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  • 1.
    Bertilsson, Monica
    et al.
    Göteborgs universitet.
    Petersson, Eva-Lisa
    Göteborgs universitet.
    Östlund, Gunnel
    Linköpings universitet.
    Wearn, Magda
    Göteborgs universitet.
    Hensing, Gunnel
    Göteborgs universitet.
    Capacity to work while depressed and anxious - a phenomenological study2013In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 35, no 20, p. 1705-1711Article in journal (Refereed)
    Abstract [en]

    Purpose: The aim was to explore experiences of capacity to work in persons working while depressed and anxious in order to identify the essence of the phenomenon capacity to work. Method: Four focus groups were conducted with 17 participants employed within the regular job market. Illness experiences ranged from symptoms to clinical diagnoses. A phenomenological approach was employed. Results: The phenomenon of capacity to work was distinguished by nine constituents related to task, time, context and social interactions. The phenomenon encompassed a lost familiarity with one’s ordinary work performance, the use of a working facade and adoption of new time-consuming work practices. Feelings of exposure in interpersonal encounters, disruption of work place order, lost “refueling” and a trade-off of between work capacity and leisure-time activities was also identified. The reduced capacity was pointed out as invisible, this invisibility was considered troublesome. Conclusions: A complex and comprehensive concept emerged, not earlier described in work capacity studies. Rehabilitation processes would benefit from deeper knowledge of the individual’s capacity to work in order to make efficient adjustments at work. Results can have particular relevance both in clinical and occupational health practice, as well as in the workplaces, in supporting re-entering workers after sickness absence.Implications for Rehabilitation

    • The reduced capacity to work due to depression and anxiety is not always understandable or observable for others, therefore, the rehabilitation process would benefit from increased knowledge and understanding of the difficulties afflicted individuals experience at work.

    • Identifying tasks that contribute to “refueling” at work might enhance the success of the rehabilitation.

    • Rehabilitation programs could be tailored to better address the inabilities that impact on the capacity to work when depressed and anxious.

  • 2.
    Björck-Åkesson, Eva
    et al.
    School of Education and Communication, Jönköping University, Jönköping, Sweden.
    Wilder, Jenny
    School of Health Sciences, Jönköping University, Jönköping, Sweden .
    Granlund, Mats
    School of Health Sciences, Jönköping University, Jönköping, Sweden .
    Pless, Mia
    Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden .
    Simeonsson, Rune
    School of Education and Communication, Jönköping University, Jönköping, Sweden.
    Adolfsson, Margareta
    School of Education and Communication, Jönköping University, Jönköping, Sweden.
    Almqvist, Lena
    Mälardalen University, School of Health, Care and Social Welfare. School of Health Sciences, Jönköping University, Jönköping, Sweden .
    Klang, Nina
    Mälardalen University, School of Education, Culture and Communication.
    Lillvist, Anne
    Mälardalen University, School of Education, Culture and Communication.
    The International Classification of Functioning, Disability and Health and the version for children and youth as a tool in child habilitation/early childhood intervention: Feasibility and usefulness as a common language and frame of reference for practice2010In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 32, no SUPPL. 1, p. 125-138Article in journal (Refereed)
    Abstract [en]

     Early childhood intervention and habilitation services for children with disabilities operate on an interdisciplinary basis. It requires a common language between professionals, and a shared framework for intervention goals and intervention implementation. The International Classification of Functioning, Disability and Health (ICF) and the version for children and youth (ICF-CY) may serve as this common framework and language. This overview of studies implemented by our research group is based on three research questions: Do the ICF-CY conceptual model have a valid content and is it logically coherent when investigated empirically? Is the ICF-CY classification useful for documenting child characteristics in services? What difficulties and benefits are related to using ICF-CY model as a basis for intervention when it is implemented in services? A series of studies, undertaken by the CHILD researchers are analysed. The analysis is based on data sets from published studies or master theses. Results and conclusion show that the ICF-CY has a useful content and is logically coherent on model level. Professionals find it useful for documenting children's body functions and activities. Guidelines for separating activity and participation are needed. ICF-CY is a complex classification, implementing it in services is a long-term project

  • 3.
    Bring, Annika
    et al.
    Uppsala University, Sweden.
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Wasteson, Elisabeth
    Mid Sweden University, Sweden.
    Åsenlöf, Pernilla
    Uppsala University, Sweden.
    Daily stressors in patients with acute Whiplash Associated Disorders2012In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 34, no 21, p. 1783-1789Article in journal (Refereed)
    Abstract [en]

