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  • 51.
    Folke, Mia
    et al.
    Mälardalens högskola, Akademin för innovation, design och teknik, Inbyggda system.
    Brangefält, Lotta
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    CERNERUD, LARS
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    PROMOTING PHYSICAL ACTIVITY OF NON-REGULARLY ACTIVE PERSONS: the use of workload at lactate threshold and motivating interviewing2010Inngår i: 3 rd International Congress on Physical Activity and Public Health, 2010Konferansepaper (Fagfellevurdert)
  • 52.
    Fritz, Johanna
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Söderbäck, Maja
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Sandborgh, Maria
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    The complexity of integrating a behavioral medicine approach into physiotherapy clinical practice2018Inngår i: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Introduction and Aim: The implementation of a behavioral medicine (BM) approach in physiotherapy is challenging, and studies regarding the determinants are sparse. Thus, the aim of this study was to explore determinants of applying a BM approach in physiotherapy for patients with persistent pain across the micro-, meso-, and macro-levels. Methods: A qualitative multiple-case study design was used. Data were collected from four cases through semi-structured interviews with physiotherapists (PTs), patients, and managers; observations of video-recorded treatment sessions; and reviews of local directives and regulations. Data were analyzed with inductive content analysis and cross-case analysis, followed by mapping to the domains of determinants at the micro-, meso-, and macro-levels within the Implementation of Change Model. Results: Similar determinants were found across the cases. At the micro-level, these determinants concerned the PTs’ ambivalence toward a BM approach, a biomedical focus, embarrassment asking about psychosocial factors, BM knowledge, skills for applying the approach, and self-awareness. Others concerned the patients’ role expectations of the PT, patients as active or passive agents in the treatment process, patients’ focus on biomedical aspects, and confidence in the PT. At the meso-level, support from managers and peers, allocation of time, and expectations from the organization were identified as determinants. No determinants were identified at the macro-level. Conclusion: The complexity of integrating a BM approach into physiotherapy clinical practice arises from multiple determinants functioning as both facilitators and barriers. By selecting strategies to address these determinants, the implementation of a BM approach could be supported.

  • 53.
    Fritz, Johanna
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Almqvist, Lena
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Wallin, Lars
    Högskolan Dalarna.
    Sandborgh, Maria
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Implementation of a behavioural medicine approach in physiotherapy – a process evaluation.2017Inngår i: World Confederation of Physical Therapy (WCPT) Congress, Cape Town, South Africa, 2-4 July, 2017., 2017Konferansepaper (Fagfellevurdert)
    Abstract [en]

    Background: A behavioural medicine approach in physiotherapy for patients with persistent musculoskeletal pain is recommended based on evidence. The approach aims at an individually tailored treatment targeting motor behaviour, cognition, disability and active patient involvement. The behavioural medicine approach is complex and it is challenging in implementation to achieve clinically relevant behaviours in physiotherapy. Process evaluation is an essential part of designing and testing implementation interventions to improve the quality of the implementation. However, studies evaluating the implementation process of a behavioural medicine approach in physiotherapy are sparse.

    Purpose: To explore the implementation process of a behavioural medicine approach in physiotherapy.

    Methods: Qualitative and quantitative methods were used. 15 physiotherapists working in six primary health care units were consecutively included. A theory based implementation intervention was tailored to the participating individual physiotherapists. Active and multifaceted implementation strategies were used during a total of seven days spread over a six months implementation period. The main implementation strategies were external facilitation and peer-learning. Ten two-hours outreach sessions were offered to each unit. The physiotherapists were encouraged to use individual goal setting and video recordings of treatment sessions to facilitate feedback and reflection during the sessions with the external facilitator. Process data were collected using semi-structured interviews, self-reports of time allocation for different implementation strategies and documented individual goals. Qualitative content analysis and quantitative frequency scorings were used for data analyses.

    Results: In median the physiotherapists participated in 9 (3-10) out of 10 sessions with the external facilitator. Discussing clinical experiences of the behavioural medicine approach together with the external facilitator was perceived as valuable. These discussions stimulated reflection and problem solving, and was also experienced as a reminder for practicing skills in behavioural medicine. Video recordings of treatment sessions were used by ten of the physiotherapists at 17 out of 57 possible sessions. Video recordings were experienced as too complicated to use in relation to the gains. Lack of time was also considered as a barrier for using video recordings. Individual goal-setting from one session to the next with the external facilitator was frequently used by all the participants. Relevant skills for the goals were practiced in between the sessions. However, goal setting was not considered important by the physiotherapists. In median the physiotherapists spent 3.25 (0-9.5) hours for peer discussions. Peer discussions were a strategy that the physiotherapists wanted to continue with, even after the implementation intervention period. Even though the physiotherapists had permission from the manager to spend time on the implementation intervention, it was challenging for the physiotherapists to prioritize the implementation intervention before patient care.

    Conclusion(s): External facilitation and peer discussions were perceived as important strategies for stimulating practice of behavioural medicine skills in physiotherapy. Further, peer discussions could stimulate sustainability of the implementation. The physiotherapists needed support to use the designated time for the implementation.

    Implications: Quantitative and qualitative analyses of the implementation process is useful for understanding the mechanisms of impact for the implementation intervention, how outcomes were achieved and for future replications.

  • 54.
    Fritz, Johanna
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Wallin, Lars
    Almqvist, Lena
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Sandborgh, Maria
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    EXPERIENCES OF USING THE MEDICAL RESEARCH COUNCIL GUIDANCE FOR PROCESS EVALUATION2019Inngår i: Advances in Health Care Sciences Conferences, Karolinska Insitutet, Stockholm, 13-14 November, 2019., 2019Konferansepaper (Fagfellevurdert)
  • 55.
    Fritz, Johanna
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Wallin, Lars
    Univ Dalarna, Falun, Sweden..
    Almqvist, Lena
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Sandborgh, Maria
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    THE EFFECT OF FACILITATION WHEN IMPLEMENTING A BEHAVIORAL MEDICINE APPROACH IN PHYSICAL THERAPY PRIMARY HEALTH CARE2018Inngår i: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 25, s. S38-S38Artikkel i tidsskrift (Annet vitenskapelig)
  • 56.
    Fritz, Johanna
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Wallin, Lars
    Almqvist, Lena
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Sandborgh, Maria
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    The effect of facilitation when implementing a behavioral medicine approach in physical therapy primary health care2018Inngår i: International Congress of Behavioral Medicine, Santiago, Chile. 14-17 november 2018., 2018Konferansepaper (Fagfellevurdert)
  • 57.
    Fritz, Johanna
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Wallin, L.
    Dalarna University, Falun, Sweden.
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Almqvist, Lena
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Sandborgh, Maria
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Implementation of a behavioral medicine approach in physiotherapy: A process evaluation of facilitation methods2019Inngår i: Implementation Science, ISSN 1748-5908, E-ISSN 1748-5908, Vol. 14, nr 1, artikkel-id 94Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: In a quasi-experimental study, facilitation was used to support implementation of the behavioral medicine approach in physiotherapy. The facilitation consisted of an individually tailored multifaceted intervention including outreach visits, peer coaching, educational materials, individual goal-setting, video feedback, self-monitoring in a diary, manager support, and information leaflets to patients. A behavioral medicine approach implies a focus on health related behavior change. Clinical behavioral change was initiated but not maintained among the participating physiotherapists. To explain these findings, a deeper understanding of the implementation process is necessary. The aim was therefore to explore the impact mechanisms in the implementation of a behavioral medicine approach in physiotherapy by examining dose, reach, and participant experiences. Methods: An explorative mixed-methods design was used as a part of a quasi-experimental trial. Twenty four physiotherapists working in primary health care were included in the quasi-experimental trial, and all physiotherapists in the experimental group (n = 15) were included in the current study. A facilitation intervention based mainly on social cognitive theory was tested during a 6-month period. Data were collected during and after the implementation period by self-reports of time allocation regarding participation in different implementation methods, documentation of individual goals, ranking of the most important implementation methods, and semi-structured interviews. Descriptive statistical methods and inductive content analysis were used. Results: The physiotherapists participated most frequently in the following implementation methods: outreach visits, peer coaching, educational materials, and individual goal-setting. They also considered these methods to be the most important for implementation, contributing to support for learning, practice, memory, emotions, self-management, and time management. However, time management support from the manager was lacking. Conclusions: The findings indicate that different mechanisms govern the initiation and maintenance of clinical behavior change. The impact mechanisms for initiation of clinical behavior change refers to the use of externally initiated multiple methods, such as feedback on practice, time management, and extrinsic motivation. The lack of self-regulation capability, intrinsic motivation, and continued support after the implementation intervention period were interpreted as possible mechanisms for the failure of maintaining the behavioral change over time. 

