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Elvén, M., Hochwälder, J., Dean, E. & Söderlund, A. (2018). Development and initial evaluation of an instrument to assess physiotherapists' clinical reasoning focused on clients' behavior change. Physiotherapy Theory and Practice, 34(5), 367-383
Open this publication in new window or tab >>Development and initial evaluation of an instrument to assess physiotherapists' clinical reasoning focused on clients' behavior change
2018 (English)In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 34, no 5, p. 367-383Article in journal (Refereed) Published
Abstract [en]

Background and Aim: A systematically developed and evaluated instrument is needed to support investigations of physiotherapists' clinical reasoning integrated with the process of clients' behavior change. This study's aim was to develop an instrument to assess physiotherapy students' and physiotherapists' clinical reasoning focused on clients' activity-related behavior and behavior change, and initiate its evaluation, including feasibility and content validity. Methods: The study was conducted in three phases: 1) determination of instrument structure and item generation, based on a model, guidelines for assessing clinical reasoning, and existing measures; 2) cognitive interviews with five physiotherapy students to evaluate item understanding and feasibility; and 3) a Delphi process with 18 experts to evaluate content relevance. Results: Phase 1 resulted in an instrument with four domains: Physiotherapist; Input from client; Functional behavioral analysis; and Strategies for behavior change. The instrument consists of case scenarios followed by items in which key features are identified, prioritized, or interpreted. Phase 2 resulted in revisions of problems and approval of feasibility. Phase 3 demonstrated high level of consensus regarding the instrument's content relevance. Conclusions: This feasible and content-validated instrument shows potential for use in investigations of physiotherapy students' and physiotherapists' clinical reasoning, however continued development and testing are needed.

Place, publisher, year, edition, pages
TAYLOR & FRANCIS INC, 2018
Keywords
Behavior change, clinical reasoning, instrument development, physiotherapy, validity
National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-38826 (URN)10.1080/09593985.2017.1419521 (DOI)000425789400004 ()29405848 (PubMedID)
Available from: 2018-03-08 Created: 2018-03-08 Last updated: 2018-03-08Bibliographically approved
Eklund, C., Elfström, M., Eriksson, Y. & Söderlund, A. (2018). Development of the web application My Stress Control—Integrating theories and existing evidence. Cogent Psychology, 5(1), 1-19
Open this publication in new window or tab >>Development of the web application My Stress Control—Integrating theories and existing evidence
2018 (English)In: Cogent Psychology, Vol. 5, no 1, p. 1-19Article in journal (Refereed) Published
Abstract [en]

Aim: To describe the systematic development of an evidence-based, tailored, interactive web application for self-management of work-related stress, and to test usability issues regarding how to proceed through the programme. Methods: Evidence from the fields of stress management, behaviour change and web-based interventions was the foundation for the theoretical framework and content. The next step was the development process of the web application and validation among experts and one possible end user. Last, a usability test with 14 possible end users was conducted. Results: The web-application, My Stress Control (MSC), was built on a solid theoretical framework. It consists of 12 modules including: introduction, psychoeducation, ambivalence, stress management strategies, lifestyle change, and maintenance. Self-monitoring, goal-setting, re-evaluating goals, feedback, and prompting formulation of intention to change are central techniques supporting behaviour change. The usability test revealed difficulties in understanding how to proceed through the programme. Conclusion: The development contributes to filling a gap in the literature regarding development of complex web-based interventions. MSC is dissimilar to existing programs in the field, considering the tailoring and multi-tracked opportunities. Although developed from the evidence in multiple fields, the web application would benefit from further development to support users in reaching the end module.

