OBJECTIVE: To study whether personal factors (self-efficacy and pain acceptance) mediate the relationship between pain and performance of valued life activities in persons with rheumatoid arthritis.

METHODS: Persons with rheumatoid arthritis for at least four years (n = 737; 73% women) answered a questionnaire measuring self-efficacy, pain acceptance, performance of valued life activities, and self-rated pain. Relationships among these constructs were explored using univariate and multivariate analyses. Structural equation modelling was then used to examine the mediational role of personal factors on the relationship between pain and performance of valued life activities.

RESULTS: A direct negative association between pain and performance of valued life activities was identified (Beta = .34, P < .001). This suggests that people with rheumatoid arthritis who had higher levels of pain has increased difficulties in performing valued life activities. Self-efficacy and activity engagement component of pain acceptance mediated the relationship between pain and performance of valued life activities, however the pain willingness component of pain acceptance did not influence participation in valued life activities.

CONCLUSION: These findings highlight the importance of considering personal factors, such as pain acceptance and self-efficacy, in facilitating participation in valued life activities.

Introduction The aim of this study was to explore how women of working age who have had a mild stroke resulting in cognitive impairment experience and manage their everyday lives. Method Data were collected using semi-structured interviews. The participants consisted of 10 women of working age who had sustained cognitive impairment after a mild stroke. The interviews were analysed using qualitative content analysis. Results Three main categories appeared: The everyday is affected by the symptoms, Living strategies, and The social environment effects and changes. Participants feel insecure about their abilities and capabilities, experience anxiety and fear in relation to work, and find it hard to live up to demands and expectations. They are required to plan their daily activities in a new way and to prioritise chores that benefit the family, rather than follow their own interests and social activities. In order to cope with everyday life, they need to allocate chores to other family members. Conclusions The constant impact of fatigue and cognitive impairments affects everyday life. The women said that they had to learn to continuously manage their limitations through their experience of everyday life, something that can be facilitated with occupational therapy.

Background: Today everyday life depends on having access to, understand and use internet inorder to participate and take part in societal resources. This understanding can be complex forpersons with intellectual disabilities (ID) due to their cognitive impairments. It is even statedthat internet-use can be yet another part of daily life activities they are excluded from. Internet-use is claimed to involve risks, but also benefits for persons with ID, but there is a shortage inempirical studies with the target group ́s own opinion regarding this. Broader knowledge isacquired of internet-use in everyday life for adolescents with ID, as a precondition toparticipation. 

Aim: This study aims to explore and describe internet-use and doing internet activities at homeand at school among adolescents with mild and moderate intellectual disabilities. Method: The study has a qualitative inductive design using observations and interviews in thetwo settings; at home and at school. Participants are six adolescents with mild and moderate ID,from special schools in the middle-region of Sweden, between the ages 13-20, that use internetto some extent. Data was collected at 2 occasions/participant for about 2hours/participant/setting. The analysis was done using a qualitative content analysis.

Result: Preliminary results show that adolescents with mild and moderate ID use internet both athome and in school, to a greater extent than was expected, but the doings of internet-activitiesvaries in the different settings. Both facilitating and hindering aspects are described by theparticipants. Pictures on the internet seem to be of support when using and navigating theinternet.

Conclusion: Deeper knowledge regarding internet-use from the target groups own perspectivehas been gained. The results can be used in the different occupational settings and in furtherresearch to survey internet use and participation in internet-activities

Introduction: Internet is an integral part of everyday life today. In Sweden 98% of adolescents are reported using internet. However, adolescents with intellectual disabilities are often excluded in national surveys, since questions are not adapted for the target group. Statistics remain therefore limited regarding internet-use among adolescents with intellectual disabilities. Objectives: To investigate and describe internet-use among adolescents with intellectual disabilities through an adapted version of a nationwide survey in Sweden. Method: A cross-sectional study was conducted using an adapted version of a survey from the Swedish Media Council on media-use among adolescents. Cognitive adaptations were included and it was accessible through the web and in paper. The sample was drawn from three municipalities using a total-selection of pupils in secondary- and upper secondary special schools. 265 surveys were sent out and the response rate was approximately 32%. Data was analyzed through descriptive statistics. Results: The result gives demographic data on the participants and descriptive statistics on the access to devices for internet-connection. Further, data are provided on activities done in leisure time and whether internet is used or not, together with perceptions of doings on internet from the participants. Conclusion: Stepwise adaptations of the survey with different levels of cognitive support enabled the participation of adolescents with intellectual disabilities and the result gives increased knowledge of internet-use among adolescents with intellectual disabilities. Finally, future comparative analysis are possible due to the national survey being used implying the voices of adolescents with intellectual disabilities being heard.

Bakgrund/Syfte*

Inom WHO pågår ett utvecklingsarbete av en ny klassifikation av åtgärder ”International Classification of Health Interventions” (ICHI), som kompletterar ICF och ICD. WHO har pågående tester av ICHI. Socialstyrelsen och nordiska klassifikationscentret har genomfört ett antal tester bland annat omfattande arbetsterapiåtgärder inom psykiatrin. Åtgärder dokumenteras med Klassifikation av vårdåtgärder (KVÅ) inom hälso- och sjukvård i Sverige.