    Purpose: Stressors in acute whiplash associated disorders (WAD), as reported on a daily basis, have hitherto been neglected in research. The primary aim of this study was to describe the most stressful daily situation or event reported by individuals with acute WAD within a month of a whiplash trauma. Another aim was to describe the meaning and significance of these daily stressors, i.e. primary appraisal. Method: A descriptive design with a content analysis approach was used. 260 WAD-daily coping assessments (WAD-DCA) generated during 1 week by 51 participants with acute WAD were included in the study. Stressors were analysed using qualitative content analysis. Results: The reported stressors generated 13 categories covering a wide range of stressful situations in daily life related to (i) work, (ii) physical symptoms, (iii) feelings and cognitions, (iv) family and home responsibilities and (v) recreation. The majority of the stressors were appraised as "expected" as well as "disabling". Most threatening stressors were related to work, driving and feelings/cognitions. Conclusions: The wide variety of stressors indicates that it is not only pain itself that influences daily life in acute WAD. Early identification of individual and situation-specific stressors gives new data regarding what bothers individuals suffering from WAD after a collision and may be helpful in understanding the coping process in relation to specific stressors and stressor appraisals

  • 4.
    Cederbom, Sara
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    von Heideken Wågert, Petra
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Söderbäck, Maja
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    The importance of a daily rhythm in a supportive environment-  promoting ability in daily activities among older women livingalone with chronic pain2014In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 36, no 24, p. 2050-2058Article in journal (Refereed)
    Abstract [en]

    Purpose: The aim of this study was to explore how older women living alone with chronic musculoskeletal pain, describe their ability in performing activities in everyday life and what could promote their ability in activities in everyday life as well as their perceived meaning of a changed ability to perform activities in everyday life. Method: Qualitative interviews were conducted with 12 women, and an inductive content analysis was used. Results: The results showed the importance of a daily rhythm of activities. Activities included in the daily rhythm were socializing with family and friends, physical activities, doing own activities as well as activities supported by relatives and the community. The activities described by the women also promoted their ability in activities in everyday life. Other findings were the women's perceived meaning of being independent and maintaining that independency, along with the meaning of accepting and adapting to a changed life situation. Conclusion: This paper concludes that it is important to be sensitive of individual needs regarding the daily rhythm of activities when health-care professionals intervene in the activities in everyday life of older women living alone, promote the women's independency, and enable them to participate in the community. 

  • 5.
    Jansson, Sara
    et al.
    Attendo Care AB, Sweden.
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    A new treatment programme to improve balance in elderly people--an evaluation of an individually tailored home-based exercise programme in five elderly women with a feeling of unsteadiness.2004In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 26, no 24, p. 1431-1443Article in journal (Refereed)
    Abstract [en]

    PURPOSE: The aim of this study was to evaluate an individually tailored home-based exercise programme of balance in the elderly. The aim was also to examine if the degree of confidence of a person in performing common daily activities without falling could be influenced by training and if there were any relations between different physical factors and balance as well as between the degree of confidence in performing common daily activities without falling and balance. METHOD: A multiple baseline design in a single case format was used and five women were included in the study. These five women trained by walking outdoors for six weeks, they trained neck rotation isolated and integrated in activities for 4 weeks and performed an individual balance programme for 2 weeks. RESULTS AND CONCLUSIONS: The results showed that four of the five women had improved their balance and increased their degree of confidence in performing common daily activities without falling. The improved balance could be related to the increased activity level through walking outdoors. The treatment programme can be a useful model for physiotherapists in their work with balance problems in elderly people.

  • 6.
    Johansson, Ann-Christin
    et al.
    Mälardalen University, School of Health, Care and Social Welfare. Örebro Universitet.
    Linton, Steven J
    Örebro Universitet.
    Rosenblad, Andreas
    Uppsala Universitet.
    Bergkvist, Leif
    Uppsala Universitet.
    Nilsson, Olle
    Uppsala Universitet.
    A prospective study of cognitive behavioural factors as predictors of pain, disability and quality of life one year after lumbar disc surgery.2010In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 32, no 7, p. 521-9Article in journal (Refereed)
    Abstract [en]

    PURPOSE: The primary aim of this study was to analyse the predictive value of cognitive and behavioural factors, in relation to pain, disability and quality of life (QoL) one year after lumbar disc surgery.

    METHOD: The study design was prospective. Fifty-nine patients scheduled for first time lumbar disc surgery were included. Pain, disability, QoL, coping, fear avoidance beliefs, expected outcome and sick leave were assessed preoperatively and 12 months after surgery. Multiple backward stepwise logistic regression analyses were performed to study the contribution of the preoperatively measured independent behavioural/cognitive factors (coping, fear avoidance beliefs and assessed chance to return to work within 3 months) to the dependent variables pain, disability and quality of life at 12 months after surgery.

