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Snögren, A. & Gustafsson, L.-K. (2019). Physiotherapy: How to work with evidence in daily practice. Journal of Evaluation In Clinical Practice, 25(2), 216-223
Open this publication in new window or tab >>Physiotherapy: How to work with evidence in daily practice
2019 (English)In: Journal of Evaluation In Clinical Practice, ISSN 1356-1294, E-ISSN 1365-2753, Vol. 25, no 2, p. 216-223Article in journal (Refereed) Published
Abstract [en]

Rationale, aims, and objectives The concept of evidence-based health care has gained increasing currency over the past decades; however, questions persist regarding how to overcome the gap between research and health care practice. The question arises whether this gap derives from a true knowledge deficit or from physiotherapists' perception of working with evidence. The aim of the current study was to illuminate changes to the meaning of working with evidence experienced by a cohort of physiotherapists following an education program. Methods A phenomenological hermeneutic design with open-ended group interviews was carried out with physiotherapists who had participated in an education program about evidence and how to implement evidence-based practice (EBP) in day-to-day practice. Findings The interviews provided descriptions of working with evidence according to three major themes: "Confidence with the concept of evidence in relation to a way of working"; "Experience of EBP as a duty to seek evidence for individual patients"; and "EBP experienced as an integrated and patient-oriented activity". Conclusions The physiotherapists' lived experiences demonstrated that the participants' perception of the concept of evidence mainly concerned a broadening of the definition of evidence, and this altered perception of evidence could interpreted as the physiotherapists viewing EBP as a more integrated and patient-oriented activity than before.

Place, publisher, year, edition, pages
WILEY, 2019
Keywords
education, elder care, evidence-based practice, physiotherapy, primary care, professional development
National Category
Physiotherapy
Identifiers
urn:nbn:se:mdh:diva-43021 (URN)10.1111/jep.13035 (DOI)000461883800007 ()30259604 (PubMedID)2-s2.0-85053862849 (Scopus ID)
Available from: 2019-04-04 Created: 2019-04-04 Last updated: 2019-04-10Bibliographically approved
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: 2018-10-26Bibliographically approved
Gustafsson, L.-K., Mattsson, K., Dubbelman, K. & Snöljung, Å. (2014). Aspects of nursing with evidence-base when nursing frail older adults: a phenomenographic analysis of interviews with nurses in municipal care. Scandinavian Journal of Caring Sciences, 28(4), 793-801
Open this publication in new window or tab >>Aspects of nursing with evidence-base when nursing frail older adults: a phenomenographic analysis of interviews with nurses in municipal care
2014 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, ISSN 0283-9318, Vol. 28, no 4, p. 793-801Article in journal (Refereed) Published
Abstract [en]

In earlier research as well as in political discussion and documents, the topic of evidence has been highlighted as one of the most important concerns in nursing care. This study focuses on understanding what lies behind nurses' ways of acting regarding evidence-based nursing through an illumination of the way they perceive the phenomena.AIM: The aim was to identify and describe the different ways municipal care nurses perceive aspects of working with evidence when nursing frail older adults.METHODS: An explorative design with a phenomenographic approach based on interviews with nurses working with home-based care within the municipality was used in order to gain understanding of nurse's perceptions of the phenomena.RESULTS: Findings revealed that the nurses perceived a variety of aspects when working with evidence when nursing frail older people. Aspects with a spectra of different perceptions shown in the analysis were as follows: Evidence-based nursing as a desired intention/mission, lack of practical supporting structures to apply evidence, lack of confidence in own capacity to apply evidence and a belief that it will work anyway.CONCLUSIONS: Findings reveal that it is a challenge to implement research both on an individual as well as on an organisational level. Understanding the contextual perceptions of evidence by nurses can cast light on the barriers as well as the prerequisites of working with evidence while caring for frail older adults in municipal care.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2014
Keywords
evidence, frail older adults, municipal care, nursing, phenomenographic analysis., evidens, sköra äldre, kommunal hemsjukvård, fenomenografi
National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-26732 (URN)10.1111/scs.12112 (DOI)000345314000020 ()24433250 (PubMedID)2-s2.0-84892468316 (Scopus ID)
Projects
EKUAHLs
Available from: 2014-12-01 Created: 2014-12-01 Last updated: 2017-12-05Bibliographically approved
Snöljung, Å., Gustafsson, L.-K. & Mattsson, K. (2014). The diverging perception among physiotherapists of how to work with the concept of evidence: A phenomenographic analysis. Journal of Evaluation In Clinical Practice, 20(6), 759-766
Open this publication in new window or tab >>The diverging perception among physiotherapists of how to work with the concept of evidence: A phenomenographic analysis
2014 (English)In: Journal of Evaluation In Clinical Practice, ISSN 1356-1294, E-ISSN 1365-2753, Vol. 20, no 6, p. 759-766Article in journal (Refereed) Published
Abstract [en]

Rationale, aims and objectives

Changes in Sweden's municipal care have impacted the situation of physiotherapists by the adoption of practice based on research evidence. Even if physiotherapists appear to be in favour of the idea of evidence-based practice, barriers still exist that prevent many from keeping up with current research. The aim of this study was to identify and describe the different ways in which physiotherapists in municipal care perceive the concept of evidence in rehabilitation.

