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Krabbe SH, Bjorbaekmo WS, Mengshoel AM, Sveen U, Groven KS. A suffering body, hidden away from others: The experience of being long-term bedridden with severe myalgic encephalomyelitis/chronic fatigue syndrome in childhood and adolescence. Nurs Inq 2024:e12625. [PMID: 38280185 DOI: 10.1111/nin.12625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 01/13/2024] [Accepted: 01/16/2024] [Indexed: 01/29/2024]
Abstract
In this article, we present findings from a qualitative study examining how young women experience being long-term bedridden with myalgic encephalomyelitis (ME), also known as chronic fatigue syndrome (CFS), during childhood and adolescence. The aim is to explore how young women who fell ill with ME/CFS during childhood and adolescence look back on their lived experience of being long-term bedridden from the vantage point of being fully or partially recovered. Informed by a phenomenological theoretical perspective, the researchers applied a narrative methodological approach involving the analysis of interviews with 13 women, aged 16-29 years at the time of the interview. Attention was particularly paid to how participants structured their narratives and to the events (telling moments) they identified as important. Four major storylines were developed: Ambivalent responses to the presence of others; A body on the edge of life; An eternity in the dark; and Recasting painful memories of being bedridden and alone. Based on our findings, we argue that the experience of being long-term bedridden with ME/CFS during childhood and adolescence can be understood and communicated as a plot in which individuals find themselves pushed to the extreme limit of suffering and loneliness.
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Affiliation(s)
- Silje Helen Krabbe
- Department of Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
- Children's Surgical Department, Division of Head, Neck and Reconstructive Surgery, Oslo University Hospital, Oslo, Norway
| | | | - Anne Marit Mengshoel
- Department for Interdisciplinary Health Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Unni Sveen
- Department of Occupational Therapy, Prosthetics and Orthotics, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
- Department of Physical Medicine & Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Karen Synne Groven
- Department of Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
- Faculty of Health Studies, VID Specialized University, Sandes, Norway
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Evensen J, Soberg HL, Sveen U, Hestad KA, Moore JL, Bronken BA. Individualized goals expressed by patients undergoing stroke rehabilitation: an observational study. J Rehabil Med 2024; 56:jrm15305. [PMID: 38226892 PMCID: PMC10807545 DOI: 10.2340/jrm.v56.15305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 12/06/2023] [Indexed: 01/17/2024] Open
Abstract
OBJECTIVES To explore the rehabilitation goals measured with the Patient-Specific Functional Scale (PSFS) in patients undergoing acute and subacute stroke rehabilitation. In addition, to assess whether PSFS goals corresponded to impairments and activity limitations, as identified by standardized measures. DESIGN Observational study. PARTICIPANTS A total of 71 participants undergoing inpatient stroke rehabilitation. METHODS The PSFS goals were linked to second-level categories in the International Classification of Functioning, Disability and Health (ICF), using established linking rules. Frequencies of the linked ICF categories were calculated. Frequencies of participants with limitations in walking, activities of daily living (ADL), vision, language, and cognition, were calculated, along with goals in corresponding areas of functioning. RESULTS The participants' goals were linked to 50 second-level ICF categories, comprising areas such as walking and moving, ADL, language, vision, and cognition. The most frequent ICF categories were "Moving around in different locations" (n = 24), "Walking" (n = 23), "Toileting" (n = 16), "Hand and arm use (n = 12) and "Fine hand use (n = 12)". Of participants with limitations in walking, cognition, and vision, 85%, 10%, and 16%, respectively, had goals in these areas. CONCLUSION Participants' goals included walking, ADL, language, vision, and cognition. Few with impairments in cognition or vision had goals in these corresponding areas on the PSFS.
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Affiliation(s)
- Janne Evensen
- Department of Physical Medicine and Rehabilitation, Innlandet Hospital Trust, Gjøvik, Norway.
| | - Helene Lundgaard Soberg
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway; Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Unni Sveen
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway; Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Knut A Hestad
- Department of Health and Nursing Sciences, Faculty of Health and Social Sciences, The Inland Norway University of Applied Sciences, Elverum, Norway; Department of Research, Innlandet Hospital Trust, Brumunddal, Norway
| | - Jennifer L Moore
- Regional Center of Knowledge Translation in Rehabilitation, Sunnaas Rehabilitation Hospital, Oslo/ Nesodden, Norway; Institute for Knowledge Translation, Carmel, IN, USA
| | - Berit Arnesveen Bronken
- Department of Health and Nursing Sciences, Faculty of Health and Social Sciences, The Inland Norway University of Applied Sciences, Elverum, Norway
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Drevland IS, Asbjørnslett M, Sveen U, Groven KS. Occupational experiences and their importance for young peoples' mental health. Scand J Occup Ther 2024; 31:2341779. [PMID: 38626736 DOI: 10.1080/11038128.2024.2341779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 04/07/2024] [Indexed: 04/18/2024]
Abstract
BACKGROUND Young peoples' mental health challenges have increased in recent years to become an urgent public health issue. Research is required to gain a better understanding of how occupations influence young peoples' everyday lives and support their mental health. AIM How do young people experience engaging in various occupations in their daily lives, and how do these experiences shape their mental health? METHOD Semi-structured interviews were conducted with 12 Norwegian young people aged 13-16 years. Verbatim transcriptions of the interviews were analysed using thematic analysis. RESULTS Four core themes emerged: 'doing' for balance and stability; self-discovery through doing; intentional doing to recharge and feel free; and reflecting on the consequences of doing social media. CONCLUSIONS Young peoples' occupational experiences shape their mental health in several ways: they serve as coping strategies, as a means to experience joy and accomplishment, and as a source of routines and opportunities for relaxation. We suggest that health-promoting initiatives for young people would strongly benefit from the inclusion of an occupational perspective.
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Affiliation(s)
- Ingvill Sørensen Drevland
- Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Norway
| | - Mona Asbjørnslett
- Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Norway
| | - Unni Sveen
- Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Norway
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Karen Synne Groven
- Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Norway
- Faculty of Health Sciences, VID Specialized University Oslo, Oslo, Norway
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Krabbe SH, Mengshoel AM, Schrøder Bjorbækmo W, Sveen U, Groven KS. Bodies in lockdown: Young women's narratives of falling severely ill with ME/CFS during childhood and adolescence. Health Care Women Int 2023; 44:1155-1177. [PMID: 35404768 DOI: 10.1080/07399332.2022.2043862] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 02/10/2022] [Accepted: 02/15/2022] [Indexed: 10/18/2022]
Abstract
Thirteen women (16-30 years) storied their experiences about the process of falling severely ill with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome during childhood and adolescence. We performed a narrative analysis informed by phenomenology which yielded three central themes: The active and meaningful life I used to live; gradually developing unhomeliness and feeling pushed toward the edge; and left abandoned on the sidelines. Out of the incomprehensible and unpredictable emerges an understanding of the scale of their ordeal, along with advice that may have made it worse. This portrays a gradual developing uncertain, unhomely life situation with no outlooks for future recovery.
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Affiliation(s)
- Silje Helen Krabbe
- Department of Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
- Children's Surgical Department, Division of Head, Neck and Reconstructive Surgery, Oslo University Hospital, Oslo, Norway
| | - Anne Marit Mengshoel
- Department for Interdisciplinary Health Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
| | | | - Unni Sveen
- Faculty of Health Sciences, Department of Occupational Therapy, Prosthetics and Orthotics, Oslo Metropolitan University, Oslo, Norway
- Department of Physical Medicine & Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Karen Synne Groven
- Department of Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
- Faculty of Health Studies, VID Specialized University, Sandes, Norway
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Lindstad MØ, Obstfelder AU, Sveen U, Stigen L. Feasibility of the Perceive, Recall, Plan and Perform system of intervention for persons with brain injury in community-based rehabilitation: a pilot for a multiple-baseline design study. BMJ Open 2023; 13:e067593. [PMID: 37380207 PMCID: PMC10410811 DOI: 10.1136/bmjopen-2022-067593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 06/14/2023] [Indexed: 06/30/2023] Open
Abstract
OBJECTIVES This paper describes a pilot study investigating the feasibility of the Perceive, Recall, Plan and Perform (PRPP) system for persons with cognitive impairments after acquired brain injury in the context of community-based rehabilitation for older individuals. DESIGN The feasibility, acceptability and practicability of the research procedures were evaluated by exploring the effectiveness of the PRPP intervention with non-concurrent multiple baseline designs. SETTING AND PARTICIPANTS Three participants (63+years of age) from two health centres were included. INTERVENTION In the PRPP intervention, the occupational therapist (OT) supports the participant in applying cognitive strategies in everyday activities to enhance task mastery, with nine sessions of 45-60 min over 3 weeks. PRIMARY AND SECONDARY OUTCOME MEASURES The participants completed measurements of five everyday tasks in each phase as dependent variables. PRPP assessment stages 1 and 2 served as the primary and secondary outcome measures, respectively. The percentage of mastery of the tasks and the participants' application of cognitive strategies at baseline acted as a control and was therefore compared with the other phases within the participant. The Goal Attainment Scale and Barthel Index served as generalisation measures. The uncertainties and acceptability of the procedures were also investigated with a procedural checklist and qualitative statements reported in the procedures or noted in dialogue meetings with the conducting OTs. RESULTS The procedures were acceptable for the OT and the participants and were feasible if the steps in the research procedure were clearly understood. The target behaviour should be changed to the use of one task with five measurement points instead of measuring five tasks. This can enable the application of recommended analysis methods. CONCLUSIONS The outcomes of this study led to a change in the target behaviour and clarification of the research procedure for the planned PRPP intervention study. TRIAL REGISTRATION NUMBER NCT05148247.
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Affiliation(s)
- Marte Ørud Lindstad
- Department of Health Science Gjøvik, Norwegian University of Science and Technology, Trondheim, Norway
| | - Aud Uhlen Obstfelder
- Department of Health Science Gjøvik, Norwegian University of Science and Technology, Trondheim, Norway
| | - Unni Sveen
- Department of Occupational Therapy, Prosthetics and Orthotics, Oslo Metropolitan University, Oslo, Norway
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Linda Stigen
- Department of Health Science Gjøvik, Norwegian University of Science and Technology, Trondheim, Norway
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van Nimwegen D, Hjelle EG, Bragstad LK, Kirkevold M, Sveen U, Hafsteinsdóttir T, Schoonhoven L, Visser-Meily J, de Man-van Ginkel JM. Interventions for improving psychosocial well-being after stroke: A systematic review. Int J Nurs Stud 2023; 142:104492. [PMID: 37084476 DOI: 10.1016/j.ijnurstu.2023.104492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 02/15/2023] [Accepted: 03/23/2023] [Indexed: 03/30/2023]
Abstract
BACKGROUND Up to one third of all stroke patients suffer from one or more psychosocial impairments. Recognition and treatment of these impairments are essential in improving psychosocial well-being after stroke. Although nurses are ideally positioned to address psychosocial well-being, they often feel insecure about providing the needed psychosocial care. Therefore, we expect that providing nurses with better knowledge to deliver this care could lead to an improvement in psychosocial well-being after stroke. Currently it is not known which interventions are effective and what aspects of these interventions are most effective to improve psychosocial well-being after stroke. OBJECTIVE To identify potentially effective interventions - and intervention components - which can be delivered by nurses to improve patients' psychosocial well-being after stroke. METHODS A systematic review and data synthesis of randomized controlled trials and quasi experimental studies was conducted. Papers were included according to the following criteria: 1) before-after design, 2) all types of stroke patients, 3) interventions that can be delivered by nurses, 4) the primary outcome(s) were psychosocial. PubMed, Embase, PsychInfo, CINAHL and Cochrane library were searched (August 2019-April 2022). Articles were selected based on title, abstract, full text and quality. Quality was assessed by using Joanna Briggs Institute checklists and a standardized data extraction form developed by Joanna Brigss Institute was used to extract the data. RESULTS In total 60 studies were included, of which 52 randomized controlled trials, three non-randomized controlled trials, four quasi-experimental studies, and one randomized cross-over study. Nineteen studies had a clear psychosocial content, twenty-nine a partly psychosocial content, and twelve no psychosocial content. Thirty-nine interventions that showed positive effects on psychosocial well-being after stroke were identified. Effective intervention topics were found to be mood, recovery, coping, emotions, consequences/problems after stroke, values and needs, risk factors and secondary prevention, self-management, and medication management. Active information and physical exercise were identified as effective methods of delivery. DISCUSSION The results suggest that interventions to improve psychosocial well-being should include the intervention topics and methods of delivery that were identified as effective. Since effectiveness of the intervention can depend on the interaction of intervention components, these interactions should be studied. Nurses and patients should be involved in the development of such interventions to ensure it can be used by nurses and will help improve patients' psychosocial well-being. FUNDING AND REGISTRATION This study was supported by the Taskforce for Applied Research SIA (RAAK.PUB04.010). This review was not registered.
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Affiliation(s)
- Dagmar van Nimwegen
- Research Group Proactive Care for Older People Living at Home, University of Applied Sciences Utrecht, Utrecht, the Netherlands
| | - Ellen Gabrielsen Hjelle
- Department of Public Health Science and CHARM Research Centre for Habilitation and Rehabilitation Models & Services, University of Oslo, Oslo, Norway; Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Norway
| | - Line Kildal Bragstad
- Department of Public Health Science and CHARM Research Centre for Habilitation and Rehabilitation Models & Services, University of Oslo, Oslo, Norway; Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Norway
| | - Marit Kirkevold
- Department of Public Health Science and CHARM Research Centre for Habilitation and Rehabilitation Models & Services, University of Oslo, Oslo, Norway; Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Unni Sveen
- Department of Rehabilitation Science and Health Technology, Oslo Metropolitan University, Oslo, Norway
| | - Thóra Hafsteinsdóttir
- Research Group Proactive Care for Older People Living at Home, University of Applied Sciences Utrecht, Utrecht, the Netherlands; Department of Nursing Science, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Lisette Schoonhoven
- Department of Nursing Science, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Johanna Visser-Meily
- Department of Rehabilitation, Physical Therapy Science & Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Janneke M de Man-van Ginkel
- Department of Nursing Science, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.
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Evensen J, Soberg HL, Sveen U, Hestad KA, Moore JL, Bronken BA. Measurement Properties of the Patient-Specific Functional Scale in Rehabilitation for Patients With Stroke: A Prospective Observational Study. Phys Ther 2023; 103:pzad014. [PMID: 37140476 PMCID: PMC10158643 DOI: 10.1093/ptj/pzad014] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 08/22/2022] [Accepted: 12/05/2022] [Indexed: 05/05/2023]
Abstract
OBJECTIVE This study investigated the validity, reliability, responsiveness, and interpretability of the Patient-Specific Functional Scale (PSFS) in subacute stroke rehabilitation to determine its suitability to measure patient-identified rehabilitation goals. METHODS A prospective observational study was designed according to the checklist from Consensus-Based Standards for Selecting Health Measurement Instruments. Seventy-one patients diagnosed with stroke were recruited in the subacute phase from a rehabilitation unit in Norway. The International Classification of Functioning, Disability and Health was used to assess the content validity. Assessment of construct validity was based on hypotheses for correlation of the PSFS and comparator measurements. We assessed reliability by calculating the Intraclass Correlation Coefficient (ICC) (3.1) and the standard error of measurement. The assessment of responsiveness was based on hypotheses for the correlation of change scores between the PSFS and the comparator measurements. A receiver operating characteristic analysis was conducted to assess responsiveness. The smallest detectable change and minimal important change were calculated. RESULTS Eighty percent of the PSFS items were classified as activities and participation in the International Classification of Functioning, Disability and Health, indicating satisfactory content validity. The reliability was satisfactory with an ICC of 0.81 (95% CI = 0.69-0.89). The standard error of measurement was 0.70 point, and the smallest detectable change was 1.94 points. Five of 7 hypotheses were confirmed for construct validity, and 5 of 6 were confirmed for responsiveness, indicating moderate construct validity and high responsiveness. Assessing responsiveness with a criterion approach resulted in an area under the curve of 0.74. A ceiling effect was identified for 25% of the participants 3 months after discharge. The minimal important change was estimated to be 1.58 points. CONCLUSION This study demonstrates satisfactory measurement properties for the PSFS in individuals undergoing inpatient stroke rehabilitation. IMPACT This study supports the use of the PSFS to document and monitor patient-identified rehabilitation goals in patients receiving subacute stroke rehabilitation when applied using a shared decision approach.