  • 58.
    Frygner-Holm, Sara
    et al.
    Uppsala Univ, Dept Neurosci, BMC, Uppsala, Sweden..
    Asenlof, Pernilla
    Uppsala Univ, Dept Neurosci, BMC, Uppsala, Sweden..
    Ljungman, Gustaf
    Uppsala Univ, Dept Womens & Childrens Hlth, Akad Sjukhuset, Uppsala, Sweden..
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Physical therapists' experiences of learning and delivering a complex behavioral medicine intervention to adolescents with painInngår i: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The objective was to study physical therapists' (PTs') experiences of learning and delivering a complex intervention, a tailored behavioral medicine treatment (BMT) targeting adolescents with pain in primary care. Method: An explorative study with qualitative approach, using content analysis. Three primary care PTs delivering the treatments in a randomized controlled study were interviewed regarding their views on the BMT. Results: The participating PTs considered learning about and delivering the BMT as challenging but rewarding. The biopsychosocial approach, tailoring of the treatment and dialogues with parents were identified as key aspects of the BMT program. The process of formulating a functional behavioral analysis was perceived as strenuous. The supervision of the PTs throughout the study was regarded as crucial and necessary for learning about and providing tailored BMT. Conclusion: Learning about and delivering BMT targeting adolescents with persistent pain is fruitful but laborious and demanding according to three PTs experienced with treatment of pediatric pain in primary care. Extensive education and long periods of supervision seem to be crucial for success and safe delivery according to protocol.

  • 59.
    Gerdle, Björn
    et al.
    Linköpings ­universitet, Linköping, Sweden; Universitetssjukhuset, Linköping, Sweden.
    Stålnacke, Britt-Marie
    Umeå universitet, Umeå, Sweden; Norrlands universitetssjukhus, Umeå, Sweden.
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Asenlöf, Pernilla
    Uppsala universitet, Uppsala, Sweden; Akademiska sjukhuset, Uppsala, Sweden.
    Multimodal rehabilitering vid smärta alltför lågt prioriterad2011Inngår i: Läkartidningen, ISSN 0023-7205, E-ISSN 1652-7518, Vol. 108, nr 11, s. 580-581Artikkel i tidsskrift (Fagfellevurdert)
  • 60.
    Gerdle, Björn
    et al.
    Linköpings universitet; Universitetssjukhuset, Linköping.
    Stålnacke, Britt-Marie
    Umeå universitet; Norrlands universitetssjukhus, Umeå.
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Åsenlöf, Pernilla
    Uppsala universitet.
    Indikation för multimodal rehabilitering vid långvarig smärta2011Rapport (Fagfellevurdert)
  • 61.
    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
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    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.2013Inngår i: Open Orthopaedics Journal, ISSN 1874-3250, E-ISSN 1874-3250, Vol. 7, nr Suppl 4:M12, s. 530-561Artikkel i tidsskrift (Fagfellevurdert)
  • 62.
    Gustafsson, Gunnel
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd. Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Aytar, Osman
    Mälardalens högskola, Akademin för hälsa, vård och välfärd. Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Akhavan, Sharareh
    Mälardalens högskola, Akademin för hälsa, vård och välfärd. Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Bogg, Lennart
    Mälardalens högskola, Akademin för hälsa, vård och välfärd. Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd. Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Tillgren, Per
    Mälardalens högskola, Akademin för hälsa, vård och välfärd. Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Områdesbeskrivningar av sju vårdverksamheter: Primärvårdens förutsättningar och befolkningens vårdbehov2014Rapport (Annet vitenskapelig)
    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.

  • 63. Gustavsson, Catharina
    et al.
    Nordlander, Jessica
    Norlund, Anders
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    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.2014Rapport (Annet vitenskapelig)
  • 64.
    Gustavsson, Catharina
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Nordlander, Jessica
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Activity and life-role targeting rehabilitation for persistent pain: feasibility of an intervention in primary healthcare.2018Inngår i: European Journal of Physiotherapy, ISSN 2167-9169, E-ISSN 2167-9177, Vol. 20, nr 3, s. 141-151Artikkel i tidsskrift (Fagfellevurdert)
  • 65.
    Götell, Eva
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Thunborg, Charlotta
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd. Örebro University, Sweden.
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Heideken Wågert, Petra
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Can caregiver singing improve person transfer in dementia care2012Inngår i: Music and Medicine, ISSN 1943-8621, Vol. 4, nr 4, s. 237-244Artikkel i tidsskrift (Fagfellevurdert)
    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.

  • 66.
    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
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    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?2015Inngår i: The Clinical Journal of Pain, ISSN 0749-8047, E-ISSN 1536-5409, Vol. 31, nr 2, s. 95-96Artikkel i tidsskrift (Annet vitenskapelig)
  • 67.
    Hellström, K.
    et al.
    Uppsala University, Sweden.
    Sandström, M.
    Uppsala University, Sweden.
    Heideken Wågert, Petra
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Sandborgh, Maria
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Thors Adolfsson, E.
    Primary Care, Central Hospital Ing., Västerås, Sweden.
    Johansson, Ann-Christin
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Fall-related self-efficacy in instrumental activities of daily living is associated with falls in older community-living people2013Inngår i: Physical & Occupational Therapy in Geriatrics, ISSN 0270-3181, E-ISSN 1541-3152, Vol. 31, nr 2, s. 128-139Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Introduction: The aim of this study was to identify fall risk factors in community-living people 75 years or older. Methods: From a random selection of 525 older adults, a total of 378 (72%) individuals participated in the study. Mean age was 81.7 years (range 75-101 years). A study-specific questionnaire including self-reported fall history for the past 6 months, the Falls-Efficacy Scale (Swedish version: FES(S)) and EuroQol 5 Dimensions (EQ5D) was used. Logistic regression analysis was conducted to find risk factors for falls. Results: The strongest significant predictor of falls was scoring low on FES(S) in instrumental activities of daily living (IADL), with an odds ratio of 7.89 (95% confidence interval 2.93-21.25). One fifth had experienced one or more falls during the past 6 months. Both fall-related self-efficacy and health-related quality of life were significantly lower among fallers. Conclusion: Our results imply that identifying community-living older adults with an increased risk of falling should include a measure of fall-related self-efficacy in IADL.

  • 68.
    Holm, S
    et al.
    Uppsala Universitet, Sweden.
    Ljungman, G
    Uppsala Universitet, Sweden.
    Åsenlöf, P
    Uppsala Universitet, Sweden.
    Linton, S J
    Örebro Universitet, Sweden.
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Treating youth in pain: Comparing tailored behavioural medicine treatment provided by physical therapists in primary care with physical exercises2016Inngår i: European Journal of Pain, ISSN 1090-3801, E-ISSN 1532-2149, Vol. 20, nr 4, s. 626-638Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVES: To study the efficacy of tailored behavioural medicine treatment within a physical therapy framework.

