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  • 1.
    Akhavan, Sharareh
    et al.
    Mälardalen University, School of Health, Care and Social Welfare. Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Aytar, Osman
    Mälardalen University, School of Health, Care and Social Welfare. Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Bogg, Lennart
    Mälardalen University, School of Health, Care and Social Welfare. Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare. Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Tillgren, Per
    Mälardalen University, School of Health, Care and Social Welfare. Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Blev det ett genombrott?: Utvärdering av det nationella lärandeprojektet – Vård på lika villkor2014Report (Other academic)
    Abstract [sv]

    Sjukvården i Sverige är i dag inte jämlik, har brister i tillgänglighet och erbjuds inte på likvärdiga villkor trots Hälso- och sjukvårdslagens mål om en god hälsa och en vård på lika villkor för hela befolkningen.

    För att bryta den pågående trenden och öka jämlikheten gjordes en överenskommelse mellan regeringen och SKL om lärandeprojektet Vård på lika villkor (under åren 2011–2014). Syftet med projektets har varit att inom socioekonomiskt resurssvaga bostadsområden öka jämlikheten i första linjens vård. Detta genom att testa, utveckla och identifiera effektiva arbetssätt och metoder vid sju primärvårdsverksamheter från fem landsting i Sverige.

    Mälardalens högskola, Akademin för hälsa, vård och välfärd, fick av SKL i uppdrag att svara för forskarstöd och att genomföra en utvärdering av de metoder och arbetssätt som utvecklades och testades i lärandeprojektet.

    Resultatet från den genomförda utvärderingen som belyser den genomförda processen, mål- och resultat samt hälsoekonomiska aspekter beskrivs närmare i denna rapport.

  • 2.
    Akhavan, Sharareh
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Aytar, Osman
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Bogg, Lennart
    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.
    Tillgren, Per
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Temaledare: Vård på lika villkor – Vad kan vi lära av Lärandeprojektet?2015In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 92, no 2, p. 103-106Article in journal (Other academic)
  • 3.
    Akhavan, Sharareh
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Tillgren, Per
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Aytar, Osman
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Bogg, Lennart
    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.
    Practice and Policy in Promoting Health and Equity –experiences from a national project in primary health care in Sweden2016Conference paper (Refereed)
    Abstract [en]

    Introduction: The Swedish Health Care Law requires the health system to provide good care on equal terms to all. However, several reports from different governmental agencies have revealed that health care is uneven in quality, lacking in accessibility, and not offered on equal terms to all people. Recent public health reports show that inequalities in health in the population have increased. To provide health care on equal terms has become a challenge for health care.

    In order to apply methods for developing practice and policy in promoting health and equity the Swedish Association of Local Authorities and Regions developed and implemented a national project entitled Care on Equal Terms. The project began in 2011 and was completed in 2014 at seven Primary Health Care Units (PHCUs) in five regions. The aim of this study was to evaluate the outcomes of this project.

    Methods: Based on a program theoretical approach an evaluation design was developed which included process, results and economical evaluation. In the data collection and analysis mixed methods were applied.

    Results: According to the process evaluation, seven different strategies were applied in the process to develop primary health care on equal terms. One of the key observations was that in order to achieve health on more equal terms, health care needs to be provided on unequal terms, i. e. more needs to be done to reach those who need more assistance to access health services. Health promotion was one of the applied strategies and it was the most common strategy at some of the health care centers with the aim of developing patients' knowledge, awareness and understanding about health, care and self-care. The results evaluation showed that the PHCUs staff identified structural and organizational factors in health care as important factors for developing health promotion and equity in access. The health economic evaluation showed that the costs for implementing the activities for an improved equity were limited. Yet the majority of the PHCUs thought that the detailed regulation of their financing and reporting requirements were a limitation in their work for improved equity. Four of five county councils have recently introduced a primary care provider payment system (ACG) which may not be supportive of efforts to improve equity in access.

    Conclusions: It is possible to develop and maintain practices that can contribute to more equitable care and increase health care personnel’s awareness about practice and policy in promoting health and equity.

  • 4.
    Arkkukangas, Marina
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Johnson, S. T.
    Uppsala University, Uppsala, Sweden.
    Hellström, K.
    Uppsala University, Uppsala, Sweden.
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Eriksson, S.
    Centre for Clinical Research Sörmland, Sweden.
    Johansson, Ann-Christin
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    A feasibility study of a randomised controlled trial comparing fall prevention using exercise with or without the support of motivational interviewing2015In: Preventive Medicine Reports, ISSN 2211-3355, Vol. 2, p. 134-140Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of this investigation was to study the feasibility of a randomised controlled trial (RCT) based on a multicentre fall prevention intervention including exercise with or without motivational interviewing compared to standard care in community-living people 75. years and older. Method: The feasibility of a three-armed, randomised controlled trial was evaluated according to the following: process, resources, management by questionnaire, and treatment outcomes. The outcome measures were fall frequency, physical performance and falls self-efficacy evaluated after three months. Twelve physiotherapists conducted the measurements and treatments and responded to the questionnaire. The first 45 participants recruited to the ongoing RCT were included: 16 individuals in the Otago Exercise Program group (OEP), 16 individuals in the OEP combined with motivational interviewing group (MI), and 13 individuals in the control group. The study was conducted from November 2012 to December 2013. Results: The feasibility of the study process, resources and management reached the set goals in most aspects; however, the set goal regarding the MI guide and planned exercise for the participating older people was not completely reached. No significant differences were found between the groups regarding the outcome measures. Conclusion: This study confirmed the acceptable feasibility for the study protocol in the ongoing RCT.

