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Eklund, C., Elfström, M. & Söderlund, A. (2019). At two step evaluation procedure of the web-application My Stress Control: feasibility and effect. In: : . Paper presented at 10th Scientific Meeting of the International Society for Research on Internet Interventions (ISRII), Auckland, New Zeeland, 13-15 February, 2019.
Open this publication in new window or tab >>At two step evaluation procedure of the web-application My Stress Control: feasibility and effect
2019 (English)Conference paper, Oral presentation only (Other academic)
Abstract [en]

Context: Stress preventive interventions should support behaviour change. Web-based programs are less resource demanding than face-to-face solutions. For the purpose of supporting behaviour change in persons with work related stress, the web-based program My Stress Control (MSC) was developed. The aim of this study was to evaluate the feasibility and effect of MSC.

Methods: MSC’s feasibility was tested with 14 end-users before evaluating its effect in a two-armed RCT with 95 persons. The same procedure as for the RCT was used in the feasibility study. Questionnaires were used as data collection method. The primary outcome was perceived stress.

Intervention: MSC was built on evidence regarding theoretical frame, content and informational design. MSC is tailored to each individual by Stages of Change and with a functional behaviour analysis (FBA) conducted by the users in interactive assignments, steering the user to stress-management strategies. Techniques supporting behavioural change are integrated throughout the program.

Results: The feasibility of MSC reached above the pre-set cut-off score. The results of the RCT revealed no significant differences between groups in the primary outcome, but a small effect size was shown between intervention and wait-list group. Adherence was low with 25% of the participants in the intervention group responding to post assessment. 

Conclusions: It is still uncertain if MSC is an effective method for supporting behaviour change in persons with work related stress. Further development must be conducted regarding adherence before next evaluation study. Nevertheless, the small effect size encourages further development and evaluation of MSC.

National Category
Physiotherapy
Identifiers
urn:nbn:se:mdh:diva-46315 (URN)
Conference
10th Scientific Meeting of the International Society for Research on Internet Interventions (ISRII), Auckland, New Zeeland, 13-15 February, 2019
Funder
AFA Insurance, 130263
Available from: 2019-12-12 Created: 2019-12-12 Last updated: 2019-12-17Bibliographically approved
Gustafsson, L.-K., Östlund, G., Zander, V., Elfström, M. & Anbäcken, E.-M. (2019). ‘Best fit’ caring skills of an interprofessional team inshort-term goal-directed reablement: older adults’perceptions. Scandinavian Journal of Caring Sciences, 33(2), 498-506
Open this publication in new window or tab >>‘Best fit’ caring skills of an interprofessional team inshort-term goal-directed reablement: older adults’perceptions
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2019 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 33, no 2, p. 498-506Article in journal (Refereed) Published
Abstract [en]

This paper reports a study conducted to illuminate older adults’ perceptions of multiproffesional team's caring skills as success factors for health support in short-term goal-directed reablement. The fact that older adults are given perquisites to live in their own homes puts great demands on the professional care given them at home. An option offered could be short-term goal-directed reablement delivered by an interprofessional team. This means after periods in hospitals to strengthen their multidimensional health, older adults’ reablement processes are supported to return to their daily life as soon as possible. Crucial in making these intentions a reality seems to be identifying the professional's approach that works as success factors for health support in the reablement process. A descriptive qualitative design with a phenomenographic approach based on interviews with 23 older persons who had received short-term goal-directed reablement at home after a period at hospital was used. The study was approved by an ethical board. The analysis revealed four major referential aspects of multiproffesional team's caring skills as success factors for health-support in short-term goal-directed reablement: a motivating caregiver, a positive atmosphere-creating caregiver, a human fellowship-oriented caregiver and a caregiver that goes beyond the expected. In this study, all caring skills in the continuum are perceived as positively loaded necessities in different situations during the reablement process. Caring skills as success factors are initially shown at a practical level, such as how the professional caregivers encourage and motivate the older persons in different training situations. At a deeper level, the caregivers open their hearts and have the capacity to go beyond the expected in the professional caregiver–patient relationship. The multiproffesional team's best fit caring skills during the home reablement process need to be addressed as evidence base in the area of elderly home care.

