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  • 1.
    Borg, Johan
    Lund universitet.
    The Participation Pyramid: a response to "Reconsideration ICF scheme" by Heerkens et al. 20172018In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 40, no 1, p. 123-124Article in journal (Other academic)
  • 2.
    Borg, Johan
    et al.
    Lunds universitet.
    Larsson, Stig
    Ostergren, Per-Olof
    Eide, Arne H.
    The Friction Model - a dynamic model of functioning, disability and contextual factors and its conceptual and practical applicability2010In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 32, no 21, p. 1790-1797Article in journal (Refereed)
    Abstract [en]

    Purpose. To develop a model of the dynamics of functioning, disability and contextual factors which harmonises with the International Classification of Functioning, Disability and Health (ICF). Method. Model parts based on ICF were identified and a model drawing from engineering concepts was developed. The conceptual and practical applicability of the model was discussed. Results. The so called Friction Model was created, which incorporates the ICF entities capacity, performance, environmental factors, health condition, body functions and structures, and personal factors. Friction describes the interaction between a person and his or her environment. The coefficient of friction is defined as the ratio between capacity and performance. Conclusion. Carrying conceptual strengths and limitations, the Friction Model appears to offer opportunities for practical applications, including ICF-based alternatives to health-economic analyses. Harmonising with the ICF model and terminology, the model uses friction to describe the interaction between a person and the environment. The coefficient of friction can be used as a simple measure of how facilitating an environment is. The applicability is not limited to functioning of people with impairments.

  • 3.
    Fridberg, Helena
    et al.
    Dalarna University, School of Education, Health and Social Studies, Medical Science.
    Gustavsson, Catharina
    Dalarna University, School of Education, Health and Social Studies, Medical Science. b Center for Clinical Research Dalarna, Uppsala University.
    Self-efficacy in activities of daily living and symptom management in people with dizziness: a focus group study2019In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 41, no 6, p. 705-713Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Self-efficacy is associated with health status, health behaviour and health behaviour change in various chronic health conditions.

    PURPOSE: To describe self-efficacy in relation to Activities of daily living and symptom management in people with dizziness.

    MATERIAL AND METHODS: Thirteen women and three men, aged 45-82 years, with persistent dizziness (duration 4 months to 30 years) were recruited from an outpatient physiotherapy unit. A qualitative study was conducted using four focus groups and one individual interview and was then analysed with qualitative content analysis.

    RESULTS: The participants conveyed, in-depth information concerning two predefined main categories. Self-efficacy in Activities of daily living was related to challenging body positions and motions, environments, social activities, work tasks, and complex cognitive behaviours. Self-efficacy in symptom management was related to distress and aggravated symptoms, unfamiliar environment, and unknown people.

    CONCLUSIONS: People with dizziness describe how self-efficacy for specific activities varies according to the perceived difficulty of the task, the context of the activity, and day-to-day variations in general wellbeing. The results underscore the importance of targeting self-efficacy in the rehabilitation of people with dizziness. Our findings can guide the rehabilitation process by providing a deeper understanding of self-efficacy judgements in relation to Activities of daily living and symptom management in people with dizziness. Implication for rehabilitation This study adds important in-depth knowledge to the rehabilitation area on self-efficacy beliefs in relation to Activities of daily living and symptom management in people with dizziness. Self-efficacy for specific activities varies according to the perceived difficulty of the task, the context in which the activity takes place and day-to-day variations in perceived general well-being. The results can be used as a topic list to guide rehabilitation efforts in exploring and intervening aspects of people's everyday activities that are affected by low self-efficacy judgements. Activities perceived to be crucial to everyday life and important for well-being should be targeted in rehabilitation to increase self-efficacy and thereby activity performance and participation in people with dizziness.

  • 4. Fritz, J.
    et al.
    Wallin, Lars
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Karolinska institutet; Sahlgrenska Academy.
    Söderlund, A.
    Almqvist, L.
    Sandborgh, M.
    Implementation of a behavioral medicine approach in physiotherapy: impact and sustainability2019In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165Article in journal (Refereed)
    Abstract [en]

    Purpose: To explore the effects on and sustainability of physiotherapists’ clinical behavior when using facilitation to support the implementation of a behavioral medicine approach in primary health care for patients with persistent musculoskeletal pain.