  • 5.
    Arkkukangas, Marina
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Sundler, Annelie Johansson
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Univ Boras, Fac Caring Sci Work Life & Social Welf, Boras, Sweden..
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Eriksson, Staffan
    Uppsala Univ, Ctr Clin Res Sormland, Eskilstuna, Sweden.;Umea Univ, Dept Community Med & Rehabil, Physiotherapy, Umea, Sweden.;Uppsala Univ, Dept Neurosci, Physiotherapy, Uppsala, Sweden..
    Johansson, Ann-Christin
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Older persons' experiences of a home-based exercise program with behavioral change support2017In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 33, no 12, p. 905-913Article in journal (Refereed)
    Abstract [en]

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

  • 6.
    Arkkukangas, Marina
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Sundler, Annelie
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Eriksson, Staffan
    Johansson, Ann Christin
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Older persons’ experiences of a home-based exercise programme with behavioural change support2017In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 33, no 12, p. 905-913Article in journal (Refereed)
    Abstract [en]

    Background: It is a challenge to promote exercise among older persons. Knowledge is needed regarding the maintenance of exercise aiming at preventing falls and promoting health and wellbeing in older persons.

    Purpose: This descriptive study used a qualitative inductive approach to describe older persons’ experiences of a fall-preventive, home-based exercise programme with support for behavioural change.

    Methods: Semi-structured interviews were conducted with twelve older persons aged 75 years or older, and a qualitative content analysis was performed.

    Results: Four categories emerged: facilitators of performing exercise in everyday life, the importance of support, perceived gains from exercise, and the existential aspects of exercise.

    Conclusion: With support from physiotherapists, home-based exercise can be adapted to individual circumstances in a meaningful way. By including exercises in everyday life and daily routines could support the experience of being stronger, result in better physical functioning and give hope for an extended active life in old age.

  • 7.
    Arkkukangas, Marina
    et al.
    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.
    Eriksson, Staffan
    Uppsala University, Sweden.
    Johansson, Ann-Christin
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Centrum för klinisk forskning LTV.
    Fall Preventive Exercise with or without behavior change support for community-dwelling older adults: A Randomized Controlled Trial With Short-Term Follow-up.In: Journal of Geriatric Physical Therapy, ISSN 1539-8412, E-ISSN 2152-0895Article in journal (Refereed)
  • 8.
    Arkkukangas, Marina
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Eriksson, Staffan
    Johansson, Ann-Christin
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    One- year adherence to the Otago Exercise Programme with or without motivational interviewing in older peopleManuscript (preprint) (Other academic)
  • 9.
    Aytar, Osman
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Akahavan, Sharareh
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Granath, Marianne
    Sveriges kommuner och landsting.
    Wallin, Hanna
    Sveriges kommuner och landsting.
    Bogg, Lennart
    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.
    Tillgren, Per
    Using program theory-driven evaluation in primary care units: An integrated evaluation perspective on a learning project providing equitable care in Sweden2013Conference paper (Refereed)
  • 10.
    Aytar, Osman
    et al.
    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.
    Att utvärdera med processtänkande för lärande2015In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 92, no 2, p. 162-175Article in journal (Refereed)
    Abstract [en]

    Change-projects can be evaluated in different ways. One of the ways is to evaluate with process thinking, which means that evaluators are involved in the process from the very beginning. Involvement of evaluators already in the beginning of a project can mean several challenges for both the project itself and the evaluators. This study is about describing and analyzing how and with what results the perspective of process thinking on evaluation of the national learning project Care on equal terms was used. The results indicate, among other things, that it was a good choice to bring in evaluation perspective at the beginning of the project. Process thinking has, among other things, contributed to the activities throughout the project, and played a role in learning from and implementation of the project itself.

  • 11.
    Aytar, Osman
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Tillgren, Per
    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.
    Bogg, Lennart
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Akhavan, Sharareh
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Health Care Provider’s Perceptions about and Experiences of Achieving Equitable Health Care: An Evaluation Study2017In: Quality in Primary Care, ISSN 1479-1072, E-ISSN 1479-1064, Vol. 25, no 5, p. 289-296Article in journal (Refereed)
    Abstract [en]

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

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

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

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

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

  • 12. Bergman, Stefan
    et al.
    Gerdle, Björn
    Hagberg, Mats
    Jacobsson, Ulf
    Linton, Steven J
    Strender, Lars-Erik
    Stålnacke, Britt-Marie
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Långvarig smärta i nacke, skuldror och rygg i Nationella riktlinjer för rörelseorganens sjukdomar 2010 – stöd för styrning och ledning: Preliminär version2010Report (Refereed)
  • 13.
    Borg, S.
    et al.
    Linköping University, Sweden.
    Öberg, B.
    Linköping University, Sweden.
    Nilsson, L.
    Linköping University, Sweden.
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Bäck, M.
    Linköping University, Sweden.
    The role of a behavioural medicine intervention in physiotherapy for the effects of rehabilitation outcomes in exercise-based cardiac rehabilitation (ECRA) - the study protocol of a randomised, controlled trial2017In: BMC Cardiovascular Disorders, ISSN 1471-2261, E-ISSN 1471-2261, Vol. 17, no 1, article id 134Article in journal (Refereed)
    Abstract [en]

    Background: To help patients with coronary artery disease (CAD) benefit from the positive health effects attained by exercise-based cardiac rehabilitation (CR), adherence to these programmes according to international guidelines is important. Strategies to increase adherence to exercise-based CR are mainly an unexplored area. The objective of this study is to investigate the effects of a behavioural medicine intervention in physiotherapy, containing goal-setting, self-monitoring and feedback, with the aim of improving rehabilitation outcomes for exercise-based CR, compared with usual care. Methods: This is a randomised, controlled trial. A total of 160 patients with CAD will be included consecutively at the Coronary Care Unit at a university hospital in Sweden. Patients are randomised 1:1 using sealed envelopes to usual care or a behavioural medicine intervention in physiotherapy, in addition to usual care for 4 months. Outcome assessment at baseline, 4 and 12 months includes submaximal aerobic capacity (primary outcome), exercise adherence, muscle endurance, level of physical activity, biomarkers, anxiety and depression, health-related quality of life, patient enablement and self-efficacy (secondary outcomes). Discussion: This is the first study to evaluate the role of an integrated behavioural medicine intervention in exercise-based CR in the effects of rehabilitation outcomes. The results of this study will provide valuable information about the effect of these interventions in exercise-based CR and it has the potential to inform and assist in further treatment in secondary prevention for patients with CAD. Trial registration: The study include all items from the World Health Organization Trial Registration Data Set. Trial registration number: NCT02895451, 2016-08-16, retrospectively registered. 