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Affiliation(s)
- Janne Evensen
- Department of Physical Medicine and Rehabilitation, Innlandet Hospital Trust, Gjøvik, Norway
| | - Helene Lundgaard Soberg
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Unni Sveen
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Knut A Hestad
- Department of Mental Health and Rehabilitation, Faculty of Health- and Social Sciences, The Inland Norway University of Applied Sciences, Elverum, Norway
- Department of Research, Innlandet Hospital Trust, Brumunddal, Norway
| | - Jennifer L Moore
- Regional Center of Knowledge Translation in Rehabilitation, Sunnaas Rehabilitation Hospital, Oslo/Nesodden, Norway
| | - Berit Arnesveen Bronken
- Department of Mental Health and Rehabilitation, Faculty of Health- and Social Sciences, The Inland Norway University of Applied Sciences, Elverum, Norway
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Borgen IMH, Løvstad M, Hauger SL, Forslund MV, Kleffelgård I, Andelic N, Sveen U, Søberg HL, Sigurdardottir S, Winter L, Lindstad MØ, Brunborg C, Røe C. Effect of an Individually Tailored and Home-Based Intervention in the Chronic Phase of Traumatic Brain Injury: A Randomized Clinical Trial. JAMA Netw Open 2023; 6:e2310821. [PMID: 37145600 PMCID: PMC10163390 DOI: 10.1001/jamanetworkopen.2023.10821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 03/14/2023] [Indexed: 05/06/2023] Open
Abstract
Importance Traumatic brain injury (TBI) can cause long-lasting and heterogeneous difficulties that require an individually tailored approach to rehabilitation. However, high-quality studies of treatment options in the chronic phase of TBI are lacking. Objective To evaluate the effect of a home-based, individualized, and goal-oriented rehabilitation intervention in the chronic phase of TBI. Design, Setting, and Participants This study was an intention-to-treat parallel-group assessor-blinded randomized clinical trial with 1:1 randomization to an intervention or control group. Participants included adults in southeastern Norway who had sustained a TBI more than 2 years earlier, lived at home, and had ongoing TBI-related difficulties. A population-based sample of 555 individuals were invited, and 120 were included. Participants were assessed at baseline, 4 months, and 12 months after inclusion. Specialized rehabilitation therapists provided the intervention in patients' homes or via video conference and telephone. Data collection was conducted between June 5, 2018, and December 14, 2021. Interventions The intervention group received an 8-session individually tailored and goal-oriented rehabilitation program over 4 months. The control group received usual care in their municipality. Main Outcomes and Measures Preestablished primary outcomes were disease-specific health-related quality of life (HRQOL; measured by the Quality of Life After Brain Injury [QOLIBRI] overall scale) and social participation (measured by the Participation Assessment With Recombined Tools-Objective [PART-O] social subscale). Preestablished secondary outcomes included generic HRQOL (measured by the EuroQol 5-dimension 5-level [EQ-5D-5L] questionnaire), difficulty with TBI-related problem management (target outcomes; mean severity calculated across 3 main self-identified problem areas that were individually measured using a 4-point Likert scale), TBI symptoms (measured by the Rivermead Post Concussion Symptoms Questionnaire [RPQ]), psychological distress (depression and anxiety; measured by the Patient Health Questionnaire 9-item scale and the Generalized Anxiety Disorder 7-item scale [GAD-7], respectively), and functional competency (measured by the Patient Competency Rating Scale). Results Among 120 participants in the chronic phase of TBI, the median (IQR) age was 47.5 (31.0-55.8) years, and the median (IQR) time since injury was 4 (3-6) years; 85 (70.8%) were male. A total of 60 participants were randomized to the intervention group, and 60 were randomized to the control group. Between baseline and 12 months, no significant between-group effects were found for the primary outcomes of disease-specific HRQOL (QOLIBRI overall scale score: 2.82; 97.5% CI, -3.23 to 8.88; P = .30) or social participation (PART-O social subscale score: 0.12; 97.5% CI, -0.14 to 0.38; P = .29). At 12 months, the intervention group (n = 57) had significantly higher generic HRQOL (EQ-5D-5L score: 0.05; 95% CI, 0.002-0.10; P = .04) and fewer symptoms of TBI (RPQ total score: -3.54; 95% CI, -6.94 to -0.14; P = .04) and anxiety (GAD-7 score: -1.39; 95% CI, -2.60 to -0.19; P = .02) compared with the control group (n = 55). At 4 months only, the intervention group (n = 59) had significantly less difficulty managing TBI-related problems (target outcomes mean severity score: -0.46, 95% CI, -0.76 to -0.15; P = .003) compared with the control group (n = 59). No adverse events were reported. Conclusions and Relevance In this study, no significant results were observed for the primary outcomes of disease-specific HRQOL or social participation. However, the intervention group reported improvements in secondary outcomes (generic HRQOL and symptoms of TBI and anxiety) that were maintained at 12-month follow-up. These findings suggest that rehabilitation interventions could help patients even in the chronic phase of TBI. Trial Registration ClinicalTrials.gov Identifier: NCT03545594.
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Affiliation(s)
- Ida M. H. Borgen
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Marianne Løvstad
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
- Department of Research, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway
| | - Solveig L. Hauger
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
- Department of Research, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway
| | - Marit V. Forslund
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Ingerid Kleffelgård
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Nada Andelic
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
- Center for Habilitation and Rehabilitation Models and Services, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Unni Sveen
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
- Department for Occupational Therapy, Prosthetics and Orthotics, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Helene L. Søberg
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
- Department of Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | | | - Laraine Winter
- M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, Pennsylvania
| | - Marte Ørud Lindstad
- Department of Health Sciences in Gjøvik, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Gjøvik, Norway
| | - Cathrine Brunborg
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - Cecilie Røe
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
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Krabbe SH, Groven KS, Schrøder Bjorbækmo W, Sveen U, Mengshoel AM. The fragile process of Homecoming - Young women in recovery from severe ME/CFS. Int J Qual Stud Health Well-being 2023; 18:2146244. [DOI: 10.1080/17482631.2022.2146244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Silje Helen Krabbe
- Faculty of Health Sciences, Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway
- Children’s Surgical Department, Division of Head, Neck and Reconstructive Surgery, Pediatric Nurse, Oslo University Hospital, Oslo, Norway
| | - Karen Synne Groven
- Faculty of Health Sciences, Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway
- Faculty of Health Studies, VID Specialized University, Oslo, Norway
| | | | - Unni Sveen
- Faculty of Health Sciences, Department of Occupational Therapy, Prosthetics and Orthotics, Oslo Metropolitan University, Oslo, Norway
- Department of Physical Medicine & Rehabilitation, Occupational Therapist, Oslo University Hospital, Oslo, Norway
| | - Anne Marit Mengshoel
- Department for Interdisciplinary Health Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
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Howe EI, Zeldovich M, Andelic N, von Steinbuechel N, Fure SCR, Borgen IMH, Forslund MV, Hellstrøm T, Søberg HL, Sveen U, Rasmussen M, Kleffelgaard I, Tverdal C, Helseth E, Løvstad M, Lu J, Arango-Lasprilla JC, Tenovuo O, Azouvi P, Dawes H, Roe C. Rehabilitation and outcomes after complicated vs uncomplicated mild TBI: results from the CENTER-TBI study. BMC Health Serv Res 2022; 22:1536. [PMID: 36527074 PMCID: PMC9758851 DOI: 10.1186/s12913-022-08908-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 11/29/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Despite existing guidelines for managing mild traumatic brain injury (mTBI), evidence-based treatments are still scarce and large-scale studies on the provision and impact of specific rehabilitation services are needed. This study aimed to describe the provision of rehabilitation to patients after complicated and uncomplicated mTBI and investigate factors associated with functional outcome, symptom burden, and TBI-specific health-related quality of life (HRQOL) up to six months after injury. METHODS Patients (n = 1379) with mTBI from the Collaborative European NeuroTrauma Effectiveness Research in TBI (CENTER-TBI) study who reported whether they received rehabilitation services during the first six months post-injury and who participated in outcome assessments were included. Functional outcome was measured with the Glasgow Outcome Scale - Extended (GOSE), symptom burden with the Rivermead Post Concussion Symptoms Questionnaire (RPQ), and HRQOL with the Quality of Life after Brain Injury - Overall Scale (QOLIBRI-OS). We examined whether transition of care (TOC) pathways, receiving rehabilitation services, sociodemographic (incl. geographic), premorbid, and injury-related factors were associated with outcomes using regression models. For easy comparison, we estimated ordinal regression models for all outcomes where the scores were classified based on quantiles. RESULTS Overall, 43% of patients with complicated and 20% with uncomplicated mTBI reported receiving rehabilitation services, primarily in physical and cognitive domains. Patients with complicated mTBI had lower functional level, higher symptom burden, and lower HRQOL compared to uncomplicated mTBI. Rehabilitation services at three or six months and a higher number of TOC were associated with unfavorable outcomes in all models, in addition to pre-morbid psychiatric problems. Being male and having more than 13 years of education was associated with more favorable outcomes. Sustaining major trauma was associated with unfavorable GOSE outcome, whereas living in Southern and Eastern European regions was associated with lower HRQOL. CONCLUSIONS Patients with complicated mTBI reported more unfavorable outcomes and received rehabilitation services more frequently. Receiving rehabilitation services and higher number of care transitions were indicators of injury severity and associated with unfavorable outcomes. The findings should be interpreted carefully and validated in future studies as we applied a novel analytic approach. TRIAL REGISTRATION ClinicalTrials.gov NCT02210221.
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Affiliation(s)
- Emilie Isager Howe
- grid.55325.340000 0004 0389 8485Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Marina Zeldovich
- grid.411984.10000 0001 0482 5331Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen, Göttingen, Germany
| | - Nada Andelic
- grid.55325.340000 0004 0389 8485Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway ,grid.5510.10000 0004 1936 8921Faculty of Medicine, Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Models and Services (CHARM), University of Oslo, Oslo, Norway
| | - Nicole von Steinbuechel
- grid.411984.10000 0001 0482 5331Institute of Medical Psychology and Medical Sociology, University Medical Center Göttingen, Göttingen, Germany
| | - Silje C. R. Fure
- grid.55325.340000 0004 0389 8485Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway ,grid.5510.10000 0004 1936 8921Faculty of Medicine, Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Models and Services (CHARM), University of Oslo, Oslo, Norway
| | - Ida M. H. Borgen
- grid.55325.340000 0004 0389 8485Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway ,grid.5510.10000 0004 1936 8921Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
| | - Marit V. Forslund
- grid.55325.340000 0004 0389 8485Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Torgeir Hellstrøm
- grid.55325.340000 0004 0389 8485Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Helene L. Søberg
- grid.55325.340000 0004 0389 8485Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway ,grid.412414.60000 0000 9151 4445Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Unni Sveen
- grid.55325.340000 0004 0389 8485Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway ,grid.412414.60000 0000 9151 4445Department for Occupational Therapy Prosthetics and Orthotics, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Mari Rasmussen
- grid.55325.340000 0004 0389 8485Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Ingerid Kleffelgaard
- grid.55325.340000 0004 0389 8485Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Cathrine Tverdal
- grid.55325.340000 0004 0389 8485Department of Neurosurgery, Oslo University Hospital, Oslo, Norway
| | - Eirik Helseth
- grid.55325.340000 0004 0389 8485Department of Neurosurgery, Oslo University Hospital, Oslo, Norway ,grid.5510.10000 0004 1936 8921Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Marianne Løvstad
- grid.5510.10000 0004 1936 8921Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway ,grid.416731.60000 0004 0612 1014Research Department, Sunnaas Rehabilitation Hospital, Bjørnemyr, Norway
| | - Juan Lu
- grid.5510.10000 0004 1936 8921Faculty of Medicine, Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Models and Services (CHARM), University of Oslo, Oslo, Norway ,grid.224260.00000 0004 0458 8737Department of Family Medicine and Population Health, Division of Epidemiology, Virginia Commonwealth University, Richmond, USA
| | | | - Olli Tenovuo
- grid.410552.70000 0004 0628 215XTurku Brain Injury Centre, Turku University Hospital, Turku, Finland ,grid.1374.10000 0001 2097 1371Department of Clinical Neurosciences, University of Turku, Turku, Finland
| | - Philippe Azouvi
- grid.50550.350000 0001 2175 4109AP-HP, GH Paris-Saclay, Hospital Raymond Poincaré, Garches, France ,grid.7429.80000000121866389Université Paris-Saclay, UVSQ, Inserm, CESP, UMR 1018, Team DevPsy, Paris, France
| | - Helen Dawes
- grid.8391.30000 0004 1936 8024College of Medicine and Health, University of Exeter, Exeter, UK ,grid.451190.80000 0004 0573 576XOxford Health Biomedical Research Centre, Oxford Health NHS Foundation Trust, Oxford, UK
| | - Cecilie Roe
- grid.55325.340000 0004 0389 8485Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway ,grid.5510.10000 0004 1936 8921Faculty of Medicine, Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Models and Services (CHARM), University of Oslo, Oslo, Norway ,grid.5510.10000 0004 1936 8921Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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11
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Borgen IM, Løvstad M, Hauger SL, Forslund MV, Kleffelgård I, Andelic N, Sveen U, Søberg HL, Lindstad MØ, Winter L, Cecil. Effects of a Goal-Oriented and Home-Based Intervention in the Chronic Phase of Traumatic Brain Injury. Arch Phys Med Rehabil 2022. [DOI: 10.1016/j.apmr.2022.08.729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
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12
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Lindstad MØ, Obstfelder AU, Sveen U, Stigen L. Effectiveness of the Perceive, Recall, Plan and Perform intervention for persons with brain injury in community-based rehabilitation: protocol for a single-case experimental design with multiple baselines. BMJ Open 2022; 12:e060206. [PMID: 36198473 PMCID: PMC9535175 DOI: 10.1136/bmjopen-2021-060206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION There is a need for standardised interventions in community-based rehabilitation to improve everyday performance for older adults with cognitive challenges due to acquired brain injury (ABI). The Perceive, Recall, Plan and Perform System (PRPP) of intervention has a growing research base. The intervention is suitable for any client with decreased performance in everyday tasks due to ineffective cognitive strategy application to enhance mastery in performance of needed or desired activities. There is no current evidence on the effectiveness of the PRPP intervention for this population. PURPOSE To describe a protocol for a clinical trial that investigates the effectiveness of the PRPP intervention in the context of community-based rehabilitation for persons (65+ years) with difficulties in task performance due to cognitive challenges after ABI. METHODS AND ANALYSIS A non-concurrent multiple baseline design across participants with systematic replications (n=6) will be used. Nine sessions of PRPP intervention will be applied by trained occupational therapists in two community-based rehabilitation units. The participants will complete five repeated measurements of everyday tasks as target behaviours. PRPP Assessment stages 1 and 2 serve as outcome measures at baseline, in the intervention period, in the postintervention period and in the follow-up phase. Mastery percentage of the tasks and the participants' application of cognitive strategies at baseline acts as a control and will be compared with the following phases within the participant. Delayed intervention phases act as a control between participants. Goal Attainment Scaling and the Barthel Index will serve as generalisation measures. Data will be analysed using systematic visual inspection of graphical data, descriptions of clinical significance and descriptive statistical analysis. ETHICS AND DISSEMINATION This trial, including the data management plan, is approved by The Norwegian Regional Ethics Committee (215391). Results will be published in congresses and scientific journals. TRIAL REGISTRATION NUMBER NCT05148247.