Place, publisher, year, edition, pages
Cogent OA, 2018
Keywords
behaviour change, health promotion, internet, occupational stress, stress management, stress prevention
National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-40238 (URN)10.1080/23311908.2018.1489457 (DOI)000436962900001 ()2-s2.0-85049310511 (Scopus ID)
Funder
AFA Insurance, 130263
Available from: 2018-07-12 Created: 2018-07-12 Last updated: 2018-07-20
Söderlund, A., Nordgren, L., Sterling, M. & Stalnacke, B.-M. (2018). Exploring patients' experiences of the whiplash injury-recovery process - a meta-synthesis. Journal of Pain Research, 11, 1263-1271
Open this publication in new window or tab >>Exploring patients' experiences of the whiplash injury-recovery process - a meta-synthesis
2018 (English)In: Journal of Pain Research, ISSN 1178-7090, E-ISSN 1178-7090, Vol. 11, p. 1263-1271Article, review/survey (Refereed) Published
Abstract [en]

Purpose: The aim of this study was to conduct a meta-synthesis to analyze qualitative research findings and thereby understand patients' experiences of whiplash-associated disorders (WAD) and the injury-recovery process. Materials and methods: A qualitative meta-synthesis, which is an interpretive integration of existing qualitative findings, was performed. The databases PubMed, PsychINFO, Scopus, and Web of Science were searched. The Critical Assessment Skills Programme was used to assess the quality of the included studies. Results: Four studies were included. The synthesis resulted in several codes, 6 categories, and 3 themes (distancing from normalcy, self-efficacy in controlling the life situation after the injury, and readjustment and acceptance) that described the participants' pain beliefs, their WAD-related life situation and their future expectations and acceptance. Changes in self-image were difficult to cope with and likely led to perceived stigmatization. Struggling with feelings of loss of control appeared to lead to low confidence and insecurity. Focusing on increasing knowledge and understanding the pain and its consequences were believed to lead to better strategies for handling the situation. Furthermore, recapturing life roles, including returning to work, was challenging, but an optimistic outlook reinforced symptom improvements and contributed to feelings of happiness. Conclusion: The results of the present study provide a comprehensive understanding of patients' complex, multifaceted experiences of WAD, and the injury-recovery process. The findings can guide us in the development of new ways to evaluate and manage WAD. The results also indicate that a more patient-centered approach is needed to determine the depth and breadth of each patient's problems.