National Category
Medical and Health Sciences Health Sciences
Identifiers
urn:nbn:se:mdh:diva-42493 (URN)10.1111/scs.12650 (DOI)000472973400025 ()30653689 (PubMedID)2-s2.0-85060252366 (Scopus ID)
Available from: 2019-01-29 Created: 2019-01-29 Last updated: 2020-03-12Bibliographically approved
Elfström, M., Wulff Hamrin, C. & Östlund, G. (2019). Correlates of desire to work in persons visiting psychiatric outpatient clinics. In: : . Paper presented at 33rd annual conference of the European Health Psychology Society, Dubrovnik, September 3-7, 2019..
Open this publication in new window or tab >>Correlates of desire to work in persons visiting psychiatric outpatient clinics
2019 (English)Conference paper, Oral presentation only (Other academic)
Abstract [en]

Persons with mental health problems often express a clear desire to work, although whatfactors that contribute to this healthy aspiration are less clear. The purpose of this study thuswas to explore person, healthcare, and work-related factors in relation to desire to work inpersons visiting psychiatric outpatient clinics. The sample consisted of 272 persons visitingone of four psychiatric outpatient centres from two county councils in the south of Sweden.The possible participants were asked if they wanted to participate in research while waitingfor their scheduled appointments. A comprehensive questionnaire consisting of factors inthe research literature as well as factors advocated by patient organisations was used. Theparticipants’ ratings were analysed using non-parametric group comparisons and logisticregressions. Free-text answers were analysed by content. Higher education, better mentalhealth self-efficacy, and more experiences of demands and conflicts at the workplace wereall significantly related to desire to work in bivariate analyses. However, fighting spirit andsocial support at work had the strongest associations with desire to work in the multivariatelogistic analyses. The Nagelkerke R2 was .34. Free text answers indicated the importanceof managers’ role for the psychosocial work climate, and for receiving help with structuringthe workday to allow recovery after sickness absence. In contrast to the traditional prevocationalrehabilitation approach, and in line with a supportive work environment approach,the results points to the possibility to influence a further improved desire to work throughsupportive leadership and an open and communicative psychosocial climate.

Keywords
work status, support from care, prejudices in care, fighting spirit, mental health self-efficacy, severe mental illness
National Category
Applied Psychology
Research subject
Social Work
Identifiers
urn:nbn:se:mdh:diva-45247 (URN)
Conference
33rd annual conference of the European Health Psychology Society, Dubrovnik, September 3-7, 2019.
Funder
AFA Insurance, 150096
Available from: 2019-09-19 Created: 2019-09-19 Last updated: 2019-11-15
Östlund, G., Anbäcken, E.-M., Gustafsson, L.-K., Zander, V. & Elfström, M. (2019). Interprofessional homebased reablement intervention of older adults - reflecting on possible trends based on the RCT pilot study.. In: : . Paper presented at International conference on geriatrics and gerontology (IAGG-ER). Göteborg, 24-25 maj.
Open this publication in new window or tab >>Interprofessional homebased reablement intervention of older adults - reflecting on possible trends based on the RCT pilot study.
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2019 (English)Conference paper, Oral presentation with published abstract (Refereed)
National Category
Social Sciences
Identifiers
urn:nbn:se:mdh:diva-46044 (URN)
Conference
International conference on geriatrics and gerontology (IAGG-ER). Göteborg, 24-25 maj
Available from: 2019-11-14 Created: 2019-11-14 Last updated: 2019-12-17Bibliographically approved
Östlund, G., Zander, V., Elfström, M., Gustafsson, L.-K. & Anbäcken, E.-M. (2019). Older adults’ experiences of a reablement process.: "To be treated like an adult, and ask for what I want and how I want it". Educational gerontology, 45(8), Article ID https://doi.org/10.1080/03601277.2019.1666525.
Open this publication in new window or tab >>Older adults’ experiences of a reablement process.: "To be treated like an adult, and ask for what I want and how I want it"
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2019 (English)In: Educational gerontology, ISSN 0360-1277, E-ISSN 1521-0472, Vol. 45, no 8, article id https://doi.org/10.1080/03601277.2019.1666525Article in journal (Refereed) Published
Abstract [en]

This is a follow-up study of intensive home-based rehabilitation from older people’s perspectives. The aim was to explore older adults’ descriptions of interactional needs related to autonomy in life. The purpose was also to explore the importance of significant others in the reablement process.