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Affiliation(s)
- Marte Ørud Lindstad
- Department of Health Science Gjøvik, Norwegian University of Science and Technology, Gjøvik, Norway
| | - Aud Uhlen Obstfelder
- Department of Health Science Gjøvik, Norwegian University of Science and Technology, Gjøvik, Norway
| | - Unni Sveen
- Department of Occupational Therapy, Prosthetics and Orthotics, Oslo Metropolitan University, Oslo, Norway
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Linda Stigen
- Department of Health Science Gjøvik, Norwegian University of Science and Technology, Gjøvik, Norway
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13
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Sagstad K, Howe EI, Fure SCR, Løvstad M, Enehaug H, Ugelstad H, Feiring M, Andelic N, Sveen U. Transition back to work after mild TBI: a qualitative study. Scand J Occup Ther 2022; 30:527-538. [PMID: 36084237 DOI: 10.1080/11038128.2022.2120067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
BACKGROUND While many persons who sustain a mild traumatic brain injury (MTBI) can resume work shortly after their injury, some experience persisting symptoms leading to longer-term sickness absence. In-depth knowledge about how these persons experience the return to work (RTW) process is needed. AIMS To explore how persons with MTBI experience the process of returning to ordinary competitive work after a prolonged period of sickness absence. MATERIAL AND METHODS Semi-structured interviews were conducted with six persons (four women) approximately 12 months after sustaining an MTBI. Data were analysed using a stepwise-deductive inductive method. RESULTS When starting work the participants experienced a crisis. They described the importance of making the actual decision to RTW. Being present at the workplace was significant. In the process of increased workload, they expressed having challenges related to time perception and capacity restrictions. The importance of being seen and valued was emphasised. When reintegrated into the workplace revaluing work tasks and priorities shaped the RTW process as well as a further professional career. CONCLUSIONS AND SIGNIFICANCE The process of RTW contained the experience of unpredictability and incompatibility with own identity and performance. Working had an impact on social participation, self-worth, daily structure, as well as reconstructing occupational biography.
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Affiliation(s)
- Kjersti Sagstad
- Department of Vocational Rehabilitation, Norwegian Labour and Welfare Administration, Oslo, Norway.,Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Emilie Isager Howe
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Silje C R Fure
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway.,Research Centre for Habilitation and Rehabilitation Models and Services (CHARM), Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Marianne Løvstad
- Department of Research, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
| | - Heidi Enehaug
- The Work Research Institute, Oslo Metropolitan University, Oslo, Norway
| | - Helene Ugelstad
- Department of Vocational Rehabilitation, Norwegian Labour and Welfare Administration, Oslo, Norway
| | - Marte Feiring
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Nada Andelic
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway.,The Work Research Institute, Oslo Metropolitan University, Oslo, Norway
| | - Unni Sveen
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.,Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
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14
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Borgen IMH, Kleffelgård I, Hauger SL, Forslund MV, Søberg HL, Andelic N, Sveen U, Winter L, Løvstad M, Røe C. Patient-Reported Problem Areas in Chronic Traumatic Brain Injury. J Head Trauma Rehabil 2022; 37:E336-E345. [PMID: 34743086 DOI: 10.1097/htr.0000000000000744] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The aims of this study were to (1) assess self-reported main problem areas reported by patients with traumatic brain injury (TBI) and their family members in the chronic phase, and (2) compare the self-prioritized problems with difficulties captured by questionnaires and neuropsychological screening through linking to the International Classification of Functioning, Disability and Health (ICF). SETTING Outpatient clinic at the Oslo University Hospital, Norway. PARTICIPANTS In total, 120 patients with TBI were recruited, of whom, 78 had a participating family member. Eligibility criteria were a clinical TBI diagnosis with verified intracranial injury, living at home, aged 18 to 72 years, 2 years or more postinjury, and experiencing perceived TBI-related difficulties, reduced physical and mental health, or difficulties with participation in everyday life. Patients with severe psychiatric or neurological disorders or inability to participate in goal-setting processes were excluded. DESIGN Cross-sectional. MAIN MEASURES Target Outcomes, that is, 3 main TBI-related problem areas reported by patients and family members, collected in a semistructured interview; standardized questionnaires of TBI-related symptoms, anxiety, depression, functioning, and health-related quality of life; neuropsychological screening battery. RESULTS Target Outcomes were related to cognitive, physical, emotional, and social difficulties. Target Outcomes were linked to 12 chapters and 112 distinct categories in the ICF, while standardized measures only covered 10 chapters and 28 categories. Some aspects of post-TBI adjustment were found to be insufficiently covered by the ICF classification, such as identity issues, lack of meaningful activities, and feeling lonely. CONCLUSION The Target Outcomes approach is a useful assessment method in a population with chronic TBI. The standardized questionnaires capture the spectrum of problems, whereas the Target Outcomes approach captures the prioritized individual problems hindering everyday life after TBI. While the standardized measures are an irreplaceable part of the assessment, Target Outcomes ensures patient involvement and may help clinicians better tailor relevant rehabilitation efforts.
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Affiliation(s)
- Ida M H Borgen
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway (Ms Borgen and Drs Kleffelgård, Forslund, Søberg, Andelic, Sveen, and Røe); Department of Psychology, Faculty of Social Sciences (Ms Borgen and Drs Hauger and Løvstad), Institute of Clinical Medicine, Faculty of Medicine (Dr Røe), and Center for Habilitation and Rehabilitation Models and Services (CHARM), Institute of Health and Society (Drs Andelic and Røe), University of Oslo, Oslo, Norway; Department of Research, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway (Drs Hauger and Løvstad); Departments of Physiotherapy (Dr Søberg) and Occupational Therapy Prosthetics and Orthotics (Dr Sveen), Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway; and M. Louise Fitzpatrick College of Nursing, Villanova University, Villanova, Pennsylvania (Dr Winter)
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15
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Soberg HL, Moksnes HØ, Anke A, Røise O, Røe C, Aas E, Sveen U, Gaarder C, Næss PA, Helseth E, Dahl HM, Becker F, Løvstad M, Bartnes K, Schäfer C, Rasmusssen MS, Perrin P, Lu J, Hellstrøm T, Andelic N. Correction: Rehabilitation Needs, Service Provision, and Costs in the First Year Following Traumatic Injuries: Protocol for a Prospective Cohort Study. JMIR Res Protoc 2022; 11:e37723. [PMID: 35320112 PMCID: PMC8987964 DOI: 10.2196/37723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 03/04/2022] [Indexed: 11/13/2022] Open
Abstract
[This corrects the article DOI: 10.2196/25980.].
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Affiliation(s)
- Helene Lundgaard Soberg
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway.,Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Håkon Øgreid Moksnes
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway.,Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Models & Services (CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Audny Anke
- Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Models & Services (CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Rehabilitation, University Hospital of North Norway, Tromsø, Norway.,Faculty of Health Sciences, Department of Clinical Medicine, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
| | - Olav Røise
- Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway.,Institute for Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Cecilie Røe
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway.,Institute for Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Eline Aas
- Department of Health Management and Health Economics, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Unni Sveen
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway.,Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Christine Gaarder
- Institute for Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Traumatology, Oslo University Hospital, Oslo, Norway
| | - Pål Aksel Næss
- Institute for Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Traumatology, Oslo University Hospital, Oslo, Norway
| | - Eirik Helseth
- Institute for Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Neurosurgery, Oslo University Hospital, Oslo, Norway
| | - Hilde Margrete Dahl
- Institute for Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Child Neurology, Oslo University Hospital, Oslo, Norway
| | - Frank Becker
- Institute for Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway
| | - Marianne Løvstad
- Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway.,Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
| | - Kristian Bartnes
- Faculty of Health Sciences, Department of Clinical Medicine, University of Tromsø, The Arctic University of Norway, Tromsø, Norway.,Department of Cardiothoracic and Vascular Surgery, University Hospital of North Norway, Tromsø, Norway
| | - Christoph Schäfer
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway.,Department of Rehabilitation, University Hospital of North Norway, Tromsø, Norway.,Faculty of Health Sciences, Department of Clinical Medicine, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
| | - Mari S Rasmusssen
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway.,Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Models & Services (CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Paul Perrin
- Departments of Psychology and Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, United States
| | - Juan Lu
- Division of Epidemiology, Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA, United States
| | - Torgeir Hellstrøm
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Nada Andelic
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway.,Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Models & Services (CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway
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Linnestad AM, Løvstad M, Groven KS, Howe EI, Fure SCR, Spjelkavik Ø, Sveen U. "Manoeuvring in uncharted waters - a balancing act": A qualitative exploration of treatment and improvement after mild traumatic brain injury. Neuropsychol Rehabil 2022; 33:592-612. [PMID: 35168477 DOI: 10.1080/09602011.2022.2034651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Background: Individuals who have sustained mild traumatic brain injury (mTBI) with a protracted course of recovery may experience long-lasting somatic, cognitive, and emotional symptoms affecting activities of daily living. There is limited knowledge regarding individuals' lived experiences with treatments and advice provided.Purpose: To explore how individuals with mTBI describe and make sense of their injury, recovery process, and their experiences with various treatment approaches.Methods: Eight participants with mTBI were recruited from the intervention group in an ongoing randomized controlled trial regarding return-to-work. They were interviewed once after treatment delivery using a qualitative hermeneutical approach. Thematic analysis was applied, and findings are discussed in light of a salutogenic theory.Results: Participants expressed uncertainty regarding conflicting advice they received in the early phase of recovery. Three main themes were developed: (1) "Ambiguity and hope"; (2) "Uncertainty concerning activity and rest"; and (3) "To become the person I used to be vs. to become a new version of myself."Conclusion: The findings showed that the participants experienced both uncertainty and hope for further recovery. The recovery process is challenged by the variability of TBI symptoms that affects participation in everyday life, as well as the conflicting advice received by the participants.
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Affiliation(s)
| | - Marianne Løvstad
- Department of Research, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
| | - Karen Synne Groven
- Faculty of Health, VID Specialized University, Oslo, Norway.,Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Emilie Isager Howe
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Silje Christine Reistad Fure
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway.,Centre for Habilitation and Rehabilitation Models and Services (CHARM), Institute of Health and Society, University of Oslo, Oslo, Norway
| | | | - Unni Sveen
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.,Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
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Borgen IMH, Hauger SL, Forslund MV, Kleffelgård I, Brunborg C, Andelic N, Sveen U, Søberg HL, Sigurdardottir S, Røe C, Løvstad M. Goal Attainment in an Individually Tailored and Home-Based Intervention in the Chronic Phase after Traumatic Brain Injury. J Clin Med 2022; 11:jcm11040958. [PMID: 35207231 PMCID: PMC8875324 DOI: 10.3390/jcm11040958] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 02/04/2022] [Accepted: 02/10/2022] [Indexed: 12/04/2022] Open
Abstract
Traumatic brain injury (TBI) is a heterogeneous condition with long-term consequences for individuals and families. Goal-oriented rehabilitation is often applied, but there is scarce knowledge regarding types of goals and goal attainment. This study describes goal attainment in persons in the chronic phase of TBI who have received an individualized, SMART goal-oriented and home-based intervention, compares goal attainment in different functional domains, and examines indicators of goal attainment. Goal attainment scaling (GAS) was recorded in the intervention group (n = 59) at the final session. The goal attainment was high, with 93.3% increased goal attainment across all goals at the final session. The level of goal attainment was comparable across domains (cognitive, physical/somatic, emotional, social). Gender, anxiety symptoms, self-reported executive dysfunction, and therapy expectations were indicators of goal attainment. These results indicate a potential for the high level of goal attainment in the chronic phase of TBI. Tailoring of rehabilitation to address individual needs for home-dwelling persons with TBI in the chronic phase represents an important area of future research.
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Affiliation(s)
- Ida M. H. Borgen
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, 0424 Oslo, Norway; (M.V.F.); (I.K.); (N.A.); (U.S.); (H.L.S.); (C.R.)
- Department of Psychology, Faculty of Social Sciences, University of Oslo, 0316 Oslo, Norway; (S.L.H.); (M.L.)
- Correspondence:
| | - Solveig L. Hauger
- Department of Psychology, Faculty of Social Sciences, University of Oslo, 0316 Oslo, Norway; (S.L.H.); (M.L.)
- Department of Research, Sunnaas Rehabilitation Hospital, 1453 Nesoddtangen, Norway
| | - Marit V. Forslund
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, 0424 Oslo, Norway; (M.V.F.); (I.K.); (N.A.); (U.S.); (H.L.S.); (C.R.)
| | - Ingerid Kleffelgård
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, 0424 Oslo, Norway; (M.V.F.); (I.K.); (N.A.); (U.S.); (H.L.S.); (C.R.)
| | - Cathrine Brunborg
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, 0424 Oslo, Norway;
| | - Nada Andelic
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, 0424 Oslo, Norway; (M.V.F.); (I.K.); (N.A.); (U.S.); (H.L.S.); (C.R.)
- Center for Habilitation and Rehabilitation Models and Services (CHARM), Institute of Health and Society, Faculty of Medicine, University of Oslo, 0316 Oslo, Norway
| | - Unni Sveen
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, 0424 Oslo, Norway; (M.V.F.); (I.K.); (N.A.); (U.S.); (H.L.S.); (C.R.)
- Department for Occupational Therapy Prosthetics and Orthotics, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway
| | - Helene L. Søberg
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, 0424 Oslo, Norway; (M.V.F.); (I.K.); (N.A.); (U.S.); (H.L.S.); (C.R.)
- Department of Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University, 0130 Oslo, Norway
| | | | - Cecilie Røe
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, 0424 Oslo, Norway; (M.V.F.); (I.K.); (N.A.); (U.S.); (H.L.S.); (C.R.)
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, 0316 Oslo, Norway
| | - Marianne Løvstad
- Department of Psychology, Faculty of Social Sciences, University of Oslo, 0316 Oslo, Norway; (S.L.H.); (M.L.)