Syfte var att mappa ett antal KVÅ-åtgärder som tillämpas inom psykiatrisk arbetsterapi till ICHI.

Metod/Tillvägagångssätt*

En lista med åtgärder inom psykiatri, som används av arbetsterapeuter från sex olika sjukhus i Sverige mappades till ICHI 2018. Mappningsregler för ICHI användes där grad av samstämmighet värderas. Även kardinalitet dvs. hur många ICHI-interventioner användes för att beskriva KVÅ-åtgärden. Resultatet bearbetades med deskriptiv statistik.

Resultat/Preliminärt resultat*

Totalt mappades 136 KVÅ-åtgärder (27 undersökande, 98 behandlande och 11 administrativa). Kardinaliteten mellan KVÅ och ICHI varierade från 1:0 till 1:28. Nio procent av KVÅ-åtgärderna kunde inte mappas till ICHI (1:0). I 37 procent var förhållandet 1:1, dvs en KVÅ-åtgärd mappades till en ICHI-intervention. I 34 procent var förhållandet 1:2 eller 1:3 och i 17 procent mellan 1:4-1:9. Fyra KVÅ-åtgärder hade förhållandet 1:14, 1:25 och 1:28. Grad av samstämmighet mellan KVÅ-åtgärd och ICHI-intervention visade att 14 procent överensstämde exakt. 67 procent av KVÅ-åtgärderna var bredare dvs. mindre specifika än ICHI-interventionerna och 18 procent av KVÅ-åtgärderna var mer specifika än ICHI-intervention.

Slutsats/Praktisk tillämpning*

ICHI har fler specifika interventioner för att dokumentera arbetsterapeuters åtgärder inom psykiatrisk verksamhet än KVÅ. Att börja tillämpa ICHI inom svenska psykiatrisk arbetsterapiverksamhet skulle öka kvalitén på dokumentationen.

Cognitive impairment may cause difficulties in planning and initiating daily activities, as well as remembering to do what is scheduled. This study investigates the effectiveness of an interactive web-based mobile reminder calendar that sends text messages to the users mobile phone as support in everyday life, for persons with cognitive impairment due to neurological injury/diagnoses. The study has a randomised controlled trail design with data collection at baseline and at follow-up sessions after two and four months. Data collection started in August 2016 and continues until December 2017. The interactive web-based mobile reminder calendar may give the needed support to remind the person and thus increase the ability to perform activities and to be independence in everyday life. Preliminary results will be presented regarding what effect the interactive web-based mobile reminder calendar have for the participants performance of everyday life activities as well as perceived quality of life.

Background: Assessing occupational performance is commonly done by occupational therapists[OT] working in special housing in municipal elder care. Assessments should be relevant and evidence-based. Even so, we know little about how assessment of occupational performance is conducted in special housing.

Aim: The aim of this study was to identify OTs’ use and perceptions of different methods to assess occupational performance for elderly clients living in special housing.  

Method: An email questionnaire was sent to OTs working in special housing in Sweden. Data was analyzed using descriptive and parametric statistics.

Results: The findings, based on data from 660 respondents, showed that OTs regularly assessed occupational performance but did not use standardized assessment instruments or structured methods to any great extent. In general, OTs reported that they were not pleased with their ability to assess their clients; however, OTs with higher education and with responsibility for fewer clients were more pleased with their assessments and stated that they had more knowledge about assessment methods. Conclusion: To support OTs in using structured assessments of occupational performance in everyday practice, organization as well as structures in the work environment and educational development need to be taken into consideration.

This article presents the findings from a qualitative research project exploring eight women’s experiences of living with rheumatoid arthritis (RA). Through semistructured interviews, the women provided insights into the physical, emotional, and social impacts of RA and the “work” involved in negotiating its influence in the everyday life. In narrating their experiences of adapting to RA, the women express a common desire for “normalcy,” to return to a time and space before the disruption of RA. The women’s accounts also emphasized the interrelatedness between bodily experience and constructions of self, highlighting the corporeal nature of RA and the constant shaping and reshaping of personal meanings and values.

Background: Rheumatoid arthritis (RA) is a chronic inflammatory disease often associated with disability. Despite new treatments, pain and activity limitations are still present. Objectives: To describe how persons with RA experience and manage pain in their daily life. Methods: Seven semi-structured focus groups (FGs) were conducted and analyzed using content analysis. Results: The analysis revealed four categories: 1) Pain expresses itself in different ways referred to pain as overwhelming, aching or as a feeling of stiffness. 2) Mitigating pain referred to the use of heat, cold, medications and activities as distractions from the pain. 3) Adapting to pain referred to strategies employed as coping mechanisms for the pain, e.g. planning and adjustment of daily activities, and use of assistive devices. 4) Pain in a social context referred to the participants social environment as being both supportive and uncomprehending, the latter causing patients to hide their pain. Conclusions: Pain in RA is experienced in different ways. This emphasizes the multi-professional team to address this spectrum of experiences and to find pain management directed to the individual experience that also include the persons social environment.

Objective

To evaluate the effects on hand function, activity limitations, and self‐rated health of a primary care hand osteoarthritis (OA) group intervention. Hand OA causes pain, impaired mobility, and reduced grip force, which cause activity limitations. OA group interventions in primary care settings are sparsely reported.

