – Second Version (OPHI-II) was selected because it is client-centred. It measures how a significant life event affects a person's occupational identity, occupational competence, and interaction with the environment. The OPHI-II was administered to capture 15 participants' experiences of being diagnosed with ASD and/or ADHD as the significant life event of focus. Three categories were formed by using qualitative content analysis: (i) strengthened occupational identity; (ii) compensatory support enhances occupational competence, and (iii) effects of the social environment on relationships. Findings indicated that the diagnostic experience had transformative effects on participants' occupational identities, occupational competence, and ability to self-advocate for increased understanding and resources within their environments. The implications of these findings and future research are discussed.

  • 194.
    Sandqvist, Jan
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Development and Evaluation of Validity and Utility of the Instrument Assessment of Work Performance (AWP)2007Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The last decades have shown a great need for vocational rehabilitation due to high levels of absenteeism due to sickness and disability pension. An essential part of the vocational rehabilitation process is assessment of persons with reduced work functioning. Adequate and reliable methods for assessment of clients with work disabilities are crucial for both the individuals who are assessed and for society as a whole. Sound and precise work assessments are needed to guide clients to suitable interventions using a minimum of rehabilitation resources. However, work function assessments are complex and there is confusion over work assessment concepts. Therefore, further development and evaluation of adequate concepts and theoretical models within the area of work assessment is needed. Furthermore, vocational rehabilitation lacks adequate and reliable assessment instruments, especially instruments used to observe clients.

    This dissertation thesis focuses specifically on the following:

    - Development of a conceptual framework for assessment of work functioning [Study I]

    - Development and evaluation of validity and utility of the observation instrument Assessment of Work Performance (AWP) [Study II-IV]

    Study I proposes a conceptual framework for different dimensions of work functioning and highlights important factors for work assessment. The study also creates a framework to define the purpose, delimination, and possible assessment outcomes of the assessment instrument AWP.

    Study II develops an observation instrument for assessment of work performance, the Assessment of Work Performance (AWP) and conducts an initial evaluation of face validity and utility for the instrument. The initial evaluation in study II was made within a group of 21 assessors in Sweden, and the result indicated face validity and utility for the AWP, a result that supported further development and evaluation of the instrument.

    Study III investigates the content validity and utility of the AWP. A questionnaire was answered by 67 respondents who used the AWP in various vocational rehabilitation settings in Sweden. The result indicated content validity and utility for the AWP.

    Study IV investigates the construct validity of the instrument AWP. This study is based on 364 assessments with the AWP (version 1.1). The clients had various work-related problems and went through an insurance medicine investigation at a Social Insurance Office in Sweden between 2004 and 2005. The major findings in this study indicated that the AWP has construct validity, sensitivity, and the ability to discriminate between clients. It is also gender neutral.

    The future evaluation of AWP will comprise testing of predictive validity, inter-rater reliability and internal consistency reliability as well as an evaluation of how and with what results the instrument can be combined with other work-related assessment instruments.

    List of papers
    1. Work functioning - a conceptual framework
    Open this publication in new window or tab >>Work functioning - a conceptual framework
    2004 (English)In: Work, ISSN 1051-9815, Vol. 23, no 2, p. 147-157Article in journal (Refereed) Published
    Abstract [en]

    Adequate and reliable methods for evaluation of clients with work disabilities are crucial for both the individuals who are assessed and for society as a whole. Sound and precise work assessments are needed to guide clients to suitable interventions using a minimum of rehabilitation resources [31,46,51,68]. Occupational therapy literature contains evidence that work function assessments are complex and that there is confusion over work assessment concepts [30,31]. Therefore, further development and evaluation of adequate concepts and theoretical models within the area of work assessment is needed [68,74]. This article proposes a conceptual framework for different dimensions of work functioning and points out important factors for work assessment. The concepts proposed and defined in the article are: work functioning, work participation, work performance, and individual capacity.