    METHODS: The study was a randomized controlled study (RCT): tailored behavioural medicine treatment (EXT) delivered by physical therapists (PTs) was compared with exercise-based treatment (CT). Thirty-two adolescents (mean age 14.3 years) with persistent pain participated. Data on pain-related disability and school attendance (primary outcomes), pain intensity, catastrophizing, fear of movement and self-efficacy were collected.

    RESULTS: The pain-related disability measured by the Functional Disability Inventory (FDI) resulted in mean score change of EXT = -18 and CT = -11, respectively. A significant change within both groups was found (EXT p = 0.003, CT p = 0.001), and a large effect size for FDI between the conditions was demonstrated (AUC of 0.77). For school attendance post-treatment, no difference was found between conditions. For secondary outcomes, a significant improvement in pain intensity and pain catastrophizing was found for the EXT and self-efficacy for the CT groups but no statistically significant difference between the two conditions was detected. Caution should be given to the small sample size, as it may affect the interpretation and generalizability of the results.

    CONCLUSION: In this study, differences between tailored behavioural medicine treatment delivered by PTs and exercise-based treatment could not be demonstrated, although the effect size was large. Patients who received either treatment demonstrated significant changes over time in pain-related disability. The low number of participants and suboptimal tailoring of the psychological components may partly explain the failure to demonstrate differences between groups, and future studies are warranted.

  • 69.
    Holm, Sara
    et al.
    Uppsala University.
    Ljungman, G.
    Uppsala University.
    Åsenlöf, P.
    Uppsala University.
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    How children and adolescents in primary care cope with pain and the biopsychosocial factors that correlate with pain-related disability2013Inngår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 102, nr 10, s. 1021-1026Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim: To describe how children and adolescents cope with pain and to examine the biopsychosocial factors that correlate with pain-related disability (PRD) in a sample of primary care patients. Methods: This cross-sectional study included 133 patients, aged from eight to 16 years, who consulted primary care physiotherapy on a pain-related problem. Data were collected with the Functional Disability Inventory, the Pain Coping Questionnaire and a study-specific questionnaire. Linear multivariate regression analyses were applied to study the associations between PRD and (i) pain coping, (ii) individual-, pain-related and psychosocial variables. Results: Behavioural distraction, externalizing and catastrophizing explained 13% of the variance in PRD (regression model 1). In addition, pain intensity, worrying and the ability to reduce pain explained 21% of the variance in PRD (regression model 2). Conclusion: Variance in PRD was partly explained by pain intensity, worrying and ability to reduce pain and by behavioural distraction, externalizing and catastrophizing. Future prospective longitudinal studies are needed to identify possible additional variables explaining PRD, establish causality and the potential benefits of addressing these variables in interventions in primary care.

  • 70.
    Holm, Sara
    et al.
    Uppsala University, Uppsala, Sweden.
    Ljungman, Gustaf
    Uppsala University, Uppsala, Sweden.
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd. Uppsala University, Uppsala, Sweden.
    Pain in children and adolescents in primary care: chronic and recurrent pain is common2012Inngår i: Acta Paediatrica, ISSN 1651-2227, Vol. 101, nr 12, s. 1246-1252Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aim:  The aim of this study was to describe a paediatric primary care pain sample and examine associations between pain, health-related quality of life and disability. Methods:  The study design is descriptive and cross-sectional. One hundred and fifty-four consecutive children and adolescents between the ages of 8 and 16 seeking care for a pain-related conditions participated in this study. Pain characteristics, health-related quality of life and disability were investigated. Results:  Eighty-seven per cent of participants had a pain duration of 3 months or more, and almost half of the group studied had a pain duration of ≥ 12 months. The disability levels in the study group as a whole were low, with a mean FDI of 10.4 (SD 7.6). However, 35% of the study group had moderate disability levels and reported a mean FDI of 18.7 (SD 4.8). Single pain location was reported in 42%, whereas 58% had two or more pain locations. The children with multiple pain locations reported lower health-related quality of life and higher disability than children with single pain location. Conclusion:  Paediatric pain patients in primary care consist partly of patients only slightly influenced by pain and partly of patients for whom pain has a great impact on their lives.

  • 71.
    Jansson, Sara
    et al.
    Attendo Care AB, Sweden.
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    A new treatment programme to improve balance in elderly people--an evaluation of an individually tailored home-based exercise programme in five elderly women with a feeling of unsteadiness.2004Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 26, nr 24, s. 1431-1443Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

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

  • 72.
    Johansson, Ann-Christin
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd. Centrum för klinisk forskning LTV.
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Öhrvik, John
    Karolinska Institutet, Sweden.
    Associations among pain, disability and psychosocial factors and the predictive value of expectations on returning to work in patients who undergo lumbar disc surgery.2016Inngår i: European spine journal, ISSN 0940-6719, E-ISSN 1432-0932, Vol. 25, nr 1, s. 296-203Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Abstract

    PURPOSE:

    The aim of this study was to describe the associations among pain, disability and psychosocial factors preoperatively as well as 3 and 24 months later for patients who undergo first time discectomy and to analyse the predictive value of psychosocial factors on the outcome 24 months after surgery.

    METHODS:

    Fifty-nine patients, 41 % women, with a mean age of 40 years and without comorbidities were included, of whom 56 responded to the 24-month follow-up; at that point, they were divided into patients with complaints (C, n = 36) and patients without complaints (NC, n = 20). Correlations among the pain intensity, disability and psychosocial factors were analysed preoperatively, 3 and 24 months after discectomy, and regression analyses of psychosocial factors on the outcome at 24 months were performed.

    RESULTS:

    Psychosocial variables were weakly correlated with the pain intensity and disability preoperatively. High expectations on the return to work were predictive of both pain intensity (β = 8.0, p = 0.03) and disability (β = 9.1, p < 0.001) at 24 months. Associations between psychosocial variables and outcome variables were strengthened at the 3-month follow-up in the C group, and this association remained 24 months after surgery. Fear of movement was most strongly correlated with leg pain intensity (r s 0.64, p < 0.001) and the ability to decrease pain was the most correlated with disability (r s 0.78, p < 0.001).

    CONCLUSION:

    Having high expectations on the return to work after surgery was the strongest predictor for a favourable outcome. Therefore, low preoperative expectations on return to work convey an important prognostic signal.

  • 73.
    Jonsson, U.
    et al.
    Karolinska Institutet, Stockholm, Sweden.
    Bertilsson, G.
    Swedish Agency for Health Technology Assessment and Assessment of Social Services, Stockholm, Sweden.
    Allard, P.
    Umeå University, Umeå, Sweden.
    Gyllensvärd, H.
    Linköping University, Linköping, Sweden .
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Tham, A.
    Karolinska Institutet, Stockholm, Sweden.
    Andersson, G.
    Karolinska Institutet, Stockholm, Sweden.
    Psychological treatment of depression in people aged 65 years and over: A systematic review of efficacy, safety, and cost-effectiveness2016Inngår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 11, nr 8, artikkel-id e0160859Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives: Depression in elderly people is a major public health concern. As response to antidepressants is often unsatisfactory in this age group, there is a need for evidence-based non-pharmacological treatment options. Our objectives were twofold: firstly, to synthesize published trials evaluating efficacy, safety and cost-effectiveness of psychological treatment of depression in the elderly and secondly, to assess the quality of evidence. Method: The electronic databases PubMed, EMBASE, Cochrane Library, CINAL, Scopus, and PsycINFO were searched up to 23 May 2016 for randomized controlled trials (RCTs) of psychological treatment for depressive disorders or depressive symptoms in people aged 65 years and over. Two reviewers independently assessed relevant studies for risk of bias. Where appropriate, the results were synthesized in meta-analyses. The quality of the evidence was graded according to GRADE (Grading of Recommendations Assessment, Development and Evaluation). Results: Twenty-two relevant RCTs were identified, eight of which were excluded from the synthesis due to a high risk of bias. Of the remaining trials, six evaluated problem-solving therapy (PST), five evaluated other forms of cognitive behavioural therapy (CBT), and three evaluated life review/reminiscence therapy. In frail elderly with depressive symptoms, the evidence supported the efficacy of PST, with large but heterogeneous effect sizes compared with treatment as usual. The results for life-review/reminiscence therapy and CBT were also promising, but because of the limited number of trials the quality of evidence was rated as very low. Safety data were not reported in any included trial. The only identified cost-effectiveness study estimated an incremental cost per additional point reduction in Beck Depression Inventory II score for CBT compared with talking control and treatment as usual. Conclusion: Psychological treatment is a feasible option for frail elderly with depressive symptoms. However, important questions about efficacy, generalizability, safety and cost-effectiveness remain.