    RESULTS: Low expectations on work return within 3 months after surgery was significantly predictive for residual leg pain, odds ratio (OR) = 8.2, back pain, OR = 9.7, disability, OR = 13.8 and sick leave, OR = 19.5. Low QoL, was best predicted by preoperatively high scores on fear avoidance beliefs OR = 6.6 and being a woman OR = 6.0. The regression model explained 26-40% of the variance in pain, disability, QoL and sick leave.

    CONCLUSIONS: Eliciting patients' expectations on work return after surgery could contribute to early identification of those who run the risk of developing long-term disability and sick-leave.

  • 7.
    Klang, Nina
    et al.
    Mälardalen University, School of Education, Culture and Communication.
    Lillvist, Anne
    Mälardalen University, School of Education, Culture and Communication. Örebro University.
    Pless, Mia
    Mälardalen University, School of Health, Care and Social Welfare.
    Granlund, Mats
    Örebro University.
    The utility of ICF for describing interaction in non-speaking children with disabilities: Caregiver ratings and perceptions2007In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 26, no 22, p. 1689-1700Article in journal (Refereed)
  • 8.
    Kyhlbäck, Maria
    et al.
    University Hospital, Uppsala, Sweden.
    Schröder Winter, Helena
    University Hospital, Uppsala, Sweden.
    Thierfelder, Tomas
    Swedish University of Agricultural Sciences SLU, Uppsala, Sweden.
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Physiotherapy treatment of the diabetic shoulder. A longitudinal study following patients with diabetes and shoulder pain using a pre-post treatment design.2014In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 36, no 7, p. 556-562Article in journal (Refereed)
    Abstract [en]

    Purpose: The aim of this study was to describe and evaluate a physiotherapy program targeted to reduce pain intensity and improve the daily functioning of diabetics with shoulder problems. It was hypothesized that patients receiving specific physiotherapy treatment improved more frequently and rapidly than diabetic patients followed up without specific physiotherapeutic intervention. Method: A pre-post treatment design was completed for a group of 10 subjects. The treatment protocol, also applied during the daily activities of the subjects, was aiming at reducing pain intensity and shoulder stiffness and improving impaired functioning in daily activities by muscle relaxation, light-load exercise and enhancing proper shoulder co-ordination. Results: The group analysis showed significant decrease of pain intensity level as well as improved shoulder functioning and sustained level of subject self-efficacy beliefs throughout the study period. Conclusions: The results suggest that it is possible to relieve shoulder pain intensity and improve daily activities of patients with diabetes-related shoulder problems by employing a physiotherapy program focusing on muscle relaxation, light-load exercise and on the enhancement of proper shoulder co-ordination in daily activities.Implications for RehabilitationA physiotherapy program can be effective in reducing pain and improving shoulder function in diabetics with shoulder problems.The treatment should focus on muscle relaxation, light-load exercise and on the enhancement of proper shoulder co-ordination in daily activities.

  • 9.
    Müllersdorf, Maria
    et al.
    Mälardalen University, School of Health, Care and Social Welfare. University of Uppsala, Uppsala, Sweden.
    Söderback, Ingrid
    Mälardalen University, School of Health, Care and Social Welfare. University of Uppsala, Uppsala, Sweden.
    The actual state of the effects, treatment and incidence of disabling pain in a gender perspective-- a Swedish study.2000In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 22, no 18, p. 840-54Article in journal (Refereed)
    Abstract [en]

    PURPOSE: The purpose of the study was to elicit the actual state of self-perceived experience of long-term and/or recurrent pain and its effects as reported by women and men with disabilities due to pain, in order to determine criteria for assessing the need for measures in rehabilitation/occupational therapy. METHODS: The study used a comparative design with a sample randomized from the Swedish population aged 18-58 years (n = 10,000). The inclusion criterion was that the respondents had or had had pain causing activity limitation or restricting participation in daily life. A special questionnaire including items concerning demography, pain, coping, occupations in daily life, work, treatments, care institutions and hospital/care staff visited, was posted to 1,849 persons and was answered by 1,448 respondents (study group n = 1,305, control group n= 117). Results: Gender differences were found in the overall prevalence of pain, women reporting more frequent episodes of pain than men did. Differences were also found in pain variables, in daily occupations, days of sick-leave and work variables. Women completed more varied treatment than men. The incidence rate of long-term/recurrent pain in the population studied was 0.07. Conclusions: As a conclusion from this study, three essential components are suggested for use when assessing the need for rehabilitation/occupational therapy: (1) shoulder/arm or lower back pain of aching, tensed and/or searing character, particularly among women; (2) emotional/affective pain effects causing restlessness and depression, particularly among women; and (3) limitations in daily occupations assessed by FSQ and the demand/control/support model with results falling within the warning zones plus long sick-leave periods.