Place, publisher, year, edition, pages
DOVE MEDICAL PRESS LTD, 2018
Keywords
whiplash-associated disorders, control, self-efficacy, happiness, life situation
National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-40257 (URN)10.2147/JPR.S158807 (DOI)000437149100001 ()29988716 (PubMedID)
Available from: 2018-07-19 Created: 2018-07-19 Last updated: 2018-07-19Bibliographically approved
Söderlund, A. (2018). WHO's sustainable development goals and physiotherapy in 2018: editorial. European Journal of Physiotherapy, 20(1), 1-1
Open this publication in new window or tab >>WHO's sustainable development goals and physiotherapy in 2018: editorial
2018 (English)In: European Journal of Physiotherapy, ISSN 2167-9169, E-ISSN 2167-9177, Vol. 20, no 1, p. 1-1Article in journal, Editorial material (Other academic) Published
Place, publisher, year, edition, pages
ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD, 2018
National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-39362 (URN)10.1080/21679169.2018.1426700 (DOI)000432136500001 ()
Available from: 2018-05-31 Created: 2018-05-31 Last updated: 2018-05-31Bibliographically approved
Engquist, M., Lofgren, H., Oberg, B., Holtz, A., Peolsson, A., Söderlund, A., . . . Lind, B. (2017). A 5-to 8-year randomized study on the treatment of cervical radiculopathy: anterior cervical decompression and fusion plus physiotherapy versus physiotherapy alone. JOURNAL OF NEUROSURGERY-SPINE, 26(1), 19-27
Open this publication in new window or tab >>A 5-to 8-year randomized study on the treatment of cervical radiculopathy: anterior cervical decompression and fusion plus physiotherapy versus physiotherapy alone
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2017 (English)In: JOURNAL OF NEUROSURGERY-SPINE, ISSN 1547-5654, Vol. 26, no 1, p. 19-27Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE The aim of this study was to evaluate the 5- to 8-year outcome of anterior cervical decompression and fusion (ACDF) combined with a structured physiotherapy program as compared with that following the same physiotherapy program alone in patients with cervical radiculopathy. No previous prospective randomized studies with a follow-up of more than 2 years have compared outcomes of surgical versus nonsurgical intervention for cervical radiculopathy. METHODS Fifty-nine patients were randomized to ACDF surgery with postoperative physiotherapy (30 patients) or to structured physiotherapy alone (29 patients). The physiotherapy program included general and specific exercises as well as pain coping strategies. Outcome measures included neck disability (Neck Disability Index [NDI]), neck and arm pain intensity (visual analog scale [VAS]), health state (EQ-5D questionnaire), and a patient global assessment. Patients were followed up for 5-8 years. RESULTS After 5-8 years, the NDI was reduced by a mean score% of 21 (95% CI 14-28) in the surgical group and 11% (95% CI 4%-18%) in the nonsurgical group (p = 0.03). Neck pain was reduced by a mean score of 39 mm (95% CI 26-53 mm) compared with 19 mm (95% CI 7-30 mm; p = 0.01), and arm pain was reduced by a mean score of 33 mm (95% CI 18-49 mm) compared with 19 mm (95% CI 7-32 mm; p = 0.1), respectively. The EQ-5D had a mean respective increase of 0.29 (95% CI 0.13-0.45) compared with 0.14 (95% CI 0.01-0.27; p = 0.12). Ninety-three percent of patients in the surgical group rated their symptoms as "better" or "much better" compared with 62% in the nonsurgical group (p = 0.005). Both treatment groups experienced significant improvement over baseline for all outcome measures. CONCLUSIONS In this prospective randomized study of 5- to 8-year outcomes of surgical versus nonsurgical treatment in patients with cervical radiculopathy, ACDF combined with physiotherapy reduced neck disability and neck pain more effectively than physiotherapy alone. Self-rating by patients as regards treatment outcome was also superior in the surgery group. No significant differences were seen between the 2 patient groups as regards arm pain and health outcome.

Keywords
cervical radiculopathy, randomized, surgery, physiotherapy, anterior cervical decompression and fusion, outcome
National Category
Physiotherapy
Identifiers
urn:nbn:se:mdh:diva-34664 (URN)10.3171/2016.6.SPINE151427 (DOI)000390725200005 ()2-s2.0-85013176762 (Scopus ID)
Available from: 2017-01-19 Created: 2017-01-19 Last updated: 2017-03-02Bibliographically approved
Aytar, O., Tillgren, P., Söderlund, A., Bogg, L. & Akhavan, S. (2017). Health Care Provider’s Perceptions about and Experiences of Achieving Equitable Health Care: An Evaluation Study. Quality in Primary Care, 25(5), 289-296
Open this publication in new window or tab >>Health Care Provider’s Perceptions about and Experiences of Achieving Equitable Health Care: An Evaluation Study
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2017 (English)In: Quality in Primary Care, ISSN 1479-1072, E-ISSN 1479-1064, Vol. 25, no 5, p. 289-296Article in journal (Refereed) Published
Abstract [en]

Background: In June 2011 the Swedish government signed an agreement with The Swedish Association of Local Authorities and Regions (SALAR), for a three year project to develop and implement “Health care on equal terms.” The project, which involved seven Primary Health Care Units (PHCU) from five county councils in different parts in Sweden, was completed in early 2014. The aim of the project was to develop methods and activities that could promote more equal health care provision in socio-economically disadvantaged areas.

Aim: To assess and compare health care providers’ experiences of and perceptions about equitable health care at the beginning and end of the national project “Health care on equal terms”.