Methods

Sixty‐four individuals with hand OA agreed to participate; 15 were excluded due to not fulfilling the inclusion criteria. The 49 remaining (90% female) participated in an OA group intervention at a primary care unit with education, paraffin wax bath, and hand exercise over a 6‐week period. Data were collected at baseline, end of intervention, and after 1 year. Instruments used were the Grip Ability Test (GAT), the Signals of Functional Impairment (SOFI), dynamometry (grip force), hand pain at rest using a visual analog scale (VAS), the Patient‐Specific Functional Scale (PSFS), the Quick Disabilities of the Arm, Shoulder, and Hand (Quick‐DASH), and the EuroQol VAS (EQ VAS). Data were analyzed using nonparametric statistics.

Results

Hand function, activity limitation, and self‐rated health significantly improved from baseline to end of intervention, grip force (right hand: P < 0.001; left hand: P = 0.008), SOFI (P = 0.011), GAT (P < 0.001), hand pain at rest (P < 0.001), PSFS (1: P = 0.008, 2: P < 0.001, and 3: P = 0.004), Quick‐DASH (P = 0.001), and EQ VAS (P = 0.039), and the effects were sustained after 1 year.

Conclusion

The hand OA group intervention in primary care improves hand function, activity limitation, and self‐rated health. The benefits are sustained 1 year after completion of the intervention.

Ohälsosamma levnadsvanor är ett problem bland patienter som vårdas inom den rättspsykiatriska slutenvården. Patienter med psykisk ohälsa har en sårbarhet och löper större risk att drabbas av livsstilsrelaterade sjukdomar och för tidig död. Syftet är att beskriva hur personalen inom rättspsykiatrisk slutenvård upplever patienternas förutsättningar till att skapa hälsofrämjande levnadsvanor. Studien omfattar kvalitativ studiedesign där åtta personer som arbetar inom rättspsykiatrisk slutenvård intervjuades. I resultatet framkommer det att begränsningen av valet och möjligheten att engagera sig i aktiviteter inverkar negativt på en persons hälsa. Patienterna på kliniken har olika förutsättningar till delaktighet i aktivitet. Resultatet visar att patienternas tidigare vanemönster har inverkan på vilka levnadsvanor patienten har inom slutenvården. Personer med psykisk ohälsa stöter på många hinder i att skapa hälsofrämjande levnadsvanor då de beskrivs ha bristande insikt över vilka konsekvenser deras handlade får i relation till deras hälsa Patientgruppen framställs som rädda för livet utanför den rättspsykiatriska slutenvården och beskrivs trygga i det hospitaliserade klimatet. Detta resulterar i att många vill och blir kvar. Arbetsterapeutens kunskap kring vanor och roller är betydande vid förändring av patienternas levnadsvanor och arbetsterapeutiska insatser kan riktas mot att främja återgång i samhällslivet. Omfattningen forskning inom ämnet är bristande och det behövs mer kunskap om hur rättspsykiatriska kliniker kan arbeta för att främja hälsa och välmående för målgruppen.

OBJECTIVE: Foot impairments are related to reduced mobility and participation restrictions in daily activities in patients with established rheumatoid arthritis (RA). The new biological medications are effective and reduce disease activity, but not disability to the same extent. Foot impairments are assumed to be related to participation restrictions also in patients with early RA, diagnosed after the introduction of biological medications. The knowledge of foot impairments needs to be more explored after the introduction of biological disease-modifying drugs (bDMARDs). The aim of this study was to explore the patients' perspective of foot impairments related to early RA.

METHODS: The sample included 59 patients (20-63 years) who were interviewed about participation dilemmas in daily life using the Critical Incident Technique. The interviews were audio-recorded and transcribed. Data related to foot impairments were extracted and analyzed thematically. A research partner validated the analysis. The study was approved by the Regional Ethics Committee.

RESULTS: Patients with early RA described a variety of participation restrictions related to foot impairments: 1) foot hindrances in domestic life, 2) foot impairments influencing work, 3) leisure activities restricted by one's feet 4) struggling to be mobile 5) foot impairments as an early sign of rheumatic disease.

CONCLUSION: There is a need to focus on foot impairments related to early RA, and for health care professionals to understand these signs. A suggestion for future research is to conduct a longitudinal follow-up of foot impairment related to medication, disease activity and disability in patients diagnosed after the introduction of bDMARDs. This article is protected by copyright. All rights reserved.

OBJECTIVE: The objective was to create a linguistically and culturally validated Swedish version of the Valued Life Activities scale. The aim was also to describe its content and concurrent validity and its internal consistency in persons with rheumatoid arthritis.

METHODS: The Valued Life Activities scale was translated to Swedish and culturally adapted. In order to describe the content validity, both the Swedish and original Valued Life Activities scale were linked to the International Classification of Functioning, Disability and Health. The concurrent validity and internal consistency were evaluated in 737 patients with rheumatoid arthritis. To establish concurrent validity, the scale was correlated to disease activity, activity limitations, and life satisfaction. Internal consistency was assessed with Cronbach's alpha.