  • 10.
    Norderyd, Johanna
    et al.
    Hälsohögskolan Jönköping, Sweden.
    Lillvist, Anne
    Mälardalen University, School of Education, Culture and Communication, Educational Sciences and Mathematics.
    Klingberg, Gunilla
    Tandvårdshögskolan Malmö, Sweden.
    Faulks, Denise
    University Hospital of Clermont-Ferrand, France.
    Granlund, Mats
    Hälsohögskolan Jönköping, Sweden.
    Oral health, medical diagnoses, and functioning profiles in children with disabilities receiving paediatric specialist dental care – a study using the ICF-CY2015In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, ISSN ISSN 0963-8288, Vol. 37, no 16, p. 1431-1438Article in journal (Refereed)
    Abstract [en]

    Purpose: To describe 0-16-year-old children with disabilities receiving paediatric specialist dental care from a biopsychosocial perspective, with focus on relationship between oral health, medical diagnosis, and functioning. Method: A questionnaire with an International Classification of Functioning, Disability and Health - Children and Youth version (ICF-CY) Checklist for Oral Health was completed using structured interview, direct observation, and information from dental records. Descriptive data analysis was performed together with principle component analysis to calculate factors of functioning used in cluster analysis in order to present functioning profiles. Results: Ninety-nine children with at least one major medical diagnosis were included. Twenty had previous caries experience. Two factors of functioning were calculated, labelled "Physical ability" and "Intellectual ability, communication, and behaviour". Based on functioning profiles three clusters were determined. There were no statistically significant differences in caries experience between medical diagnoses or clusters. Conclusion: It was possible to identify profiles of functioning in children with disabilities receiving specialist dental care. Despite complex disabilities, the children had good oral health. Neither medical diagnosis nor functioning was found to have a clear relationship with oral health. To understand the environmental context leading to high-quality oral health, further studies of dental management in relation to medical and oral diagnoses and child functioning are needed.

  • 11.
    Nordgren, Lena
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Uppsala universitet.
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Associations between socio-demographic factors, encounters with healthcare professionals and the perceived ability to return to work in people sick-listed due to heart failure in Sweden: A cross-sectional study2016In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 38, no 2, p. 168-173Article in journal (Refereed)
    Abstract [en]

    Purpose: The aim of this study was to investigate associations between socio-demographic factors, experiences of positive/negative encounters with healthcare professionals, and the encounters' impact on the ability to return to work in a population of people on sick leave due to heart failure. Methods: This was a cross-sectional study. Data were collected from two official registries in Sweden and from a postal questionnaire. In all, 590 people with heart failure responded to the questionnaire. Associations between variables were calculated with bivariate correlation analyses and logistic regression analyses. Results: For people on sick leave due to heart failure, positive encounters with healthcare professionals are associated with being Swedish-born, female gender, and high income. People with high income are more likely to be supported back to work by positive encounters with healthcare professionals. To perceive that healthcare professionals believe in person's ability to return to work can be facilitating. Conclusions: Women, people who are not foreign-born, and people with high income are more likely to perceive encounters with healthcare professionals as positive. Healthcare professionals who work with rehabilitation for people with heart failure need to be aware of social inequalities and that being on sick leave is a process of change.Implications for Rehabilitation

    • A failing heart limits everyday life implying risk for long-term sick leave. Even though there are rehabilitation programs for people with heart failure, vocational rehabilitation is often over-looked. The knowledge about factors associated with sick leave due to heart failure is scarce.

    • Experiences of positive encounters with healthcare professionals were associated with being Swedish-born, female gender, and high income. People with high income were more likely to be supported back to work by positive encounters with healthcare professionals.

    • Healthcare professionals who work with rehabilitation for people with heart failure can support patients with heart failure by showing them confidence and trust. However, they need to be aware that sick leave implies a process of change.

  • 12.
    Sandborgh, Maria
    et al.
    Uppsala University, Uppsala, Sweden.
    Lindberg, Per
    Uppsala University, Uppsala, Sweden.
    Denison, Eva
    Mälardalen University, School of Health, Care and Social Welfare. Uppsala University, Uppsala, Sweden.
    The Pain Belief Screening Instrument (PBSI): predictive validity for disability status in persistent musculoskeletal pain2008In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 30, no 15, p. 1123-30Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To evaluate the predictive validity of a screening instrument measuring disability, self-efficacy, fear of movement and catastrophizing, for disability status in patients with musculoskeletal pain in primary health care physical therapy. Development over time of pain-related disability, pain intensity, self-reported work capacity and overall daily function for subgroups of patients was also investigated. METHOD: Prospective and correlational study, where patients (n = 168) with a pain-duration of 4 weeks or more completed the questionnaires and their cases were followed for 8 months to assess the variables of interest. For predictive validity of the screening instrument discriminant analyses were conducted. The development over time for subgroups was analysed by comparing scores at the first and second measurement. RESULTS: The PBSI correctly classified 72% of the subjects as High-disabled (n = 33) or Low-disabled (n = 110), as measured with the Pain Disability Index (Wilks' lambda = 0.848, p < 0.005). For pain intensity, self-reported changes in work capacity and overall daily function the discriminant analyses were not significant. The High-disability group had increased disability, unchanged pain intensity and decreased work capacity and daily function after 8 months. CONCLUSION: The predictive validity of the PBSI for disability was confirmed. In clinical use the PBSI could serve as a mean to obtain supplementary and clinically useful information.