  • 14.
    Bring, Annika
    et al.
    Uppsala University.
    Bring, Johan
    University of Gävle.
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Wasteson, Elisabeth
    Mid Sweden University.
    Åsenlöf, Pernilla
    Uppsala University.
    Coping patterns and their relation to daily activity, worries, depressive mood, and pain intensity in acute Whiplash Associated Disorders2013In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 20, no 2, p. 293-303Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    There is a lack of knowledge regarding how individuals with acute whiplash-associated disorders (WAD) appraise and cope with situation-specific stressors.

    PURPOSE:

    The aim of the study was to describe the daily process of coping reported in a daily coping assessment by individuals with acute WAD within 1 month after the accident. More specifically, profiles of coping strategies were identified and patterns between stressors, primary and secondary appraisals, and coping strategy profiles were described in relation to reported level of activity, worries, depressed mood and pain intensity during the day.

    METHOD:

    A descriptive and exploratory design was applied. Two hundred and twenty-nine whiplash-associated disorders-daily coping assessment (WAD-DCA) collected during seven consecutive days from 51 participants with acute WAD in Sweden, were included. Cluster analysis was used to obtain coping strategy profiles and data were graphically visualised as patterns through the coping process.

    RESULTS:

    When measuring coping as a daily process relating to the specific stressful situation, different coping process patterns appeared. During days with a high degree of physical and mental well-being, high self-efficacy beliefs seemed to be working as an important secondary appraisal, whereas during days with a low degree of physical and mental well-being primary appraisals of the stressor as a threat and catastrophic thoughts were present in the coping process.

    CONCLUSIONS:

    Early identification of situational- and individual-specific stressors, appraisals and coping efforts as measured by the WAD-DCA may contribute to the understanding of the coping process in the acute stage of WAD and its possible impact on recovery and adjustment.

  • 15.
    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

  • 16.
    Bring, Annika
    et al.
    Uppsala university, Sweden.
    Åsenlöf, Pernilla
    Uppsala university, Sweden.
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Comparison of different treatment approaches after acute WAD – Standard-treatment compared to behavioural medicine interventions: A randomized group study2010In: European Journal of Pain, ISSN 1090-3801, E-ISSN 1532-2149, Vol. 13, no S1, p. S265-Article in journal (Refereed)
  • 17.
    Bring, Annika
    et al.
    Uppsala University, Uppsala, Sweden.
    Åsenlöf, Pernilla
    Uppsala University, Uppsala, Sweden.
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    What is the comparative effectiveness of current standard treatment, against an individually tailored behavioural programme delivered either on the internet or face-to-face for people with acute whiplash associated disorder?: A randomized controlled trial.2016Conference paper (Refereed)
  • 18.
    Bring, Annika
    et al.
    Uppsala Universitet, Sweden.
    Åsenlöf, Pernilla
    Uppsala Universitet, Sweden.
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    What is the comparative effectiveness of current standard treatment, against an individually tailored behavioural programme delivered either on the Internet or face-to-face for people with acute whiplash associated disorder?: A randomized controlled trial2016In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 30, no 5, p. 187-188, article id Meeting Abstract: O579Article in journal (Refereed)
  • 19.
    Bring, Annika
    et al.
    Uppsala Universitet, Sweden.
    Åsenlöf, Pernilla
    Uppsala Universitet, Sweden.
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    What is the comparative effectiveness of current standard treatment, against an individually tailored behavioural programme delivered either on the Internet or face-to-face for people with acute whiplash associated disorder?: A randomized controlled trial2015In: Clinical Rehabilitation, ISSN 0269-2155, E-ISSN 1477-0873, Vol. 30, no 5, p. 441-453Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: To investigate the comparative effectiveness of current standard treatment, against an individually tailored behavioural programme delivered via the Internet or face-to-face for people with acute whiplash associated disorders.

    DESIGN: A multicentre, randomized, three-group design, with concealed allocation.

    SUBJECTS AND SETTINGS: A total of 55 participants (37 female), age 18-65, with acute Whiplash Associated Disorder (Grade I-II), recruited at two emergency clinics in Sweden.

    INTERVENTIONS: Before randomization all participants received standard self-care instructions. The Internet and face-to-face groups followed a seven-week behavioural programme involving individual tailoring, via email (Internet group), or in sessions at a physical therapy unit (face-to-face group). The control group only received the self-care instructions.

    MAIN MEASURES: Pain-related disability, pain intensity, self-efficacy in daily activities, catastrophizing and fear of movement/(re)injury. Assessments were performed at baseline (2-4 weeks postinjury) and at three, six and 12 months postintervention.

    RESULTS: Both the Internet (n = 16) and face-to-face (n = 14) group showed a larger decrease in pain-related disability than the control group (n = 16); -12 and -11, respectively, compared with -5 in the control group at 12-months follow-up. Significant differences between the groups in overall treatment effect were shown in all outcomes except pain intensity. All groups improved significantly over time in all outcomes, except for fear of movement/(re)injury and catastrophizing in the control group.

    CONCLUSION: An individually tailored behavioural programme improved biopsychosocial factors in patients with whiplash associated disorders up to 12 months after treatment. Internet-delivered intervention was as effective as clinic-based face-to-face therapy sessions.

