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Publications (10 of 25) Show all publications
Fritz, J., Söderlund, A., Wallin, L., Almqvist, L. & Sandborgh, M. (2019). EXPERIENCES OF USING THE MEDICAL RESEARCH COUNCIL GUIDANCE FOR PROCESS EVALUATION. In: Advances in Health Care Sciences Conferences, Karolinska Insitutet, Stockholm, 13-14 November, 2019.: . Paper presented at Advances in Health Care Sciences Conferences, Karolinska Insitutet, Stockholm, 13-14 November, 2019..
Open this publication in new window or tab >>EXPERIENCES OF USING THE MEDICAL RESEARCH COUNCIL GUIDANCE FOR PROCESS EVALUATION
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2019 (English)In: Advances in Health Care Sciences Conferences, Karolinska Insitutet, Stockholm, 13-14 November, 2019., 2019Conference paper, Oral presentation with published abstract (Refereed)
National Category
Medical and Health Sciences Health Sciences
Identifiers
urn:nbn:se:mdh:diva-46056 (URN)
Conference
Advances in Health Care Sciences Conferences, Karolinska Insitutet, Stockholm, 13-14 November, 2019.
Available from: 2019-11-15 Created: 2019-11-15 Last updated: 2019-12-17Bibliographically approved
Fritz, J., Wallin, L., Söderlund, A., Almqvist, L. & Sandborgh, M. (2019). Implementation of a behavioral medicine approach in physiotherapy: A process evaluation of facilitation methods. Implementation Science, 14(1), Article ID 94.
Open this publication in new window or tab >>Implementation of a behavioral medicine approach in physiotherapy: A process evaluation of facilitation methods
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2019 (English)In: Implementation Science, ISSN 1748-5908, E-ISSN 1748-5908, Vol. 14, no 1, article id 94Article in journal (Refereed) Published
Abstract [en]

Background: In a quasi-experimental study, facilitation was used to support implementation of the behavioral medicine approach in physiotherapy. The facilitation consisted of an individually tailored multifaceted intervention including outreach visits, peer coaching, educational materials, individual goal-setting, video feedback, self-monitoring in a diary, manager support, and information leaflets to patients. A behavioral medicine approach implies a focus on health related behavior change. Clinical behavioral change was initiated but not maintained among the participating physiotherapists. To explain these findings, a deeper understanding of the implementation process is necessary. The aim was therefore to explore the impact mechanisms in the implementation of a behavioral medicine approach in physiotherapy by examining dose, reach, and participant experiences. Methods: An explorative mixed-methods design was used as a part of a quasi-experimental trial. Twenty four physiotherapists working in primary health care were included in the quasi-experimental trial, and all physiotherapists in the experimental group (n = 15) were included in the current study. A facilitation intervention based mainly on social cognitive theory was tested during a 6-month period. Data were collected during and after the implementation period by self-reports of time allocation regarding participation in different implementation methods, documentation of individual goals, ranking of the most important implementation methods, and semi-structured interviews. Descriptive statistical methods and inductive content analysis were used. Results: The physiotherapists participated most frequently in the following implementation methods: outreach visits, peer coaching, educational materials, and individual goal-setting. They also considered these methods to be the most important for implementation, contributing to support for learning, practice, memory, emotions, self-management, and time management. However, time management support from the manager was lacking. Conclusions: The findings indicate that different mechanisms govern the initiation and maintenance of clinical behavior change. The impact mechanisms for initiation of clinical behavior change refers to the use of externally initiated multiple methods, such as feedback on practice, time management, and extrinsic motivation. The lack of self-regulation capability, intrinsic motivation, and continued support after the implementation intervention period were interpreted as possible mechanisms for the failure of maintaining the behavioral change over time. 