  • 74.
    Jull, Gwendolen A
    et al.
    Univ Queensland, Australia.
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Stemper, Brian D
    Med Coll Wisconsin, USA.
    Kenardy, Justin
    Univ Queensland, Australia.
    Gross, Anita R
    McMaster Univ, Canada.
    Côté, Pierre
    Univ Toronto, Canada.
    Treleaven, Julia
    Univ Queensland, Australia.
    Bogduk, Nikolai
    Royal Newcastle Ctr, Newcastle Bone & Joint Inst, Dept Clin Res, Newcastle, NSW, Australia.
    Sterling, Michele
    Univ Queensland, Australia.
    Curatolo, Michele
    Univ Bern, Switzerland.
    Toward optimal early management after whiplash injury to lessen the rate of transition to chronicity2011Inngår i: Spine, ISSN 0362-2436, E-ISSN 1528-1159, Vol. 36, nr 25 Suppl, s. S335-S342Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    STUDY DESIGN: Expert debate and synthesis of research to inform future management approaches for acute whiplash disorders.

    OBJECTIVE: To identify a research agenda toward improving outcomes for acute whiplash-injured individuals to lessen the incidence of transition to chronicity.

    SUMMARY OF BACKGROUND DATA: International figures are concordant, estimating that 50% of individuals recover from pain and disability within 3 to 6 months of a whiplash injury. The remainder report continuing symptoms up to 1 to 2 years or longer postinjury. As no management approach to date has improved recovery rates, new clinical/research directions are required for early management of whiplash-injured patients.

    METHODS: A group of multidisciplinary researchers critically debated evidence and current research concerning whiplash from biological, psychological, and social perspectives toward informing future research directions for management of acute whiplash.

    RESULTS: It was recognized that effective treatments for acute whiplash are constrained by a limited understanding of causes of whiplash-associated disorders. Acute whiplash presentations are heterogeneous leading to the proposal that a research priority was development of a triage system based on modifiable prognostic indicators and clinical features to better inform individualized early management decisions. Other priorities identified included researching effective early pain management for individuals presenting with moderate to high levels of pain; development of best education/information for acute whiplash; testing the efficacy of stratified and individualized rehabilitation, researching modes of delivery considering psychosocial modulators of pain and disability; and the timing, nature, and mode of delivery of cognitive-behavioral therapies. Directions were highlighted for future biomechanical research into injury prevention.

    CONCLUSION: The burden of whiplash injuries, the high rate of transition to chronicity, and evidence of limited effects of current management on transition rates demand new directions in evaluation and management. Several directions have been proposed for future research, which reflect the potential multifaceted dimensions of an acute whiplash disorder.

  • 75.
    Kyhlbäck, Maria
    et al.
    University Hospital, Uppsala, Sweden.
    Schröder Winter, Helena
    University Hospital, Uppsala, Sweden.
    Thierfelder, Tomas
    Swedish University of Agricultural Sciences SLU, Uppsala, Sweden.
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Physiotherapy treatment of the diabetic shoulder. A longitudinal study following patients with diabetes and shoulder pain using a pre-post treatment design.2014Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 36, nr 7, s. 556-562Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

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

  • 76.
    Kyhlbäck, Maria
    et al.
    Uppsala University, Uppsala, Sweden.
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Thierfelder, Tomas
    Swedish University of Agricultural Sciences SLU, Uppsala, Sweden.
    Frykberg, G.E
    Uppsala University, Uppsala, Sweden.
    Elmgren, Gunilla
    Uppsala University, Uppsala, Sweden.
    Physiotherapy treatment of the diabetic shoulder: health-related quality of life and measures of shoulder function regarding patients with type 1 diabetes2019Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 41, nr 12, s. 1435-1442Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Purpose: The aim of this study was to investigate how health-related quality of life (HRQoL) and functional shoulder range of motion are affected among patients with diabetes with shoulder problems, treated with a specific physiotherapy programme. A further aim was to investigate how health-related quality of life, functional shoulder range of motion, pain intensity, and shoulder function correlate within the group of patients after the treatment period. Method: A pre-post treatment design was applied for a study group of ten patients with type 1 diabetes and shoulder problems. The physiotherapy treatment consisted of exercises promoting enhanced micro-circulation in the shoulder tissues, optimal shoulder co-ordination, and muscle relaxation. The Short Form-36 (SF-36), shoulder range of motion measures, the Shoulder Rating Scale - Swedish version, and pain intensity measures were used. The results regarding SF-36 were compared with the results of a control group of patients having either type 1 or type 2 diabetes and shoulder problems that did not receive any specific physiotherapy treatment. Results: As a potential result of physiotherapy training, a significant change towards higher scores was observed in the physical component summary (PCS) measure of SF-36. There was a significant improvement regarding PCS in the study group as compared with the control group. There were negative correlations between the four aspects of pain intensity and PCS and Shoulder Rating Scale - Swedish version, respectively, but a positive correlation between PCS and Shoulder Rating Scale - Swedish version. "Hand-raising" and "hand-behind-back" were significantly improved, and proved to be positively correlated with Shoulder Rating Scale - Swedish version. Conclusions: The results of this study indicate that patients with type 1 diabetes and shoulder problems, treated with a specific physiotherapy programme, may improve with respect to physical aspects of health-related quality of life, and partially regain their range of motion in the shoulder joint. Based on these results, the associated treatment protocol may be recommended for physiotherapy treatment in such patients.

  • 77.
    Kyhlbäck, Maria
    et al.
    Uppsala University Hospital, Sweden.
    Thierfelder, Tomas
    Uppsala University Hospital, Sweden.
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Prognostic factors in whiplash-associated disorders2002Inngår i: International Journal of Rehabilitation Research, ISSN 0342-5282, E-ISSN 1473-5660, Vol. 25, nr 3, s. 181-187Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Whiplash-associated disorders (WADs) have become an increasing problem over the years and many authors have addressed the issue. The aim of the present study is to identify predictors for perceived disability and self-registered pain from a functional perspective, as well as to study the temporal evolution of patients' complaints. Eighty-three patients suffering from pain in the neck following acute whiplash injury were included in the study and they were consecutively monitored at three weeks, three months and one year after injury. The results suggest that a linear combination of sex, self-efficacy and WAD grade significantly explains 24% of the variation observed in pain intensity at the one-year follow-up, whereas a linear combination of self-efficacy, sex and age significantly explains 36% of the variation observed in disability at the one-year follow-up. Five per cent of the patients were non-symptomatic at the first monitoring occasion and 16% at the one-year follow-up. It is concluded that WAD patients' self-efficacy at an early stage after whiplash injury significantly predicts the temporal development of pain intensity and disability. It may therefore be suggested that patients' confidence in performing daily activities should be reinforced in order to optimize treatment after whiplash injury.