  • 20.
    Cederbom, Sara
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Rydwik, Elisabeth
    Jakobsbergs Hosp, Sweden.
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Denison, Eva
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Frandin, Kerstin
    Karolinska Inst, Sweden.
    Petra, von Heideken Wågert
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    A behavioral medicine intervention for older women living alone with chronic pain - a feasibility study2014In: Clinical Interventions in Aging, ISSN 1176-9092, E-ISSN 1178-1998, Vol. 9, p. 1383-1397Article in journal (Refereed)
    Abstract [en]

    Background: To be an older woman, live alone, have chronic pain, and be dependent on support are all factors that may have an impact on daily life. One way to promote ability in everyday activities in people with pain-related conditions is to use individualized, integrated behavioral medicine in physical therapy interventions. How this kind of intervention works for older women living alone at home, with chronic pain, and dependent on formal care to manage their everyday lives has not been studied. The aim was to explore the feasibility of a study and to evaluate an individually tailored integrated behavioral medicine in physical therapy intervention for the target group of women. Materials and methods: The study was a 12-week randomized trial with two-group design. Primary effect outcomes were pain-related disability and morale. Secondary effect outcomes focused on pain-related beliefs, self-efficacy for exercise, concerns of falling, physical activity, and physical performance. Results: In total, 23 women agreed to participate in the study and 16 women completed the intervention. The results showed that the behavioral medicine in physical therapy intervention was feasible. No effects were seen on the primary effect outcomes. The experimental intervention seemed to improve the level of physical activity and self-efficacy for exercise. Some of the participants in both groups perceived that they could manage their everyday life in a better way after participation in the study. Conclusion: Results from this study are encouraging, but the study procedure and interventions have to be refined and tested in a larger feasibility study to be able to evaluate the effects of these kinds of interventions on pain-related disability, pain-related beliefs, self-efficacy in everyday activities, and morale in the target group. Further research is also needed to refine and evaluate effects from individualized reminder routines, support to collect self-report data, safety procedures for balance training, and training of personnel to enhance self-efficacy.

  • 21.
    Cederbom, Sara
    et al.
    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.
    Denison, Eva
    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.
    Chronic pain among older women living alone. A study focusing on disability and morale.2014In: European Journal of Physiotherapy, ISSN 2167-9169, E-ISSN 2167-9177, Vol. 16, no 3, p. 139-150Article in journal (Refereed)
    Abstract [en]

    Purpose: To investigate 1)how older women who are living alone perceive chronic musculoskeletal pain,Activities of Daily Living (ADL), physical activity, affective distress,pain-related beliefs, pain management, and rate pain-related disability andmorale,  2) the relationships betweendemographic variables, ADL, physical activity, affective distress, pain-relatedbeliefs, and pain management with pain-related disability and morale.Method: The study had across-sectional and correlational design. Sixty women, living alone with chronicpain and community support aged ≥65 years were included.Results: The women were on average 81 years old and had lived with pain forabout 21.5 years. They reported low scores of affective distress,catastrophizing thoughts and self-efficacy, high scores of fear of movement,low degrees of pain-related disability, and low levels of  morale. The multiple regression analysisshowed that only catastrophizing thoughts significantlyexplained the variation in pain-related disability, and both affective distress and catastrophizing thoughtssignificantly explained the variation in morale. Conclusion: These older women livingalone with chronic pain reported similar prevalence ofchronic pain and pain-related disability but lower morale when comparingthe results with similar studies about older people in the same age group orolder people who are in need of help to manage their daily life. The only variable that was independely associated to bothpain-related disability and morale was catastrophizing. Further researchshould focus on identifying catastrophizing thougts,and also on developing a rehabilitation program based on a biopsychosocialperspective with the goal to decrease catastrophizing, pain-relateddisability, and increase morale for this target group

  • 22.
    Cederbom, Sara
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Karolinska Institutet, Huddinge, Sweden; The Unit for Rehabilitation in the municipality of Eskilstuna, Sweden.
    Thunborg, Charlotta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Denison, Eva
    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.
    von Heideken Wågert, Petra
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Home Help Service Staffs' Descriptions of Their Role in Promoting Everyday Activities Among Older People in Sweden Who Are Dependent on Formal Care.2017In: Journal of Applied Gerontology, ISSN 0733-4648, E-ISSN 1552-4523, Vol. 36, no 8, p. 971-992Article in journal (Refereed)
    Abstract [en]

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

  • 23.
    Cederbom, Sara
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    von Heideken Wågert, Petra
    Mälardalen University, School of Health, Care and Social Welfare.
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare.
    Söderbäck, Maja
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Older women´s daily rhythm of activities in a supporting environment, Living with persistent musculoskeletal pain.2012Conference paper (Other academic)
  • 24.
    Cederbom, Sara
    et al.
    Mälardalen University, School of Health, Care and Social Welfare.
    von Heideken Wågert, Petra
    Mälardalen University, School of Health, Care and Social Welfare.
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare.
    Söderbäck, Maja
    Mälardalen University, School of Health, Care and Social Welfare.
    Older Women’s descriptions of how they activate themselves in their everyday living and what will promote their activity abilities.2012Conference paper (Refereed)
  • 25.
    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. 

  • 26.
    Dean, E.
    et al.
    University of British Columbia, Vancouver, Canada .
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    What is the role of lifestyle behaviour change associated with non-communicable disease risk in managing musculoskeletal health conditions with special reference to chronic pain?2015In: BMC Musculoskeletal Disorders, ISSN 1471-2474, E-ISSN 1471-2474, Vol. 16, no 1, article id 87Article in journal (Refereed)
    Abstract [en]

    Background: Other than activity and exercise, lifestyle practices such as not smoking and healthy nutrition, well established for preventing and managing lifestyle-related non-communicable diseases (i.e., heart disease, cancer, hypertension, stroke, obstructive lung disease, diabetes, and obesity), are less emphasized in the physical therapy guidelines for addressing chronic pain, e.g., back pain. This state-of-the-art review examines the relationships between lifestyle behaviours and musculoskeletal health, with special reference to chronic pain, and their clinical and research implications. Discussion: A state-of-the-art review was conducted to synthesize evidence related to lifestyle factors (not smoking, healthy diet, healthy weight, optimal sleep and manageable stress, as well as physical activity) and musculoskeletal health, with special reference to chronic pain. The findings support that health behaviour change competencies (examination/assessment and intervention/treatment) may warrant being included in first-line management of chronic pain, either independently or in conjunction with conventional physical therapy interventions. To address knowledge gaps in the literature however three lines of clinical trial research are indicated: 1) to establish the degree to which traditional physical therapy interventions prescribed for chronic pain augment the benefits of lifestyle behaviour change; 2) to establish the degree to which adopting healthier lifestyle practices, avoids or reduces the need for conventional physical therapy; and 3) to establish whether patients/clients with healthier lifestyles and who have chronic pain, respond more favourably to conventional physical therapy interventions than those who have less healthy lifestyles. Summary: Lifestyle behaviour change is well accepted in addressing lifestyle-related non-communicable diseases. Compelling evidence exists however supporting the need for elucidation of the role of negative lifestyle behaviours on the incidence of chronic pain, and the role of positive lifestyle behaviours on its incidence and effective management. Addressing lifestyle behaviour change in patients/clients with chronic pain, e.g., back pain, as a first-line intervention might not only constitute a novel approach, but also reduce the socioeconomic burden related to chronic pain as well as non-communicable diseases.