Method: The sample consisted of 23 women aged 72–92 who were included consecutively in the first project year. Data were collected through face-to-face semi-structured interviews that were recorded, transcribed, and analyzed using qualitative latent content analysis.

Results: Regaining autonomy through reablement was achieved by the interviewees although not always to the same extent as before. Three themes related to interactional needs were identified: (1) Transitional relations, referring to encounters with staff in time-limited relations. (2) More stable relations with significant others without limitation of time. (3) The acceptance of growing older and of death as a “natural departure”. Transitional relations with professionals, and more stable relations with significant others, are important parts of the reablement process according to older adults.

In conclusion: Professionals within gerontology need to recognize the social and historical context including the symbolic meanings each older person gives to life’s necessaries. Older adults appreciate reablement which includes rehabilitation goals related to the person’s stable relationships and larger life context.

National Category
Social Sciences Health Sciences
Research subject
Social Work
Identifiers
urn:nbn:se:mdh:diva-41258 (URN)10.1080/03601277.2019.1666525 (DOI)000486894500001 ()2-s2.0-85074283281 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2017-00126
Available from: 2018-10-31 Created: 2018-10-31 Last updated: 2019-12-13
Eklund, C., Elfström, M., Eriksson, Y. & Söderlund, A. (2019). User experiences from a web-based, self-management programme: struggling with what I need when stress management is about me. European Journal of Physiotherapy, 39-48
Open this publication in new window or tab >>User experiences from a web-based, self-management programme: struggling with what I need when stress management is about me
2019 (English)In: European Journal of Physiotherapy, ISSN 2167-9169, E-ISSN 2167-9177, p. 39-48Article in journal (Refereed) Published
Abstract [en]

Objectives: To explore users’ experiences of a tailored, interactive web application that supports behaviour change in stress management and to identify if and in that case what in the web-based programme that needed further development or adjustment to be feasible in a randomised controlled trial.

Method: The design of this study was explorative with a qualitative approach. Nine individuals were recruited among the staff at a university. Semi-structured individual interviews were conducted and analysed using qualitative content analysis, after the participants had completed the web-based stress management programme.

Results: One theme was identified, Struggling with what I need when stress management is about me, describing the paradox in having a programme that is perceived as supporting stress management while also being perceived as extensive and time consuming. The theme was divided in two categories: Defining the needs, where the users expressed what they needed from the programme and their everyday environment, to be able to use the programme, and It is about me, where the programme was described as helping the users understand their own stress.

Conclusion: The participants expressed acceptance of using a web-based programme for stress related problems. The perceived extensiveness of the programme must be considered in further development.

Place, publisher, year, edition, pages
Taylor & Francis Group, 2019
Keywords
stress management, behaviour change, behaviour medicine, content analysis, e-health
National Category
Medical and Health Sciences Other Medical Sciences
Research subject
Care Sciences
Identifiers
urn:nbn:se:mdh:diva-40273 (URN)10.1080/21679169.2018.1468814 (DOI)000470063000008 ()2-s2.0-85046429289 (Scopus ID)
Available from: 2018-07-20 Created: 2018-07-20 Last updated: 2019-11-11
Gustafsson, L.-K., Anbäcken, E.-M., Zander, V., Elfström, M. L. & Östlund, G. (2019). Working with short-term goal-directed reablement with older adults: strengthened by a collaborative approach. Nordic journal of nursing research, 39(4), 178-185
Open this publication in new window or tab >>Working with short-term goal-directed reablement with older adults: strengthened by a collaborative approach
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2019 (English)In: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 39, no 4, p. 178-185Article in journal (Refereed) Published
Abstract [en]