RESULTS: The equivalence of meaning between the Swedish and the original Valued Life Activities scale was ensured by harmonization review. Content validity was high when linked to the International Classification of Functioning, Disability and Health. Concurrent validity showed a strong correlation with the activity limitations (r = 0.87), moderate with life satisfaction (r = -0.61), and weak with disease activity (r = 0.38). Internal consistency was excellent (Cronbach's alpha = 0.97).

CONCLUSIONS: The Swedish Valued Life Activities scale has been tested in a large and well-characterized sample and found to be a linguistically valid and culturally adapted self-reported measure of participation. Content validity of the Valued Life Activities scale was excellent, concurrent validity strong, and the internal consistency excellent. Since both individual preferences and International Classification of Functioning, Disability and Health concepts of disability are taken into account, the Swedish Valued Life Activities scale appears to be a promising new scale addressing important aspects of participation.

BackgroundNew technologies such as mobile/smartphones have the potential to help senior people perform everyday activities. However, senior people may find it difficult using mobile/smartphones, especially the digital calendar and short text message features. Therefore, senior people might need user-friendly, flexible, and interactive digital calendars that provide them with active reminders about their everyday activities. This study focuses on community dwelling seniors experiences learning and using RemindMe, an interactive digital calendar with active reminders, as part of customizing an intervention appropriate for senior people with cognitive impairments.MethodsFour focus groups were conducted with 20 community dwelling seniors (11 men and 9 women) who all had used RemindMe for six weeks. The focus groups were tape recorded, transcribed verbatim, and analysed using content analysis.ResultsFor participants in this study, using a calendar was an essential part of their everyday lives, but only a few had experiences using a digital calendar. Although the participants described RemindMe as easy to use, they had a difficult time incorporating RemindMe into their daily routines. In part, these difficulties were the result of the participants needing to change their mobile/smartphone routines. Some participants felt that using an interactive digital calendar was a sign of modernity allowing them to take part in the society at large, but others felt that their inability to use the technology was due to their age, dependence, and loss of function. Participants found that receiving active reminders through short text messages followed by actively acknowledging the reminder helped them perform more everyday life activities. This feature gave them a higher sense of independence and control.ConclusionsCommunity dwelling seniors found that RemindMe was easy to learn and to use, although they also found it challenging to integrate into their everyday lives. For senior people to make the effort to develop new routines for mobile/smartphone use, a prerequisite for using a digital calendar, they need to be motivated and believe that the technology will make their lives better.

Objective: Adolescents’ leisure activities are increasingly focusing on Internet activities, and today, these coexist with traditional leisure activities such as sport and meeting friends. The purpose of the present study was to investigate leisure activities, particularly Internet activities, among boys and girls with ADHD, and compare these with boys and girls from the general population. The objective was also to explore how traditional leisure activities and Internet activities interrelate among adolescents with ADHD. 

Method: Adolescents with ADHD (n = 102) were compared with adolescents from the general population on leisure activities and Internet use. 

Results: Leisure activities among adolescents with ADHD tended to focus on Internet activities, particularly online games. Internet activities were broadening leisure activities among adolescents with ADHD, rather than being a substitute for traditional leisure activities. 

Conclusion: Internet activities may provide adolescents with ADHD accessible means of social interaction.

The aim of the study was to describe the occupational transition process to upper secondary school, further education and/or work, and to discover what support influences the process from the perspectives of young adults with Asperger’s disorder (AS) or attention deficit/hyperactivity disorder (ADHD). This qualitative study comprised semi-structured interviews with 15 young adults with AS or ADHD, eight men and seven women (aged 20 to 29 years). Most of the participants were attending community-based day centres at local businesses. Analysis identified three different occupational transition pathways following compulsory school. Support influencing the occupational transition process included: occupational transition preparation in compulsory school, practical work experience in a safe environment, and support beyond the workplace. The overall understanding shows that the occupational transition process was a longitudinal one starting as early as in middle school, and continuing until the young adults with AS and ADHD obtained and were able to remain in employment or further education. Support from community-based day centres was described both as an important step towards finding employment in the regular labour market in which participants could develop practical work experience, and as being too far away from the regular labour market.

Introduction: One type of support in school that holds promise for students with attention deficit hyperactivity disorder (ADHD) is the use of information and communication technology (ICT) such as computers and Internet. Computer use in educational activities may be one promising tool to support academic performance of students with ADHD experiencing difficulties in school. However, students with ADHD may be overlooked regarding available support compared with students with physical disabilities.Objectives: The aim of this study was to investigate computer use in educational activities by students with attention deficit hyperactivity disorder (ADHD) in comparison with that of students with physical disabilities and students from the general population.Methods: The design of the study was cross-sectional with group comparison. Students with a primary diagnosis of ADHD and related disorders were recruited from habilitation centres (HCs). Students with ADHD (n=102) were pairmatched in terms of age and sex with students with physical disabilities and students from the general population (n = 940) were used as a reference group.Results: Students with ADHD reported significantly less frequent use of computers for almost all educational activities compared with students with physical disabilities and students from the general population. Students with ADHD reported low satisfaction with computer use in school. In addition, students with ADHD reported a desire to use computers more often and for more activities in school compared with students with physical disabilities. Conclusion: From an equality perspective, it is essential to enable students with ADHD to use computers in educational activities. Contribution to the practice/evidence base of occupational therapy: Focusing on promoting computer use in educational activities in school for students with physical disabilities as well as students with ADHD is an emerging field in occupational therapy.