  • 78.
    Lassenius, O.
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd. Karolinska Institutet, Sweden.
    Arman, M.
    Karolinska Institutet, Sweden.
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Wiklund-Gustin, Lena
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd. Narvik University College, Norway.
    Motivation does not come with an ending-it's the beginning of something new: Experiences of motivating persons with psychiatric disabilities to physical activity2014Inngår i: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 35, nr 9, s. 713-720Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Despite strong evidence for the positive relationship between physical activity and mental health, physical activity is used far too little to promote health in mental health care. Fourteen caregivers working in community mental health services were interviewed about their experiences of motivating adult persons with psychiatric disabilities to be physically active, and data were analysed using a phenomenological-hermeneutical approach. Three themes emerged: (1) An approach of conscious acts, (2) Companionship as a joint creation, and (3) Understanding as a way to create meaning. The interpreted meaning of motivating to physical activity was expressed as a dynamic way of being, relating, and understanding.

  • 79.
    Lassenius, Oona
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Arman, Maria
    Karolinska Institutet, Department of Neurobiology.
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Åkerlind, Ingemar
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Wiklund Gustin, Lena
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd. Narvik University College.
    Moving toward Reclaiming Life: Lived Experiences of Being Physically Active Among Persons with Psychiatric Disabilities2013Inngår i: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 34, nr 10, s. 739-746Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    There is abundant documentation in research about the significant relationship between physical activity and mental health, but there is still more to be learned about what can enhance motivation to become more physically active. Fourteen persons with psychiatric disabilities were interviewed about their experiences of being physically active, and data was analyzed using a phenomenologicalhermeneutic method. Five themes emerged: Capability for Living, Liberation from a Heavy Mind, Companionship in Being in Motion, Longing for Living One’s Life, and Struggling with Limitations. The interpreted meaning of being physically active was to be moving toward reclaiming one’s life.

  • 80.
    Lassenius, Oona
    et al.
    Karolinska Institutet, Sweden.
    Arman, Maria
    Karolinska Institutet, Sweden.
    Wiklund-Gustin, Lena
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd.
    Exploring the significance of interactive video games for physical activity among persons with psychiatric disabilities using experimental single case designManuskript (preprint) (Annet vitenskapelig)
    Abstract [en]

    Problem: Persons with psychiatric disabilities exhibit low levels of physical activity, which is a known general health risk factor. Nonetheless, physical activity is used far too little as health promotion in mental health care. Interactive video games are an emerging technology that can be used to increase physical activity levels. This study primarily aimed at exploring the significance of these games as a way to promote physical activity and health among persons with psychiatric disabilities.

    Method: Two participants played the interactive video game during an intervention for a period of 15 weeks. The study was conducted as a pilot study with a single case design and with an applied mixed methods approach.

    Results: Both participants increased their playing time during the intervention, and playing the game was experienced as fun, stimulating, and evolving. Through the challenge that the game provided, the participants’ motivation to continue playing seemed to be reinforced. Playing the game was found to strengthen the participants’ sense of capability and provided an experience of companionship with oneself.

    Conclusions: Being physically active in this manner enabled experiences of evolvement and competence, which could be considered an essential driving force of recovery and reconnection with one’s own life. The technique can therefore be regarded as an enabling tool for physical activity — however, the value of the support from another human being cannot be overlooked.

  • 81.
    Lassenius, Oona
    et al.
    Karolinska Institutet.
    Åkerlind, Ingemar
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Wiklund Gustin, Lena
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Arman, Maria
    Karolinska Institutet.
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Self-reported health and physical activity among community mental healthcare users2013Inngår i: Journal of Psychiatric and Mental Health Nursing, ISSN 1351-0126, E-ISSN 1365-2850, Vol. 20, nr 1, s. 82-90Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The aim of the study was to survey the self-reported health and physical activity in a sample of community mental healthcare users in a city of Sweden. The study was conducted through a cross-sectional design with participants requested to fill out a self-report questionnaire. Participants (n =103) were persons with psychiatric disabilities living in residential psychiatric settings and/or participating in daily activities provided by community mental healthcare services. The results showed that the group is affected with serious risk factors, such as high body mass index, low rated extent and frequency of physical activity and low self-estimated general state of health. Even though some difficulties associated with the answering process of this questionnaire emerged, these self-reported results clearly confirm the fact that persons with psychiatric disabilities constitute a vulnerable group in need for health-promoting caring activities and interventions.

  • 82.
    Lindstedt, Helena
    et al.
    Uppsala Univ.
    Grann, Martin
    Karolinska Inst.
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Mentally disordered offenders' daily occupations after one year of forensic care2011Inngår i: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 18, nr 4, s. 302-311Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Persons detained as mentally disordered offenders need support for transition from care to community life. Few systematic studies have been completed on the outcomes of standard forensic care. The aim was to investigate the target group's life conditions and daily occupations one year aftercare. In a follow-up design occupational performance (OP) and social participation (SP) were investigated at two time points. After informed consent 36 consecutively recruited participants reported OP using the Capability to Perform Daily Occupations, Self-Efficacy Scale, Importance scale, and Allen Cognitive Level Screen. SP was measured with the Manchester Short Assessment of Quality of Life, and Interview Schedule for Social Interaction. After one year 24 participants were still incarcerated, 11 were conditionally released, and one participant was discharged. The group were generally more satisfied and engaged in daily occupations than at admission. The study's attrition rate, 51%, is discussed. The conclusion and the clinical implications indicate that the target group need early, goal directed interventions in OP and SP for alterations in daily occupations. Furthermore, to increase the knowledge base concerning mentally disordered offenders, studies with research designs that have the potential to uncover changes in daily occupation and other measures for this target group are necessary.

  • 83.
    Lindstedt, Helena
    et al.
    Uppsala University, Uppsala, Sweden.
    Ivarsson, Ann-Britt
    Örebro University, Örebro, Sweden.
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Background factors related to and/or influencing occupation in mentally disordered offenders2006Inngår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 20, nr 3, s. 331-338Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    OBJECTIVE: Knowledge of background and occupational related factors of mentally disordered offenders are missing. It is essential to understand these issues when planning discharge from forensic psychiatric hospital care to enable community dwelling. AIMS: One aim was to investigate mentally disordered offenders' background factors, confidence in and how they value occupations. Another aim was to investigate MDOs background factors' in relation to and the influences on Occupational Performance and Social Participation. METHOD: Data was collected with an explorative, correlative design after informed consent, from 74 mentally disordered offenders (mean age 34,2) cared for in forensic psychiatric hospitals. Assessments were Allen Cognitive Level Screen, Capability to Perform Daily Occupations, Interview Schedule of Social Interaction, Manchester Short Assessment of Quality of Life, Self-efficacy Scale and Importance scale. Eight background factors were assembled from the individual forensic psychiatric investigation. FINDINGS: Most of the investigated background factors relate to and half of them influence occupational performance, particular the cognitive aspect of occupational performance. The influences on occupation originate from adulthood, such as suffering from schizophrenia, psycho/social problems, and having performed violent crimes. These findings indicate that staff in forensic hospital care should initiate rehabilitation with knowledge about MDOs' complex daily occupations. For avoiding information bias, information gathering preceding treatment planning should be performed in collaboration between caring staff and mentally disordered offenders.