  • 13.
    Sjöquist, Emma
    et al.
    Karolinska Institutet.
    Almqvist, Lena
    Mälardalen University, School of Health, Care and Social Welfare.
    Åsenlöf, Pernilla
    Uppsala University.
    Lampa, Jon
    Uppsala University.
    Opava, Christina H.
    Karolinska Institutet.
    Physical-activity coaching and health status in rhematoid arthritis: a person-oriented approach2010In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 32, no 10, p. 816-825Article in journal (Refereed)
    Abstract [en]

    No interventions to promote physical activity can succeed for all participants. Insights into the specific characteristics of those who do succeed are needed. One aim was to investigate whether a selection of correlates of general health perception creates cluster typologies in individuals with rheumatoid arthritis (RA). Another was to evaluate whether magnitude of change in health status differs between clusters after a 1-year coaching intervention targeting health-enhancing physical activity.

    METHOD:

    Two hundred and twenty-eight patients (74% women, mean age 56 years, disease duration 1 year) with RA, from 10 rheumatology clinics in Sweden, participated. The patients were assigned at random to intervention or control. The intervention group underwent 1 year of coaching to adopt health-enhancing physical activity (moderately intensive, 30 min/day, > 4 days/week). The cluster analysis included five correlates of general health perception: disease activity; pain; timed standing; activity limitation; and self-reported physical activity. The primary outcome of the coaching intervention was self-reported health status.

    RESULTS:

    One-hundred and forty-six patients were eligible for inclusion in the cluster analysis. The eight clusters identified both at baseline and post interventions were operationalized according to the number of cluster variables affected: less (LE) affected or more (MO) affected, respectively. Clusters with LE affected variables had significantly better general health perception at baseline than those with MO affected variables. Further, coached individuals in MO affected clusters significantly improved self-reported health status compared both to those coached in LE affected clusters and to those in MO affected clusters in the control group.

    CONCLUSION:

    This person-based approach contributed more than did the results in a previous randomized controlled trial to the understanding of which patients benefit most from the present physical-activity coaching intervention. The intervention may thus be most beneficial for individuals more severely affected by their disease at baseline.

  • 14.
    Skjutar, Åsa
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Müllersdorf, Maria
    Mälardalen University, School of Health, Care and Social Welfare.
    Schult, Marie-Louise
    Institutionen för kliniska vetenskaper, Danderyds Sjukhus.
    Improving occupational performance: a single case study of patients with chronic painIn: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165Article in journal (Refereed)
  • 15.
    Sverker, A.
    et al.
    Linköping University, Linköping, Sweden.
    Östlund, Gunnel
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Thyberg, M.
    Linköping University, Linköping, Sweden.
    Thyberg, I.
    Linköping University, Linköping, Sweden.
    Valtersson, E.
    Linköping University, Linköping, Sweden.
    Björk, M.
    Linköping University, Linköping, Sweden.
    Dilemmas of participation in everyday life in early rheumatoid arthritis: A qualitative interview study (The Swedish TIRA Project)2015In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 37, no 14, p. 1251-1259Article in journal (Refereed)
    Abstract [en]

    Purpose: To explore the experiences of today's patients with early rheumatoid arthritis (RA) with respect to dilemmas of everyday life, especially regarding patterns of participation restrictions in valued life activities. Methods: A total of 48 patients, aged 20-63, three years post-RA diagnosis were interviewed using the Critical Incident Technique. Transcribed interviews were condensed into meaningful units describing actions/situations. These descriptions were linked to ICF participation codes according to the International Classification of Functioning, Disability and Health (ICF) linking rules. Results: Dilemmas in everyday life were experienced in domestic life, interpersonal interactions and relationships, community, social and civic life. Most dilemmas were experienced in domestic life, including participation restrictions in, e.g. gardening, repairing houses, shovelling snow, watering pot plants, sewing or walking the dog. Also many dilemmas were experienced related to recreation and leisure within the domain community, social and civic life. The different dilemmas were often related to each other. For instance, dilemmas related to community life were combined with dilemmas within mobility, such as lifting and carrying objects. Conclusions: Participation restrictions in today's RA patients are complex. Our results underline that the health care needs to be aware of the patients' own preferences and goals to support the early multi-professional interventions in clinical practice.