Place, publisher, year, edition, pages
BioMed Central Ltd., 2019
National Category
Physiotherapy
Identifiers
urn:nbn:se:mdh:diva-46027 (URN)10.1186/s13012-019-0942-y (DOI)000494477200001 ()31684977 (PubMedID)2-s2.0-85074548087 (Scopus ID)
Available from: 2019-11-14 Created: 2019-11-14 Last updated: 2019-11-21
Yuwanich, N., Akhavan, S., Nantsupawat, W., Martin, L., Elfström, M. & Sandborgh, M. (2018). Development and psychometric properties of the stressor scale for emergency nurses. International Emergency Nursing, 39, 77-88
Open this publication in new window or tab >>Development and psychometric properties of the stressor scale for emergency nurses
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2018 (English)In: International Emergency Nursing, ISSN 1755-599X, E-ISSN 1878-013X, Vol. 39, p. 77-88Article in journal (Refereed) Published
Abstract [en]

Introduction: Emergency department nurses are exposed to specific stressors and report higher stress levels than nurses in other hospital departments. This study aimed to develop and test the psychometric properties of a questionnaire-based instrument for identifying stressors for emergency department nurses. Methods: The instrument's content and face validities were examined by five experts and nurses in emergency nursing field. The test-retest reliability was examined on 30 emergency department nurses. The construct validity, including an exploratory and a confirmatory factor analysis, was tested on 405 emergency department nurses. Cronbach's alpha values and intra-class coefficients were calculated. Results: The instrument's content and face validities were satisfactory. The exploratory factor analysis provided a five-factor solution, whereas the confirmatory factor analysis provided a final four-factor solution with 25 items distributed among the factors Life and death situations, Patients' and families' actions and reactions, Technical and formal support, and Conflicts. The Cronbach's alpha values ranged from 0.89 to 0.93 per factor, and the intra-class correlation coefficient was 0.89, indicating good homogeneity and stability. Conclusions: The instrument's content, face, and construct validities were satisfactory, and the internal consistency and test-retest reliability were good. This instrument can be useful in the management of emergency departments.

Place, publisher, year, edition, pages
ELSEVIER SCI LTD, 2018
Keywords
Emergency room nursing, Instrument development, Occupational stress, Questionnaire, Validation
National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-40256 (URN)10.1016/j.ienj.2018.01.005 (DOI)000436593800012 ()29409734 (PubMedID)2-s2.0-85041302081 (Scopus ID)
Available from: 2018-07-19 Created: 2018-07-19 Last updated: 2019-11-12
Sandborgh, M., Elvén, M., von Heideken Wågert, P., Snöljung, Å. & Söderlund, A. (2018). IMPLEMENTATION OF BEHAVIORAL MEDICINE IN A PHYSIOTHERAPY UNDERGRADUATE CURRICULUM STUDENT EVALUATIONS. International Journal of Behavioral Medicine, 25, S64-S65
Open this publication in new window or tab >>IMPLEMENTATION OF BEHAVIORAL MEDICINE IN A PHYSIOTHERAPY UNDERGRADUATE CURRICULUM STUDENT EVALUATIONS
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2018 (English)In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 25, p. S64-S65Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
SPRINGER, 2018
National Category
Physiotherapy Psychology
Identifiers
urn:nbn:se:mdh:diva-41224 (URN)000446532700205 ()
Available from: 2018-10-25 Created: 2018-10-25 Last updated: 2019-11-11
Asenlof, P., Igelstrom, H., Sandborgh, M. & Fritz, J. (2018). INTEGRATION OF PHYSIOTHERAPY IN BEHAVIORAL MEDICINE INTERVENTION RESEARCH. International Journal of Behavioral Medicine, 25(Suppl 1:1), S3-S3
Open this publication in new window or tab >>INTEGRATION OF PHYSIOTHERAPY IN BEHAVIORAL MEDICINE INTERVENTION RESEARCH
2018 (English)In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 25, no Suppl 1:1, p. S3-S3Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
SPRINGER, 2018
National Category
Physiotherapy Psychology
Identifiers
urn:nbn:se:mdh:diva-41222 (URN)10.1007/s12529-018-9740-1 (DOI)000446532700014 ()
Available from: 2018-10-25 Created: 2018-10-25 Last updated: 2019-11-12
Fritz, J., Söderbäck, M., Sandborgh, M. & Söderlund, A. (2018). The complexity of integrating a behavioral medicine approach into physiotherapy clinical practice. Physiotherapy Theory and Practice
Open this publication in new window or tab >>The complexity of integrating a behavioral medicine approach into physiotherapy clinical practice
2018 (English)In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040Article in journal (Refereed) Published
Abstract [en]