  • 84.
    Lindstedt, Helena
    et al.
    Uppsala University, Sweden.
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Stålenheim, G
    Uppsala University, Sweden.
    Sjödén, P-O
    Uppsala University, Sweden.
    Mentally Disordered Offenders’ Abilities in Occupational Performance and Social Participation2004Inngår i: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 11, nr 3, s. 118-127Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The major aim was to describe occupational performance (OP) and social participation (SP) of mentally disordered offenders (MDO), and to compare professionals' and MDOs' appraisals of these abilities. Also, diagnostic groups and groups with/without substance related disorders were compared with regard to OP and SP. Self-report instruments (Capability to Perform Daily Occupations, Self-Efficacy Scale, Importance scale, Interview Schedule for Social Interaction), observations (Allen Cognitive Level Screen), and register data (Psychosocial and Environment Problems - Axis IV; Global Assessment of Functioning Scale - Axis V; Assessment Concerning Support and Service for Persons with Certain Functional Impairments) were utilized. Demographic and register data were collected from the Swedish National Board of Forensic Medicine. Seventy-four out of 161 incarcerated subjects (46%), selected consecutively after informed consent during a period of 16 months, were interviewed on their hospital wards. The MDOs reported some disability in performing occupations and participating in community life. However, they were satisfied with their performance and participation, implying limited awareness of their disabilities. The professionals judged the MDOs as having problems with social participation, and major, longstanding disablements in several areas. Subjects with schizophrenia scored lower in some OP and SP variables than did subjects with personality disorders and other mental disorders. The results suggest that a large proportion of MDOs need support to enable their community living.

  • 85.
    Lindstedt, Helena
    et al.
    Uppsala Science Park, Uppsala.
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Stålenheim, Gunilla
    Uppsala University, Sweden .
    Sjödén, Per-Olow
    Uppsala University, Sweden .
    Personality traits as predictors of occupational performance and life satisfaction among mentally disordered offenders2005Inngår i: Nordic Journal of Psychiatry, ISSN 0803-9488, E-ISSN 1502-4725, Vol. 59, nr 5, s. 357-364Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The study investigated to what extent personality traits, e.g. socialization, proneness for anxiety, aggression and hostility were associated with and predictive of self-reported and observed occupational performance and perceived life satisfaction among male mentally disordered offenders (MDOs). Also, subjects with psychopathic-related personality traits were compared with subjects without such traits regarding demographic data and dependent variables. The MDOs were included from the Swedish National Board of Forensic Medicine. A total of 55 subjects were visited at their hospital ward for data collection with the Karolinska Scales of Personality (KSP), Capability to Perform Daily Occupation (CPDO), Allen Cognitive Level Screen (ACLS) and the Manchester Quality of Life Scale (MANSA). Seven KSP scales and two KSP factors correlated significantly with the dependent variables. Regression analyses revealed that the KSP Socialization scale, the KSP Anxiety-proneness and Psychopathy factors were the most important predictors. Subjects with psychopathy differed from remaining groups by having more conduct disorders before 15 years, being more often brought up in outcasted families and less subjected to measures of pupil welfare activities. The life history was concluded to be important influencing occupational performance and life satisfaction. Subjects with high anxiety proneness should be given attention in treatment planning.

  • 86.
    Linnman, Clas
    et al.
    Uppsala University, Uppsala, Sweden; McLean Hospital, Harvard Medical School, Boston, Massachusetts, USA.
    Appel, Lieuwe
    The PET Center in Uppsala, Uppsala, Sweden.
    Fredrikson, Mats
    Uppsala University, Uppsala, Sweden.
    Gordh, Torsten
    Uppsala University Hospital, Uppsala, Sweden.
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd. Uppsala University, Uppsala, Sweden.
    Långström, Bengt
    Uppsala University, Uppsala, Sweden; Imperial College, London, United Kingdom.
    Engler, Henry
    University of the Republic, Montevideo, Uruguay; Uruguayan Centre of Molecular Imaging, Montevideo, Uruguay; Uppsala University Hospital, Uppsala, Sweden.
    Elevated [11C]-D-deprenyl uptake in chronic Whiplash Associated Disorder suggests persistent musculoskeletal inflammation2011Inngår i: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 6, nr 4, s. e19182-Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    There are few diagnostic tools for chronic musculoskeletal pain as structural imaging methods seldom reveal pathological alterations. This is especially true for Whiplash Associated Disorder, for which physical signs of persistent injuries to the neck have yet to be established. Here, we sought to visualize inflammatory processes in the neck region by means Positron Emission Tomography using the tracer (11)C-D-deprenyl, a potential marker for inflammation. Twenty-two patients with enduring pain after a rear impact car accident (Whiplash Associated Disorder grade II) and 14 healthy controls were investigated. Patients displayed significantly elevated tracer uptake in the neck, particularly in regions around the spineous process of the second cervical vertebra. This suggests that whiplash patients have signs of local persistent peripheral tissue inflammation, which may potentially serve as a diagnostic biomarker. The present investigation demonstrates that painful processes in the periphery can be objectively visualized and quantified with PET and that (11)C-D-deprenyl is a promising tracer for these purposes.

  • 87.
    Linnman, Clas
    et al.
    Department of Psychology, Uppsala university.
    Appel, Lieuwe
    Uppsala Imanet AB, GE Healthcare, Uppsala.
    Furmark, Tomas
    Department of Psychology, Uppsala university.
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Gordh, Torsten
    Laboratory of Pain Research, Department of Surgical Sciences, Division of Anaesthesiology and Intensive Care Medicine, Uppsala University Hospital.
    Långström, Bengt
    Department of Biochemistry and Organic Chemistry, Uppsala University, Sweden g Neuropsychopharmacology Section, Faculty of Medicine, Imperial College, London, UK.
    Fredriksson, Mats
    Department of Psychology, Uppsala university.
    Ventromedial prefrontal neurokinin 1 receptor availability is reduced in chronic pain2010Inngår i: Pain, ISSN 0304-3959, E-ISSN 1872-6623, Vol. 149, nr 1, s. 64-70Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Neurokinin 1 (NK1) receptors are involved in pain and anxiety behaviors in animals, but little is known about central alterations in this receptor system in human pain. With positron emission tomography, using a [11]-Carbon labeled NK1 receptor antagonist, we demonstrate attenuated NK1 receptor availability in frontal, insular and cingulate cortex, as well as the hippocampus, amygdala and the periaqueductal gray area in patients with chronic pain. The reduced availability was most pronounced in the ventromedial prefrontal cortex (vmPFC), where attenuations correlated to measures of fear and avoidance of movement. Further, vmPFC NK1 levels also displayed opposing influences in patients as compared to controls on regional cerebral blood flow in the anterior cingulate. We conclude that the central NK1 receptor system is altered in human chronic pain. The results suggest that NK1 receptors in the vmPFC modulate motor inhibition, and contribute to fear and avoidance of movement. (C) 2010 International Association for the Study of Pain. 

  • 88.
    Linnman, Clas
    et al.
    Department of Psychology, Uppsala University.
    Appel, Lieuwe
    Uppsala Imanet AB.
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Frans, Örjan
    Uppsala Imanet AB.
    Engler, Henry
    Uppsala Imanet AB.
    Furmark, Tomas
    Uppsala Imanet AB.
    Gordh, Torsten
    Department of Surgical Science, Uppsala University.
    Långström, Bengt
    Uppsala Imanet AB.
    Fredriksson, Mats
    Department of Psychology, Upspala University.
    Chronic whiplash symptoms are related to altered regional cerebral blood flow in the resting state2009Inngår i: European Journal of Pain, ISSN 1090-3801, E-ISSN 1532-2149, Vol. 13, nr 1, s. 65-70Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    The neural pathogenic mechanisms involved in mediating chronic pain and whiplash associated disorders(WAD) after rear impact car collisions are largely unknown. This study’s first objective was to compareresting state regional cerebral blood flow (rCBF) by means of positron emission tomography with15O labelled water in 21 WAD patients with 18 healthy, pain-free controls. A second objective was toinvestigate the relations between brain areas with altered rCBF to pain experience, somatic symptoms,posttraumatic stress symptoms and personality traits in the patient group. Patients had heightened restingrCBF bilaterally in the posterior parahippocampal and the posterior cingulate gyri, in the right thalamusand the right medial prefrontal gyrus as well as lowered tempero-occipital blood flow comparedwith healthy controls. The altered rCBF in the patient group was correlated to neck disability ratings.We thus suggest an involvement of the posterior cingulate, parahippocampal and medial prefrontal gyriin WAD and speculate that alterations in the resting state are linked to an increased self-relevant evaluationof pain and stress.