  • 27.
    Dean, Elizabeth
    et al.
    Univ British Columbia, Canada.
    Moffat, Marilyn
    NYU, USA.
    Skinner, Margot
    University of Otago, New Zealand.
    de Andrade, Armele Dornelas
    Universidade Federal de Pernambuco, Brazil.
    Myezwa, Hellen
    Witwatersrand University, South Africa.
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Toward core inter-professional health promotion competencies to address the non-communicable diseases and their risk factors through knowledge translation: Curriculum content assessment2014In: BMC Public Health, ISSN 1471-2458, E-ISSN 1471-2458, Vol. 14, p. 717-Article in journal (Refereed)
    Abstract [en]

    Background: To increase the global impact of health promotion related to non-communicable diseases, health professionals need evidence-based core competencies in health assessment and lifestyle behavior change. Assessment of health promotion curricula by health professional programs is a first step. Such program assessment is a means of 1. demonstrating collective commitment across health professionals to prevent non-communicable diseases; 2. addressing the knowledge translation gap between what is known about non-communicable diseases and their risk factors consistent with 'best' practice; and, 3. establishing core health-based competencies in the entry-level curricula of established health professions. Discussion: Consistent with the World Health Organization's definition of health (i.e., physical, emotional and social wellbeing) and the Ottawa Charter, health promotion competencies are those that support health rather than reduce signs and symptoms primarily. A process algorithm to guide the implementation of health promotion competencies by health professionals is described. The algorithm outlines steps from the initial assessment of a patient's/client's health and the indications for health behavior change, to the determination of whether that health professional assumes primary responsibility for implementing health behavior change interventions or refers the patient/client to others. An evidence-based template for assessment of the health promotion curriculum content of health professional education programs is outlined. It includes clinically-relevant behavior change theory; health assessment/examination tools; and health behavior change strategies/interventions that can be readily integrated into health professionals' practices. Summary: Assessment of the curricula in health professional education programs with respect to health promotion competencies is a compelling and potentially cost-effective initial means of preventing and reversing non-communicable diseases. Learning evidence-based health promotion competencies within an inter-professional context would help students maximize use of non-pharmacologic/non-surgical approaches and the contribution of each member of the health team. Such a unified approach would lead patients/clients to expect their health professionals to assess their health and lifestyle practices, and empower and support them in achieving lifelong health. Benefits of such curriculum assessment include a basis for reflection and discussion within and across health professional programs that could impact the epidemic of non-communicable diseases globally, through inter-professional education and evidence-based practice related to health promotion.

  • 28.
    Dean, Elizabeth
    et al.
    University of British Columbia.
    Nordgren, Lena
    Centre for Clinical Research in Sörmland, Sörmland County Council, Eskilstuna, Sweden.
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    An Exploration of the Scientific Writing Experience of Non-native English-speaking Doctoral Supervisors and Students Using a Phenomemographic Approach2015In: Journal of Biomedical Education, ISSN 2314-5021, article id 542781Article in journal (Refereed)
    Abstract [en]

    Nonnative English-speaking scholars and trainees are increasingly submitting their work to English journals. The study’s aim was to describe their experiences regarding scientific writing in English using a qualitative phenomenographic approach. Two focus groups (5 doctoral supervisors and 13 students) were conducted. Participants were nonnative English-speakers in a Swedish health sciences faculty. Group discussion focused on scientific writing in English, specifically, rewards, challenges, facilitators, and barriers. Participants were asked about their needs for related educational supports. Inductive phenomenographic analysis included extraction of referential (phenomenon as a whole) and structural (phenomenon parts) aspects of the transcription data. Doctoral supervisors and students viewed English scientific writing as challenging but worthwhile. Both groups viewed mastering English scientific writing as necessary but each struggles with the process differently. Supervisors viewed it as a long-term professional responsibility (generating knowledge, networking, and promotion eligibility). Alternatively, doctoral students viewed its importance in the short term (learning publication skills). Both groups acknowledged they would benefit from personalized feedback on writing style/format, but in distinct ways. Nonnative English-speaking doctoral supervisors and students in Sweden may benefit from on-going writing educational supports. Editors/reviewers need to increase awareness of the challenges of international contributors and maximize the formative constructiveness of their reviews.

  • 29. Dean, Elizabeth
    et al.
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Komplekse problemstillinger. (Principles for Management of the Patient with Complex Co-morbidity).2017In: Basisbog i Fysioterapi / [ed] Lund, H., Bjørnlund, I.B., Sjöberg, N.E., Copenhagen: Munksgaard Forlag, 2017, 2Chapter in book (Other academic)
  • 30. Dean, Elizabeth
    et al.
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Lifestyle and musculoskeletal health.2015In: Grieve’s Modern Musculoskeletal Physiotherapy. / [ed] GA. Jull, A. Morre, D. Falla, J. Lewis, C. McGarthy, M. Sterling, London: Elsevier, 2015, 4, p. 117-125Chapter in book (Other academic)
  • 31. Dean, Elizabeth
    et al.
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Role of physiotherapy in lifestyle and health promotion in musculoskeletal conditions2015In: Grieve’s Modern Musculoskeletal Physiotherapy / [ed] GA. Jull, A. Morre, D. Falla, J. Lewis, C. McGarthy, M. Sterling, London: Elsevier, 2015, 4, p. 364-378Chapter in book (Other academic)
  • 32.
    Elvén, Maria
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Hochwälder, Jacek
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Dean, Elizabeth
    University of British Columbia, Canada .
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    A clinical reasoning model focused on clients’ behaviour change with reference to physiotherapists: Its multiphase development and validation2014In: Abstract book. The International Conference on Health and Social Welfare and Coproduction. Mälardalen University, Eskilstuna, Sweden. 9-10 sept 2014, 2014Conference paper (Refereed)
  • 33.
    Elvén, Maria
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Hochwälder, Jacek
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Dean, Elizabeth
    University of British Columbia, Canada .
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    A clinical reasoning model focused on clients’ behaviour change with reference to physiotherapists: Its multiphase development and validation2015In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 31, no 4, p. 231-243Article in journal (Refereed)
    Abstract [en]