  • 16.
    Sverker, Annette
    et al.
    Östergötlands läns landsting, Sweden.
    Thyberg, Ingrid
    Linköpings universitet, Sweden.
    Östlund, Gunnel
    Linköpings universitet, Sweden.
    Valtersson, Eva
    Östergötlands läns landsting, Sweden.
    Thyberg, Mikael
    Linköpings universitet, Sweden.
    Participation in work in early rheumatoid arthritis: A qualitative interview study interpreted in terms of the ICF2014In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 36, no 1, p. 242-249Article in journal (Refereed)
    Abstract [en]

    Purpose: To explore what work-related dilemmas are experienced by patients with early rheumatoid arthritis (RA), according to their own descriptions, and to interpret this in terms of participation categories of the International Classification of Functioning, Disability and Health (ICF). Method: In 48 patients with early RA, qualitative interviews were analyzed, followed by linking of concepts to the activity/participation component of the ICF and interpretation of general themes. Results: Work-related dilemmas represented different societal perspectives on work related to acquiring, keeping and terminating a job, self-employment, part-time, full-time and non-remunerative employment. Dilemmas also represented participation priorities in economic self-sufficiency, self-care such as health care, and avoiding social relationships and recreation in favor of work. Leisure time was influenced because efforts of working took energy and time of day-to-day procedures. Embedded actions in work-related dilemmas were carrying out daily routine, mobility including using transportation, self-care, domestic life and social interaction. Conclusion: The general themes societal perspectives, participation priorities and embedded actions, with the included ICF categories that are described in detail according to the experiences of the patients, can support clinical reasoning and research on quantitative relations to disease activity, body functions, ability and contextual factors.Implications for RehabilitationIn early rheumatoid arthritis, keeping a job is complex; patients and practitioners need to know and handle the perspectives of, e.g. employers and social insurance agents.Participation in work is an issue of prioritizing against, e.g. maintaining one's health and social relationships.Rehabilitation practitioners need to analyze what actions are embedded in a work situation.

  • 17.
    Sverker, Annette
    et al.
    Linköpings universitet, Sverige.
    Östlund, Gunnel
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Thyberg, Mikael
    Linköpings universitet, Sverige.
    Thyberg, Ingrid
    Linköpings universitet, Sverige.
    Valtersson, Eva
    Landstinget i Östergötland, Sverige.
    Björk, Mathilda
    Linköpings universitet, Sverige.
    Dilemmas ofparticipation in everyday life in early rheumatoid arthritis. A qualitativeinterview study (The Swedish TIRA Project).2014In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165Article in journal (Refereed)
    Abstract [en]

    Abstract Purpose: To explore the experiences of today's patients with early rheumatoid arthritis (RA) with respect to dilemmas of everyday life, especially regarding patterns of participation restrictions in valued life activities. Methods: A total of 48 patients, aged 20-63, three years post-RA diagnosis were interviewed using the Critical Incident Technique. Transcribed interviews were condensed into meaningful units describing actions/situations. These descriptions were linked to ICF participation codes according to the International Classification of Functioning, Disability and Health (ICF) linking rules. Results: Dilemmas in everyday life were experienced in domestic life, interpersonal interactions and relationships, community, social and civic life. Most dilemmas were experienced in domestic life, including participation restrictions in, e.g. gardening, repairing houses, shovelling snow, watering pot plants, sewing or walking the dog. Also many dilemmas were experienced related to recreation and leisure within the domain community, social and civic life. The different dilemmas were often related to each other. For instance, dilemmas related to community life were combined with dilemmas within mobility, such as lifting and carrying objects. Conclusions: Participation restrictions in today's RA patients are complex. Our results underline that the health care needs to be aware of the patients' own preferences and goals to support the early multi-professional interventions in clinical practice. Implications of Rehabilitation Today's rheumatoid arthritis (RA) patients experience participation restrictions in activities not included in International Classification of Functioning, Disability and Health (ICF) core set for RA or in traditionally questionnaires with predefined activities. The health care need to be aware of the patients' own preferences and goals to meet the individual needs and optimize the rehabilitation in early RA in clinical practice.