Aim: The aim of the study was to examine the usability of an interactive web-based mobile reminder calendar (RemindMe) developed for supporting individuals in organizing, planning and executing activities in everyday life, from the perspectives of professionals.

Methods and material: Eleven professionals working in community services evaluated the usability of RemindMe in their clinical practice. Data were collected using semi-structured interviews and analysed with inductive qualitative analysis.

Results: The professionals perceived that RemindMe was useful, easy to use, and intuitive. There was a need among professionals for a web-based reminder calendar that requires the active acknowledgement of reminders. RemindMe's feedback system offering self-monitored information based on the user's interaction with the system supported the professionals in discussions, evaluation, and follow-up based on the needs of the persons with cognitive impairments.

Conclusion: The results indicate that RemindMe may be potentially useful to professionals who provide support to individuals with cognitive impairments. However, further research is needed to evaluate experience of using RemindMe from the perspective of individuals with cognitive impairments.

The purpose of this study was to describe and explore the experiences of support at school among young adults with Asperger’s disorder (AS) and attention-deficit/hyperactivity disorder (ADHD), and also to examine what support they, in retrospect, described as influencing learning. Purposive sampling was used to enroll participants. Data were collected through semi-structured interviews with thirteen young adults aged between 20-29 years. A qualitative analysis, based on interpreting people’s experiences was conducted by grouping and searching for patterns in data. The findings indicate that the participants experienced difficulties at school that included academic, social and emotional conditions, all of which could influence learning. Support for learning included small groups, individualized teaching methods, teachers who cared, and practical and emotional support. These clusters together confirm the overall understanding that support for learning aligns academic and psychosocial support. In conclusion, academic support combined with psychosocial support at school seems to be crucial for learning among students with AS and ADHD.

This article reports research findings on how gaze-based assistive technology contributed to performance of daily activities for a group of children with severe physical impairments and without speech.

This study aims to describe and explore parents’ experiences when their children with severe physical impairments receive gaze-based assistive technology (gaze-based AT) for use in daily life. Semi-structured interviews were conducted twice, with one year in between, with parents of eight children with cerebral palsy that used gaze-based AT in their daily activities. To understand the parents’ experiences, hermeneutical interpretations were used during data analysis. The results demonstrate that for parents, children’s gaze-based AT usage meant that children demonstrated agency, provided them with opportunities to show  personality and competencies, and gave children possibilities to develop. Overall, children’s gaze-based AT provides hope to parents for a better future for their children with severe physical impairments; a future in which the children can develop and gain influence in life. In conclusion, gaze-based AT provides children with new opportunities to perform activities and take initiatives to communicate, giving parents hope about the children’s future.

Objective: To establish the impact of a gaze-based assistive technology (AT) intervention on activity repertoire, autonomous use, and goal attainment in children with severe physical impairments, and to examine parents’ satisfaction with the gaze-based AT and with services related to the gaze-based AT intervention.

Methods: Non-experimental multiple case study with before, after, and follow-up design. Ten children with severe physical impairments without speaking ability (aged 1–15 years) participated in gaze-based AT intervention for 9–10 months, during which period the gaze-based AT was implemented in daily activities.

Results: Repertoire of computer activities increased for seven children. All children had sustained usage of gaze-based AT in daily activities at follow-up, all had attained goals, and parents’ satisfaction with the AT and with services was high.

Discussion: The gaze-based AT intervention was effective in guiding parents and teachers to continue supporting the children to perform activities with the AT after the intervention program.

Gaze-based assistive technology (gaze-based AT) has the potential to provide children affected by severe physical impairments with opportunities for communication and activities. This study aimed to examine changes in eye gaze performance over time (time on task and accuracy) in children with severe physical impairments, without speaking ability, using gaze-based AT. A longitudinal study with an AB design was conducted on ten children (aged 1–15 years) with severe physical impairments, who were beginners to gaze-based AT at baseline. Thereafter, all children used the gaze-based AT in daily activities over the course of the study. Compass computer software was used to measure time on task and accuracy with eye selection of targets on screen, and tests were performed with the children at baseline, after 5 months, 9–11 months, and after 15–20 months. Findings showed that the children improved in time on task after 5 months and became more accurate in selecting targets after 15–20 months. This study indicates that these children with severe physical impairments, who were unable to speak, could improve in eye gaze performance. However, the children needed time to practice on a long-term basis to acquire skills needed to develop fast and accurate eye gaze performance.

The aim of the study was to identify problematic situations in using zebra crossings. They were identified from photo documentations comprising film sequences and the perspectives of people with dementia. The aim was also to identify how they would understand, interpret and act in these problematic situations based on their previous experiences and linked to the film sequences.

A qualitative grounded theory approach was used. Film sequences from five zebra crossings were analysed. The same film sequences were used as triggers in two focus group interviews with persons with dementia. Individual interviews with three informants were also performed.