- Department of Research, Sunnaas Rehabilitation Hospital, 1453 Nesoddtangen, Norway
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18
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Mangset M, Kitzmüller G, Evju AS, Angel S, Aadal L, Martinsen R, Bronken BA, Kvigne KJ, Bragstad LK, Hjelle EG, Sveen U, Kirkevold M. Perceived study-induced influence on the control group in a randomized controlled trial evaluating a complex intervention to promote psychosocial well-being after stroke: a process evaluation. Trials 2021; 22:850. [PMID: 34838094 PMCID: PMC8627040 DOI: 10.1186/s13063-021-05765-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 10/27/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A commonly applied control condition in trials evaluating complex interventions in rehabilitation research is "usual care." The main challenge is to ensure that the control group receives genuine usual care as delivered in everyday clinical practice. The assessment interviews and dialogues with the data collectors may influence the control group participants' reflections on their condition and adjustments. This represents a threat to the internal validity of the trial. Thus, the aim of this study was to explore the perceived study-induced influence of assessment interviews on the adjustment of the members of a control group in a randomized clinical trial. The aim of the trial was to test a dialogue-based psychosocial intervention aiming at promoting the psychosocial well-being and adjustment of stroke survivors. METHODS Fifteen participants in the control group of a multicenter stroke rehabilitation trial participated in narrative semi-structured interviews. Ricoeur's interpretation theory guided the analysis. RESULTS The perceived study-induced influence of the assessment interviews on the adjustment process of members of the control group varied considerably. The results demonstrated that the assessment interviews facilitated some participants' feelings of control and their ability to cope. Other participants' statements indicate that they relied on their existing personal capacity to cope and adjust and that the assessment interviews did not make any difference either on their coping ability or on their process of adjustment. Five themes were identified that described the perceived study-induced influence of the assessment interviews in the control group. The themes illustrated that the assessments served as a safety net, enhanced awareness and understanding, encouraged seeking support, allowed the opportunity to vent disappointment, or did not make any difference either way. CONCLUSIONS RCT assessment interviews may influence the adjustment process and represent a serious problem in measuring interventions over time in trials of complex interventions in rehabilitation research. To uphold rigor and stringency, the usual care control conditions should be thoroughly assessed and described. Informing participants only about the treatment they were allocated to receive might counteract the potential to dilute the difference between the two arms of the trial. TRIAL REGISTRATION ClinicalTrials.gov NCT02338869. Registered on October 4, 2014.
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Affiliation(s)
- Margrete Mangset
- Department of Geriatric Medicine, Oslo University Hospital, Ullevaal, P.O. Box 4956, 0424 Oslo, Nydalen Norway
| | - Gabriele Kitzmüller
- Faculty of Health Sciences, Department of Health and Care Sciences, UiT The Arctic University of Norway, P.O. Box 385, 8505 Narvik, Norway
| | - Anne S. Evju
- Faculty of Health Sciences, Department of Health and Care Sciences, UiT The Arctic University of Norway, P.O. Box 385, 8505 Narvik, Norway
| | - Sanne Angel
- Department of Public Health – Research Unit for Nursing and Healthcare, Department of Science in Nursing, Aarhus University, 8000 Aarhus, Denmark
- Faculty of Health Sciences and Social Care, Molde University College, P.O. Box 2110, NO-6402 Molde, Norway
| | - Lena Aadal
- Faculty of Health Sciences and Social Care, Molde University College, P.O. Box 2110, NO-6402 Molde, Norway
- Hammel Neurorehabilitation Centre and University Research Clinic, 8450 Hammel, Denmark
- Department of Clinical Medicine, Aarhus University, C, 8000 Aarhus, Denmark
| | - Randi Martinsen
- Inland Norway University of Applied Sciences, P.B. 400, 2418 Elverum, Norway
| | | | - Kari J. Kvigne
- Inland Norway University of Applied Sciences, P.B. 400, 2418 Elverum, Norway
- The Faculty of Nursing and Health Sciences, Nord University, P.B. 1490, 8049 Bodø, Norway
| | - Line K. Bragstad
- Department of Geriatric Medicine, Oslo University Hospital, Ullevaal, P.O. Box 4956, 0424 Oslo, Nydalen Norway
- University of Oslo, P.O. Box 1130, 0318 Oslo, Blindern Norway
- Institute of Health and Society and Research Center for Habilitation and Rehabilitation Services and Models (CHARM), University of Oslo, P.O. Box 1130, 0318 Oslo, Blindern Norway
| | - Ellen Gabrielsen Hjelle
- University of Oslo, P.O. Box 1130, 0318 Oslo, Blindern Norway
- Institute of Health and Society and Research Center for Habilitation and Rehabilitation Services and Models (CHARM), University of Oslo, P.O. Box 1130, 0318 Oslo, Blindern Norway
| | - Unni Sveen
- Department of Geriatric Medicine, Oslo University Hospital, Ullevaal, P.O. Box 4956, 0424 Oslo, Nydalen Norway
- Oslo Metropolitan University, P.O. Box 4, St. Olavs plass, 0130 Oslo, Norway
| | - Marit Kirkevold
- University of Oslo, P.O. Box 1130, 0318 Oslo, Blindern Norway
- Oslo Metropolitan University, P.O. Box 4, St. Olavs plass, 0130 Oslo, Norway
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19
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Martinsen R, Kitzmüller G, Mangset M, Kvigne K, Evju AS, Bronken BA, Bragstad LK, Hjelle EG, Sveen U, Kirkevold M. Nurses' and occupational therapists' experiences of conducting a home-based psychosocial intervention following stroke: a qualitative process evaluation. BMC Health Serv Res 2021; 21:791. [PMID: 34376188 PMCID: PMC8356405 DOI: 10.1186/s12913-021-06857-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 07/30/2021] [Indexed: 11/24/2022] Open
Abstract
Background Persons with stroke are susceptible to psychosocial problems, and express disappointment at how health care professionals fail to meet their psychosocial needs following discharge to home. The responsibility of nurses and occupational therapists in stroke rehabilitation is to assist the persons and their families during the recovery and adjustment process. A home-based dialogical intervention aiming to enhance psychosocial support was therefore developed and tested in a randomized controlled trial. This study is a part of the process evaluation conducted alongside the trial. The aim was to explore the nurses’ and occupational therapists’ experiences of conducting the intervention. Methods Eighteen nurses and four occupational therapists participated in six focus groups to explore their experiences when providing the intervention. The themes discussed in the focus groups were the aspects that facilitated the delivering of the intervention and the challenges they encountered during the study period. The interviews were analysed using qualitative content analysis. Results The analysis generated two themes. The theme Developing a supportive relationship to facilitate the adjustment process following stroke had two subthemes: Getting personally involved and Handling challenges. This theme reveals how the nurses and occupational therapists experienced their relationship with the persons with stroke and potential threats which challenged them while conducting the intervention. The theme Developing professional skills in providing psychosocial support had two subthemes: Becoming confident in conducting dialogues and Integrating psychosocial topics. This theme reveals the aspects that the nurses and occupational therapists perceived as facilitating the development of their professional skills in conducting the dialogues. Conclusion Delivering the psychosocial intervention was perceived as deeply meaningful and increased the nurses’ and occupational therapists’ understanding of how to support stroke survivors to live with the consequences of stroke. However, balancing the professional and the personal relationship was challenging. A basic educational programme, training, supervision and having dedicated time were crucial elements to instil confidence in professionals conducting theme-based dialogues to promote post-stroke psychosocial well-being. Individual clinical experience and knowledge of stroke care were considering important to enable professionals to integrate psychosocial rehabilitation into community health care. Trial registration ClinicalTrials.gov, NCT 02338869, registered 10/04/2014.
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Affiliation(s)
- Randi Martinsen
- Department of Health and Nursing Sciences, Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, P.B. 400, 2418, Elverum, Norway.
| | - Gabriele Kitzmüller
- Department of Health and Care Sciences, Faculty of Health Sciences, UIT The Arctic University of Norway, Tromsø, Norway
| | - Margrete Mangset
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Kari Kvigne
- Department of Health and Nursing Sciences, Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, P.B. 400, 2418, Elverum, Norway
| | - Anne Svelstad Evju
- Department of Health and Care Sciences, Faculty of Health Sciences, UIT The Arctic University of Norway, Tromsø, Norway
| | - Berit Arnesveen Bronken
- Department of Health and Nursing Sciences, Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, P.B. 400, 2418, Elverum, Norway
| | - Line Kildal Bragstad
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway.,Department of Nursing Science and Research Center for habilitation and rehabilitation services and models (CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Ellen Gabrielsen Hjelle
- Department of Nursing Science and Research Center for habilitation and rehabilitation services and models (CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Unni Sveen
- Department of Geriatric Medicine and Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Marit Kirkevold
- Department of Nursing Science and Research Center for habilitation and rehabilitation services and models (CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway
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20
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Koren Solvang P, Sveen U, Søberg HL. User involvement in the making: Positions and types of knowledge enacted in the interaction between service users and researchers in user panel meetings. Health Expect 2021; 24:1424-1432. [PMID: 34048617 PMCID: PMC8369089 DOI: 10.1111/hex.13281] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/18/2021] [Accepted: 04/29/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Numerous studies of user involvement in research have been conducted. However, there is a lack of studies applying observational methods and addressing the concrete practice of involvement. OBJECTIVE To determine what knowledge types and competences users apply when involved in the research process through user panel meetings. DESIGN User panel meetings in a qualitative project in rehabilitation were sound-recorded and transcribed verbatim. Data analysis applied an abductive approach framed by positioning theory. SETTING AND PARTICIPANTS Six rehabilitation service users and a similar number of researchers met 20 times during a six-year project period. They discussed various issues in the research process such as interview guides, analysis and dissemination of results. FINDINGS The service users combined their respective knowledge and competence into six positions enacted in the panel interactions. They engaged as co-researchers, based their contributions on their respective personal histories, represented an NGO and peers, applied their respective professional and educational backgrounds and, finally, engaged as concerned citizens. DISCUSSION AND CONCLUSION The findings add to the discussion of professionalization of user involvement by introducing a wider array of positions enacted than do the findings of previous studies. Researchers recruiting user panel members, as well as NGOs appointing candidates for user panels, are advised to consider a wide competence profile for possible candidates. A panel is also considered as a resource in confirming and elaborating on a study's findings. PATIENT AND PUBLIC CONTRIBUTION A service user panel contributed to the study.
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Affiliation(s)
| | - Unni Sveen
- Department of Occupational Therapy, Prosthetics and OrthoticsOslo Metropolitan UniversityOsloNorway
- Department of Physical Medicine & RehabilitationOslo University HospitalOsloNorway
| | - Helene Lundgaard Søberg
- Department of PhysiotherapyOslo Metropolitan UniversityOsloNorway
- Department of Physical Medicine & RehabilitationOslo University HospitalOsloNorway
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21
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Fure SCR, Howe EI, Andelic N, Brunborg C, Sveen U, Røe C, Rike PO, Olsen A, Spjelkavik Ø, Ugelstad H, Lu J, Ponsford J, Twamley EW, Hellstrøm T, Løvstad M. Cognitive and vocational rehabilitation after mild-to-moderate traumatic brain injury: A randomised controlled trial. Ann Phys Rehabil Med 2021; 64:101538. [PMID: 33957293 DOI: 10.1016/j.rehab.2021.101538] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 02/13/2021] [Accepted: 03/17/2021] [Indexed: 01/18/2023]
Abstract
BACKGROUND Returning to work is often a primary rehabilitation goal after traumatic brain injury (TBI). However, the evidence base for treatment options regarding return to work (RTW) and stable work maintenance remains scarce. OBJECTIVE This study aimed to examine the effect of a combined cognitive and vocational intervention on work-related outcomes after mild-to-moderate TBI. METHODS In this study, we compared 6 months of a combined compensatory cognitive training and supported employment (CCT-SE) intervention with 6 months of treatment as usual (TAU) in a randomised controlled trial to examine the effect on time to RTW, work percentage, hours worked per week and work stability. Eligible patients were those with mild-to-moderate TBI who were employed ≥50% at the time of injury, 18 to 60 years old and sick-listed ≥50% at 8 to 12 weeks after injury due to post-concussion symptoms, assessed by the Rivermead Post Concussion Symptoms Questionnaire. Both treatments were provided at the outpatient TBI department at Oslo University Hospital, and follow-ups were conducted at 3, 6 and 12 months after inclusion. RESULTS We included 116 individuals, 60 randomised to CCT-SE and 56 to TAU. The groups did not differ in characteristics at the 12-month follow-up. Overall, a high proportion had returned to work at 12 months (CCT-SE, 90%; TAU, 84%, P=0.40), and all except 3 were stably employed after the RTW. However, a significantly higher proportion of participants in the CCT-SE than TAU group had returned to stable employment at 3 months (81% vs. 60%, P=0.02). CONCLUSION These results suggest that the CCT-SE intervention might help patients with mild-to-moderate TBI who are still sick-listed 8 to 12 weeks after injury in an earlier return to stable employment. However, the results should be replicated and a cost-benefit analysis performed before concluding.
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Affiliation(s)
- Silje C R Fure
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway; Research Centre for Habilitation and Rehabilitation Models and Services (CHARM), Institute of Health and Society, University of Oslo, Oslo, Norway.
| | - Emilie Isager Howe
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Nada Andelic
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway; Research Centre for Habilitation and Rehabilitation Models and Services (CHARM), Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Cathrine Brunborg
- Oslo Centre for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Oslo, Norway
| | - Unni Sveen
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway; Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Cecilie Røe
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway; Research Centre for Habilitation and Rehabilitation Models and Services (CHARM), Institute of Health and Society, University of Oslo, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Per-Ola Rike
- Department of Research, Sunnaas Rehabilitation Hospital Trust, Nesoddtangen, Norway
| | - Alexander Olsen
- Department of Psychology, Norwegian University of Technology and Science, Trondheim, Norway; Department of Physical Medicine and Rehabilitation, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | | | - Helene Ugelstad
- Department of Vocational Rehabilitation, Norwegian Labor and Welfare Administration, Oslo, Norway
| | - Juan Lu
- Research Centre for Habilitation and Rehabilitation Models and Services (CHARM), Institute of Health and Society, University of Oslo, Oslo, Norway; Division of Epidemiology, Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA, USA
| | - Jennie Ponsford
- Monash Epworth Rehabilitation Research Centre, Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Elizabeth W Twamley
- Center of Excellence for Stress and Mental Health, Veterans Affairs (VA) San Diego Healthcare System, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Torgeir Hellstrøm
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Marianne Løvstad
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway; Department of Psychology, University of Oslo, Oslo, Norway
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22
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Fraser T, Karon L, Lund A, Sveen U, Kessler D. Examining components of community psychosocial stroke interventions using concept mapping. Scand J Occup Ther 2021; 29:325-336. [PMID: 34181505 DOI: 10.1080/11038128.2021.1933172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Stroke impacts psychosocial well-being and engagement in occupation. Psychosocial interventions reduce depression and anxiety but may not impact occupation. Knowledge of key processes and components of community psychosocial stroke interventions can inform future intervention development. AIM/OBJECTIVE(S) To determine the essential elements common to three psychosocial interventions for stroke survivors. MATERIAL(S) AND METHOD(S) Concept maps were created for three community psychosocial stroke interventions based on published literature and communication with researchers who tested the intervention with stroke survivors. The concept maps were then compared to identify common elements. Ongoing communication with researchers ensured accurate representation of each respective intervention. RESULTS Similarities in intervention processes and components included support for autonomy; individualized information exchange; coping, life skill development and adaptation support; competence development; and the incorporation of goals. Differences included intervention delivery (individual versus group), and the avenues in which psychosocial needs are addressed (occupation versus dialogue). CONCLUSIONS Concept mapping identified similarities among the three interventions that can be best understood using self-determination theory. Clinicians may utilize findings revealed in the process to inform evidence-based psychosocial stroke interventions. SIGNIFICANCE Knowledge of key 'active ingredients' for psychosocial community stroke interventions, can be used to guide clinical reasoning and inform development of interventions.
