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  • 1.
    Bergström, H.
    et al.
    Karolinska Institutet.
    Hochwälder, Jacek
    Mälardalen University, School of Business, Society and Engineering.
    Kottorp, A.
    Karolinska Institutet.
    Elinder, L. S.
    Karolinska Institutet.
    Psychometric evaluation of a scale to assess satisfaction with life among people with intellectual disabilities living in community residences2013In: Journal of Intellectual Disability Research, ISSN 0964-2633, E-ISSN 1365-2788, Vol. 57, no 3, p. 250-256Article in journal (Refereed)
    Abstract [en]

    Background In the context of a health intervention among people with intellectual disabilities (ID), there was a need to assess satisfaction with some aspects of life, in order to monitor both potential positive and negative effects of the intervention. The aim of the present study was to develop and evaluate an easily administered scale for assessing satisfaction with home environment and leisure time among people with mild or moderate ID, living in community residences. Methods A number of questions were constructed to measure satisfaction with home environment and leisure time. The questions were answered by 132 adults with mild or moderate ID, living in community residences in Sweden. The dimensionality of the scale was evaluated by factor analysis, and the reliability was estimated using Cronbach's alpha coefficients. Results The analysis supported a four-factor solution with 12 items. The four factors were: (I) Satisfaction with housing environment; (II) Satisfaction with life; (III) Satisfaction with meals; and (IV) Satisfaction with recreational activity. The four factors explained almost 70% of the variance in the data set. Cronbach alpha coefficients for all scales were above 0.70, indicating that the reliabilities of the scales were satisfactory. Correlations between the four sub-scales ranged from 0.06 to 0.52, indicating low to moderate inter-correlations between the four sub-scales. Conclusion The scale has fairly good psychometric properties and is easy to administer. The scale, which can be further improved, can be an important resource in health intervention studies.

  • 2.
    Elvén, Maria
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Hochwälder, Jacek
    Mälardalen University, School of Business, Society and Engineering. Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Dean, Elizabeth
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Dept Phys Therapy, Vancouver, BC, Canada..
    Hallman, Olle
    Uppsala Univ, Dept Informat Technol, Uppsala, Sweden..
    Söderlund, Anne
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Criterion scores, construct validity and reliability of a web-based instrument to assess physiotherapists' clinical reasoning focused on behaviour change: 'Reasoning 4 Change'2018In: AIMS PUBLIC HEALTH, ISSN 2327-8994, Vol. 5, no 3, p. 235-259Article in journal (Refereed)
    Abstract [en]

    Background and aim: 'Reasoning 4 Change' (R4C) is a newly developed instrument, including four domains (D1-D4), to assess clinical practitioners' and students' clinical reasoning with a focus on clients' behaviour change in a physiotherapy context. To establish its use in education and research, its psychometric properties needed to be evaluated. The aim of the study was to generate criterion scores and evaluate the reliability and construct validity of a web-based version of the R4C instrument. Methods: Fourteen physiotherapy experts and 39 final-year physiotherapy students completed the R4C instrument and the Pain Attitudes and Beliefs Scale for Physiotherapists (PABS-PT). Twelve experts and 17 students completed the R4C instrument on a second occasion. The R4C instrument was evaluated with regard to: internal consistency (five subscales of D1); test-retest reliability (D1-D4); inter-rater reliability (D2-D4); and construct validity in terms of convergent validity (D1.4, D2, D4). Criterion scores were generated based on the experts' responses to identify the scores of qualified practitioners' clinical reasoning abilities. Results: For the expert and student samples, the analyses demonstrated satisfactory internal consistency (alpha range: 0.67-0.91), satisfactory test-retest reliability (ICC range: 0.46-0.94) except for D3 for the experts and D4 for the students. The inter-rater reliability demonstrated excellent agreement within the expert group (ICC range: 0.94-1.0). The correlations between the R4C instrument and PABS-PT (r range: 0.06-0.76) supported acceptable construct validity. Conclusions: The web-based R4C instrument shows satisfactory psychometric properties and could be useful in education and research. The use of the instrument may contribute to a deeper understanding of physiotherapists' and students' clinical reasoning, valuable for curriculum development and improvements of competencies in clinical reasoning related to clients' behavioural change.