Introduction and Aim: The implementation of a behavioral medicine (BM) approach in physiotherapy is challenging, and studies regarding the determinants are sparse. Thus, the aim of this study was to explore determinants of applying a BM approach in physiotherapy for patients with persistent pain across the micro-, meso-, and macro-levels. Methods: A qualitative multiple-case study design was used. Data were collected from four cases through semi-structured interviews with physiotherapists (PTs), patients, and managers; observations of video-recorded treatment sessions; and reviews of local directives and regulations. Data were analyzed with inductive content analysis and cross-case analysis, followed by mapping to the domains of determinants at the micro-, meso-, and macro-levels within the Implementation of Change Model. Results: Similar determinants were found across the cases. At the micro-level, these determinants concerned the PTs’ ambivalence toward a BM approach, a biomedical focus, embarrassment asking about psychosocial factors, BM knowledge, skills for applying the approach, and self-awareness. Others concerned the patients’ role expectations of the PT, patients as active or passive agents in the treatment process, patients’ focus on biomedical aspects, and confidence in the PT. At the meso-level, support from managers and peers, allocation of time, and expectations from the organization were identified as determinants. No determinants were identified at the macro-level. Conclusion: The complexity of integrating a BM approach into physiotherapy clinical practice arises from multiple determinants functioning as both facilitators and barriers. By selecting strategies to address these determinants, the implementation of a BM approach could be supported.

Keywords
Behavioral medicine,  physiotherapy,  clinical practice,  determinant,  facilitator,  barrier
National Category
Medical and Health Sciences
Research subject
Physiotherapy
Identifiers
urn:nbn:se:mdh:diva-41172 (URN)10.1080/09593985.2018.1476996 (DOI)29847287 (PubMedID)2-s2.0-85047962277 (Scopus ID)
Funder
AFA Insurance, 12169
Available from: 2018-10-15 Created: 2018-10-15 Last updated: 2019-11-11
Fritz, J., Söderlund, A., Wallin, L., Almqvist, L. & Sandborgh, M. (2018). THE EFFECT OF FACILITATION WHEN IMPLEMENTING A BEHAVIORAL MEDICINE APPROACH IN PHYSICAL THERAPY PRIMARY HEALTH CARE. International Journal of Behavioral Medicine, 25, S38-S38
Open this publication in new window or tab >>THE EFFECT OF FACILITATION WHEN IMPLEMENTING A BEHAVIORAL MEDICINE APPROACH IN PHYSICAL THERAPY PRIMARY HEALTH CARE
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2018 (English)In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 25, p. S38-S38Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
SPRINGER, 2018
National Category
Physiotherapy Psychology
Identifiers
urn:nbn:se:mdh:diva-41223 (URN)000446532700125 ()
Available from: 2018-10-25 Created: 2018-10-25 Last updated: 2019-11-15
Fritz, J., Söderlund, A., Wallin, L., Almqvist, L. & Sandborgh, M. (2018). The effect of facilitation when implementing a behavioral medicine approach in physical therapy primary health care. Paper presented at International Congress of Behavioral Medicine, Santiago, Chile. 14-17 november 2018.. International Journal of Behavioral Medicine, 25(Supplement 1)
Open this publication in new window or tab >>The effect of facilitation when implementing a behavioral medicine approach in physical therapy primary health care
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2018 (English)In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 25, no Supplement 1Article in journal, Meeting abstract (Refereed) Published
National Category
Medical and Health Sciences Health Sciences
Identifiers
urn:nbn:se:mdh:diva-46055 (URN)10.1007/s12529-018-9740-1 (DOI)
Conference
International Congress of Behavioral Medicine, Santiago, Chile. 14-17 november 2018.
Funder
AFA Insurance, 12169
Available from: 2019-11-15 Created: 2019-11-15 Last updated: 2019-12-18Bibliographically approved
Fritz, J., Söderlund, A., Almqvist, L., Wallin, L. & Sandborgh, M. (2017). Implementation of a behavioural medicine approach in physiotherapy – a process evaluation.. In: World Confederation of Physical Therapy (WCPT) Congress, Cape Town, South Africa, 2-4 July, 2017.: . Paper presented at World Confederation of Physical Therapy (WCPT) Congress, Cape Town, South Africa, 2-4 July, 2017..
Open this publication in new window or tab >>Implementation of a behavioural medicine approach in physiotherapy – a process evaluation.
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2017 (English)In: World Confederation of Physical Therapy (WCPT) Congress, Cape Town, South Africa, 2-4 July, 2017., 2017Conference paper, Oral presentation with published abstract (Refereed)
Abstract [en]