    Keywords
    occupational therapy, ability, performance, capacity, assessment
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-12892 (URN)
    Available from: 2008-01-21 Created: 2008-01-21 Last updated: 2009-06-03
    2. Assessment of Work Performance - Development of an Instrument
    Open this publication in new window or tab >>Assessment of Work Performance - Development of an Instrument
    2006 (English)In: Work, ISSN 1051-9815, Vol. 26, no 4, p. 379-387Article in journal (Refereed) Published
    Abstract [en]

    Adequate work assessments are a matter of importance both for individuals and society [5,29,31,38,40,46,52]. However, there is a lack of adequate and reliable instruments for use in work rehabilitation [14,15,20,21,31,44]. The purpose of this study was to develop and evaluate an observation instrument for assessing work performance, the AWP (Assessment of Work Performance). The purpose of the 14-item instrument is to assess the individual's observable working skills in three different areas: motor skills, process skills, and communication and interaction skills. This article describes the development and results of preliminary testing of the AWP. The testing indicates a satisfactory face validity and utility for the AWP and supports further research and testing of the instrument.

    Keywords
    Occupational therapy, measurement, instrument development, skills, MOHO
    National Category
    Occupational Therapy
    Identifiers
    urn:nbn:se:liu:diva-12893 (URN)
    Available from: 2008-01-21 Created: 2008-01-21 Last updated: 2009-06-03
    3. Content Validity and Utility of the Assessment of Work Performance (AWP)
    Open this publication in new window or tab >>Content Validity and Utility of the Assessment of Work Performance (AWP)
    2008 (English)In: Work, ISSN 1051-9815, Vol. 30, no 4, p. 441-450Article in journal (Refereed) Published
    Abstract [en]

    In the area of work rehabilitation, many decisions about future interventions for the client are based on the results of various kinds of assessments. Therefore, it is important that the assessment instruments used are adequate, useful, and reliable. The purpose of this study was to investigate the content validity and utility of the instrument Assessment of Work Performance (AWP) which is used to assess an individual's observable (working) skills during work performance, i.e. how efficient and appropriate a client performs a work activity. A questionnaire was answered by 67 respondents who used the AWP in various work rehabilitation settings in Sweden. The result indicates content validity and utility for the AWP that supports further testing of the instrument.

    Keywords
    Occupational therapy, measurement, instrument development, skills, MOHO
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-12894 (URN)
    Available from: 2008-01-21 Created: 2008-01-21 Last updated: 2009-05-14
    4. Construct validity of the Assessment of Work Performance (AWP)
    Open this publication in new window or tab >>Construct validity of the Assessment of Work Performance (AWP)
    Show others...
    2009 (English)In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 32, no 2, p. 211-218Article in journal (Refereed) Published
    Abstract [en]

    The instrument Assessment of Work Performance (AWP 1.1) can be used to assess an individuals skills during work performance-how efficient and appropriate a client performs a work task. The instrument is currently used by over 300 assessors working in a variety of work rehabilitation settings in Sweden, and it has been used with over 10,000 clients. In this study, the construct validity of the AWP 1.1 was tested with 364 assessments of clients with a variety of various work-related problems assessed by six occupational therapists in a Social Insurance Office in Sweden between 2004 and 2005. Principal Component Analysis shows construct validity of the AWP 1.1. Further, the findings indicate that the instrument is sensitive and discriminates between clients, and no gender related patterns were identified.