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Affiliation(s)
- Theresa Fraser
- School of Rehabilitation Therapy, Queens University, Kingston, Canada
| | - Leora Karon
- School of Rehabilitation Therapy, Queens University, Kingston, Canada
| | - Anne Lund
- Department of Occupational Therapy, Prosthetics and Orthotics, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Unni Sveen
- Department of Occupational Therapy, Prosthetics and Orthotics, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Dorothy Kessler
- School of Rehabilitation Therapy, Queens University, Kingston, Canada
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23
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Soberg HL, Moksnes HØ, Anke A, Røise O, Røe C, Aas E, Sveen U, Gaarder C, Næss PA, Helseth E, Dahl HM, Becker F, Løvstad M, Bartnes K, Schäfer C, Rasmussen MS, Perrin P, Lu J, Hellstrøm T, Andelic N. Rehabilitation Needs, Service Provision, and Costs in the First Year Following Traumatic Injuries: Protocol for a Prospective Cohort Study. JMIR Res Protoc 2021; 10:e25980. [PMID: 33688841 PMCID: PMC8082380 DOI: 10.2196/25980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 02/19/2021] [Accepted: 03/09/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Traumatic injuries, defined as physical injuries with sudden onset, are a major public health problem worldwide. There is a paucity of knowledge regarding rehabilitation needs and service provision for patients with moderate and major trauma, even if rehabilitation research on a spectrum of specific injuries is available. OBJECTIVE This study aims to describe the prevalence of rehabilitation needs, the provided services, and functional outcomes across all age groups, levels of injury severity, and geographical regions in the first year after trauma. Direct and indirect costs of rehabilitation provision will also be assessed. The overarching aim is to better understand where to target future efforts. METHODS This is a population-based prospective follow-up study. It encompasses patients of all ages with moderate and severe acute traumatic injury (New Injury Severity Score >9) admitted to the regional trauma centers in southeastern and northern Norway over a 1-year period (2020). Sociodemographic and injury data will be collected. Upon hospital discharge, rehabilitation physicians estimate rehabilitation needs. Rehabilitation needs are assessed by the Rehabilitation Complexity Scale Extended-Trauma (RCS E-Trauma; specialized inpatient rehabilitation), Needs and Provision Complexity Scale (NPCS; community-based rehabilitation and health care service delivery), and Family Needs Questionnaire-Pediatric Version (FNQ-P). Patients, family caregivers, or both will complete questionnaires at 6- and 12-month follow-ups, which are supplemented by telephone interviews. Data on functioning and disability, mental health, health-related quality of life measured by the EuroQol Questionnaire (EQ-5D), and needs and provision of rehabilitation and health care services are collected by validated outcome measures. Unmet needs are represented by the discrepancies between the estimates of the RCS E-Trauma and NPCS at the time of a patient's discharge and the rehabilitation services the patient has actually received. Formal service provision (including admission to inpatient- or outpatient-based rehabilitation), informal care, and associated costs will be collected. RESULTS The project was funded in December 2018 and approved by the Regional Committee for Medical and Health Research Ethics in October 2019. Inclusion of patients began at Oslo University Hospital on January 1, 2020, and at the University Hospital of North Norway on February 1, 2020. As of February 2021, we have enrolled 612 patients, and for 286 patients the 6-month follow-up has been completed. Papers will be drafted for publication throughout 2021 and 2022. CONCLUSIONS This study will improve our understanding of existing service provision, the gaps between needs and services, and the associated costs for treating patients with moderate and major trauma. This may guide the improvement of rehabilitation and health care resource planning and allocation. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/25980.
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Affiliation(s)
- Helene Lundgaard Soberg
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital HF, Oslo, Norway.,Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Håkon Øgreid Moksnes
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway.,Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Models & Services (CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Audny Anke
- Department of Rehabilitation, University Hospital of North Norway, Tromsø, Norway.,Department of Cardiothoracic and Vascular Surgery, University Hospital of North Norway, Tromsø, Norway
| | - Olav Røise
- Division of Orthopaedic Surgery, Oslo University Hospital, Oslo, Norway.,Institute for Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Cecilie Røe
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway.,Institute for Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Eline Aas
- Department of Health Management and Health Economics, Institute for Health and Society, University of Oslo, Oslo, Norway
| | - Unni Sveen
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.,Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Christine Gaarder
- Institute for Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Traumatology, Oslo University Hospital, Oslo, Norway
| | - Pål Aksel Næss
- Institute for Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Traumatology, Oslo University Hospital, Oslo, Norway
| | - Eirik Helseth
- Institute for Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Neurosurgery, Oslo University Hospital, Oslo, Norway
| | - Hilde Margrete Dahl
- Institute for Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Child Neurology, Oslo University Hospital, Oslo, Norway
| | - Frank Becker
- Institute for Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway
| | - Marianne Løvstad
- Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway.,Department of Psychology, University of Oslo, Oslo, Norway
| | - Kristian Bartnes
- Department of Cardiothoracic and Vascular Surgery, University Hospital of North Norway, Tromsø, Norway.,Institute of Clinical Medicine, University of Tromsø, The Arctic University of Norway, Tromsø, Norway
| | - Christoph Schäfer
- Department of Rehabilitation, University Hospital of North Norway, Tromsø, Norway.,Department of Cardiothoracic and Vascular Surgery, University Hospital of North Norway, Tromsø, Norway
| | - Mari S Rasmussen
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital HF, Oslo, Norway.,Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Models & Services (CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Paul Perrin
- Departments of Psychology and Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, United States
| | - Juan Lu
- Division of Epidemiology, Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, VA, United States
| | - Torgeir Hellstrøm
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital HF, Oslo, Norway
| | - Nada Andelic
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital HF, Oslo, Norway.,Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Models & Services (CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway
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24
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Maass R, Bonsaksen T, Gramstad A, Sveen U, Stigen L, Arntzen C, Horghagen S. Factors Associated with the Establishment of New Occupational Therapist Positions in Norwegian Municipalities after the Coordination Reform. Health Serv Insights 2021; 14:1178632921994908. [PMID: 33795934 PMCID: PMC7970166 DOI: 10.1177/1178632921994908] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 01/25/2021] [Indexed: 11/23/2022] Open
Abstract
Community-based occupational therapy is an increasingly important domain of work for occupational therapists. In Norway, this has been emphasized by the Coordination reform (2012), which assigned municipalities increased responsibility to protect and promote the health of their inhabitants. However, even if approximately 400 positions have been established between 2012 and 2017, little is known whether they have contributed to increased and/or more equal coverage across municipalities. To explore this matter, survey data was gathered among members of the Norwegian Occupational Therapy Association during 2017. Data was analyzed statistically (descriptive, comparative and associative) with SPSS 25. Results suggest large regional variations in the establishment of new positions. Moreover, most new positions were established in medium-sized municipalities that already had (an) occupational therapist(s) in the community. Number of prior positions, as well as being in the process of merging with another municipality were the only significant predictors for the establishment of new positions during regression analysis. Findings suggest that no levelling-out of geographical distributions of OT-coverage has occurred, even if new positions might have contributed to level-out workload (number-of-patients-per-therapist). Further, we discuss implications of our findings for policy-making and recruitment of Occupational Therapists for rural positions.
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Affiliation(s)
- Ruca Maass
- Departement of Nevromedicine and
Movement Science, Faculty of Medicine and Health Science, Norwegian University of
Science and Technology, Norway
| | - Tore Bonsaksen
- Departement of Health and Nursing
Sciences, Faculty of Social and Health Sciences, Inland Norway University of Applied
Science, Elverum, Norway
| | - Astrid Gramstad
- Departement for Health and Care
Sciences, The Arctic University of Norway, Norway
- Center for Care Research, North
| | - Unni Sveen
- Departement for Occupational Therapy
Prosthetics and Orthotics, Faculty of Health Sciences, Oslo Metropolitan University,
Norway
| | - Linda Stigen
- Departement of Health Sciences, Gjøvik,
Faculty for Medicine and Health Sciences, Norwegian University of Science and
Technology, Norway
| | - Cathrine Arntzen
- Departement for Health and Care
Sciences, The Arctic University of Norway, Norway
- Center for Care Research, North
| | - Sissel Horghagen
- Departement of Nevromedicine and
Movement Science, Faculty of Medicine and Health Science, Norwegian University of
Science and Technology, Norway
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25
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Horghagen S, Bonsaksen T, Sveen U, Dolva AS, Arntzen C. Generalist, specialist and generic positions experienced by occupational therapists in Norwegian municipalities. IJOT 2020. [DOI: 10.1108/ijot-03-2020-0006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Purpose
Reforms in the health-care system may impact how health-care professionals perceive and enact their roles. This study aims to examine the way in which occupational therapists experience and describe their roles in municipalities after the implementation of a health reform (the Coordination Act) in Norway.
Design/methodology/approach
This qualitative study was designed within the perspectives of social constructivism. Data was collected through focus group interviews with 10 community-working occupational therapists. A thematic framework analysis was used to examine the participants’ experiences.
Findings
The following four themes emerged: external factors that framed and shaped the occupational therapists’ roles in municipalities; the strengths and dilemmas of the generalist; the problematic generic position and the strengths; and dilemmas of the specialist.
Originality/value
The study suggests that occupational therapy practitioners should identify new opportunities and adapt to health reform changes. They also need to renegotiate their roles as the health reforms require more specialized competences. Greater emphasis must be placed on the core knowledge and competences of occupational therapists to strengthen their professional identity in the municipalities.
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Evensen J, Soberg HL, Sveen U, Hestad KA, Bronken BA. The Applicability of the Patient-Specific Functional Scale (PSFS) in Rehabilitation for Patients with Acquired Brain Injury (ABI) - A Cohort Study. J Multidiscip Healthc 2020; 13:1121-1132. [PMID: 33116558 PMCID: PMC7553661 DOI: 10.2147/jmdh.s259151] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 08/24/2020] [Indexed: 12/05/2022] Open
Abstract
Aim The primary aim of this study was to investigate the applicability of the Patient-Specific Functional Scale (PSFS) in patients with acquired brain injury (ABI) admitted to a specialized rehabilitation unit in a regional hospital. A secondary aim was to identify patient characteristics and functioning that predicted changes in the PSFS. Patients and Methods In a cohort study, 59 patients with ABI were assessed for the ability to complete the PSFS. A trained multidisciplinary team applied the PSFS as part of a collaborative development of rehabilitation goals. The modified Rankin Scale (mRS), the Functional Ambulation Categories (FAC), the Rivermead Behavioural Memory Test (RBMT), the Norwegian Basic Aphasia Assessment (NBAA) and the Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) were used to identify characteristics of the sample. Multivariate regression analyses were performed to investigate associations between changes in the PSFS score from admission to discharge and a selected set of participant baseline characteristics and functioning. Results Fifty-four patients (92%) of the patients with ABI were able to complete the PSFS. The five (8%) who were unable to complete the PSFS had severe cognitive or language impairment. The PSFS score improved by a mean of 2.6 (SD 2.0) points from admission to discharge. The LOTCA score made the strongest unique contribution to explain the change in the PSFS score (beta = 0.477, p= 0.020). Conclusion In the present study, most patients with ABI (92%) were able to complete the PSFS. Cognitive function on admission was a predictor of improved functioning on the PSFS.
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Affiliation(s)
- Janne Evensen
- Department of Physical Medicine and Rehabilitation, Innlandet Hospital Trust, Gjøvik, Norway
| | - Helene Lundgaard Soberg
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.,Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Unni Sveen
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.,Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Knut A Hestad
- Department of Health and Nursing Sciences, Faculty of Health- and Social Sciences, The Inland Norway University of Applied Sciences, Elverum, Norway.,Department of Research, Innlandet Hospital Trust, Brumunddal, Norway
| | - Berit Arnesveen Bronken
- Department of Health and Nursing Sciences, Faculty of Health- and Social Sciences, The Inland Norway University of Applied Sciences, Elverum, Norway
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Andelic N, Lu J, Gutenbrunner C, Nugraha B, Gormley M, Søberg HL, Sveen U, Anke A, Kirkevold M, Røe C. Description of health-related rehabilitation service provision and delivery in randomized controlled trials: A topic review. J Rehabil Med 2020; 52:jrm00093. [PMID: 32830278 DOI: 10.2340/16501977-2726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To determine how health-related rehabilitation services have been described in recently pub-lished randomized clinical trials, using the International Classification System for Service Organization in Health-Related Rehabilitation (ICSO-R 2.0) as a framework. METHODS Medline was searched for English--language randomized clinical trials (RCTs) published between 1 January 2018 and 31 December 2018. RCTs were eligible if the primary goal was to provide rehabilitation services to targeted patient populations. Two authors independently screened and extracted data, and assessed the methodological quality of eligible trials. Descriptive analysis was used to compare service descriptions between eligible trials and the ICSO-R 2.0 framework (23 categories, 9 categories for provider, 14 categories for delivery). RESULTS Twenty-nine RCTs, with a wide range of organizational units and target groups, were included. The median number of categories reported in the provider dimension was 4 (range 3-5). The median number of categories reported in the service delivery dimension was 8 (range 6-12). None of the RCTs described all ICSO-R recommended categories. CONCLUSION Descriptions of service organization in rehabilitation varied widely among recently published randomized clinical trials. Use of the framework for the classification of service organization and standardization of description of services is recommended in future RCTs, to facilitate better comparisons in service research across studies.
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Affiliation(s)
- Nada Andelic
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway. E-mail: ,
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Johnson SG, Bruset EB, Hjelle KM, Mongs M, Sveen U. An exploration of evidence-based practice work files for occupational therapy students during clinical placements: a descriptive cross-sectional study. BMC Med Educ 2020; 20:255. [PMID: 32762774 PMCID: PMC7410154 DOI: 10.1186/s12909-020-02178-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 07/27/2020] [Indexed: 05/30/2023]
Abstract
BACKGROUND Bachelor students of occupational therapy are expected to work in accordance with evidence-based practice (EBP). The EBP work file, a learning tool in a Word document format, covering all steps in the EBP process, is an approach to teaching and learning EBP. The aim of this study was to examine the attitudes and behaviours of occupational therapy students' in relation to applying evidence-based practice during their second-year clinical placement. We compared cohorts who received training in EBP work files with those who did not receive such training. METHODS A descriptive, cross-sectional comparative study was conducted. Five cohorts of second-year occupational therapy students took part in the study. The students answered two questionnaires, the EBP Beliefs Scale and the EBP Implementation Scale, after completing their second-year clinical placement. The analysis was based on descriptive statistics and calculation of the frequencies, percentages, mean and standard deviations of all participating students' scores across both questionnaires. ANOVA with Bonferroni correction was conducted to analyse the differences between the mean totals of the questionnaires. RESULTS In this study, 126 occupational therapy students participated (response rate = 57.3%). The students reacted positively to EBP, although few were practicing EBP. The students believed that EBP resulted in the best clinical care for patients, but they lacked confidence in their own ability to apply EBP. The students in Cohort 5, who received extra instruction and assignments via the EBP work file, rated their EBP behaviour statistically lower than the students in Cohort 1, who did not receive extra training on the EBP work file. CONCLUSIONS Additional EBP work file assignments were insufficient in terms of supporting students in the implementation of EBP during clinical placements. It is, therefore, important to facilitate the learning strategies of EBP skills and demonstrate how students can practise this competency during clinical placements. Including clinical instructors in EBP teaching and learning seems essential.