Methods

A phenomenographic design with semi-structured interviews was carried out with physiotherapists working with frail older people in three municipal care units in two neighbouring municipalities in Sweden. The physiotherapists' perceptions of evidence were explored in 12 interviews.

Results

Distinct perceptions of the concept of evidence are identified in three categories: ‘Confidence with the concept of evidence in relation to measurement instruments’; ‘Perception of evidence-based practice as a duty, condition and demand of the profession’; and ‘Evidence-based work as a separate rather than directly patient-oriented activity’.

Conclusions

Physiotherapists take full responsibility to comply with what they perceive to be the demands of their profession. However, what evidence actually meant, and therefore what the practical element of this responsibility consisted of, was not as clear.

Place, publisher, year, edition, pages
John Wiley & Sons, 2014
Keywords
evidence-based practice, frail older adults, municipal care, phenomenographic analysis, physiotherapy
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:mdh:diva-25112 (URN)10.1111/jep.12167 (DOI)000350450200005 ()24815563 (PubMedID)2-s2.0-84922943616 (Scopus ID)
Available from: 2014-06-05 Created: 2014-06-05 Last updated: 2019-06-26Bibliographically approved
Ahlgren, Å., Bergroth, A., Ekholm, J. & Ekholm, K. S. (2008). Selection of clients for vocational rehabilitation at six local social insurance offices: a combined register and questionnaire study on rehabilitation measures and attitudes among social insurance officers.. Journal of Rehabilitation Medicine, 40(3), 178-184
Open this publication in new window or tab >>Selection of clients for vocational rehabilitation at six local social insurance offices: a combined register and questionnaire study on rehabilitation measures and attitudes among social insurance officers.
2008 (English)In: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 40, no 3, p. 178-184Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: The aim of this study was to evaluate possible differences between local social insurance offices with regard to their selection of clients for vocational rehabilitation. A further aim was to determine whether social insurance officers from different local insurance offices have uniform attitudes regarding professional practice in their application of the insurance system. METHODS: A register-based investigation of 815 vocational rehabilitees served by 6 local social insurance offices in a Swedish county. The study was supplemented with a questionnaire to 30 officers about attitudes to social insurance. RESULTS: The office with the lowest rate of sick-listing periods exceeding one year, and a high frequency of employment training, showed the highest degree of work resumption and the lowest pension rate after vocational rehabilitation. There were wide differences in attitude among the local social insurance officers regarding professional practice in their application of the system. CONCLUSION: Intra-county differences occur in handling people on sick-leave who undergo vocational rehabilitation. The local social insurance offices with the highest and lowest outcome rates of work resumption and disability pension, respectively, select clients for vocational rehabilitation from different categories of cases. Social insurance officers from different local offices differ in their attitudes towards the social insurance system and its clients.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:mdh:diva-10752 (URN)10.2340/16501977-0157 (DOI)000254393600004 ()18292918 (PubMedID)2-s2.0-41349085204 (Scopus ID)
Available from: 2010-11-03 Created: 2010-11-03 Last updated: 2017-12-12Bibliographically approved
Ahlgren, Å., Bergroth, A., Ekholm, J. & Schüldt, K. (2007). Work resumption after vocational rehabilitation: a follow-up two years after completed rehabilitation. Work: A journal of Prevention, Assesment and rehabilitation, 28(4), 343-354
Open this publication in new window or tab >>Work resumption after vocational rehabilitation: a follow-up two years after completed rehabilitation
2007 (English)In: Work: A journal of Prevention, Assesment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 28, no 4, p. 343-354Article in journal (Refereed) Published
Abstract [en]