    Place, publisher, year, edition, pages
    IOS Press, 2009
    Keywords
    Instrument development, Model of Human Occupation (MOHO), occupational therapy, vocational rehabilitation
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-17879 (URN)10.3233/WOR-2009-0807 (DOI)000264925800012 ()
    Available from: 2009-04-25 Created: 2009-04-24 Last updated: 2017-12-13Bibliographically approved
  • 195.
    Sandqvist, Jan
    et al.
    Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy. Linköping University, Faculty of Medicine and Health Sciences.
    Ekbladh, Elin
    Linköping University, Department of Social and Welfare Studies, Division of Occupational Therapy. Linköping University, Faculty of Medicine and Health Sciences.
    Applying the Model of Human Occupation to Vocational Rehabilitation2017In: Kielhofner's Model of Human Occupation, Fifth Edition: THEORY AND APPLICATION / [ed] Renee Taylor, Wolters Kluwer, 2017, 5, p. 377-396Chapter in book (Other academic)
  • 196.
    Sandqvist, Jan
    et al.
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Törnquist, Kristina
    Örebro Universitet, Örebro, Sweden.
    Henriksson, Chris
    Linköping University, Department of Social and Welfare Studies, Health, Activity, Care. Linköping University, Faculty of Health Sciences.
    Assessment of Work Performance - Development of an Instrument2006In: Work, ISSN 1051-9815, Vol. 26, no 4, p. 379-387Article in journal (Refereed)
    Abstract [en]

    Adequate work assessments are a matter of importance both for individuals and society [5,29,31,38,40,46,52]. However, there is a lack of adequate and reliable instruments for use in work rehabilitation [14,15,20,21,31,44]. The purpose of this study was to develop and evaluate an observation instrument for assessing work performance, the AWP (Assessment of Work Performance). The purpose of the 14-item instrument is to assess the individual's observable working skills in three different areas: motor skills, process skills, and communication and interaction skills. This article describes the development and results of preliminary testing of the AWP. The testing indicates a satisfactory face validity and utility for the AWP and supports further research and testing of the instrument.

  • 197.
    Seing, Ida
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    Activating the Sick-Listed: Policy and Practice of Return to Work in Swedish Sickness Insurance and Working Life2014Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    A critical task of social policy in most Western welfare states during recent decades has consisted of reducing the economic burden on society due to sick leave, by stimulating participation in the labour market. Many jurisdictions have introduced activation policies, based on the premise that work “per se” has a therapeutic effect on sick-listed workers. People are expected to be “active”, rather than “passive”, recipients of financial benefits. However, there is limited knowledge of how activation policies focusing on return to work (RTW) are carried out in local practice. Against this background, the overall aim of this thesis is to study the local practice of activation policies by analysing how they are received, implemented and experienced by welfare state organizations, employers and sick-listed workers. The analysis has been influenced by theories concerning organization fields, individualization, street-level bureaucracy and organizational governance.

    In this thesis, the overall aim is investigated in four interrelated papers. In Paper I, the aim is to analyse the perspectives of stakeholders (i.e. welfare state actors and employers) on work ability by studying multistakeholder meetings. Paper II sheds light on activation policy, focusing on early RTW in the context of modern working conditions; the aim is to analyse RTW practice in local workplace contexts, in relation to Swedish early-RTW policy. The third paper focuses on employers, with the aim of analysing their role and activities regarding RTW, in local workplace practice. In Paper IV, the aim is to analyse sick-listed workers’ experiences of the sickness insurance system in their contact with the Swedish Social Insurance Agency (SSIA) and their front-line staff.

    The empirical material comprises two empirical studies: 1) audio-recorded multi-stakeholder meetings from regular practice (n=9) and 2) semi-structured interviews with sick-listed workers and their supervisors in 18 workplaces (n=36). The analyses of the material have been performed in accordance with the principles of qualitative content analysis.