The core category, the hazard of meeting unfolding problematic traffic situations when only one layer at a time can be kept in focus, showed how a problematic situation as a whole consisted of different layers of problematic situations. The first category, adding layers of problematic traffic situations to each other, was characterized by the informants’ creation of a problematic situation as a whole. The different layers were described in the subcategories of layout of streets and zebra crossings, weather conditions, vehicles and crowding of pedestrians. The second category, actions used to meet different layers of problematic traffic situations, was characterized by avoiding problematic situations, using traffic lights as reminders and security precautions, following the flow at the zebra crossing and being cautious pedestrians.

In conclusion, as community-dwelling people with dementia commonly are pedestrians, it is important that health care professionals and caregivers take their experiences and management of problematic traffic situations into account when providing support.

Bakgrund: Autismspektrumtillstånd utmärker sig främst genom bristande verbal- och ickeverbal kommunikation, nedsatt social ömsesidighet och en oförmåga att skapa samt bibehålla relationer. Detta innebär en aktivitetsproblematik inom; ADL, fritid, skola och arbete.

Syfte: Att undersöka vilka arbetsterapeutiska interventioner som finns för ungdomar och vuxna personer med autismspektrumtillstånd.

Metod: En systematisk litteraturstudie utfördes med sammanlagt 23 artiklar som inkluderades. Databassökningen utfördes i de fyra databaserna; PubMed, AMED, CINAHL och Scopus.

Resultat: Det framkom fyra teman; 1) skapa förutsättningar för aktiviteter, 2) träna sociala färdigheter, med två underteman; 2.1) träna sociala färdigheter med datorprogram, 2.2) träna sociala färdigheter med rollspel, 3.) träna motoriska färdigheter och träna i aktivitet samt 4) handledning.

Konklusion: Det framkom att sociala färdigheter är fokus för arbetsterapeutisk intervention. Även att teknikstöd och rollspel var vanligt förekommande för unga vuxna och vuxna med AST.

Using a meta-analysis, meta-regression, and a meta-epidemiological approach, we conducted a systematic review to examine the influence of interdisciplinary multimodal pain therapy (IMPT) dosage on pain, disability, return to work, quality of life, depression, and anxiety in published randomised controlled trials (RCTs) in patients with non-specific chronic low back pain (CLBP). We considered all RCTs of IMPT from a Cochrane review and searched PubMed for additional RCTs through 30 September 2018. A subgroup random-effects meta-analysis by length, contact, and intensity of treatment was performed followed by a meta-regression analysis. Using random and fixed-effect models and a summary relative odds ratio (ROR), we compared the effect sizes (ES) from short-length, non-daily contact, and low-intensity RCTs with long-length, daily contact, and high-intensity RCTs. Heterogeneity was quantified with the I-2 metric. A total of 47 RCTs were selected. Subgroup meta-analysis showed that there were larger ES for pain and disability in RCTs with long-length, non-daily contact, and low intensity of treatment. Larger ES were also observed for quality of life in RCTs with short-length, non-daily contact, and low intensity treatment. However, these findings were not confirmed by the meta-regression analysis. Likewise, the summary RORs were not significant, indicating that the length, contact, and intensity of treatment did not have an overall effect on the investigated outcomes. For the outcomes investigated here, IMPT dosage is not generally associated with better ES, and an optimal dosage was not determined.

Background Guidance during Meals is a two-week inpatient intervention undertaken at the Folke Bernadotte Regional Habilitation Centre, Sweden, to help parents deal with children's eating problems. Parents are given advice about medical and/or behavioural reasons for food selectivity and possible treatment strategies. Aims To identify the way parents handle mealtimes and associated difficulties and investigate parents' opinion on children's progress using Guidance during Meals. Method A questionnaire, consisting of 30 statements and answered by 41 parents, was used to investigate parents' opinions regarding the success of the intervention in altering their child's eating habits at home. Findings Most parents thought that the intervention had helped them and their child, by teaching them how to guide their child during mealtimes, what made it easier for their child to eat, and how to communicate with their child in an encouraging way. Most children retained their increased interest in eating once back at home. These results were not dependent on time of onset of eating problems, number of intervention periods, length of time since the intervention, or gastrostomy. Conclusion The Guidance during Meals intervention helps parents develop knowledge about factors that hinder or facilitate eating in their child and tools that can help their child finish meals, and gives them a sense of hope that positive change can occur.

In 2016, more than 65 million people were refugees for reasons of feared persecution, conflict, violence etc. Refugees have an increased risk of decreased health, and for them to handle their new situation, it is important to engage in activities. Leisure is an important part of life during adolescence and the aim of this study was to investigate what activities young adults who had fled to Sweden performed in their leisure time and how these activities were experienced. Data was collected through 18 activity diaries and six interviews. The collected data was analyzed by descriptive quantitative analysis and descriptive qualitative analysis. The results showed that the participants mostly (59%) perceived their leisure activities as "extremely meaningful" or "meaningful". The ability of self-determination and the social context had impacts on the perceived meaningfulness of leisure. Examples of activities that were performed most in leisure time were playing football, playing games, and religious activities. The amount of leisure and the activities that were performed in leisure time varied depending on how each individual perceived their leisure. The perception of activity and leisure is subjective and affects the value of each activity for the individual.