  • 3.
    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)
  • 4.
    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. 

  • 5.
    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)
  • 6.
    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.

  • 7.
    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)
  • 8.
    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)
  • 9.
    Eriksson, Monica
    et al.
    Mid Sweden University.
    Asplund, Kenneth
    Mid Sweden University.
    Hochwälder, Jacek
    Mälardalen University, School of Health, Care and Social Welfare.
    Svedlund, Marianne
    Mid Sweden University.
    Changes in hope and health-related quality of life in couples following acute myocardial infarction: A quantitative longitudinal study2013In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 27, no 2, p. 295-302Article in journal (Refereed)
    Abstract [en]

    Acute myocardial infarction (AMI) is a life-changing event that affects both the patient and the family and can have an influence on hope as well as HRQoL during the recovery period. Aims: To compare self-rated scores of hope and health-related quality of life (HRQoL) 1, 7, 13 and 25months, after an AMI with regard to (i) differences across time, and (ii) differences between patients and their partners. Design: Explorative and longitudinal study. Methods: In this nonrandomized study, Short Form 36 Health Questionnaire (SF-36) and Herth Hope Index-Swedish (HHI-S) questionnaires were completed by thirteen post-AMI patients and their partners. Data were collected on four occasions. Results: In general, hope as well as HRQoL scores increased over time. A 2 (groups)×4 (times) anova for mixed design showed significant changes in mental as well as in physical health over time but no significant effect of group on mental or physical health. Calculation of the minimum detectable change (MDC-index) for HHI-S and SF-36 revealed that scores between data collection points were not stable. Conclusion: Our results show that although hope and HRQoL scores increased, only a few of the changes were statistically significant. Neither HHI-S nor SF-36 seems to measure stable states. Changes in hope and HRQoL levels may be due to participants striving to adapt to the current situation. Relevance to clinical practice: These results can be used in the training of nursing staff to enhance their understanding of the significance of a family-centred approach after an AMI. © 2012 Nordic College of Caring Science.

  • 10.
    Eriksson, Ulrika
    et al.
    Mid Sweden Univ.
    Hochwälder, Jacek
    Mälardalen University, School of Sustainable Development of Society and Technology.
    Carlsund, Åsa
    Mid Sweden Univ.
    Sellström, Eva
    Mid Sweden Univ.
    Health outcomes among Swedish children: the role of social capital in the family, school and neighbourhood2012In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 101, no 5, p. 513-517Article in journal (Refereed)
    Abstract [en]

    Aim: The aim of the study was to explore the extent to which Swedish childrens perceptions of social capital in the family, school and neighbourhood predicted health complaints and well-being. Methods: The study used data from the Swedish Health Behaviour in School-aged Children survey. The sample consisted of 3926 children aged 11-15 years. Correlations and hierarchical multiple linear regression were performed. Results: Higher degrees of family, school and neighbourhood social capital corresponded to lower levels of health complaints and higher levels of well-being. Social capital in these three spheres had a cumulative effect on children's health and well-being. Conclusions: Social capital in the family, school and neighbourhood matters for children's health and well-being and the contributions from each context seem to be additive. Besides the family context, investments for improving child health should primarily be in the school, focusing on social relations and on creating safe and cohesive school environments. Neighbourhood social capital is also of importance and so must be taken into consideration when planning child health promotion interventions.

  • 11.
    Eriksson, Ulrika
    et al.
    Mid Sweden Univ.
    Hochwälder, Jacek
    Mälardalen University, School of Sustainable Development of Society and Technology.
    Sellstrom, Eva
    Mid Sweden Univ.
    Perceptions of community trust and safety - consequences for children's well-being in rural and urban contexts2011In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 100, no 10, p. 1373-1378Article in journal (Refereed)
    Abstract [en]

    Aim: To explore the associations between subjective well-being and perceptions of community trust and safety amongst children in rural and urban areas. Methods: The study used self-reported data from the 2001/2002 Swedish cross-national WHO study Health Behaviour in School-aged Children. The sample consisted of 3852 children aged 11-15 years, living in different residential areas. Bivariate analyses and multivariate logistic regression were performed. Results: The results indicated that a greater proportion of children in urban areas perceived low community trust and safety, compared with children in rural areas. Further, the multivariate analysis revealed that perceived community trust and safety significantly impacts upon children's subjective well-being in both rural and urban contexts. Conclusion: Children's perceptions of trust and safety have different magnitudes in urban and rural areas. The associations of perceptions of community trust and safety for children's subjective well-being are relevant in both urban and rural areas. As perceptions of low trust and safety in the community seem to be related to low subjective well-being, efforts to encourage community trust and safety should be included amongst the key priorities in community health promotion.