    Main findings of the papers reflect strong organizational boundaries in the implementation process of activation policies. Welfare state actors and employers appear to be governed by their own organizational logics and interests, so the actors involved fail to take a holistic view of sick-listed workers and do not share a common social responsibility for individuals’ RTW. This thesis illustrates how current activation policies focusing on RTW are based on a rather idealized image of the standard workplace. There is an explicit or implicit assumption that employers and work organizations are able to welcome sick-listed workers back to work in a healthy way. However, the intensity of modern working life leaves limited room for accommodating people with reduced work ability, who are not considered to have a business value to the workplace. In several cases, findings indicate that the SSIA’s focus on activation and early RTW clashes with the financially oriented perspective of employers. Economic considerations regarding their business take precedence over legal and ethical considerations, and employers have difficulty taking social responsibility for RTW. Sick-listed workers are encouraged to adjust to new workplace settings and environments to meet the demands of the workplace, and, if RTW is not possible, to the demands of the labour market. The findings also show that sick-listed workers experience that contacts with the SSIA are ‘standardized’; i.e., they perceive that the officials are loyal  to demands in their organizations rather than being involved actors who support workers’ individual needs. Sick-listed workers clearly experience that measures in Swedish activation policies have a strong focus on demanding aspects (financial work incentives) and less on enabling aspects (investments in skills).

    Overall, this thesis illustrates an emerging social climate where sick-listed workers are positioned as active agents who must take responsibility for their sick leave and their RTW process. In a Swedish context, RTW is a matter of activating the sick-listed rather than activating the workplace.

    List of papers
    1. Policy and Practice of Work Ability: A Negotiation of Responsibility in Organizing Return to Work
    Open this publication in new window or tab >>Policy and Practice of Work Ability: A Negotiation of Responsibility in Organizing Return to Work
    Show others...
    2012 (English)In: Journal of occupational rehabilitation, ISSN 1053-0487, E-ISSN 1573-3688, Vol. 22, no 4, p. 553-564Article in journal (Refereed) Published
    Abstract [en]

    Purpose In welfare policy and practical work it is unclear what the concept of work ability involves and assessments may be different among involved actors, partly due to a lack of theoretical research in relation to regulations and practice. Based on theoretical and legal aspects of work ability the aim of the study is to analyze stakeholders’ perspectives on work ability in local practice by studying multi-stakeholder meetings.

    Methods The material comprises nine digitally recorded multi-stakeholder meetings. Apart from the sick-listed individual, representatives from the public Social Insurance Agency, health care, employers, public employment service and the union participated in the meeting. The material was analyzed using qualitative content analysis.

    Results Three perspectives on work ability were identified: a medical perspective, a workplace perspective and a regulatory perspective. The meetings developed into negotiations of responsibility concerning workplace adjustments, rehabilitation efforts and financial support. Medical assessments served as objective expert statements to legitimize stakeholders’ perspectives on work ability and return to work.

    Conclusions Although the formal goal of the status meeting was to facilitate stakeholder collaboration, the results demonstrates an unequal distribution of power among cooperating actors where the employers had the “trump card” due to their possibilities to offer workplace adjustments. The employer perspective often determined whether or not persons could return to work and if they had work ability.

    Place, publisher, year, edition, pages
    Springer, 2012
    National Category
    Occupational Therapy Work Sciences Public Health, Global Health, Social Medicine and Epidemiology Political Science Sociology
    Identifiers
    urn:nbn:se:liu:diva-73888 (URN)10.1007/s10926-012-9371-3 (DOI)000310472400012 ()
    Available from: 2012-01-16 Created: 2012-01-16 Last updated: 2017-12-08
    2. Early-Return-to-Work in the Context of an Intensification of Working Life and Changing Employment Relationships
    Open this publication in new window or tab >>Early-Return-to-Work in the Context of an Intensification of Working Life and Changing Employment Relationships
    2015 (English)In: Journal of occupational rehabilitation, ISSN 1053-0487, E-ISSN 1573-3688, Vol. 25, no 1, p. 74-85Article in journal (Refereed) Published
    Abstract [en]

    Purpose Many Western welfare states have introduced early-return-to-work policies, in which getting sick-listed people back to work before they have fully recovered is presented as a rather unproblematic approach. This reflects a belief in the ability of employers and the labour market to solve sickness absence. Against this background, the aim of this study was to analyse return-to-work practice in local workplace contexts, in relation to Swedish early-return-to-work policy.