Bakgrund: Det är viktigt för äldres välbefinnande och hälsa att känna delaktighet i aktivitet. Delaktighet i aktivitet påverkas av individens egna förutsättningar och miljöns utformning. Hemmet är en viktig aktivitetsmiljö där många äldre spenderar mycket tid. Det är vanligt att äldre flyttar till ett särskilt boende när de är i behov av hjälp och stöd för att klara sin vardag. Syfte: Att studera hur miljön påverkar äldres delaktighet i aktivitet på särskilt boende. Metod: En kvalitativ studie innefattande sju intervjuer med äldre och observationer på tre olika särskilda boenden har genomförts. Resultat: I resultatet framkom de fem kategorierna bristande tillgänglighet i den fysiska miljön, tillgångar i den fysiska miljön, betydelsen av hjälpmedel, betydelsen av att interagera med andra människor samt personalens betydelse för de äldres delaktighet i aktivitet. Den fysiska miljöns utformning bidrog till att de äldre inte uppfattade det särskilda boendet som hemlikt då de inte fick plats med alla de personliga tillhörigheter de önskade. Det visade sig att många äldre kände sig ensamma och inte upplevde någon samhörighet med de medboende. Gemensamma aktiviteter var mycket uppskattat av de äldre bland annat eftersom det gav dem en möjlighet att interagera med andra. Konklusion: Den fysiska och den sociala miljön på ett särskilt boende kunde både främja och hindra äldres delaktighet i aktivitet.

People with mental disabilities have difficulty obtaining and keeping a job in the regular labor market. The target group is at greater risk of developing illness, as they are often excluded from the labor market due to their difficulties and their needs for adaptations in the work environment. The purpose of this study is to describe how people with mental disabilities who have received interventions through the ‘Supported Employment’ method experience their work environment and how it affects their well-being. Seventeen people with different mental disabilities and with experience of a specific work environment participated in the study. The ‘Work Environment Impact Scale’ (WEIS) assessment was used for data collection along with the associated interview guide to gather information about how the participants perceived their work environment. In the results it emerged that factors such as cooperation with coworkers, job design, the stimulus of work, working hours, and the value and importance of work were the factors that were most supportive for well-being in the work environment. The most obstructive factors for well-being in the work environment were the work demands, benefits, sensory characteristics, expectations of performance at work, and work tools. Several studies show that a soundly functioning work environment is important in order to perform at work. More studies are needed that focus on developing work environment interventions that help people with mental disabilities to enjoy and keep their jobs. 

The Nintendo Wii is a gaming console with motion-sensitive controls that is making inroads into health care and rehabilitation. However, there is still limited knowledge on how elderly people perceive the use of such a product. The aim of this study was to examine how the use of the Wii Sports Bowling in an activity group was perceived by elderly people. The data consisted of observations and interviews with participants who used Wii Sports Bowling and was analysed with content analysis. The findings are described in three themes; ‘The use of the Wii Sports game’, ‘Engagement in the game’ and ‘Social interaction around the activity’. Wii Sports Bowling was described as easier to play compared to real-life bowling and was enjoyable and a social activity. The opportunity to meet the group each week was important for the participants. Playing the game resulted in signs of immersion and a flow-like state. The Wii was perceived to be easy to use, to provide a way to socialize with peers and to give opportunities to participate in activities in a new way. More studies regarding elderly people’s experiences and apprehensions regarding new technology such as gaming consoles and virtual reality are needed.

The presented MOHO intervention methods; strategies and interventions, for facilitating change has not been investigated in practice in Sweden. MOHO is often seen as an assessment model. Many assessments have been translated and tested for scientific standard in Sweden but the intervention part has not been noticed in the same way. The aim of the presented survey was to investigate the use of the methods for facilitating change with MOHO in a Swedish context. Ten OT in the area of mental health were invited to partaken in the survey. In their daily work they reported on a questionnaire which methods they used if they were applying MOHO in the treatment sessions together with the client. Regarding therapeutic strategies in total 78 treatment sessions were reported. After following a treatment planning process including different MOHO assessments depending on the client ́s needs, it was stated that the main areas of concern for the clients were volition or habit or performance capacity to almost the same extent for all three elements. The result show that two of the strategies; “Validation” and “Identifying” was use most frequently. “Providing Physical Support” and “Negotiating” was used very sparingly. The most surprising result was that ”Structuring” was rated as number 6of the 9 strategies. When OT describe what they are doing, structuring daily occupations very often is mention as a regular intervention. The interventions are currently being tested, the results will be presented in September.

The Interest Checklist was translated into Swedish already in 1987 but it has never been adapted to Swedish context. And, since MOHO has been updated severely times since 1983 it was advisable to initially make asurvey in Sweden examining interests’ people do today.

In total 76 people participated by filling in a questionnaire investigated to what extent the interests on the list were carried out today by adults. The responder could add new interests and they could make comments to the list. Based on the feedback and national surveys on how leisure time in Sweden is spend an updated list was designed. The different interests were categorized into sex areas; Outdoor interests, Exercise, Productivity - at home, Art and creative, Social, and Others. All, 68, interests are stated extensively in verbform and arranged in alphabetical order within each group. New interests have been added, others have been updated, clarified or removed. Example of new interests is "Networks and be active on social media (eg Facebook, Instagram, Blogs)". Example of updated interest is "Clothes", which now is called "Follow fashion (eg clothes, makeup)". Some interests have been removed either because they are part of one of the new interests or because they are not a leisure interest, for example "Housecleaning”. The new Swedish version, completed in 2019, has also been related to the latest MOHO (2017) and ICF. An assessment manual has been developed with an introduction, theoretical ground, instructions to self-report and additionally a case has been added.