    Background and purpose: A biopsychosocial approach and behaviour change strategies have long been proposed to serve as a basis for addressing current multifaceted health problems. This emphasis has implications for clinical reasoning of health professionals. This study's aim was to develop and validate a conceptual model to guide physiotherapists' clinical reasoning focused on clients' behaviour change. Methods: Phase 1 consisted of the exploration of existing research and the research team's experiences and knowledge. Phases 2a and 2b consisted of validation and refinement of the model based on input from physiotherapy students in two focus groups (n=5 per group) and from experts in behavioural medicine (n=9). Results: Phase 1 generated theoretical and evidence bases for the first version of a model. Phases 2a and 2b established the validity and value of the model. The final model described clinical reasoning focused on clients' behaviour change as a cognitive, reflective, collaborative and iterative process with multiple interrelated levels that included input from the client and physiotherapist, a functional behavioural analysis of the activity-related target behaviour and the selection of strategies for behaviour change. Conclusions: This unique model, theory- and evidence-informed, has been developed to help physiotherapists to apply clinical reasoning systematically in the process of behaviour change with their clients. 

  • 34.
    Elvén, Maria
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Hochwälder, Jacek
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Dean, Elizabeth
    University of British Columbia, Canada .
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    An innovative instrument to assess physiotherapists’ clinical reasoning focused on clients’ behaviour change: Its development and validation.2016In: Physiotherapy, ISSN 0031-9406, E-ISSN 1873-1465, Vol. 102, no s1, p. e155-e155Article in journal (Refereed)
  • 35.
    Elvén, Maria
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Hochwälder, Jacek
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Dean, Elizabeth
    Univ British Columbia, Vancouver, BC, Canada..
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Development and initial evaluation of an instrument to assess physiotherapists' clinical reasoning focused on clients' behavior change2018In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 34, no 5, p. 367-383Article in journal (Refereed)
    Abstract [en]

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

  • 36.
    Elvén, Maria
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Hochwälder, Jacek
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Dean, Elizabeth
    University of British Columbia, Canada .
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Development of a model of Clinical Reasoning with focus on patients’ Activity-related Behaviour and Behaviour change.2013In: Abstrakt bok. Sjukgymnastdagarna 2-4 oktober 2013, 2013, p. 110-111Conference paper (Refereed)
  • 37.
    Elvén, Maria
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Hochwälder, Jacek
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Dean, Elizabeth
    University of British Columbia, Canada .
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Development of a tool for assessing physiotherapy students’ clinical reasoning with focus on patients’ behavioural change2013In: Nordic Advances in Health Care Sciences Research. November 13-14 2013 in Lund. Abstract book, 2013, p. 13-13Conference paper (Refereed)
  • 38.
    Engh, L
    et al.
    Ortopedic Clinic, Falu Hospital, Falun, Sweden .
    Fall, M
    St. Görans Hospital, Stockholm, Sweden.
    Hennig, M
    Uppsala University, Uppsala, Sweden.
    Söderlund, Anne
    Uppsala University, Uppsala, Sweden.
    Intra- and inter-rater reliability of goniometric method of measuring head posture2003In: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040, Vol. 19, no 3, p. 175-182Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to investigate the intra- and inter-rater reliability of a method aimed to measure the head position relative to shoulders with a universal goniometer. The subjects included 31 healthy individuals with mean age 31.5 years. To examine intra-rater reliability, two assistants carried out the measurements on two occasions with an interval of eight days. To examine inter-rater reliability, four assistants carried out the measurements. The intraclass correlation coefficient (ICC based on one factor repeated measures ANOVA) was 0.91 for the first assistantand 0.94 for the second. No significant difference was evident between the two assessment occasions for the two assistants. ICC was also used to estimate the inter-rater reliability of the four assistants' measurements and was 0.95. The mean difference between the four assistants' reading varied from 0.1 to 1.6 degrees. It was concluded that the measurement of head position relative to shoulders with a goniometer is a reliable method. However, standardisation of method is important to get reliable measurement results in this method, as it is in any measurement method.

  • 39.
    Engquist, M.
    et al.
    Department of Orthopaedics, Ryhov Hospital, S-551 85 Jönköping.
    Löfgren, H.
    Neuro-orthopedic Center, Ryhov Hospital, Jönköping.
    Öberg, B.
    Linköping University.
    Holtz, A.
    ala University Hospital,.
    Peolsson, A.
    Linköping University.
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Vavruch, L.
    Neuro-orthopedic Center, Ryhov Hospital.
    Lind, B.
    Department of Orthopaedics, Ryhov Hospital.
    Surgery versus nonsurgical treatment of cervical radiculopathy: A prospective, randomized study comparing surgery plus physiotherapy with physiotherapy alone with a 2-year follow-up2013In: Spine, ISSN 0362-2436, E-ISSN 1528-1159, Vol. 38, no 20, p. 1715-1722Article in journal (Refereed)
    Abstract [en]