A short-term evaluation of vocational rehabilitation (VR) may give conclusions not automatically applicable over a longer term. The present study follows up alterations in work resumption or in social insurance benefits from the time of completed VR and during the following two years. AIM: The primary objective was to evaluate work resumption among previous sick-leavers granted vocational rehabilitation. The aim of the follow-up was to assess the stability of the outcome of VR over time and to analyse factors of importance for clients that remained at work. METHOD: A register investigation was based on 815 cases where the clients had taken part in vocational rehabilitation and were served by one of six local social insurance offices of a Swedish county. RESULTS: Of the clients studied, 52.4% had attained full working capacity The proportion had decreased to 37.4% two years later. One factor that differed between those who resumed work and those who returned to sick leave was the duration of the previous sick-leave period. Those who returned to work had had shorter sick leave, had jobs to return to and had received job training as a vocational rehabilitation measure. CONCLUSIONS: The clients with the best chances of being in work two years after completed vocational rehabilitation were those with short sickness absence, who had been selected for job training as a vocational rehabilitation, were aged 16-29 years and were employed in industry.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:mdh:diva-10750 (URN)17522455 (PubMedID)2-s2.0-34249650073 (Scopus ID)
Available from: 2010-11-03 Created: 2010-11-03 Last updated: 2017-12-12Bibliographically approved
Ahlgren, A., Broman, L., Bergroth, A. & Ekholm, J. (2005). Disability pension despite vocational rehabilitation?: A study from six social insurance offices of a county. International Journal of Rehabilitation Research, 28(1), 33-42
Open this publication in new window or tab >>Disability pension despite vocational rehabilitation?: A study from six social insurance offices of a county
2005 (English)In: International Journal of Rehabilitation Research, ISSN 0342-5282, E-ISSN 1473-5660, Vol. 28, no 1, p. 33-42Article in journal (Refereed) Published
Abstract [en]

Many long-term sick-listed individuals move from vocational rehabilitation to pension, rather than reaching the goal of return to work. There is thus reason to consider whether rehabilitation resources are being used optimally. Individuals receiving disability pensions are consuming financial and personnel resources at the insurance offices and also consume a large amount of health care. The general objective of the study was to evaluate the proportion of individuals granted vocational rehabilitation but then obtaining temporary or permanent disability pensions. All persons receiving any kind of rehabilitation and attending one of six local national insurance offices in a county in Sweden in 1998 and 1999 were studied. A 2-year follow-up was carried out to assess changes in status among those who had received temporary disability pensions. Of all individuals receiving rehabilitation, 46.2% ended up with a disability pension allowance. In addition, a large portion of the temporary disability pensions was transformed to permanent disability pensions within 2 years. For clients with a temporary disability pension, the rate of resuming work was close to nil. Among rehabilitation measures, investigation showed the lowest figures of work resumption while job training showed the best outcome in this respect. The study concluded that a large portion of the financial and personnel resources allocated by the national insurance offices to rehabilitation resulted in disability pensions.

National Category
Occupational Therapy Health Care Service and Management, Health Policy and Services and Health Economy
Identifiers
urn:nbn:se:mdh:diva-10751 (URN)10.1097/00004356-200503000-00005 (DOI)000227940200005 ()15729095 (PubMedID)2-s2.0-15444368953 (Scopus ID)
Available from: 2010-11-03 Created: 2010-11-03 Last updated: 2017-12-12Bibliographically approved
Ahlgren, A., Bergroth, A. & Ekholm, J. (2004). Work resumption or not after rehabilitation?: A descriptive study from six social insurance offices. International Journal of Rehabilitation Research, 27(3), 171-180
Open this publication in new window or tab >>Work resumption or not after rehabilitation?: A descriptive study from six social insurance offices
2004 (English)In: International Journal of Rehabilitation Research, ISSN 0342-5282, E-ISSN 1473-5660, Vol. 27, no 3, p. 171-180Article in journal (Refereed) Published
Abstract [en]

The objective of this study was to describe measures and outcomes of vocational rehabilitation at six local national insurance offices in the same county in Sweden. Data were collected from mainframe registers and other records at each office. There were great differences in sickness allowance, incapacity rate, selected rehabilitation measures and resuming work. The percentage of sick-listed people who received any rehabilitation measure differed from 1.2 to 8.7%. The gender distribution for the study population was 36% men and 64% women and the predominant diagnosis was musculoskeletal pain conditions, which was followed by psychiatric disorders. Outcomes varied from office B, which reported 58% fully fit after completed planned rehabilitation, to office C, which reported only 24% fully fit. The clear differences in outcome between the offices indicate that various rehabilitation measures differ in effectiveness. The rehabilitation measure 'investigation of working ability' was not linked to any great proportion of people resuming work, but showed a greater correspondence to full disability pension. There were also large differences in social and demographic factors in the different municipalities. The effect of these on the rehabilitation process requires further investigation.

National Category
Occupational Therapy Other Health Sciences
Identifiers
urn:nbn:se:mdh:diva-10754 (URN)10.1097/00004356-200409000-00001 (DOI)000224163900001 ()15319686 (PubMedID)2-s2.0-4744351082 (Scopus ID)
Available from: 2010-11-03 Created: 2010-11-03 Last updated: 2017-12-12Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-1023-2046

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