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Affiliation(s)
- Susanne Grødem Johnson
- Department of Health and Function, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Inndalsveien 28, 5063 Bergen, Norway
| | - Else Britt Bruset
- Department of Occupational Therapy, Oslo Metropolitan University, PO Box 4, St. Olavs plass, NO-0130 Oslo, Norway
| | - Kari Margrete Hjelle
- Department of Health and Function, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Inndalsveien 28, 5063 Bergen, Norway
| | - Malin Mongs
- Department of Occupational Therapy, Oslo University Hospital, Rikshospitalet, Postboks 4950 Nydalen, 0424 Oslo, Norway
| | - Unni Sveen
- Department of Occupational Therapy, Oslo Metropolitan University, PO Box 4, St. Olavs plass, NO-0130 Oslo, Norway
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Sveen U, Guldager R, Soberg HL, Andreassen TA, Egerod I, Poulsen I. Rehabilitation interventions after traumatic brain injury: a scoping review. Disabil Rehabil 2020; 44:653-660. [DOI: 10.1080/09638288.2020.1773940] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Unni Sveen
- Faculty of Health Sciences, OsloMet – Oslo Metropolitan University, Oslo, Norway
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Rikke Guldager
- Department of Neurosurgery, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Department of Neurorehabilitation, Traumatic Brain Injury Unit, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Helene Lundgaard Soberg
- Faculty of Health Sciences, OsloMet – Oslo Metropolitan University, Oslo, Norway
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Tone Alm Andreassen
- Centre for the Study of Professions, OsloMet – Oslo Metropolitan University, Oslo, Norway
| | - Ingrid Egerod
- Intensive Care Unit, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark
| | - Ingrid Poulsen
- Department of Neurorehabilitation, Traumatic Brain Injury Unit, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Research Unit for Nursing and Health Care, Department of Health, Aarhus University, Aarhus, Denmark
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30
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Bragstad LK, Hjelle EG, Zucknick M, Sveen U, Thommessen B, Bronken BA, Martinsen R, Kitzmüller G, Mangset M, Kvigne KJ, Hilari K, Lightbody CE, Kirkevold M. The effects of a dialogue-based intervention to promote psychosocial well-being after stroke: a randomized controlled trial. Clin Rehabil 2020; 34:1056-1071. [PMID: 32517513 PMCID: PMC7372590 DOI: 10.1177/0269215520929737] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Objective: To evaluate the effect of a dialogue-based intervention targeting
psychosocial well-being at 12 months post-stroke. Design: Multicenter, prospective, randomized, assessor-blinded, controlled trial with
two parallel groups. Setting: Community. Subjects: Three-hundred and twenty-two adults (⩾18 years) with stroke within the last
four weeks were randomly allocated into intervention group
(n = 166) or control group
(n = 156). Interventions: The intervention group received a dialogue-based intervention to promote
psychosocial well-being, comprising eight individual 1–1½ hour sessions
delivered during the first six months post-stroke. Main measures: The primary outcome measure was the General Health Questionnaire-28 (GHQ-28).
Secondary outcome measures included the Stroke and Aphasia Quality of Life
Scale-39g, the Sense of Coherence scale, and the Yale Brown single-item
questionnaire. Results: The mean (SD) age of the participants was 66.8 (12.1) years in the
intervention group and 65.7 (13.3) years in the control group. At 12 months
post-stroke, the mean (SE) GHQ-28 score was 20.6 (0.84) in the intervention
group and 19.9 (0.85) in the control group. There were no between-group
differences in psychosocial well-being at 12 months post-stroke (mean
difference: −0.74, 95% confidence interval (CI): −3.08, 1.60). The secondary
outcomes showed no statistically significant between-group difference in
health-related quality of life, sense of coherence, or depression at
12 months. Conclusion: The results of this trial did not demonstrate lower levels of emotional
distress and anxiety or higher levels of health-related quality of life in
the intervention group (dialogue-based intervention) as compared to the
control group (usual care) at 12 months post-stroke.
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Affiliation(s)
- Line Kildal Bragstad
- Research Center for Habilitation and Rehabilitation Services and Models (CHARM), Institute of Health and Society, University of Oslo, Oslo, Norway.,Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Ellen Gabrielsen Hjelle
- Research Center for Habilitation and Rehabilitation Services and Models (CHARM), Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Manuela Zucknick
- Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, University of Oslo, Oslo, Norway
| | - Unni Sveen
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway.,Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.,Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Bente Thommessen
- Department of Neurology, Akershus University Hospital, Lørenskog, Norway
| | - Berit Arnesveen Bronken
- Department of Health and Nursing Sciences, Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
| | - Randi Martinsen
- Department of Health and Nursing Sciences, Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
| | - Gabriele Kitzmüller
- Department of Health and Care Sciences, Faculty of Health Sciences, UiT, The Arctic University of Norway, Narvik, Norway
| | - Margrete Mangset
- Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Kari Johanne Kvigne
- Department of Health and Nursing Sciences, Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
| | - Katerina Hilari
- Centre for Language and Communication Sciences Research, School of Health Sciences, City, University of London, London, UK
| | | | - Marit Kirkevold
- Research Center for Habilitation and Rehabilitation Services and Models (CHARM), Institute of Health and Society, University of Oslo, Oslo, Norway.,Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
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31
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Bragstad LK, Lerdal A, Gay CL, Kirkevold M, Lee KA, Lindberg MF, Skogestad IJ, Hjelle EG, Sveen U, Kottorp A. Psychometric properties of a short version of Lee Fatigue Scale used as a generic PROM in persons with stroke or osteoarthritis: assessment using a Rasch analysis approach. Health Qual Life Outcomes 2020; 18:168. [PMID: 32503548 PMCID: PMC7275526 DOI: 10.1186/s12955-020-01419-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 05/24/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Fatigue is a common symptom associated with a wide range of diseases and needs to be more thoroughly studied. To minimise patient burden and to enhance response rates in research studies, patient-reported outcome measures (PROM) need to be as short as possible, without sacrificing reliability and validity. It is also important to have a generic measure that can be used for comparisons across different patient populations. Thus, the aim of this secondary analysis was to evaluate the psychometric properties of the Norwegian 5-item version of the Lee Fatigue Scale (LFS) in two distinct patient populations. METHODS The sample was obtained from two different Norwegian studies and included patients 4-6 weeks after stroke (n = 322) and patients with osteoarthritis on a waiting list for total knee arthroplasty (n = 203). Fatigue severity was rated by five items from the Norwegian version of the LFS, rating each item on a numeric rating scale from 1 to 10. Rasch analysis was used to evaluate the psychometric properties of the 5-item scale across the two patient samples. RESULTS Three of the five LFS items ("tired", "fatigued" and "worn out") showed acceptable internal scale validity as they met the set criterion for goodness-of-fit after removal of two items with unacceptable goodness-of-fit to the Rasch model. The 3-item LFS explained 81.6% of the variance, demonstrated acceptable unidimensionality, could separate the fatigue responses into three distinct severity groups and had no differential functioning with regard to disease group. The 3-item version of the LFS had a higher separation index and better internal consistency reliability than the 5-item version. CONCLUSIONS A 3-item version of the LFS demonstrated acceptable psychometric properties in two distinct samples of patients, suggesting it may be useful as a brief generic measure of fatigue severity. TRIAL REGISTRATION Clinicaltrials.gov: NCT02338869; registered 10/04/2014 (stroke study).
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Affiliation(s)
- Line Kildal Bragstad
- Department of Geriatric Medicine, Oslo University Hospital, P.O Box 4956, Ullevaal, Nydalen, 0424, Oslo, Norway. .,Department of Nursing Science and Research Center for Habilitation and Rehabilitation Services and Models (CHARM), University of Oslo, Faculty of Medicine, Institute of Health and Society, P.O. Box 1130, Blindern, N-0318, Oslo, Norway.
| | - Anners Lerdal
- Department of Nursing Science, University of Oslo, Faculty of Medicine, Institute of Health and Society, P.O. Box. 1130, Blindern, N-0318, Oslo, Norway.,Department for Patient Safety and Research, Lovisenberg Diaconal Hospital, P.O. Box 04970, Nydalen, N-0440, Oslo, Norway
| | - Caryl L Gay
- Department for Patient Safety and Research, Lovisenberg Diaconal Hospital, P.O. Box 04970, Nydalen, N-0440, Oslo, Norway.,Department of Family Health Care Nursing, University of California, San Francisco, 2 Koret Way, San Francisco, CA, 94143, USA
| | - Marit Kirkevold
- Department of Nursing Science and Research Center for Habilitation and Rehabilitation Services and Models (CHARM), University of Oslo, Faculty of Medicine, Institute of Health and Society, P.O. Box 1130, Blindern, N-0318, Oslo, Norway
| | - Kathryn A Lee
- Department of Family Health Care Nursing, University of California, San Francisco, 2 Koret Way, San Francisco, CA, 94143, USA
| | - Maren Falch Lindberg
- Department of Nursing Science, University of Oslo, Faculty of Medicine, Institute of Health and Society, P.O. Box. 1130, Blindern, N-0318, Oslo, Norway.,Department for Surgery, Lovisenberg Diaconal Hospital, P.O. Box 04970, Nydalen, N-0440, Oslo, Norway
| | - Ingrid Johansen Skogestad
- Department for Medicine, Lovisenberg Diaconal Hospital, P.O. Box 04970, Nydalen, N-0440, Oslo, Norway
| | - Ellen Gabrielsen Hjelle
- Department of Nursing Science and Research Center for Habilitation and Rehabilitation Services and Models (CHARM), University of Oslo, Faculty of Medicine, Institute of Health and Society, P.O. Box 1130, Blindern, N-0318, Oslo, Norway
| | - Unni Sveen
- Department of Geriatric Medicine, Oslo University Hospital, P.O Box 4956, Ullevaal, Nydalen, 0424, Oslo, Norway.,Faculty of Health Sciences, Oslo Metropolitan University, P.O. Box 4, St. Olavs Plass, N-0130, Oslo, Norway.,Department of Physical Medicine and Rehabilitation, Oslo University Hospital, P.O. Box 4956, Nydalen, N-0424, Oslo, Norway
| | - Anders Kottorp
- Faculty of Health and Society, Malmö University, 205 06, Malmö, Sweden
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Borgen IMH, Løvstad M, Andelic N, Hauger S, Sigurdardottir S, Søberg HL, Sveen U, Forslund MV, Kleffelgård I, Lindstad MØ, Winter L, Røe C. Traumatic brain injury-needs and treatment options in the chronic phase: Study protocol for a randomized controlled community-based intervention. Trials 2020; 21:294. [PMID: 32216840 PMCID: PMC7099773 DOI: 10.1186/s13063-020-4195-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 02/20/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Traumatic brain injury (TBI) is often associated with life-long medical, cognitive, emotional, and behavioral changes. Although long-lasting disabilities are expected, research on effective treatment options in the chronic phase of TBI is scarce. METHODS/DESIGN This study protocol describes a randomized controlled trial (RCT) aimed at evaluating the effectiveness of a goal-oriented and community-based intervention for increasing community integration, quality of life, and functional independence in the chronic phase of complicated mild to severe TBI. Participants will be recruited from Oslo University Hospital, Norway. Patients aged 18-72 years living at home with MRI/CT-verified intracranial abnormalities, a TBI diagnosis, a time since injury of ≥ 2 years, and who experience either current TBI-related problems or restrictions in community integration will be included. The 120 participants will be randomized 1:1 to either (a) an intervention group, which will receive an in-home intervention program over 4 months, or (b) a control group receiving standard care in the municipalities. The intervention will consist of six home visits and two telephone contacts with a rehabilitation professional. A SMART-goal approach will be adopted to target the individual's self-reported TBI difficulties in everyday life. Primary outcomes will be self-reported quality of life and participation. Secondary outcomes include symptom burden, emotional functioning, and clinician-assessed global outcome and need for rehabilitation services. Outcomes will be evaluated at baseline and 4-5 and 12 months after baseline. Caregiver burden and general health will be assessed in participating family members. Goal attainment and acceptability will be evaluated in the intervention group. A process evaluation will be carried out to evaluate protocol adherence, and a cost-effectiveness analysis will be applied if the intervention is found to be effective. DISCUSSION The current study provides an innovative approach to rehabilitation in the chronic phase of TBI evaluated using an RCT design that may inform treatment planning, health policies, and coordination of patient care. Further, the study may demonstrate new modes of establishing collaboration and knowledge transition between specialized rehabilitation facilities and local rehabilitation services that may improve patient outcomes. TRIAL REGISTRATION ClinicalTrials.gov, NCT03545594. Registered on June 4th, 2018.
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Affiliation(s)
- Ida Maria H. Borgen
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
| | - Marianne Løvstad
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
- Department of Research, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway
| | - Nada Andelic
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
- Center for Habilitation and Rehabilitation Models and Services (CHARM), Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Solveig Hauger
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
- Department of Research, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway
| | | | - Helene L. Søberg
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Unni Sveen
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Marit V. Forslund
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Ingerid Kleffelgård
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Marte Ørud Lindstad
- Department of Health Sciences in Gjøvik, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Gjøvik, Norway
| | - Laraine Winter
- Philadelphia Research and Education Foundation, Philadelphia, PA USA
- Nursing Service, Department of Veterans Affairs Medical Center, Philadelphia, PA USA
| | - Cecilie Røe
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
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Andelic N, Forslund MV, Perrin PB, Sigurdardottir S, Lu J, Howe EI, Sveen U, Rasmussen MS, Søberg HL, Røe C. Long-term follow-up of use of therapy services for patients with moderate-to-severe traumatic brain injury. J Rehabil Med 2020; 52:jrm00034. [PMID: 32179933 DOI: 10.2340/16501977-2662] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To examine the probabilities and baseline predictors of the use of physical therapy, occupational therapy and speech therapy over a period of 10 years after traumatic brain injury. DESIGN Longitudinal prospective follow-up at 1, 2, 5 and 10 years after traumatic brain injury. PARTICIPANTS A total of 97 patients with moderate-to-severe traumatic brain injury recruited from Oslo University Hospital, Norway, during acute hospital admission in 2005-2007. METHODS Socio-demographics and injury characteristics were recorded at baseline. Use of physical therapy, occupational therapy and speech therapy were recorded at follow-ups. Hierarchical linear modelling was applied to examine service use probabilities across the 4 time-points. RESULTS Service use decreased substantially over time, with physical therapy being the main service utilized at the 10-year follow-up (physical therapy 16%, occupational therapy 1%, speech therapy 3%). Use of services was related to severity of injury (CT head severity scores and post-traumatic amnesia), female sex, and pre-injury employment. In addition, in this sample, time since injury was associated with use of occupational therapy and speech therapy. CONCLUSION This study presents a novel model for the long-term probability of use of physical therapy, occupational therapy and speech therapy following traumatic brain injury. The use of services was much lower than the expected problem profile of severe traumatic brain injuries, suggesting an insufficient long-term provision of traditional traumatic brain injury rehabilitation services.