  • 12.
    Hochwälder, Jacek
    Natl. Inst. for Working Life, Stockholm, Sweden .
    Assumptions about human nature: Comparison of implicit and explicit personality theories2000In: Psychological Reports, ISSN 0033-2941, Vol. 87, no 2, p. 611-622Article in journal (Refereed)
    Abstract [en]

    Hjelle and Ziegler (1981) believe that people's positions on nine fundamental dimensions of human nature affect their personality theories, and that differences between people on these dimensions contribute to differences between their personality theories. The present study was conducted in order to obtain information about the ordinary person's position on these dimensions and to compare the ordinary person's position with 10 personality theorists' positions. 84 subjects rated their positions on each of nine Ii-step bipolar dimensions. The following results were obtained: (1) According to the ordinary person, the human being is free, changeable, influenced by the subjective world of experience, a product of the environment, and best understood from a holistic perspective; (2) The position of the ordinary person is most similar to Allport's position, and least similar to Skinner's position. The results are discussed in light of the relation between implicit (lay) and explicit (scientific) theories of personality.

  • 13.
    Hochwälder, Jacek
    Mälardalen University, School of Health, Care and Social Welfare.
    Negative Life Events and Mental Ill-Health Among Women: A Prospective Study of the Main, Moderating and Mediating Effect of Sense of Coherence2013In: Journal of Happiness Studies, ISSN 1389-4978, Vol. 14, no 6, p. 1739-1750Article in journal (Refereed)
    Abstract [en]

    Antonovsky's original observations of mental health among women who had survived Nazi concentration camps became the start for the formulation of sense of coherence (SOC) and suggested that the experience of negative life events can be a risk-factor for, whilst SOC can be a protection-factor against, mental ill-health. In the present study, 1,012 women responded to a questionnaire at two points in time that measured mental ill-health, SOC and the experience of negative life events. The results showed that women who had recently experienced negative life events had higher levels of mental ill-health compared to women who had not recently experienced any negative life events. SOC was also found to have a main effect on mental ill-health but neither moderated nor mediated the relation between negative life events and mental ill-health. Suggestions for future research and practical implications are given. © 2013 Springer Science+Business Media Dordrecht.

  • 14.
    Hochwälder, Jacek
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Test of Antonovsky's postulate: High sense of coherence helps people avoid negative life events2015In: Psychological Reports, ISSN 0033-2941, E-ISSN 1558-691X, Vol. 116, no 2, p. 363-376Article in journal (Refereed)
    Abstract [en]

    This study tested Antonovsky's postulate that a high sense of coherence (SOC) helps people avoid negative life events. It was assumed that negative life events that were uncontrollable would not show this effect, while those events that potentially could be controlled would show a significant relationship with SOC. 1,012 female nurses (M age = 46.9 yr.; SD = 8.9) participated in this longitudinal study and were divided into groups with low, moderate, and high SOC. Sixteen negative life events were categorized into uncontrollable and controllable events, with the controllable events divided into three sub-categories. Five one-way analyses of variance (ANOVAs) for independent measures followed up with post hoc tests were performed, with the number of experienced events in a given cat-egory by each participant (at Time 2) as the dependent variable and the three SOC groups (formed at Time 1) as the independent variable. The results indicated that the high SOC group reported fewer controllable negative life events, while there was no significant relationship between the SOC level and uncontrollable negative life events. The findings support the postulate in Antonovsky's model, with the distinction between controllable and uncontrollable negative life events.