    Methods: A quasi-experimental pre-/post-test trial was conducted. Fifteen physiotherapists were included in the experimental group, and nine in the control group. Based on social cognitive theory and the Promoting Action on Research Implementation in Health Services framework, facilitation with multifaceted implementation methods was used during a six-month period. Clinical behaviors were investigated with a study-specific questionnaire, structured observations, self-reports and patient records. Descriptive and non-parametric statistical methods were used for analyzing differences over time and effect size.

    Results: A sustained increase in self-efficacy for applying the behavioral medicine approach was found. Clinical actions and verbal expressions changed significantly, and the effect size was large; however, changes were not sustained at follow-ups. The behavioral changes were mainly related to the goal setting, self-monitoring and functional behavioral analysis components. No changes in clinical behavior were found in the control group.

    Conclusion: Tailored multifaceted facilitation can support the implementation of a behavioral medicine approach in physiotherapy in primary health care, but more comprehensive actions targeting sustainability are needed.Implications for rehabilitation Tailored multifaceted facilitation can support the implementation of an evidence based behavioral medicine approach in physiotherapy. Facilitation can be useful for increasing self-efficacy beliefs for using behavioral medicine approach in physiotherapist’s clinical practice. Further research is required to establish strategies that are effective in sustaining behavioral changes.

  • 5.
    Palstam, Annie
    et al.
    Sahlgrenska Academy, University of Gothenburg.
    Gard, Gunvor
    Mannerkorpi, Kaisa
    Factors promoting sustainable work in women with fibromyalgia.2013In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 35, no 19, p. 1622-1629Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To examine and describe the factors promoting sustainable work in women with fibromyalgia (FM).

    METHODS: A qualitative interview study. Twenty-seven gainfully employed women with FM participated in five focus group interviews. Their median age was 52 years, ranging from 33 to 62. The interviews were recorded, transcribed verbatim and analysed by qualitative latent content analysis.

    RESULTS: Four categories were identified describing factors promoting sustainable work: the meaning of work and individual strategies were individual promoters while a favourable work environment and social support outside work were environmental promoters. The meaning of work included individual meaning and social meaning. The individual strategies included handling symptoms, the work day and long-term work life. A favourable work environment included the physical and psychosocial work environment. Social support outside work included societal and private social supports.

    CONCLUSIONS: Promoting factors for work were identified, involving individual and environmental factors. These working women with FM had developed advanced well-functioning strategies to enhance their work ability. The development of such strategies should be supported by health-care professionals as well as employers to promote sustainable work in women with FM.

    IMPLICATIONS FOR REHABILITATION: Work disability is a common consequence of fibromyalgia (FM). Working women with FM appear to have developed advanced well-functioning individual strategies to enhance their work ability. The development of individual strategies should be supported by health-care professionals as well as employers to promote sustainable work and health in women with FM.

  • 6. Rasmussen-Barr, E.
    et al.
    Campello, M.
    Arvidsson, I.
    Nilsson-Wikmar, L.
    Äng, Björn
    Factors predicting clinical outcome 12 and 36 months after an exercise intervention for recurrent low-back pain2012In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 34, no 2, p. 136-44Article in journal (Refereed)
  • 7. Shannon, Michelle M
    et al.
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Churilov, Leonid
    Olver, John
    Pert, Alan
    Bernhardt, Julie
    Can the physical environment itself influence neurological patient activity?2019In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 41, no 10, p. 1177-1189Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To evaluate if a changed physical environment following redesign of a hospital ward influenced neurological patient physical and social activity.

    METHODS: A "before and after" observational design was used that included 17 acute neurological patients pre-move (median age 77 (IQR 69-85) years Ward A and 20 post-move (median age 70 (IQR 57-81) years Ward B. Observations occurred for 1 day from 08.00-17.00 using Behavioral Mapping of patient physical and social activity, and location of that activity. Staff and ward policies remained unchanged throughout. An Environmental Description Checklist of each ward was also completed.

    RESULTS: Behavioral Mapping was conducted pre-/post-move with a total of 801 Ward A and 918 Ward B observations. Environmental Description Checklists showed similarities in design features in both neurological wards with similar numbers of de-centralized nursing stations, however there were more single rooms and varied locations to congregate in Ward B (30% more single-patient rooms and separate allied health therapy room). Patients were alone >60% of time in both wards, although there was more in bed social activity in Ward A and more out of bed social activity in Ward B. There were low amounts of physical activity outside of patient rooms in both wards. Significantly more physical activity occurred in Ward B patient rooms (median = 47%, IQR 14-74%) compared to Ward A (median = 2% IQR 0-14%), Wilcoxon Rank Sum test z = -3.28, p = 0.001.