Background​: Daily activity centre is an LSS initiative for people of working age. Retirement can often cause reduced participation in activity and few studies relate to how the person should be involved in his own retirement decision. Purpose​: To describe how people with intellectual disabilities perceive occupational participation after and in conjunction with retirement from a daily activity centre. Method​: An empirical study using a qualitative method, with a combined criteria and snowball sampling method resulted in eleven interviews. The interview guide had its theoretical foundation in the Model of Human Occupation. Transcribed data was analysed by systematic text condensation. Result​: The first theme presents positive and negative perceptions of participation in retirement. In general, there was a diffuse perception of why the retirement occurred. The next theme includes participation in the residence that was associated with making independent decisions. The third theme emphasizes that occupational participation was promoted by performing activities that were meaningful before retirement. The final theme distinguishes participation in social contexts as important for well-being and the perception of belonging. Discussion​: In order for the participants to achieve an optimal retirement transition, individualized preparations are required. The importance of decision-making can be related to experience from institutional care. The society provided accessible activities which offered variety in the physical and social environment. Conclusion​: Preparation, successive transition, opportunities to engage in decision-making and join a social network were important to perceptions of occupational participation after retirement.

Assistive technology (AT) can be used as early intervention in order to reduce activity limitations in play and communication. This longitudinal case study examines eye-gaze control technology as early intervention for a young child with high spinal cord injury without the ability to make sounds. The young child was followed by repeated measures concerning performance and communication from baseline at 9 months to 26 months, and finalized at 36 months by field observations in the home setting. The results showed eye-gaze performance and frequency of use of eye-gaze control technology increased over time. Goals set at 15 months concerning learning and using the AT; naming objects and interactions with family was successfully completed at 26 months. Communicative functions regarding obtaining objects and social interaction increased from unintentional actions to purposeful choices and interactions. At 36 months, the toddler was partly independent in eye gazing, used all activities provided, and made independent choices. In conclusion, the results show that a 9-month-old child with profound motor disabilities can benefit from eye-gaze control technology in order to gradually perform activities, socially interact with family members, and make choices.

Purpose: To systematically review research concerning parent-child agreement in health-related assessments to reveal overall agreement, directions of agreement, and the factors that affect agreement in ratings. Method: The Uni-Search and five additional databases were searched. Childrens health issues were grouped into psychosocial issues including autism and ADHD, and physical and performance issues including pain. Measures used for comparison were those addressing (a) psychosocial functioning, (b) physical and performance functioning, and (c) health-related quality of life. Results: Totally, 39 studies met the inclusion criteria, comprising 44 analyses in all since four studies contained more than one analyses. Moderate child-parent agreement was demonstrated in 23 analyses and poor agreement in 20 analyses. Several analyses found more agreement on observable/external than on non-observable/internal domains. Overall, parents considered their children had more difficulties than did the children themselves, although there were indications that for children with physical performance issues, parents may underreport their childrens difficulties in emotional functioning and pain. There were no consistencies in differences between childrens and parents ratings on levels of agreement with respect to the childrens health issue, age or gender. Conclusions: Discrepancies between child and parent reports seem to reflect their different perspectives and not merely inaccuracy or bias. IMPLICATIONS FOR REHABILITATION In general, parents consider their children to have more difficulties - or more extensive difficulties than the children themselves think they have. The perspectives of the child and his or her parents should be sought whenever possible since both constitute important information concerning the childs health and well-being. Children with physical and performance issues reported more difficulties than their parents concerning the childrens emotional functioning and pain. Clinicians should prioritize obtaining childrens views on subjective aspects such as emotional issues as well as on pain.

The United Nations' position is that digital access is a matter involving equality between groups of people, the securing of democratic rights, and equal opportunities for all citizens. This study investigates digital equality in school and leisure between young people with and without disabilities. A cross-sectional design with group comparisons was applied. Participants were young people (10–18 years of age) with disabilities (n=389) and a reference group in about the same ages. Data were collected by a survey focusing on access to and engagement in ICT activities in school and during leisure time. The results demonstrated young people with disabilities had restricted participation in computer use in educational activities, in comparison to young people in general. During leisure time young people with disabilities had a leading position compared to the reference group with respect to internet use in a variety of activities. Beneficial environmental conditions at home (and the reverse in schools) are discussed as parts of the explanation for the differing engagement levels at home and in school, and among young people with disabilities and young people in general.

Conclusion: Schools need to prioritise use of ICT by young people with disabilities.

This session focuses on the latest developments of gaze-based assistive technology (AT) and the impact of gaze-based AT interventions in the home and at school. In particular, for play, communication, assessments and early intervention. The discussion focuses on how research findings can advance future developments.

This is a case study exploring gaze-based AT as early intervention, for a ten-month-old non-verbal child with severe physical impairments. Data was collected repeatedly over time through questionnaires, videos clips, and field observations until the child was three years old.