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Affiliation(s)
- Nada Andelic
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
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34
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van Walsem MR, Howe EI, Perrin PB, Sigurdardottir S, Røe C, Sveen U, Lu J, Forslund MV, Andelic N. Trajectories of self-reported competency up to 10 years following moderate-to-severe traumatic brain injury. Brain Inj 2020; 34:335-342. [PMID: 31928233 DOI: 10.1080/02699052.2019.1704061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objectives: To describe trajectories of self-reported functional competency up to 10 years following traumatic brain injury (TBI) and identify their predictors from baseline socio-demographic and injury severity characteristics.Design and methods: Data from 94 participants from a longitudinal cohort of patients with moderate-to-severe TBI were analyzed. Socio-demographic and injury severity data were recorded at baseline. Participants completed the Patient Competency Rating Scale (PCRS) at 1, 2, 5, and 10 years. Hierarchical linear modeling was used to examine PCRS trajectories over time and assess baseline predictors.Results: There was no significant change in average PCRS scores across the follow-up time points in the full sample. Emotional and cognitive competencies had the lowest mean scores. Gender, employment, and the interaction term between gender and time were significant predictors of PCRS trajectories. Females and those who were unemployed at the time of injury showed lower trajectories of self-reported competency.Conclusion: Self-reported competency remained stable from one-year post-injury for men only. Lower mean scores in the domains of emotional and cognitive competencies suggest a need for continued rehabilitation focus in the chronic phase after TBI. Special attention to women and individuals who are unemployed at the time of injury may be warranted.
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Affiliation(s)
- Marleen R van Walsem
- Department of Neurohabilitation, Oslo University Hospital, Oslo, Norway.,Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Models and Services (CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Emilie I Howe
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Paul B Perrin
- Department of Psychology, Virginia Commonwealth University, Richmond, USA
| | | | - Cecilie Røe
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Unni Sveen
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway.,Faculty of Health Sciences, Department of Occupational Therapy, Prosthetics and Orthotics, Oslo Metropolitan University, Oslo, Norway
| | - Juan Lu
- Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Models and Services (CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Family Medicine and Population Health, Division of Epidemiology, Virginia Commonwealth University, Richmond, USA
| | - Marit V Forslund
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Nada Andelic
- Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Models and Services (CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
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35
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Hjelle EG, Bragstad LK, Kirkevold M, Zucknick M, Bronken BA, Martinsen R, Kvigne KJ, Kitzmüller G, Mangset M, Thommessen B, Sveen U. Effect of a dialogue-based intervention on psychosocial well-being 6 months after stroke in Norway: A randomized controlled trial. J Rehabil Med 2019; 51:557-565. [PMID: 31411337 DOI: 10.2340/16501977-2585] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE To evaluate the effect of a dialogue-based intervention on psychosocial well-being 6 months after stroke. DESIGN Multicentre, prospective, randomized controlled trial. SUBJECTS Adults (aged ≥ 18 years) who had their first or recurrent stroke within the last month, were medically stable, had sufficient cognitive functioning to participate and understood and spoke Norwegian. METHODS A total of 322 participants were randomly assigned to the intervention (n = 166) or control (n = 156) group. Participants in the intervention group received up to 8 individual sessions aimed at supporting the coping and life skills of stroke survivors in addition to usual care. The primary outcome was the proportion of participants with normal mood measured by the General Health Questionnaire-28 (GHQ-28). The secondary outcomes included health-related quality of life (Stroke and Aphasia Quality of Life Scale; SAQOL-39g), depression (Yale-Brown single-item questionnaire; Yale) and sense of coherence (SOC-13). RESULTS After controlling for the baseline values, no significant benefit was found in the intervention group over the control group (odds ratio (OR): 0.898: 95% confidence interval (95% CI): 0.54-1.50, p = 0.680) 6 months post-stroke. CONCLUSION Psychosocial well-being improved during the first 6 months after stroke in both arms of the trial, but no statistically significant benefit of the dialogue-based intervention was found compared with usual care.
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Affiliation(s)
- Ellen G Hjelle
- Department of Nursing Science and Research Center for Habilitation and Rehabilitation Services and Models (CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway.
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Bonsaksen T, Sveen U, Dolva AS, Horghagen S, Thyness EM, Hagby C, Arntzen C. Perceived Influence on Service Goals Among Community-Working Occupational Therapists in Norway. J Prim Care Community Health 2019; 9:2150132718813491. [PMID: 30465623 PMCID: PMC6852353 DOI: 10.1177/2150132718813491] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
AIM This study aimed to assess the perceived influence that community-working occupational therapists in Norway have on the service goals of their respective organizations. In addition, we aimed to assess sociodemographic and work-related factors associated with the perceived level of influence. METHODS A cross-sectional survey was distributed to occupational therapists in community-based services in Norway (n = 1767), to which 561 (32%) responded. By multivariate regression analysis, factors associated with "self-perceived influence" were assessed. RESULTS After controlling for all variables, having a master's degree ( β = 0.09, P < .05), being involved in a research and development project ( β = 0.25, P < .001), and not working with assistive technology ( β = -0.19, P < .001) were associated with higher perceived influence. CONCLUSIONS For occupational therapy to reach its potential in Norwegian community-based health care, the profession needs to establish itself more firmly and increase its influence within the health care services. To do so, it appears important to support occupational therapists' educational aspirations, their participation in research and development projects, and their autonomous role in relation to the provision of assistive technology equipment.
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Affiliation(s)
- Tore Bonsaksen
- 1 OsloMet-Oslo Metropolitan University, Oslo, Norway.,2 VID Specialized University, Sandnes, Norway
| | - Unni Sveen
- 1 OsloMet-Oslo Metropolitan University, Oslo, Norway.,3 Oslo University Hospital, Oslo, Norway
| | - Anne-Stine Dolva
- 4 Inland Norway University College of Applied Sciences, Lillehammer, Norway
| | - Sissel Horghagen
- 5 Norwegian University of Science and Technology, Trondheim, Norway
| | - Else Merete Thyness
- 6 Ergoterapeutene-The Norwegian Occupational Therapy Association, Oslo, Norway
| | | | - Cathrine Arntzen
- 8 UiT-the Arctic University of Norway, Tromsø, Norway.,9 University Hospital of North Norway, Tromsø, Norway
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Kitzmüller G, Mangset M, Evju AS, Angel S, Aadal L, Martinsen R, Bronken BA, Kvigne K, Bragstad LK, Hjelle EG, Sveen U, Kirkevold M. Finding the Way Forward: The Lived Experience of People With Stroke After Participation in a Complex Psychosocial Intervention. Qual Health Res 2019; 29:1711-1724. [PMID: 30862270 DOI: 10.1177/1049732319833366] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Stroke patients' well-being is threatened after stroke. A psychosocial intervention was developed for Norwegian stroke patients living in the community. Eight individual sessions between people with stroke and a trained health care professional were conducted 1 to 6 months post-stroke with one group of participants and 6 to 12 months post-stroke with another group. Subsequently, 19 of these stroke patients were interviewed to gain an in-depth understanding of their lived experience of the influence of the intervention on their adjustment process. Interview texts were analyzed using Ricoeur's interpretation theory. Two participants did not personally find the intervention useful. The remaining participants greatly appreciated dialogues with the empathetic intervention personnel, feeling free to discuss their fears and worries. The intervention raised these participants' awareness of their needs and resources. They were guided to resume their everyday life and adopt a future-oriented attitude. The intervention facilitated their meaning-making endeavors and post-stroke adjustment.
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Affiliation(s)
| | | | - Anne S Evju
- UiT The Arctic University of Norway, Narvik, Norway
| | - Sanne Angel
- Aarhus University, Aarhus, Denmark
- Molde University College, Molde, Norway
| | - Lena Aadal
- Aarhus University, Aarhus, Denmark
- Hammel Neurorehabilitation Centre and University Research Clinic, Hammel, Denmark
| | - Randi Martinsen
- Inland Norway University of Applied Sciences, Elverum, Norway
| | - Berit A Bronken
- Inland Norway University of Applied Sciences, Elverum, Norway
| | - Kari Kvigne
- Inland Norway University of Applied Sciences, Elverum, Norway
- Nord University, Sandnessjøen, Norway
| | - Line K Bragstad
- Oslo University Hospital, Oslo, Norway
- University of Oslo, Oslo, Norway
| | | | - Unni Sveen
- Oslo University Hospital, Oslo, Norway
- Oslo Metropolitan University, Oslo, Norway
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Bonsaksen T, Dolva AS, Horghagen S, Sveen U, Hagby C, Arntzen C. Characteristics of community-based occupational therapy: Results of a norwegian survey. Scand J Occup Ther 2019; 27:39-46. [DOI: 10.1080/11038128.2019.1609085] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Tore Bonsaksen
- Department of Occupational Therapy, Prosthetics and Orthotics, OsloMet - Oslo Metropolitan University, Oslo, Norway
- Faculty of Health Studies, VID Specialized University, Sandnes, Norway
| | - Anne-Stine Dolva
- Department of Education and Social Work, Inland Norway University of Applied Sciences, Norway
| | - Sissel Horghagen
- Department of Neuromedicine and Movement Science, Norwegian University of Technology and Science, Trondheim, Norway
| | - Unni Sveen
- Faculty of Health Studies, VID Specialized University, Sandnes, Norway
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Cathrine Hagby
- NAV Norwegian assistive technology center in Buskerud county, Norway
| | - Cathrine Arntzen
- Department of Health and Care Sciences, UiT, the Arctic University of Norway, Tromsø, Norway
- University Hospital of North Norway, Tromsø, Norway
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Hjelle EG, Bragstad LK, Zucknick M, Kirkevold M, Thommessen B, Sveen U. The General Health Questionnaire-28 (GHQ-28) as an outcome measurement in a randomized controlled trial in a Norwegian stroke population. BMC Psychol 2019; 7:18. [PMID: 30902115 PMCID: PMC6431023 DOI: 10.1186/s40359-019-0293-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Accepted: 02/27/2019] [Indexed: 11/18/2022] Open
Abstract
Background Several studies have documented the variety of post-stroke psychosocial challenges, which are complex, multifaceted, and affect a patient’s rehabilitation and recovery. Due to the consequences of these challenges, psychosocial well-being should be considered an important outcome of the stroke rehabilitation. Thus, a valid and reliable instrument that is appropriate for the stroke population is required. The factor structure of the Norwegian version of GHQ-28 has not previously been examined when applied to a stroke population. The purpose of this study was to explore the psychometric properties of the GHQ-28 when applied in the stroke population included in the randomized controlled trial; “Psychosocial well-being following stroke”, by evaluating the internal consistency, exploring the factor structure, construct validity and measurement invariance. Methods Data were obtained from 322 individuals with a stroke onset within the past month. The Kaiser-Meyer-Olkin (KMO) test was used to test the sampling adequacy for exploratory factor analysis, and the Bartlett’s test of sphericity was used to test equal variances. Internal consistency was analysed using Cronbach’s alpha. The factor structure of the GHQ-28 was evaluated by exploratory factor analysis (EFA), and a confirmatory factor analysis (CFA) was used to determine the goodness of fit to the original structure of the outcome measurement. Measurement invariance for two time points was evaluated by configural, metric and scalar invariance. Results The results from the EFA supported the four-factor dimensionality, but some of the items were loaded on different factors compared to those of the original structure. The differences resulted in a reduced goodness of fit in the CFA. Measurement invariance at two time points was confirmed. Conclusions The change in mean score from one to six months on the GHQ-28 and the factor composition are assumed to be affected by characteristics in the stroke population. The results, when applying the GHQ-28 in a stroke population, and sub-factor analysis based on the original factor structure should be interpreted with caution. Trial registration ClinicalTrials.gov, NCT02338869, registered 10/04/2014.
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Affiliation(s)
- Ellen G Hjelle
- Department of Nursing Science, and Research Center for Habilitation and Rehabilitation Services and Models (CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - Line Kildal Bragstad
- Department of Nursing Science, and Research Center for Habilitation and Rehabilitation Services and Models (CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Manuela Zucknick
- Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Marit Kirkevold
- Department of Nursing Science, and Research Center for Habilitation and Rehabilitation Services and Models (CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Bente Thommessen
- Department of Neurology, Akershus University Hospital, Lorenskog, Norway
| | - Unni Sveen
- Department of Geriatric Medicine and Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway.,Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
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Bragstad LK, Bronken BA, Sveen U, Hjelle EG, Kitzmüller G, Martinsen R, Kvigne KJ, Mangset M, Kirkevold M. Implementation fidelity in a complex intervention promoting psychosocial well-being following stroke: an explanatory sequential mixed methods study. BMC Med Res Methodol 2019; 19:59. [PMID: 30876403 PMCID: PMC6419826 DOI: 10.1186/s12874-019-0694-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 02/25/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Evaluation of complex interventions should include a process evaluation to give evaluators, researchers, and policy makers greater confidence in the outcomes reported from RCTs. Implementation fidelity can be part of a process evaluation and refers to the degree to which an intervention is delivered according to protocol. The aim of this implementation fidelity study was to evaluate to what extent a dialogue-based psychosocial intervention was delivered according to protocol. A modified conceptual framework for implementation fidelity was used to guide the analysis. METHODS This study has an explanatory, sequential two-phase mixed methods design. Quantitative process data were collected longitudinally along with data collection in the RCT. Qualitative process data were collected after the last data collection point of the RCT. Descriptive statistical analyses were conducted to describe the sample, the intervention trajectories, and the adherence measures. A scoring system to clarify quantitative measurement of the levels of implementation was constructed. The qualitative data sources were analyzed separately with a theory-driven content analysis using categories of adherence and potential moderating factors identified in the conceptual framework of implementation fidelity. The quantitative adherence results were extended with the results from the qualitative analysis to assess which potential moderators may have influenced implementation fidelity and in what way. RESULTS The results show that the core components of the intervention were delivered although the intervention trajectories were individualized. Based on the composite score of adherence, results show that 80.1% of the interventions in the RCT were implemented with high fidelity. Although it is challenging to assess the importance of each of the moderating factors in relation to the other factors and to their influence on the adherence measures, participant responsiveness, comprehensiveness of policy description, context, and recruitment appeared to be the most prominent moderating factors of implementation fidelity in this study. CONCLUSIONS This evaluation of implementation fidelity and the discussion of what constitutes high fidelity implementation of this intervention are crucial in understanding the factors influencing the trial outcome. The study also highlights important methodological considerations for researchers planning process evaluations and studies of implementation fidelity. TRIAL REGISTRATION ClinicalTrials.gov , NCT02338869; registered 10/04/2014.