  • 15.
    Hochwälder, Jacek
    Mälardalen University, School of Sustainable Development of Society and Technology.
    The contribution of the big five personality factors to sense of coherence2012In: Personality and Individual Differences, ISSN 0191-8869, E-ISSN 1873-3549, Vol. 53, no 5, p. 591-596Article in journal (Refereed)
    Abstract [en]

    How much of the variation among individuals with regard to sense of coherence (SOC) can be explained by some of the important and central factors in people's lives, above what can be explained by the big five personality factors? Six hundred and ninety-eight randomly selected persons (419 women and 279 men, aged 30-65 years) responded to a questionnaire that measured SOC, the big five personality factors, demographic, socio-economic, private-life, and work-life variables. The five personality factors explained 38% (for women) and 40% (for men) of the variation in SOC and the demographic, socio-economic, private-life, and work-life variables explained an additional 17% (for women) and 12% (for men) of the variation in SOC. Thus, the five personality factors explain a substantial part of the variation in SOC but SOC captures additional aspects that cannot be captured by the five fundamental personality factors.

  • 16.
    Hochwälder, Jacek
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Brucefors, Agneta Bergsten
    Karolinska Univ Hosp Huddinge, Stockholm CF Ctr, Stockholm, Sweden..
    Hjelte, Lena
    Karolinska Univ Hosp Huddinge, Stockholm CF Ctr, Stockholm, Sweden.;Karolinska Inst, Div Intervent & Implementat Res, Dept Publ Hlth, Stockholm, Sweden..
    Psychometric evaluation of the Swedish translation of the revised Cystic Fibrosis Questionnaire in adults2017In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 122, no 1, p. 61-66Article in journal (Refereed)
    Abstract [en]

    Aim: The CFQ-R is one of the most established disease-specific, health-related quality of life (HRQOL) measurements for patients with cystic fibrosis (CF). The aim was to evaluate the psychometric properties of the Swedish translation of CFQ-R in adults. Method: A total of 173 CF patients answered the CFQ-R. The CFQ-R was evaluated with regard to: (1) distributional properties; (2) reliability; and (3) construct validity. Results: The majority of scales were negatively skewed with ceiling effects. Eight of the 12 scales had satisfactory homogeneity; 10 of the 12 scales had satisfactory test-retest reliability. On many of the CFQ-R scales expected differences were observed when patients were divided regarding disease severity, nutritional status, age, and gender. Conclusion: Some weaknesses were detected, but overall the instrument has satisfactory psychometric properties.

  • 17.
    Manasatchakun, Pornpun
    et al.
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Boromarajonani College of Nursing Udon Thani, Udon Thani, Thailand .
    Chotiga, Pleumjit
    Boromarajonani College of Nursing Chiang Mai, Chiang Mai, Thailand.
    Hochwälder, Jacek
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Roxberg, Åsa
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. School of Health and Welfare, Halmstad University, Halmstad, Sweden; VID Specialized University, Bergen, Norway .
    Sandborgh, Maria
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Asp, Margareta
    Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.
    Factors Associated with Healthy Aging among Older Persons in Northeastern Thailand2016In: Journal of Cross-Cultural Gerontology, ISSN 0169-3816, E-ISSN 1573-0719, Vol. 31, no 4, p. 369-384Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to describe factors associated with perceived health and healthy aging among older people in northeastern Thailand. Thailand’s aging population is growing and facing an increasing old-age dependency ratio. Northeastern Thailand, known as Isan, is a region in which the number of older residents is projected to grow rapidly. Older people in this region are likely to confront great threats to their health and well-being. These issues require appropriate attention and actions to promote healthy aging. However, healthy aging in this region has not been studied. A cross-sectional study was conducted on a sample of 453 older people, aged 60 years or older. Participants completed the Healthy Aging Instrument (HAI) and provided relevant demographic characteristics. Mann-Whitney U tests, Kruskal-Wallis tests and multiple regression models were used to analyze the data. Through comparative analyses, significant differences in HAI scores were observed for the following factors: marital status, residential area, disability, income level, and perceived meaningfulness in life. In the multiple regression models, residential area, disability, and marital status explained 24.30 % of the variance in HAI scores. Health promotion strategies and future targeted intervention programs should consider the importance of these factors. 

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