  • 18.
    Söderlund, Anne
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Asenlöf, Pernilla
    Uppsala University, Uppsala, Sweden.
    The mediating role of self-efficacy expectations and fear of movement and (re)injury beliefs in two samples of acute pain2010In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 32, no 25, p. 2118-2126Article in journal (Refereed)
    Abstract [en]

    Purpose. The overall aim of this study was to estimate the possible mediating role of self-efficacy, catastrophic thinking and fear of movement and (re)injury between pain intensity and pain-related disability in two samples of acute pain patients, i.e. patients with musculoskeletal injuries and patients with whiplash injury. Method. A cross sectional design with data-collection after an acute injury was used. Subjects were recruited at an emergency department. Sixty-four patients with acute whiplash associated disorders (WAD) and 74 patients with musculoskeletal injury completed the questionnaires. Results. Self-efficacy was found to be a mediator between pain intensity and pain-related disability in the WAD group, whereas fear of movement and (re)injury appeared as mediator in the musculoskeletal-injury group. The strength of association between variables was weaker in the musculoskeletal-injury group compared to the WAD group. Conclusions. It is important to assess fear of movement beliefs in patients with musculoskeletal injuries. Similarly, patients with acute WAD expressing low self-efficacy beliefs should be identified. An early detection of these beliefs may improve management at the acute phase and possibly reduce risks for slow improvements.

  • 19.
    Söderlund, Anne
    et al.
    Uppsala University, Uppsala, Sweden .
    Lindberg, Per
    Uppsala University, Uppsala, Sweden .
    An integrated physiotherapy/cognitive-behavioural approach to the analysis and treatment of chronic whiplash associated disorders, WAD.2001In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 23, no 10, p. 436-447Article in journal (Refereed)
    Abstract [en]

    PURPOSE: The aim of this paper was to describe a model for an integrated physiotherapy/cognitive-behavioural approach in the analysis and treatment of chronic WAD patients, as well as to evaluate the effectiveness of this approach in three experimental single case studies. METHOD: Three patients with a diagnosis of chronic WAD were included in the study. Psychological and physical functional analyses were used to describe the problem areas and as a basis for the management of WAD. A programme including learning of basic and applied skills, generalization, and maintenance was carried through. RESULTS AND CONCLUSION: The results showed that functional behavioural analyses can be useful in physiotherapy for structured patient assessment and in planning of treatment. It was also shown that physiotherapy integrated with cognitive behavioural components decreased the patients' pain intensity in problematic daily activities.

  • 20.
    Tjulin, Åsa
    et al.
    Linköpings Universitet.
    MacEachen, Ellen
    Institute for Work and Health, Toronto, ON, Canada.
    Edvardsson Stiwne, Elinor
    Linköpings Universitet.
    Ekberg, Kerstin
    Linköpings Universitet.
    The social interaction of return-to-work explored from co-workers experinces.2011In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 33, no 21-22, p. 1979-1989Article in journal (Refereed)
    Abstract [en]

    Purpose.The objective was to explore the role and contribution of co-workers in the return-to-work process. The social interaction of co-workers in the return-to-work process are analysed within the framework of the Swedish national and local employer organisational return-to-work policies. Methods. An exploratory qualitative method was used, consisting of open-ended interviews with 33 workplace actors across seven work units. Organisational return-to-work policies were collected from the three public sector employers. Results.The key findings that emerged during analysis showed that some co-workers have a more work-task oriented approach towards the return-to-work process, whilst others had a more social relational approach. In both situations, the social relations worked hand in hand with job tasks (how task were allocated, and how returning workers were supported by others) and could make or break the return-to-work process. Conclusion.A suggestion for improvement of return-to-work models and policies is the need to take into account the social relations amongst workplace actors, especially involving co-workers when planning for return-to-work interventions. Otherwise the proper attention to work arrangements, social communication and the role of co-workers in the return-to-work process might not be seen.

  • 21.
    Tjulin, Åsa
    et al.
    Linköpings Universitet.
    MacEachen, Ellen
    Institute for Work and Health, Toronto, Canada .
    Ekberg, Kerstin
    Linköpings Universitet.
    Exploring the meaning of early contact in return-to-work from workplace actors’ perspective2011In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 33, no 2, p. 137-145Article in journal (Refereed)
    Abstract [en]

    Purpose.The objective of this article was to explore the meaning of early contact in return-to-work, and how social relational actions and conditions can facilitate or impede early contact among actors in the workplace. Method.An exploratory qualitative method was used, consisting of individual open-ended interviews with 33 workplace actors at seven worksites across three public employers in Sweden. The workplace actors represented in these interviews included re-entering workers, supervisors, co-workers and human resources managers. Organisational policies on return-to-work were collected from the three employers. Results.The analysis indicated that early contact is a complex return-to-work measure with shifting incentives among workplace actors for making contact. For instance, the findings indicated obligation and responsibilities as incentives, incentives through social relations, and the need to acknowledge and balance the individual needs in relation to early contact. Conclusion.The findings strengthen the importance of early contact as a concept with a social relational context that comprises more than just an activity carried out (or not) by the employer, and suggest that early contact with a sick-listed worker is not always the best approach for a return-to-work situation. This study provides a starting point for a more articulated conceptualisation of early contact.