    Methods Semi-structured interviews were conducted with 18 matched pairs of workers and managers. The material, comprising a total of 36 interviews, was analysed using qualitative content analysis.

    Results Three main themes were identified: (1) intensive workplaces and work conditions (2) employer support—a function of worker value and (3) work attachment and resistance to job transition. The results reflected the intensity of modern working life, which challenged return-to-work processes. Managers had different approaches to workers’ return-to-work, depending on how they valued the worker. While managers used the discourse of ‘new opportunities’ and ‘healthy change’ to describe the transition process (e.g. relocation, unemployment and retirement), workers regularly experienced transitions as difficult and unjust.

    Conclusions In the context of early-return-to-work policy and the intensity of modern working life, a great deal of responsibility was placed on workers to be adaptable to workplace demands in order to be able to return and stay at work. Overall, this study illustrates an emerging social climate where sick-listed workers are positioned as active agents who must take responsibility for sick leave and return-to-work process.

    Place, publisher, year, edition, pages
    Springer, 2015
    Keywords
    Social policy; Return-to-work; Sick leave; Work place; Career mobility
    National Category
    Occupational Therapy Public Health, Global Health, Social Medicine and Epidemiology Sociology Political Science Work Sciences
    Identifiers
    urn:nbn:se:liu:diva-112396 (URN)10.1007/s10926-014-9526-5 (DOI)000349971100008 ()24920449 (PubMedID)
    Available from: 2014-11-25 Created: 2014-11-25 Last updated: 2017-12-05Bibliographically approved
    3. Return to work or job transition?: Employer dilemmas in taking social responsibility for return to work in local workplace practice
    Open this publication in new window or tab >>Return to work or job transition?: Employer dilemmas in taking social responsibility for return to work in local workplace practice
    2015 (English)In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 37, no 18-19, p. 1760-1769Article in journal (Refereed) Published
    Abstract [en]

    Purpose: The aim was to analyze the role and activities of employers with regard to return to work (RTW), in local workplace practice.

    Method: Semi-structured interviews were conducted with sick-listed workers and their supervisors in 18 workplaces (n  = 36). The analytical approach to study the role of employers in RTW was based on the three-domain model of social corporate responsibility. The model illustrates the linkage between corporations and their social environment, and consists of three areas of corporate responsibility: economic, legal and ethical.

    Results: Employers had difficulties in taking social responsibility for RTW, in that economic considerations regarding their business took precedence over legal and ethical considerations. Employers engaged in either “RTW activities” or “transition activities” that were applied differently depending on how valued sick-listed workers were considered to be to their business, and on the nature of the job (e.g. availability of suitable work adjustments).

    Conclusions: This study suggests that Swedish legislation and policies does not always adequately prompt employers to engage in RTW. There is a need for further attention to the organizational conditions for employers to take social responsibility for RTW in the context of business pressure and work intensification.

    Implications for Rehabilitation

    • Employers may have difficulties in taking social responsibility for RTW when economic considerations regarding their business take precedence over legal and ethical considerations.
    • Rehabilitation professionals should be aware of that outcomes of an RTW process can be influenced by the worker’s value to the employer and the nature of the job (e.g. availability of suitable work adjustments). “Low-value” workers at workplaces with limited possibilities to offer workplace adjustments may run a high risk of dismissal.
    • Swedish legislation and policies may need reforms to put more pressure on employers to promote RTW.
    Place, publisher, year, edition, pages
    Informa Healthcare, 2015
    Keywords
    Activation policy, employers, sick leave, work accommodation, workplace
    National Category
    Occupational Therapy Public Health, Global Health, Social Medicine and Epidemiology Political Science Sociology Work Sciences
    Identifiers
    urn:nbn:se:liu:diva-112397 (URN)10.3109/09638288.2014.978509 (DOI)000359878700020 ()25355548 (PubMedID)
    Available from: 2014-11-25 Created: 2014-11-25 Last updated: 2017-12-05Bibliographically approved
    4. Activation Policies and Sick-Listed Workers’ Experiences and Trust in the Sickness Insurance System in Local Practice
    Open this publication in new window or tab >>Activation Policies and Sick-Listed Workers’ Experiences and Trust in the Sickness Insurance System in Local Practice
    2014 (English)Manuscript (preprint) (Other academic)
    Abstract [en]