Methods: A web survey was sent to all staff at the seven participating Primary Health Care Units (PHCU) at the beginning (2012) and the end (2013) of the project. Data were analyzed with descriptive statistics and the open issues with content analysis.

Results: In 2013, the percentage of health care providers who reported thinking patients’ ethnicity had no or very little impact on access to care increased, but the proportion of those who reported that they had “no idea” that patients’ gender, age, mental health and physical functioning were significant for access to care was lower in 2013 than in 2012. The results from analysis of the open-ended questions did not show meaningful changes in the respondents’ perceptions of the issues addressed in 2012-2013, but the analysis contributes to a deeper explanation of the answers.

Conclusion: The main conclusion is that it was possible to implement changes aiming for more equitable care through projects with a focus on learning.

Place, publisher, year, edition, pages
London: , 2017
Keywords
Sweden; Primary health care providers; Equity; Health services research
National Category
Health Care Service and Management, Health Policy and Services and Health Economy Social Work
Research subject
Care Sciences; Social Work
Identifiers
urn:nbn:se:mdh:diva-37165 (URN)
Projects
Det nationella lärandeprojektet - Vård på lika villkor
Available from: 2017-10-31 Created: 2017-10-31 Last updated: 2018-01-09Bibliographically approved
Cederbom, S., Thunborg, C., Denison, E., Söderlund, A. & von Heideken Wågert, P. (2017). Home Help Service Staffs' Descriptions of Their Role in Promoting Everyday Activities Among Older People in Sweden Who Are Dependent on Formal Care.. Journal of Applied Gerontology, 36(8), 971-992
Open this publication in new window or tab >>Home Help Service Staffs' Descriptions of Their Role in Promoting Everyday Activities Among Older People in Sweden Who Are Dependent on Formal Care.
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2017 (English)In: Journal of Applied Gerontology, ISSN 0733-4648, E-ISSN 1552-4523, Vol. 36, no 8, p. 971-992Article in journal (Refereed) Published
Abstract [en]

The study aimed to explore how home help service staff described their role in improving the abilities of older people, in particular, older women with chronic pain who are dependent on formal care, to perform everyday activities. Three focus group interviews were conducted, and a qualitative inductive thematic content analysis was used. The analysis resulted in one theme: struggling to improve the care recipients' opportunities for independence but being inhibited by complex environmental factors. By encouraging the care recipients to perform everyday activities, the staff perceived themselves to both maintain and improve their care recipients' independence and quality of life. An important goal for society and health care professionals is to improve older people's abilities to "age in place" and to enable them to age independently while maintaining their quality of life. A key resource is home help service staff, and this resource should be utilized in the best possible way.

Keywords
dependency, focus group interviews, home help service staff, independency, older people, qualitative study, quality of life, rehabilitation, team
National Category
Physiotherapy
Identifiers
urn:nbn:se:mdh:diva-29398 (URN)10.1177/0733464815595511 (DOI)000404415600004 ()26209706 (PubMedID)2-s2.0-85021438772 (Scopus ID)
Available from: 2015-10-27 Created: 2015-10-27 Last updated: 2018-01-30Bibliographically approved
Söderlund, A., Sandborgh, M. & Johansson, A.-C. (2017). Is self-efficacy and catastrophizing in pain-related disability mediated by control over pain and ability to decrease pain in whiplash-associated disorders?. Physiotherapy Theory and Practice, 33(5), 376-385
Open this publication in new window or tab >>Is self-efficacy and catastrophizing in pain-related disability mediated by control over pain and ability to decrease pain in whiplash-associated disorders?
2017 (English)In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 33, no 5, p. 376-385Article in journal (Refereed) Published
Abstract [en]

Pain perception is influenced by several cognitive and behavioral factors of which some identified as mediators are important in pain management. We studied the mediating role of control over pain and ability to decrease pain in relation to functional self-efficacy, catastrophizing, and pain-related disability in patients with Whiplash-Associated Disorders, (WAD). Further, if the possible mediating impact differs over time from acute to three and 12 months after an accident, cross-sectional and prospective design was used, and 123 patients with WAD were included. Regression analyses were conducted to examine the mediating effect. The results showed that control over pain and ability to decrease pain were not mediators between self-efficacy, catastrophizing, and disability. Self-efficacy had a larger direct effect on pain-related disability compared to catastrophizing. Thus, healthcare staff should give priority to increase patients' self-efficacy, decrease catastrophic thinking, and have least focus on control over pain or ability to decrease pain.