    CONCLUSIONS: Overall, patient social and physical activity was low, with little to no use of communal spaces. However we found more physical activity in patient rooms in the Ward B environment. Given the potential for patient activity to drive brain reorganization and repair, the physical environment should be considered an active factor in neurological rehabilitation and recovery. Implications for Rehabilitation Clinicians should include consideration of the impact of physical environment on physical and social activity of neurological patients when designing therapeutic rehabilitation environments. Despite architectural design intentions patient and social activity opportunities can be limited. Optimal neurological patient neuroplasticity and recovery requires sufficient environmental challenge, however current hospital environments for rehabilitation do not provide this.

  • 8.
    Talman, Lena
    et al.
    Mälardalens högskola.
    Gustafsson, Christine
    Mälardalens högskola.
    Stier, Jonas
    Dalarna University, School of Humanities and Media Studies.
    Wilder, Jenny
    Mälardalens högskola.
    Staffs’ documentation of participation for adults with profound intellectual disability or profound intellectual and multiple disabilities2018In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 40, no 1, p. 2527-2537Article in journal (Refereed)
    Abstract [en]

    Purpose: This study investigated what areas of International Classification of Functioning, Disability and Health were documented in implementation plans for adults with profound intellectual disability or profound intellectual and multiple disabilities with focus on participation.

    Methods: A document analysis of 17 implementation plans was performed and International Classification of Functioning, Disability and Health was used as an analytic tool.

    Results: One hundred and sixty-three different codes were identified, especially in the components Activities and participation and Environmental factors. Participation was most frequently coded in the chapters Community, social and civic life and Self-care. Overall, the results showed that focus in the implementation plans concerned Self-care and Community, social and civic life. The other life areas in Activities and participation were seldom, or not at all, documented.

    Conclusions: A deeper focus on participation in the implementation plans and all life areas in the component Activities and participation is needed. It is important that the documentation clearly shows what the adult wants, wishes, and likes in everyday life. It is also important to ensure that the job description for staff contains both life areas and individual preferences so that staff have the possibility to work to fulfill social and individual participation for the target group.

    • Implications for rehabilitation
    • There is a need for functioning working models to increase participation significantly for adults with profound intellectual disability or profound intellectual and multiple disabilities.

    • For these adults, participation is achieved through the assistance of others and support and services carried out must be documented in an implementation plan.

    • The International Classification of Functioning, Disability and Health can be used to support staff and ensure that information about the most important factors in an individual’s functioning in their environment is not omitted in documentation.

  • 9.
    Åberg, Anna Cristina
    et al.
    Department of Public Health and Caring Sciences/Geriatrics, Uppsala University.
    Lindmark, Birgitta
    Department of Neurosciences, Uppsala University, University Hospital, Uppsala, Sweden Read More: http://informahealthcare.com/doi/abs/10.3109/02699052.2014.919534.
    Lithell, Hans
    Department of Public Health and Caring Sciences/Geriatrics, Uppsala University.
    Development and reliability of the General Motor Function Assessment Scale (GMF)--a performance-based measure of function-related dependence, pain and insecurity.2003In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 25, no 9, p. 462-72Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To develop a scale for assessment of three components-dependence, pain and insecurity - related to motor functions of importance for activities of daily living among older rehabilitation patients and to establish its clinical practicality and reliability.

    METHOD: A General Motor Function Assessment Scale (GMF) with the above aims was constructed. Clinical practicality was explored by questionnaires to 14 physiotherapists. Inter-rater and test-retest reliability was tested on patients in three different forms of geriatric rehabilitation (n=20-25) and analysed by percentage agreement (PA) and a non-parametric statistical method, which provide measures of the random disagreement separately from the systematic part of the disagreement.

    RESULTS: In the clinical test the GMF was found to be time efficient and clinically adequate. Analysis of reliability showed overall high values of PA (PA> or =70) and of the rank-order agreement coefficient (r(a)>0.82), and low degrees of systematic disagreement.

    CONCLUSIONS: GMF was found to be a clinically useful assessment scale in geriatric rehabilitation. The statistical analyses indicted a high degree of reliability. Comparison of these results with reliability of comparable rating scales is difficult on account of the statistical methods used in other studies, which commonly do not take into account the non-metric properties of the data.

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