  • 22.
    Ullenhag, A.
    et al.
    Karolinska Institutet.
    Krumlinde-Sundholm, L.
    Karolinska Institutet.
    Granlund, M.
    Jönköping University.
    Almqvist, Lena
    Mälardalen University, School of Health, Care and Social Welfare. Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Differences in patterns of participation in leisure activities in Swedish children with and without disabilities2014In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 36, no 6, p. 464-471Article in journal (Refereed)
    Abstract [en]

    Purpose: To compare participation in leisure activities between Swedish children with and without disabilities and to examine whether age, gender, presence of disabilities, and mother's educational level influence participation. Method: A Swedish version of the Children's Assessment of Participation and Enjoyment was used to study the diversity, intensity, and enjoyment of participation in leisure activities of children aged 6 to 17 years. Fifty-five of the children had disabilities and 337 of the children did not have disabilities. A multiple regression analysis was conducted to explore the impact of age, gender, mother's level of education, and disability on the diversity, intensity, and enjoyment of leisure activities. A t-test for independent samples was used to compare the diversity and intensity of participation between children with and without disabilities. Results: The multiple regression analysis explained 4-36% of the variance of diversity, intensity, and enjoyment. Children with disabilities participated with higher diversity, but with less intensity, than children without disabilities. Younger children had higher levels of enjoyment. Conclusions: Children with disabilities participated in several different activities, but the presence of a disability was associated with lower intensity of participation. The low explanatory value of the investigated variables indicates that the combined effect of several variables needs to be taken into consideration when designing participation interventions.Implications for RehabilitationChildren with disabilities participated in a high number of activities but with a low intensity compared to children without disabilities. Analysis of the children's personal and environmental barriers and facilitators is critical to providing the therapist with ideas about which strategies should be implemented to increase participation. Assessment and intervention may need to focus on methods for supporting the children's autonomy and on creating goals for intervention that focus on activities that are determined by the child based on their interests and desires.Age and gender influenced the variance in the diversity and enjoyment outcome and the presence of disability was associated with the intensity outcome.Age, gender, parental educational level, and disability only explain a small proportion of the variance in leisure participation patterns. Thus, client-centred and individually tailored interventions are needed that are based on the individual's unique situation. © 2014 Informa UK Ltd. All rights reserved: reproduction in whole or part not permitted.

  • 23.
    Wickford, Jenny
    et al.
    Göteborgs universitet.
    Hultberg, John
    Göteborgs universitet.
    Rosberg, Susanne
    Göteborgs universitet.
    Physiotherapy in Afghanistan – needs and challenges for development.2008In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 30, no 4, p. 305-313Article in journal (Refereed)
  • 24.
    Zakirova-Engstrand, Rano
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Granlund, Mats
    The International classification of functioning, disability and health - children and youth (ICF-CY): testing its utility in classifying information from eco-cultural family interviews with ethnically diverse families with children with disabilities in Kyrgyzstan2009In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 31, no 12, p. 1018-1030Article in journal (Refereed)
    Abstract [en]

    Purpose. The objective of this study was to test the utility of the International classification of functioning, disability and health - children and youth's (ICF-CY) Environmental Factors component by classifying family interview data from two ethnically and culturally diverse - Kyrgyz and Uzbek - families that have children with various types of disabilities in Kyrgyzstan, Central Asia. Methods. The eco-cultural family interview (EFI) was used to interview four Kyrgyz and four Uzbek families. The obtained data were analysed by using manifest content analysis; identified units of meaning named as 'EFI items' and 'EFI concepts' were then linked to the ICF-CY's codes by application of ten linkage rules. Results. The analysis of transcribed interviews identified 669 EFI items and 745 EFI concepts. The linking of EFI items to the ICF-CY showed: 92 EFI items and concepts were linked to nd (not definable); 104 items were linked to nc (not covered by the ICF-CY); 15 items were categorised as pf (personal factors); 21 items were linked to categories found in Activities and Participation; and 3 were linked to Body Functions components. The rest of EFI items and concepts were linked to categories of the Environmental Factors component. Conclusion. The codes included into Chapters 1, 2 and 5 of the ICF-CY environmental component can be easily assigned to the relevant EFI items. There is a necessity to add more codes in Chapters 3 and 4 of the Environmental Factors component, and the inclusion of a separate component of Personal Factors into the classification is suggested.

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