  • 89.
    Nilsson, B-M
    et al.
    Southern Älvsborgs Hospital, Borås, Sweden .
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Head posture in patients with whiplash-associated disorders and the measurement method's reliability - A comparison to healthy subjects2005Inngår i: Advances in Physiotherapy, ISSN 1403-8196, E-ISSN 1651-1948, Vol. 7, nr 1, s. 13-19Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Whiplash-associated disorders (WAD) are a major problem for healthcare providers and sufferers. Neck pain is one of the most common WAD, and forward head posture may contribute to neck pain. Objective methods for assessing head posture are necessary in the evaluation of postural correction. The purpose of this study was to investigate the inter-rater reliability of the goniometer and to examine differences in head posture inpatients with WAD compared with healthy individuals. Twenty-seven consecutive patients and 40 healthy subjects matched for age and gender were included in the study. Head position relative to shoulders in standing was assessed by three examiners. The inter-rater reliability for the goniometer showed an intraclass correlation coefficient of 0.95. The absolute reliability for the three testers was 1.8°. An independent t-test showed that the difference in head posture between the patients and controls was significant. The patient group showed more forward head posture.Patients with WAD had more forward head posture than persons without neck problems. The goniometer proved to be reliable with high inter-rater reliability in assessing the head position relative to shoulders.

  • 90.
    Nordgren, L.
    et al.
    Centre for Clinical Research in Sörmland/Uppsala University, Uppsala, Sweden.
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Emotions and encounters with healthcare professionals as predictors for the self-estimated ability to return to work: A cross-sectional study of people with heart failure2016Inngår i: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 6, nr 11, artikkel-id e009896Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Objectives: To live with heart failure means that life is delimited. Still, people with heart failure can have a desire to stay active in working life as long as possible. Although a number of factors affect sick leave and rehabilitation processes, little is known about sick leave and vocational rehabilitation concerning people with heart failure. This study aimed to identify emotions and encounters with healthcare professionals as possible predictors for the self-estimated ability to return to work in people on sick leave due to heart failure. Design: A population-based cross-sectional study design was used. Setting: The study was conducted in Sweden. Data were collected in 2012 from 3 different sources: 2 official registries and 1 postal questionnaire. Participants: A total of 590 individuals were included. Statistics: Descriptive statistics, correlation analysis and linear multiple regression analysis were used. Results: 3 variables, feeling strengthened in the situation (β=.0.21, p=0.02), feeling happy (β=.0.24, p=0.02) and receiving encouragement about work (β= .0.32, p.0.001), were identified as possible predictive factors for the self-estimated ability to return to work. Conclusions: To feel strengthened, happy and to receive encouragement about work can affect the return to work process for people on sick leave due to heart failure. In order to develop and implement rehabilitation programmes to meet these needs, more research is needed.

  • 91.
    Nordgren, L.
    et al.
    Sormland Cty Council, Clin Res Ctr, Eskilstuna, Sweden..
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd. Malardalen Univ, Vasteras, Sweden..
    Impact of encounters with healthcare professionals on perceived ability to return to work in people on sick leave due to heart failure2016Inngår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 15, s. S48-S49Artikkel i tidsskrift (Annet vitenskapelig)
  • 92.
    Nordgren, Lena
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd. Uppsala universitet.
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Associations between socio-demographic factors, encounters with healthcare professionals and the perceived ability to return to work in people sick-listed due to heart failure in Sweden: A cross-sectional study2016Inngår i: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 38, nr 2, s. 168-173Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

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

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

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

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

  • 93.
    Nordgren, Lena
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Being on sick leave due to heart failure: Encounters with social insurance officers and associations with sociodemographic factors and self-estimated ability to return to work2016Inngår i: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 15, nr 3, s. E27-E36Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Background: Little is known about sick leave and the ability to return to work (RTW) for people with heart failure (HF). Previous research findings raise questions about the significance of encounters with social insurance officers (SIOs) and sociodemographics in people sick-listed due to HF. Aims: To investigate how people on sick leave due to HF experience encounters with SIOs and associations between sociodemographic factors, experiences of positive/negative encounters with SIOs, and self-estimated ability to RTW. Methods: This was a population-based study with a cross-sectional design. The sample consisted of 590 sick-listed people with HF in Sweden. A register-based investigation supplemented with a postal survey questionnaire was conducted. Bivariate correlations and logistic regression analysis was used to test associations between sociodemographic factors, positive and negative encounters, and self-estimated ability to RTW. Results: People with low income were more likely to receive sickness compensation. A majority of the responders experienced encounters with SIOs as positive. Being married was significantly associated with positive encounters. Having a low income was related to negative encounters. More than a third of the responders agreed that positive encounters with SIOs facilitated self-estimated ability to RTW. High income was strongly associated with the impact of positive encounters on self-estimated ability to RTW. Conclusion: Encounters between SIOs and people on sick leave due to HF need to be characterized by a person-centred approach including confidence and trust. People with low income need special attention.

  • 94.
    Nordgren, Lena
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Being on sick leave due to heart failure: self-rated health, encounters with healthcare professionals and social insurance officers and self-estimated ability to return to work2015Inngår i: Psychology, Health & Medicine, ISSN 1354-8506, E-ISSN 1465-3966, Vol. 20, nr 5, s. 582-593Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Younger people with heart failure often experience poor self-rated health. Furthermore, poor self-rated health is associated with long-term sick leave and disability pension. Socio-demographic factors affect the ability to return to work. However, little is known about people on sick leave due to heart failure. The aim of this study was to investigate associations between self-rated health, mood, socio-demographic factors, sick leave compensation, encounters with healthcare professionals and social insurance officers and self-estimated ability to return to work, for people on sick leave due to heart failure. This population-based investigation had a cross-sectional design. Data were collected in Sweden in 2012 from two official registries and from a postal questionnaire. In total, 590 subjects, aged 23-67, responded (response rate 45.8%). Descriptive statistics, correlation analyses (Spearman bivariate analysis) and logistic regression analyses were used to investigate associations. Poor self-rated health was strongly associated with full sick leave compensation (OR = 4.1, p < .001). Compared self-rated health was moderately associated with low income (OR = 2.6, p = .003). Good self-rated health was strongly associated with positive encounters with healthcare professionals (OR = 3.0, p = .022) and to the impact of positive encounters with healthcare professionals on self-estimated ability to return to work (OR = 3.3, p < .001). People with heart failure are sicklisted for long periods of time and to a great extent receive disability pension. Not being able to work imposes reduced quality of life. Positive encounters with healthcare professionals and social insurance officers can be supportive when people with heart failure struggle to remain in working life.

  • 95.
    Nordgren, Lena
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Heart failure clients' encounters with professionals and self-rated ability to return to work2016Inngår i: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 23, nr 2, s. 115-126Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    BACKGROUND: People with heart failure are sick listed for long periods and disability pension is common. Healthcare professionals need knowledge about factors that can enhance their return to work processes.

    AIMS: This study focus on people on sick leave due to heart failure and their encounters with healthcare professionals/social insurance officers. Specifically, it aimed to investigate associations between: (1) encounters and socio-demographic factors and, (2) encounters and self-rated ability to return to work.

    MATERIAL AND METHODS: A cross-sectional study based on registry data and a postal questionnaire to people on sick leave due to heart failure (n = 590). Bivariate correlation analyses and logistic regression analyses were used.

    RESULTS: Gender, income, and age were strongly associated with encounters with both social insurance officers and healthcare professionals. Self-rated ability to return to work was associated with the encounters 'Made reasonable demands', 'Gave clear and adequate information/advice' and 'Did not keep our agreements'.