The increased number of older adults who experience longevity requires increased investment in healthcare services. Short-term goal-directed reablement is expected to strengthen the functional capacity and quality of life of older adults, while homecare hours, and thus municipal expenditures, decrease. Facilitation of successful interprofessional collaboration includes not only enhancing coordination structurally, but also establishing a commitment regarding culture that overcomes professionally differentiated attitudes. Nurses have an obvious role in these multi-professional teams and the study explores some aspects' of working in this type of collaboration. The aim was to illuminate the meaning of working with short-term goal-directed reablement of older adults as experienced by an interprofessional team. Data were collected after an intervention with goal-directed time-limited reablement of older people. Written narratives from an interprofessional team were analyzed using a phenomenological-hermeneutic approach. Findings identified four major thematic structures that characterized the meaning: 1) Reliable relationship; including the aspects ‘Confidence between the older adult and staff’, ‘A sense of security’ and ‘Continuity’, 2) Empowered participation, including the following aspects: ‘Listen to the older adult’s desires’ and ‘Put the person in control’, 3) Team with a negotiated approach, including the aspects: ‘Closeness’, ‘Same direction and overarching goal’, ‘Learning from interprofessional dialogue’, 4) Time for growth with the aspects ‘Creating harmony’ and ‘Building the older adult’s self-confidence’. The process of reablement seemed strengthened by the collaborative approach of different professions and their combined efforts. The present study argues that teamwork gives confidence both in terms of general knowledge of reablement but also specific confidence in one’s profession.

National Category
Medical and Health Sciences Health Sciences
Identifiers
urn:nbn:se:mdh:diva-45848 (URN)10.1177/2057158519850974 (DOI)
Available from: 2019-10-25 Created: 2019-10-25 Last updated: 2019-12-09Bibliographically approved
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
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: 2019-11-11
Eklund, C., Elfström, M., Eriksson, Y. & Söderlund, A. (2018). Evaluation of a Web-Based Stress Management Application: A Feasibility Study. Journal of Technology in Behavioral Science, 3(3), 150-160
Open this publication in new window or tab >>Evaluation of a Web-Based Stress Management Application: A Feasibility Study
2018 (English)In: Journal of Technology in Behavioral Science, ISSN 2366-5963, Vol. 3, no 3, p. 150-160Article in journal (Refereed) Published
Abstract [en]

The aim of the current study was to investigate the feasibility of a Web-based program that promotes behavior change for stress-related problems in terms of the program’s acceptability, practicability, and any possible effects. In addition, the aim was also to study how appropriate and realistic the study’s process and resource management would be for conducting a randomized controlled trial. A convenience sample consisting of 14 individuals was recruited from a university in Sweden. The participants had access to the program for a duration of 9 weeks. Questionnaires were answered before accessing, during use of, and after completing the program. Both qualitative and quantitative data were collected and analyzed. The program was considered acceptable and practically feasible, though small adjustments have to be made. The program was considered time-consuming, extensive, and in need of some clarifications. Regarding process and resource management, the study participants required minimum support. It was difficult to identify the time point when to send out the process measures because the participants worked at their own pace. Also, one of the process measurements, the motivation to change, remained stable. With some adjustments to the instructions to the study participants and minor changes in the program, the intervention and study’s procedure were considered as feasible and can be carried out in a randomized controlled trial.

Place, publisher, year, edition, pages
Springer, 2018
Keywords
stress, internet, behaviour change, occupational stress, health promotion, feasibility
National Category
Medical and Health Sciences Health Sciences
Research subject
Care Sciences
Identifiers
urn:nbn:se:mdh:diva-40272 (URN)10.1007/s41347-018-0044-8 (DOI)30238058 (PubMedID)
Funder
AFA Insurance, 130263
Available from: 2018-07-20 Created: 2018-07-20 Last updated: 2019-11-11
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-5098-8489

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