    In recent welfare and labour market reforms in Europe and North America, there is a general trend towards activation, in that people (e.g. those who are sick-listed, unemployed and recipients of social welfare) are expected to be “active”, rather than “passive”, recipients of financial benefits. Meanwhile, street-level bureaucracy in many welfare state organizations has been fundamentally reformed in recent years with the implementation of New Public Management Principles which have come to influence the day-to-day work of front-line staff. The aim of this paper is to analyse sick-listed workers’ experiences of the sickness insurance system in their contact with the SSIA and their front-line staff. The data consists of semistructured interviews with 18 sick-listed workers in Sweden. The material was analysed using qualitative content analysis. The findings illustrate that sick-listed workers experienced contacts with the Social Insurance Agency (SSIA) as “standardized”; that is, they perceived that the officials were loyal to demands in their organizations rather than involved actors that supported workers’ individual needs. The SSIA was described as having a mainly administrative and controlling function during their sick leave, resulting in a distant relationship. It was also clear that sick-listed individuals experienced the activation policy as demanding, and their sick leave was characterized by insecurity and uncertainty. Overall, this paper suggests that activation policies with regulations emphasizing time limits, and enforcement of standardized work processes at the SSIA, challenge sick-listed workers’ trust in the sickness insurance system.

    National Category
    Occupational Therapy Public Health, Global Health, Social Medicine and Epidemiology Work Sciences Political Science Sociology
    Identifiers
    urn:nbn:se:liu:diva-112398 (URN)
    Available from: 2014-11-25 Created: 2014-11-25 Last updated: 2014-11-26
  • 198.
    Seing, Ida
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    MacEachen, Ellen
    Department of Public Health and Health Systems, Faculty of Applied Public Health, University of Waterloo, Ontario, Canada.
    Ekberg, Kerstin
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, HELIX Vinn Excellence Centre. Linköping University, Faculty of Health Sciences.
    Ståhl, Christian
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    Activation Policies and Sick-Listed Workers’ Experiences and Trust in the Sickness Insurance System in Local Practice2014Manuscript (preprint) (Other academic)
    Abstract [en]

    In recent welfare and labour market reforms in Europe and North America, there is a general trend towards activation, in that people (e.g. those who are sick-listed, unemployed and recipients of social welfare) are expected to be “active”, rather than “passive”, recipients of financial benefits. Meanwhile, street-level bureaucracy in many welfare state organizations has been fundamentally reformed in recent years with the implementation of New Public Management Principles which have come to influence the day-to-day work of front-line staff. The aim of this paper is to analyse sick-listed workers’ experiences of the sickness insurance system in their contact with the SSIA and their front-line staff. The data consists of semistructured interviews with 18 sick-listed workers in Sweden. The material was analysed using qualitative content analysis. The findings illustrate that sick-listed workers experienced contacts with the Social Insurance Agency (SSIA) as “standardized”; that is, they perceived that the officials were loyal to demands in their organizations rather than involved actors that supported workers’ individual needs. The SSIA was described as having a mainly administrative and controlling function during their sick leave, resulting in a distant relationship. It was also clear that sick-listed individuals experienced the activation policy as demanding, and their sick leave was characterized by insecurity and uncertainty. Overall, this paper suggests that activation policies with regulations emphasizing time limits, and enforcement of standardized work processes at the SSIA, challenge sick-listed workers’ trust in the sickness insurance system.