Background: A behavioural medicine approach in physiotherapy for patients with persistent musculoskeletal pain is recommended based on evidence. The approach aims at an individually tailored treatment targeting motor behaviour, cognition, disability and active patient involvement. The behavioural medicine approach is complex and it is challenging in implementation to achieve clinically relevant behaviours in physiotherapy. Process evaluation is an essential part of designing and testing implementation interventions to improve the quality of the implementation. However, studies evaluating the implementation process of a behavioural medicine approach in physiotherapy are sparse.

Purpose: To explore the implementation process of a behavioural medicine approach in physiotherapy.

Methods: Qualitative and quantitative methods were used. 15 physiotherapists working in six primary health care units were consecutively included. A theory based implementation intervention was tailored to the participating individual physiotherapists. Active and multifaceted implementation strategies were used during a total of seven days spread over a six months implementation period. The main implementation strategies were external facilitation and peer-learning. Ten two-hours outreach sessions were offered to each unit. The physiotherapists were encouraged to use individual goal setting and video recordings of treatment sessions to facilitate feedback and reflection during the sessions with the external facilitator. Process data were collected using semi-structured interviews, self-reports of time allocation for different implementation strategies and documented individual goals. Qualitative content analysis and quantitative frequency scorings were used for data analyses.

Results: In median the physiotherapists participated in 9 (3-10) out of 10 sessions with the external facilitator. Discussing clinical experiences of the behavioural medicine approach together with the external facilitator was perceived as valuable. These discussions stimulated reflection and problem solving, and was also experienced as a reminder for practicing skills in behavioural medicine. Video recordings of treatment sessions were used by ten of the physiotherapists at 17 out of 57 possible sessions. Video recordings were experienced as too complicated to use in relation to the gains. Lack of time was also considered as a barrier for using video recordings. Individual goal-setting from one session to the next with the external facilitator was frequently used by all the participants. Relevant skills for the goals were practiced in between the sessions. However, goal setting was not considered important by the physiotherapists. In median the physiotherapists spent 3.25 (0-9.5) hours for peer discussions. Peer discussions were a strategy that the physiotherapists wanted to continue with, even after the implementation intervention period. Even though the physiotherapists had permission from the manager to spend time on the implementation intervention, it was challenging for the physiotherapists to prioritize the implementation intervention before patient care.

Conclusion(s): External facilitation and peer discussions were perceived as important strategies for stimulating practice of behavioural medicine skills in physiotherapy. Further, peer discussions could stimulate sustainability of the implementation. The physiotherapists needed support to use the designated time for the implementation.

Implications: Quantitative and qualitative analyses of the implementation process is useful for understanding the mechanisms of impact for the implementation intervention, how outcomes were achieved and for future replications.

Keywords
behavioural medicine, physical therapy, implementation, process evaluation
National Category
Medical and Health Sciences
Research subject
Physiotherapy
Identifiers
urn:nbn:se:mdh:diva-41203 (URN)
Conference
World Confederation of Physical Therapy (WCPT) Congress, Cape Town, South Africa, 2-4 July, 2017.
Funder
AFA Insurance, 12169
Available from: 2018-10-21 Created: 2018-10-21 Last updated: 2019-11-12
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: 2019-11-12
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-1912-3110

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