    STUDY DESIGN.: Prospective randomized controlled trial. OBJECTIVE.: To study the outcome of anterior cervical decompression and fusion combined with a structured physiotherapy program compared with the same physiotherapy program alone for patients with cervical radiculopathy. SUMMARY OF BACKGROUND DATA.: Knowledge concerning the effects of interventions for patients with cervical radiculopathy is scarce due to a lack of randomized studies. METHODS.: Sixty-three patients were randomized to surgery with postoperative physiotherapy (n = 31) or physiotherapy alone (n = 32). The surgical group was treated with anterior cervical decompression and fusion. The physiotherapy program included general/specific exercises and pain-coping strategies. The outcome measures were disability (Neck Disability Index), neck and arm pain intensity (visual analogue scale), and the patient's global assessment. Patients were followed for 24 months. RESULTS.: The result from the repeated-measures analysis of variance showed no significant between-group difference for Neck Disability Index (P = 0.23). For neck pain intensity, the repeated-measures analysis of variance showed a significant between-group difference during the study period in favor of the surgical group (P = 0.039). For arm pain intensity, no significant between-group differences were found according to the repeated-measures analysis of variance (P = 0.580). Eighty-seven percent of the patients in the surgical group rated their symptoms as "better/much better" at the 12-month follow-up compared with 62% in the nonsurgical group (P < 0.05). At 24 months, the corresponding figures were 81% and 69% (P = 0.28). The difference was significant only at the 12-month follow-up in favor of the surgical group. Significant reduction in Neck Disability Index, neck pain, and arm pain compared with baseline was seen in both groups (P < 0.001). CONCLUSION.: In this prospective, randomized study of patients with cervical radiculopathy, it was shown that surgery with physiotherapy resulted in a more rapid improvement during the first postoperative year, with significantly greater improvement in neck pain and the patient's global assessment than physiotherapy alone, but the differences between the groups decreased after 2 years. Structured physiotherapy should be tried before surgery is chosen. Copyright © 2013 Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited.

  • 40.
    Engquist, Markus
    et al.
    Ryhov Hosp, Jönköping, Sweden..
    Lofgren, Hakan
    Ryhov Hosp, Jönköping, Sweden..
    Oberg, Birgitta
    Linköping Univ, Linköping, Sweden..
    Holtz, Anders
    Univ Uppsala Hosp, Uppsala, Sweden..
    Peolsson, Anneli
    Linköping Univ, Linköping, Sweden..
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Vavruch, Ludek
    Ryhov Hosp, Jönköping, Sweden..
    Lind, Bengt
    Univ Gothenburg, Gothenburg, Sweden..
    A 5-to 8-year randomized study on the treatment of cervical radiculopathy: anterior cervical decompression and fusion plus physiotherapy versus physiotherapy alone2017In: JOURNAL OF NEUROSURGERY-SPINE, ISSN 1547-5654, Vol. 26, no 1, p. 19-27Article in journal (Refereed)
    Abstract [en]

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

  • 41.
    Engquist, Markus
    et al.
    Ryhov Hospital, Jönköping, Sweden.
    Löfgren, Håkan
    Ryhov Hospital, Jönköping, Sweden.
    Öberg, Birgitta
    Linkoping University, Linköping, Sweden.
    Holtz, Anders
    Uppsala University Hospital, Uppsala, Sweden.
    Peolsson, Anneli
    Linkoping University, Linköping, Sweden.
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Vavruch, Ludek
    Spine Center Goteborg, Gothenburg, Sweden.
    Lind, Bengt
    Spine Center Goteborg, Gothenburg, Sweden.
    Factors affecting the outcome of surgical versus nonsurgical treatment of cervical radiculopathy: A randomized, controlled study2015In: Spine, ISSN 0362-2436, E-ISSN 1528-1159, Vol. 40, no 20, p. 1553-1563Article in journal (Refereed)
    Abstract [en]

    STUDY DESIGN: Prospective randomized controlled trial.

    OBJECTIVE: To analyze factors that may influence the outcome of anterior cervical decompression and fusion (ACDF) followed by physiotherapy versus physiotherapy alone for treatment of patients with cervical radiculopathy.

    SUMMARY OF BACKGROUND DATA: An understanding of patient-related factors affecting the outcome of ACDF is important for preoperative patient selection. No previous prospective, randomized study of treatment effect modifiers relating to outcome of ACDF compared with physiotherapy has been carried out.

    METHODS: Sixty patients with cervical radiculopathy were randomized to ACDF followed by physiotherapy or physiotherapy alone. Data for possible modifiers of treatment outcome at one year, such as sex, age, duration of pain, pain intensity, disability (Neck Disability Index, NDI), patient expectations of treatment, anxiety due to neck/arm pain, distress (Distress And Risk Assessment Method, DRAM), self efficacy (Self Efficacy Scale, SES) health status (EQ-5D) and MRI findings were collected. A multivariate analysis was performed to find treatment effect modifiers affecting the outcome regarding arm/ neck pain intensity and NDI.

    RESULTS: Factors that significantly altered the treatment effect between treatment groups in favor of surgery were: duration of neck pain < 12 months (p = 0.007), duration of arm pain < 12 months (p = 0.01) and female sex (p = 0.007) (outcome: arm pain), low EQ-5D index (outcome: neck pain, p = 0.02), high levels of anxiety due to neck/arm pain (outcome: neck pain, p = 0.02 and NDI, p = 0.02), low SES score (p = 0.05) and high DRAM score (p = 0.04). (outcome: NDI). No factors were found to be associated with better outcome with physiotherapy alone.

    CONCLUSIONS: In this prospective, randomized study of patients with cervical radiculopathy, short duration of pain, female sex, low health quality, high levels of anxiety due to neck/arm pain, low self efficacy and a high level of distress before treatment were associated with better outcome from surgery. No factors were found to be associated with better outcome from physiotherapy alone.