  • 199.
    Seing, Ida
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    MacEachen, Ellen
    Department of Public Health and Health Systems, Faculty of Applied Public Health, University of Waterloo, Ontario, Canada.
    Ekberg, Kerstin
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences. Linköping University, HELIX Vinn Excellence Centre.
    Ståhl, Christian
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences. Linköping University, HELIX Vinn Excellence Centre.
    Return to work or job transition?: Employer dilemmas in taking social responsibility for return to work in local workplace practice2015In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 37, no 18-19, p. 1760-1769Article in journal (Refereed)
    Abstract [en]

    Purpose: The aim was to analyze the role and activities of employers with regard to return to work (RTW), in local workplace practice.

    Method: Semi-structured interviews were conducted with sick-listed workers and their supervisors in 18 workplaces (n  = 36). The analytical approach to study the role of employers in RTW was based on the three-domain model of social corporate responsibility. The model illustrates the linkage between corporations and their social environment, and consists of three areas of corporate responsibility: economic, legal and ethical.

    Results: Employers had difficulties in taking social responsibility for RTW, in that economic considerations regarding their business took precedence over legal and ethical considerations. Employers engaged in either “RTW activities” or “transition activities” that were applied differently depending on how valued sick-listed workers were considered to be to their business, and on the nature of the job (e.g. availability of suitable work adjustments).

    Conclusions: This study suggests that Swedish legislation and policies does not always adequately prompt employers to engage in RTW. There is a need for further attention to the organizational conditions for employers to take social responsibility for RTW in the context of business pressure and work intensification.

    Implications for Rehabilitation

    • Employers may have difficulties in taking social responsibility for RTW when economic considerations regarding their business take precedence over legal and ethical considerations.
    • Rehabilitation professionals should be aware of that outcomes of an RTW process can be influenced by the worker’s value to the employer and the nature of the job (e.g. availability of suitable work adjustments). “Low-value” workers at workplaces with limited possibilities to offer workplace adjustments may run a high risk of dismissal.
    • Swedish legislation and policies may need reforms to put more pressure on employers to promote RTW.
  • 200.
    Seing, Ida
    et al.
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences.
    MacEachen, Ellen
    School of Public Health and Health Systems, Faculty of Applied Health Sciences, University of Waterloo, Canada.
    Ståhl, Christian
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences. Linköping University, HELIX Vinn Excellence Centre.
    Ekberg, Kerstin
    Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences. Linköping University, HELIX Vinn Excellence Centre.
    Early-Return-to-Work in the Context of an Intensification of Working Life and Changing Employment Relationships2015In: Journal of occupational rehabilitation, ISSN 1053-0487, E-ISSN 1573-3688, Vol. 25, no 1, p. 74-85Article in journal (Refereed)
    Abstract [en]

    Purpose Many Western welfare states have introduced early-return-to-work policies, in which getting sick-listed people back to work before they have fully recovered is presented as a rather unproblematic approach. This reflects a belief in the ability of employers and the labour market to solve sickness absence. Against this background, the aim of this study was to analyse return-to-work practice in local workplace contexts, in relation to Swedish early-return-to-work policy.

    Methods Semi-structured interviews were conducted with 18 matched pairs of workers and managers. The material, comprising a total of 36 interviews, was analysed using qualitative content analysis.

    Results Three main themes were identified: (1) intensive workplaces and work conditions (2) employer support—a function of worker value and (3) work attachment and resistance to job transition. The results reflected the intensity of modern working life, which challenged return-to-work processes. Managers had different approaches to workers’ return-to-work, depending on how they valued the worker. While managers used the discourse of ‘new opportunities’ and ‘healthy change’ to describe the transition process (e.g. relocation, unemployment and retirement), workers regularly experienced transitions as difficult and unjust.

    Conclusions In the context of early-return-to-work policy and the intensity of modern working life, a great deal of responsibility was placed on workers to be adaptable to workplace demands in order to be able to return and stay at work. Overall, this study illustrates an emerging social climate where sick-listed workers are positioned as active agents who must take responsibility for sick leave and return-to-work process.

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