Place, publisher, year, edition, pages
TAYLOR & FRANCIS INC, 2017
Keywords
Ability to decrease pain, catastrophizing, control over pain, self-efficacy, Whiplash-Associated Disorders
National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-35793 (URN)10.1080/09593985.2017.1307890 (DOI)000402066300004 ()28398100 (PubMedID)2-s2.0-85017420395 (Scopus ID)
Available from: 2017-06-15 Created: 2017-06-15 Last updated: 2018-01-24Bibliographically approved
Dean, E. & Söderlund, A. (2017). Komplekse problemstillinger. (Principles for Management of the Patient with Complex Co-morbidity). (2ed.). In: Lund, H., Bjørnlund, I.B., Sjöberg, N.E. (Ed.), Basisbog i Fysioterapi: . Copenhagen: Munksgaard Forlag
Open this publication in new window or tab >>Komplekse problemstillinger. (Principles for Management of the Patient with Complex Co-morbidity).
2017 (English)In: Basisbog i Fysioterapi / [ed] Lund, H., Bjørnlund, I.B., Sjöberg, N.E., Copenhagen: Munksgaard Forlag, 2017, 2Chapter in book (Other academic)
Place, publisher, year, edition, pages
Copenhagen: Munksgaard Forlag, 2017 Edition: 2
National Category
Physiotherapy
Research subject
Care Sciences
Identifiers
urn:nbn:se:mdh:diva-34874 (URN)978-87-628-1444-8 (ISBN)
Available from: 2017-02-15 Created: 2017-02-15 Last updated: 2017-02-16Bibliographically approved
Arkkukangas, M., Sundler, A. J., Söderlund, A., Eriksson, S. & Johansson, A.-C. (2017). Older persons' experiences of a home-based exercise program with behavioral change support. Physiotherapy Theory and Practice, 33(12), 905-913
Open this publication in new window or tab >>Older persons' experiences of a home-based exercise program with behavioral change support
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2017 (English)In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 33, no 12, p. 905-913Article in journal (Refereed) Published
Abstract [en]

Background: It is a challenge to promote exercise among older persons. Knowledge is needed regarding the maintenance of exercise aiming at preventing falls and promoting health and well-being in older persons. Purpose: This descriptive study used a qualitative inductive approach to describe older persons' experiences of a fall-preventive, home-based exercise program with support for behavioral change. Methods: Semi-structured interviews were conducted with 12 elderly persons aged 75years or older, and a qualitative content analysis was performed. Results: Four categories emerged: facilitators of performing exercise in everyday life, the importance of support, perceived gains from exercise, and the existential aspects of exercise. Conclusion: With support from physiotherapists (PTs), home-based exercise can be adapted to individual circumstances in a meaningful way. Including exercises in everyday life and daily routines could support the experience of being stronger, result in better physical functioning, and give hope for an extended active life in old age.

Place, publisher, year, edition, pages
TAYLOR & FRANCIS INC, 2017
Keywords
Community-living, motivational interviewing, older persons, Otago exercise program
National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-37405 (URN)10.1080/09593985.2017.1359869 (DOI)000416020200002 ()28812402 (PubMedID)2-s2.0-85027534558 (Scopus ID)
Available from: 2017-12-07 Created: 2017-12-07 Last updated: 2018-01-23Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-4537-030X

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