  • 42.
    Folke, Mia
    et al.
    Mälardalen University, School of Innovation, Design and Engineering, Embedded Systems.
    Brangefält, Lotta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Cernerud, Lars
    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.
    Framja fysisk aktivitet med LACTA och motiverande samtal2010Conference paper (Refereed)
  • 43.
    Folke, Mia
    et al.
    Mälardalen University, School of Innovation, Design and Engineering, Embedded Systems.
    Brangefält, Lotta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    CERNERUD, LARS
    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.
    PROMOTING PHYSICAL ACTIVITY OF NON-REGULARLY ACTIVE PERSONS: the use of workload at lactate threshold and motivating interviewing2010In: 3 rd International Congress on Physical Activity and Public Health, 2010Conference paper (Refereed)
  • 44.
    Gerdle, Björn
    et al.
    Linköpings ­universitet, Linköping, Sweden; Universitetssjukhuset, Linköping, Sweden.
    Stålnacke, Britt-Marie
    Umeå universitet, Umeå, Sweden; Norrlands universitetssjukhus, Umeå, Sweden.
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Asenlöf, Pernilla
    Uppsala universitet, Uppsala, Sweden; Akademiska sjukhuset, Uppsala, Sweden.
    Multimodal rehabilitering vid smärta alltför lågt prioriterad2011In: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 108, no 11, p. 580-581Article in journal (Refereed)
  • 45.
    Gerdle, Björn
    et al.
    Linköpings universitet; Universitetssjukhuset, Linköping.
    Stålnacke, Britt-Marie
    Umeå universitet; Norrlands universitetssjukhus, Umeå.
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Åsenlöf, Pernilla
    Uppsala universitet.
    Indikation för multimodal rehabilitering vid långvarig smärta2011Report (Refereed)
  • 46.
    Gross, A
    et al.
    McMaster University.
    Kaplan, F
    McMaster University.
    Huang, S
    McMaster University.
    Khan, M
    McMaster University.
    Santaguida, PL
    McMaster University.
    Carlesso, LC
    McMaster University.
    MacDermid, JC
    St. Joseph’s Health Centre, London, ON, Canada.
    Walton, DM
    University of Western Ontario, London, ON, Canada.
    Kenardy, J
    The University of Queensland.
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Verhagen, A
    Erasmus Medical Centre, Utrecht, The Netherlands.
    Hartvigsen, J
    University of Southern Denmark.
    Psychological Care, Patient Education, Orthotics, Ergonomics and Prevention Strategies for Neck Pain: A Systematic Overview: Update as part of the ICON* Project.2013In: Open Orthopaedics Journal, ISSN 1874-3250, E-ISSN 1874-3250, Vol. 7, no Suppl 4:M12, p. 530-561Article in journal (Refereed)
  • 47.
    Gustafsson, Gunnel
    et al.
    Mälardalen University, School of Health, Care and Social Welfare. Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Aytar, Osman
    Mälardalen University, School of Health, Care and Social Welfare. Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Akhavan, Sharareh
    Mälardalen University, School of Health, Care and Social Welfare. Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Bogg, Lennart
    Mälardalen University, School of Health, Care and Social Welfare. Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare. Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Tillgren, Per
    Mälardalen University, School of Health, Care and Social Welfare. Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Områdesbeskrivningar av sju vårdverksamheter: Primärvårdens förutsättningar och befolkningens vårdbehov2014Report (Other academic)
    Abstract [sv]

    Lärandeprojektet Vård på lika villkor har varit en överenskommelse mellan staten och Sveriges Kommuner och Landsting som pågått mellan 2011 och 2014. Målet med projektet har varit att utveckla arbetssätt och metoder som kan främja en mer jämlik första linjens vård. Inom ramen för projektet har SKL uppdragit åt forskare vid Mälardalens högskola att göra områdesbeskrivningar för de sju medverkande vårdverksamheterna.

    Syftet med områdesbeskrivningarna är försöka ge en jämförbar beskrivning av de medverkande sju verksamheterna i projektet. Beskrivningen är gjord utifrån relevant statistik och demografi ska data på patientnivå, samt utifrån organisatoriska förutsättningar och resurser. Förhoppningen är att dessa uppgifter kan ge ökad förståelse för vilka patienter som fi nns i området och fungera som ett stöd i arbetet för en mer jämlik vård.

  • 48. Gustavsson, Catharina
    et al.
    Nordlander, Jessica
    Norlund, Anders
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    ALAR - Activity and life-role targeting rehabilitation for people with persistent musculoskeletal pain: a randomised controlled trial of a return-to-work intervention in primary health care REHSAM.2014Report (Other academic)
  • 49.
    Götell, Eva
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Thunborg, Charlotta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Örebro University, Sweden.
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Heideken Wågert, Petra
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Can caregiver singing improve person transfer in dementia care2012In: Music and Medicine, ISSN 1943-8621, Vol. 4, no 4, p. 237-244Article in journal (Refereed)
    Abstract [en]

    Everyday person transfer situations involving persons with dementia and their caregivers can be reciprocally problematic. Group interviews with professional caregivers were conducted, focusing on the caregivers’ experiences of singing during person transfer situations with residents with dementia, and a qualitative content analysis was performed. The caregivers expressed that compared to everyday transfer situations without singing, there were obvious differences during singing. When the caregiver sang, communication was mutually enhanced between the caregivers and the residents. Caregivers reported that residents seemed to show their true personalities, were able to move more fluidly and easily, seemed to better understand what was going on, and reacted with a spirited cheerfulness. The caregivers experienced themselves as more competent in and motivated to provide care in addition to positive emotions and moods. Caregiver singing during transfer situations may be one of several suitable nonpharmacological interventions that can be utilized when caregivers need to assist persons with dementia in transfer.

  • 50.
    Hasenbring, M. I.
    et al.
    Ruhr-University of Bochum, Germany.
    Lundberg, M.
    University Hospital of Gothenburg, Sweden.
    Parker, R.
    University of Cape Town, South Africa.
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Bolton, B.
    Mill ParkPort, Elizabeth, South Africa .
    Smeets, R. J. E. M.
    Maastricht University, Maastricht, Netherlands .
    Ljutov, A.
    Swiss Paraplegic-Centre, Nottwil, Switzerland .
    Simmonds, M. J.
    University of Texas, San Antonio, TX, United States .
    Pain, mind, and movement in musculoskeletal pain: Is physical activity always health-promoting or are there detrimental aspects?2014In: The Clinical Journal of Pain, ISSN 0749-8047, E-ISSN 1536-5409, Vol. 31, no 2, p. 95-96Article in journal (Other academic)
123 1 - 50 of 135
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