    CONCLUSION AND SIGNIFICANCE: To enhance clients' abilities to return to work demands should be reasonable, information and advice need to be clear, and agreements should be kept. These results can be used by healthcare professionals as occupational therapists involved in vocational rehabilitation for people on sick leave due to heart failure.

  • 96.
    Nordgren, Lena
    et al.
    Uppsala University, Uppsala, Sweden.
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Received and needed social support in relation to sociodemographic and socio-economic factors in a population of people on sick leave due to heart failure2017Inngår i: ESC Heart Failure, E-ISSN 2055-5822, E-ISSN 2055-5822, Vol. 4, nr 1, s. 46-55Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aims

    The aim of this study was to determine differences between sociodemographic and socio-economic factors for perceptions of received and needed social support in a population of people on sick leave due to heart failure.

    Methods and results

    A cross-sectional design was used. A postal questionnaire was distributed to all people in Sweden who had been sick listed due to heart failure during March to May 2012 (N = 1297). The questionnaire measured perceptions of received and needed social support from managers, colleagues at work, family and friends. Differences between groups were estimated with the Mann–Whitney U-test. The sample included 414 men and 176 women aged 23 to 67 years (mean 58, median 60, SD = 6.75). Respondents with low income received significantly less support than respondents with high income and also needed significantly more support. Respondents with lower educational level needed significantly more support than people with higher education. Unmarried respondents needed significantly more support than married.

    Conclusions

    People with lower level of education, those who were unmarried and respondents with low income needed more support than they received. By identification of vulnerable patients, healthcare professionals can tailor and target supportive measures for patients who need extra social support.

  • 97.
    Nordgren, Lena
    et al.
    Uppsala Univ, Ctr Clin Res Sormland, Uppsala, Sweden.
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Social support, self-rated health and low mood in people on sick leave due to heart failure: a cross-sectional study2018Inngår i: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 46, nr 6, s. 606-612Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    Aims: The aim of this study was to investigate social support in relation to self-rated health and the prevalence of low mood in people on sick leave due to heart failure. Methods: A cross-sectional design was used, and 590 individuals on sick leave due to heart failure in Sweden responded to the postal questionnaire. The questions therein concerned received and needed functional and structural support from managers, work colleagues, families and friends. Multivariate analyses were conducted. Results: The variables of income and needed support from family contributed significantly and negatively to self-rated health. Those who perceived that they needed more support from their manager reported experiencing low mood more frequently. Conclusions: The results showed a negative relation between manager support and low mood. Thus, support from managers and perceptions of low mood during sick leave are negatively associated, however, we do not know anything about the causality of this association. The results also indicated that needed support from family was negatively associated with self-rated health. The results also highlighted a multidimensional frailty in people with heart failure that needs to be recognized in future research as well as in clinical practice.

  • 98.
    Peolsson, Anneli
    et al.
    Linköping University.
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Engquist, M
    Sahlgrenska Academy, University of Gothenburg.
    Lind, Bengt
    Sahlgrenska Academy, University of Gothenburg.
    Löfgren, Håkan
    Neuro-Orthopedic Center, Ryhov Hospital, Jönköping.
    Vavruch, L
    Neuro-Orthopedic Center, Ryhov Hospital, Jönköping.
    Holtz, Anders
    Uppsala University Hospital.
    Winström-Christensson, Anneli
    Department of Physiotherapy, Ryhov Hospital, Jönköping.
    Isaksson, I
    Department of Physiotherapy, Ryhov Hospital, Jönköping.
    Öberg, Birgitta
    Linköping University.
    Physical Function Outcome in Cervical Radiculopathy Patients after Physiotherapy Alone Compared with Anterior Surgery Followed by Physiotherapy: A Prospective Randomized Study With a Two-Year Follow-up.2013Inngår i: Spine, ISSN 0362-2436, E-ISSN 1528-1159, Vol. 38, nr 4, s. 300-307Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    STUDY DESIGN.: Prospective randomized study. OBJECTIVE.: To investigate differences in physical functional outcome in patients with radiculopathy due to cervical disc disease, after structured physiotherapy alone (consisting of neck-specific exercises with a cognitive-behavioral approach) versus after anterior cervical decompression and fusion (ACDF) followed by the same structured physiotherapy program. SUMMARY OF BACKGROUND DATA.: No earlier studies have evaluated the effectiveness of a structured physiotherapy program or postoperative physical rehabilitation after ACDF for patients with magnetic resonance imaging-verified nerve compression due to cervical disc disease. METHODS.: Our prospective randomized study included 63 patients with radiculopathy and magnetic resonance imaging-verified nerve root compression, who were randomized to receive either ACDF in combination with physiotherapy or physiotherapy alone. For 49 of these patients, an independent examiner measured functional outcomes, including active range of neck motion, neck muscle endurance, and hand-related functioning before treatment and at 3-, 6-, 12-, and 24-month follow-ups. RESULTS.: There were no significant differences between the 2 treatment alternatives in any of the measurements performed (P = 0.17-0.91). Both groups showed improvements over time in neck muscle endurance (P = 0.01), manual dexterity (P = 0.03), and right-handgrip strength (P = 0.01). CONCLUSION.: Compared with a structured physiotherapy program alone, ACDF followed by physiotherapy did not result in additional improvements in neck active range of motion, neck muscle endurance, or hand-related function in patients with radiculopathy. We suggest that a structured physiotherapy program should precede a decision for ACDF intervention in patients with radiculopathy, to reduce the need for surgery.

  • 99.
    Sandborgh, Maria
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Dean, Elizabeth
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd. University of British Columbia , Vancouver , Canada.
    Denison, Eva
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd. Norwegian Institute of Public Health , Nydalen , Oslo , Norway.
    Elvén, Maria
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Fritz, Johanna
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    von Heideken Wågert, Petra
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Moberg, Johan
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Overmeer, Thomas
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd. Örebro University, Örebro, Sweden.
    Snöljung, Åsa
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Johansson, Ann-Christin
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Integration of Behavioral Medicine Competencies into Physical Therapy Curriculum in an Exemplary Swedish Program: Rationale, Process and Ten-year ReviewInngår i: Physiotherapy Theory and Practice, ISSN 0959-3985, E-ISSN 1532-5040Artikkel i tidsskrift (Fagfellevurdert)
    Abstract [en]

    In 2004, Mälardalen University, Sweden, introduced a new undergraduate entry-level physiotherapy program. Program developers constructed the curriculum with behavioral medicine content that reflected the contemporary definition and values of the physiotherapy profession aligning it with current best practices, evidence, and the International Classification of Functioning, Disability, and Health (ICF). The new curriculum conceptualized movement and function as modifiable behaviors in that they reflect behavioral contingencies, perceptions, beliefs, and lifestyle factors as well as pathophysiology and environmental factors. The purpose of this article is to describe how one university accordingly structured its new curriculum and its review. We describe the rationale for the curriculum's behavioral medicinecontent and competencies, its development and implementation, challenges, long-term outcomes, and its related research enterprise. We conclude that physiotherapy practiced by our graduates augments that taught in other programs based on accreditation reviews. With their expanded practice scope, graduates are systematically practicing within the constructs of health and function conceptualized within the ICF. Our intent in sharing our experience is to exemplify one university's initiative to best prepare students with respect to maximizing physiotherapy outcomes as well as establish a dialogue regarding minimum standards of behavioral medicine competencies in physiotherapy education and practice.

  • 100.
    Sandborgh, Maria
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Elvén, Maria
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    von Heideken Wågert, Petra
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Snöljung, Åsa
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    IMPLEMENTATION OF BEHAVIORAL MEDICINE IN A PHYSIOTHERAPY UNDERGRADUATE CURRICULUM STUDENT EVALUATIONS2018Inngår i: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 25, s. S64-S65Artikkel i tidsskrift (Annet vitenskapelig)
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