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Affiliation(s)
- Line Kildal Bragstad
- Department of Geriatric Medicine, Oslo University Hospital, Ullevål, P. O Box 4956 Nydalen, 0424, Oslo, Norway. .,Institute of Health and Society and Research Center for Habilitation and Rehabilitation Services and Models (CHARM), University of Oslo, P.O. Box 1130 Blindern, 0318, Oslo, Norway.
| | - Berit Arnesveen Bronken
- Faculty of Social and Health Sciences, Department of Health and Nursing Sciences, Inland Norway University of Applied Sciences, P.O. Box 400, 2418, Elverum, Norway
| | - Unni Sveen
- Faculty of Health Sciences, Oslo Metropolitan University, P.O. Box 4 St. Olavs Plass, 0130, Oslo, Norway.,Department of Physical Medicine and Rehabilitation and Department of Geriatric Medicine, Oslo University Hospital, P.O. Box 4956 Nydalen, 0424, Oslo, Norway
| | - Ellen Gabrielsen Hjelle
- Institute of Health and Society and Research Center for Habilitation and Rehabilitation Services and Models (CHARM), University of Oslo, P.O. Box 1130 Blindern, 0318, Oslo, Norway
| | - Gabriele Kitzmüller
- Faculty of Health Sciences, Department of Health and Care Sciences, UIT, the Arctic University of Norway, P.O. Box 385, 8505, Narvik, Norway
| | - Randi Martinsen
- Faculty of Social and Health Sciences, Department of Health and Nursing Sciences, Inland Norway University of Applied Sciences, P.O. Box 400, 2418, Elverum, Norway
| | - Kari J Kvigne
- Faculty of Social and Health Sciences, Department of Health and Nursing Sciences, Inland Norway University of Applied Sciences, P.O. Box 400, 2418, Elverum, Norway
| | - Margrete Mangset
- Department of Geriatric Medicine, Oslo University Hospital, Ullevål, P. O Box 4956 Nydalen, 0424, Oslo, Norway
| | - Marit Kirkevold
- Institute of Health and Society and Research Center for Habilitation and Rehabilitation Services and Models (CHARM), University of Oslo, P.O. Box 1130 Blindern, 0318, Oslo, Norway
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Arntzen C, Sveen U, Hagby C, Bonsaksen T, Dolva AS, Horghagen S. Community-based occupational therapy in Norway: Content, dilemmas, and priorities. Scand J Occup Ther 2019; 26:371-381. [PMID: 30632858 DOI: 10.1080/11038128.2018.1548647] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Profound changes in municipal health services, are calling for new models for community-based occupational therapy services. OBJECTIVE The aim of the study is to explore how Norwegian occupational therapists position themselves in relation to the tasks delivered. METHOD Focus group interviews were conducted with ten community-based occupational therapists. Systematic text condensation was then used in the data analysis. RESULTS Norwegian occupational therapists description of professional practices can be constructed into four ideal types; being 'the all-rounder', 'the provider of assistive device', 'the fire extinguisher', or 'the innovator'. The ideal types can help us understand more of the content and dilemmas that community-based occupational therapists encountered in their daily practice, and the priorities they make during these encounters. CONCLUSIONS AND SIGNIFICANCE Community-based occupational therapists positioned themselves in different ways, and some of these positions were considered to be more favourable than others. The therapists struggled between 'traditional' occupational therapy tasks and new ways of delivering occupational therapy services. The study reveals similarities and differences between rural and urban occupational therapy practice. The ideal types can help community-based therapists to reflect on their own practice and empower them to be more in keeping with the OT's objectives and preferences.
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Affiliation(s)
- Cathrine Arntzen
- a Department of Health and Care Sciences, Centre for Care Research, North, UiT , The Arctic University of Norway , Tromsø , Norway.,b Division of Rehabilitation Services , University Hospital of North Norway , Tromsø , Norway
| | - Unni Sveen
- c OsloMet , Oslo Metropolitan University , Oslo , Norway.,d Oslo University Hospital , Oslo , Norway
| | - Cathrine Hagby
- e NAV Norwegian Assistive Technology Center in Buskerud County , Drammen , Norway
| | - Tore Bonsaksen
- c OsloMet , Oslo Metropolitan University , Oslo , Norway.,f Faculty of Health Studies , VID Specialized University , Sandnes , Norway
| | | | - Sissel Horghagen
- h Health Science , Norwegian University of Technology and Science , Trondheim , Norway
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Bonsaksen T, Dolva AS, Hagby C, Sveen U, Horghagen S, Thyness EM, Arntzen C. Involvement in Research and Development Projects Among Community-working Occupational Therapists in Norway. Occup Ther Health Care 2018; 33:22-36. [PMID: 30596456 DOI: 10.1080/07380577.2018.1526434] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
A cross-sectional descriptive survey was conducted (n = 561). Almost half of the participants took part in research and development projects. Being involved in research and development was associated with lower age, having further education, and higher levels of work experience. The current and prioritized research topics were reablement and assistive technology. The study implies that community-working occupational therapists are largely involved in research and development, or eager to become involved.
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Affiliation(s)
- Tore Bonsaksen
- a Department of Occupational Therapy, Prosthetics and Orthotics, Faculty of Health Sciences , OsloMet - Oslo Metropolitan University , Oslo , Norway.,b Faculty of Health Studies , VID Specialized University , Sandnes , Norway
| | - Anne-Stine Dolva
- c Inland Norway University College of Applied Sciences , Lillehammer , Norway
| | | | - Unni Sveen
- a Department of Occupational Therapy, Prosthetics and Orthotics, Faculty of Health Sciences , OsloMet - Oslo Metropolitan University , Oslo , Norway.,e Department of Physical Medicine and Rehabilitation , Oslo University Hospital , Oslo , Norway
| | - Sissel Horghagen
- f Norwegian University of Science and Technology , Trondheim , Norway
| | - Else Merete Thyness
- g Ergoterapeutene - the Norwegian Occupational Therapy Association , Oslo , Norway
| | - Cathrine Arntzen
- h UiT - the Arctic University of Norway , Tromsø , Norway.,i University Hospital of North Norway , Tromsø , Norway
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Njølstad BW, Mengshoel AM, Sveen U. 'It's like being a slave to your own body in a way': a qualitative study of adolescents with chronic fatigue syndrome. Scand J Occup Ther 2018; 26:505-514. [PMID: 29607759 DOI: 10.1080/11038128.2018.1455895] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is a relatively common disabling illness in adolescents that may limit participation in daily life. AIM This study explored interactions between the illness experiences of adolescents with CFS/ME, their occupational lives and expectations for the future. METHODS Seven adolescents with CFS/ME were interviewed. The interviews were analyzed using thematic analysis. RESULTS Three themes were developed. 'Being ruled by an unfamiliar and inexplicable body', which illustrated that altered and strange bodies seemed to separate and disrupt the participants from their former occupational lives. 'On the sideline of life with peers', which demonstrated that the informants spent time at home, doing undemanding activities instead of participating in activities with peers. 'A coherent connection between present and future life', which was reflected by how the participants eventually accepted their situation and rebuilt a meaningful occupational life and value of self. CONCLUSION CFS/ME made the body unfamiliar and disconnected informants from participating in their usual daily occupations. A coherent interaction between body, occupational life and social self was achieved by taking their new body into account and adjusting their occupations accordingly. This practice enabled the participants to hope for a better future life.
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Affiliation(s)
- Berit Widerøe Njølstad
- a Section of Orthopaedic Rehabilitation, Division of Orthopaedic Surgery , Oslo University Hospital , Oslo , Norway
| | | | - Unni Sveen
- c Department of Physical Medicine and Rehabilitation, Division of Clinical Neuro-science , Oslo University Hospital , Oslo , Norway.,d Faculty of Health Sciences , Oslo and Akershus University, College of Applied Sciences , Oslo , Norway
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Kirkevold M, Kildal Bragstad L, Bronken BA, Kvigne K, Martinsen R, Gabrielsen Hjelle E, Kitzmüller G, Mangset M, Angel S, Aadal L, Eriksen S, Wyller TB, Sveen U. Promoting psychosocial well-being following stroke: study protocol for a randomized, controlled trial. BMC Psychol 2018; 6:12. [PMID: 29615136 PMCID: PMC5883408 DOI: 10.1186/s40359-018-0223-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2017] [Accepted: 03/11/2018] [Indexed: 11/25/2022] Open
Abstract
Background Stroke is a major public health threat globally. Psychosocial well-being may be affected following stroke. Depressive symptoms, anxiety, general psychological distress and social isolation are prevalent. Approximately one third report depressive symptoms and 20% report anxiety during the first months or years after the stroke. Psychosocial difficulties may impact significantly on long-term functioning and quality of life, reduce the effects of rehabilitation services and lead to higher mortality rates. The aim of the study is to evaluate the effect of a previously developed and feasibility tested dialogue-based psychosocial intervention aimed at promoting psychosocial well-being and coping following stroke among stroke survivors with and without aphasia. Methods The study will be conducted as a multicenter, randomized, single blind controlled trial with one intervention and one control arm. It will include a total of 330 stroke survivors randomly allocated into either an intervention group (dialogue-based intervention to promote psychosocial well-being) or a control group (usual care). Participants in the intervention group will receive eight individual sessions of supported dialogues in their homes during the first six months following an acute stroke. The primary outcome measure will be psychosocial well-being measured by the General Health Questionnaire (GHQ). Secondary outcome measures will be quality of life (SAQoL), sense of coherence (SOC), and depression (Yale). Process evaluation will be conducted in a longitudinal mixed methods study by individual qualitative interviews with 15–20 participants in the intervention and control groups, focus group interviews with the intervention personnel and data collectors, and a comprehensive analysis of implementation fidelity. Discussion The intervention described in this study protocol is based on thorough development and feasibility work, guided by the UK medical research council framework for developing and testing complex interventions. It combines classical effectiveness evaluation with a thorough process evaluation. The results from this study may inform the development of further trials aimed at promoting psychosocial well-being following stroke as well as inform the psychosocial follow up of stroke patients living at home. Trial registration NCT02338869; registered 10/04/2014 (On-going trial).
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Affiliation(s)
- Marit Kirkevold
- Institute of Health and Society and Research Center for habilitation and rehabilitation services and models (CHARM), University of Oslo, P.O.Box 1130, Blindern, 0318, Oslo, Norway.
| | - Line Kildal Bragstad
- Institute of Health and Society and Research Center for habilitation and rehabilitation services and models (CHARM), University of Oslo, P.O.Box 1130, Blindern, 0318, Oslo, Norway
| | - Berit A Bronken
- Inland Norway University of Applied Sciences, P.O.Box 400, 2418, Elverum, Norway
| | - Kari Kvigne
- Inland Norway University of Applied Sciences, P.O.Box 400, 2418, Elverum, Norway
| | - Randi Martinsen
- Inland Norway University of Applied Sciences, P.O.Box 400, 2418, Elverum, Norway
| | - Ellen Gabrielsen Hjelle
- Institute of Health and Society and Research Center for habilitation and rehabilitation services and models (CHARM), University of Oslo, P.O.Box 1130, Blindern, 0318, Oslo, Norway
| | - Gabriele Kitzmüller
- Faculty of Health UIT, The Arctic University of Norway, Campus, Narvik, Norway
| | - Margrete Mangset
- Department of Geriatric Medicine, Oslo University Hospital, P.O box 4956, Nydalen, 0424, Oslo, Norway
| | - Sanne Angel
- Institute of Public Health, Aarhus University, Hoegh-Guldbergs Gade 6 A, 8000, Aarhus, Denmark
| | - Lena Aadal
- Hammel Neurorehabilitation and Research Centre, Voldbyvej 15 8450, Hammel, Denmark
| | - Siren Eriksen
- Norwegian National Advisory Unit on Ageing and Health (Ageing and Health), P. O. Box 2136, 3103, Tønsberg, Norway
| | - Torgeir B Wyller
- Institute of Clinical Medicine, University of Oslo, and Department. of Geriatric Medicine, Oslo University Hospital, P.O box 4956 Nydalen, 0424, Oslo, Norway
| | - Unni Sveen
- Dept. of Geriatric Medicine, and Dept. of Physical Medicine and Rehabilitation, Oslo University Hospital, P.O box 4956 Nydalen, 0424, Oslo, Norway
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Røe C, Kirkevold M, Andelic N, Soberg H, Sveen U, Bautz-Holter E, Jahnsen R, Walsem M, Bragstad L, Hjelle E, Klevberg G, Oretorp P, Habberstad A, Hagfors J, Væhle R, Engen G, Gutenbrunner C. The challenges of describing rehabilitation services: A discussion paper. J Rehabil Med 2018; 50:151-158. [DOI: 10.2340/16501977-2299] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Haveraaen L, Brouwers EPM, Sveen U, Skarpaas LS, Sagvaag H, Aas RW. The First Six Years of Building and Implementing a Return-to-Work Service for Patients with Acquired Brain Injury. The Rapid-Return-to-Work-Cohort-Study. J Occup Rehabil 2017; 27:623-632. [PMID: 28144771 DOI: 10.1007/s10926-016-9693-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Background and objective Despite large activity worldwide in building and implementing new return-to-work (RTW) services, few studies have focused on how such implementation processes develop. The aim of this study was to examine the development in patient and service characteristics the first six years of implementing a RTW service for persons with acquired brain injury (ABI). Methods The study was designed as a cohort study (n=189). Data were collected by questionnaires, filled out by the service providers. The material was divided into, and analyzed with, two implementation phases. Non-parametrical statistical methods and hierarchical regression analyses were applied on the material. Results The number of patients increased significantly, and the patient group became more homogeneous. Both the duration of the service, and the number of consultations and group session days were significantly reduced. Conclusion The patient group became more homogenous, but also significantly larger during the first six years of building the RTW service. At the same time, the duration of the service decreased. This study therefore questions if there is a lack of consensus on the intensity of work rehabilitation for this group.
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Affiliation(s)
- L Haveraaen
- Presenter, Stavanger, Norway, Stavanger Innovation park, Prof. Olav Hansenssvei 7A, 4021, Stavanger, Norway
| | - E P M Brouwers
- Tilburg School of Social and Behavioral Sciences, Tilburg University, Tranzo, PO Box 90153, 5000 LE, Tilburg, The Netherlands
| | - U Sveen
- Faculty of Health Sciences, Oslo and Akershus University College, PO Box 4, St. Olavs plass, 0130, Oslo, Norway
- Dept. Physical Medicine and Rehabilitation, Oslo University Hospital, PO Box 4950, Nydalen, 0424, Oslo, Norway
| | - L S Skarpaas
- Presenter, Stavanger, Norway, Stavanger Innovation park, Prof. Olav Hansenssvei 7A, 4021, Stavanger, Norway
- Faculty of Health Sciences, Oslo and Akershus University College, PO Box 4, St. Olavs plass, 0130, Oslo, Norway
| | - H Sagvaag
- Faculty of Social Science, University of Stavanger, PO Box 8600, Forus, 4036, Stavanger, Norway
| | - R W Aas
- Presenter, Stavanger, Norway, Stavanger Innovation park, Prof. Olav Hansenssvei 7A, 4021, Stavanger, Norway.
- Faculty of Health Sciences, Oslo and Akershus University College, PO Box 4, St. Olavs plass, 0130, Oslo, Norway.
- Faculty of Social Science, University of Stavanger, PO Box 8600, Forus, 4036, Stavanger, Norway.
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Howe EI, Langlo KPS, Terjesen HCA, Røe C, Schanke AK, Søberg HL, Sveen U, Aas E, Enehaug H, Alves DE, Klethagen P, Sagstad K, Moen CM, Torsteinsbrend K, Linnestad AM, Nordenmark TH, Rismyhr BS, Wangen G, Lu J, Ponsford J, Twamley EW, Ugelstad H, Spjelkavik Ø, Løvstad M, Andelic N. Combined cognitive and vocational interventions after mild to moderate traumatic brain injury: study protocol for a randomized controlled trial. Trials 2017; 18:483. [PMID: 29041954 PMCID: PMC5645893 DOI: 10.1186/s13063-017-2218-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 09/27/2017] [Indexed: 11/25/2022] Open
Abstract
Background A considerable proportion of patients with mild to moderate traumatic brain injury (TBI) experience long-lasting somatic, cognitive, and emotional symptoms that may hamper their capacity to return to work (RTW). Although several studies have described medical, psychological, and work-related factors that predict RTW after TBI, well-controlled intervention studies regarding RTW are scarce. Furthermore, there has traditionally been weak collaboration among health-related rehabilitation services, the labor and welfare sector, and workplaces. Methods/design This study protocol describes an innovative randomized controlled trial in which we will explore the effect of combining manualized cognitive rehabilitation (Compensatory Cognitive Training [CCT]) and supported employment (SE) on RTW and related outcomes for patients with mild to moderate TBI in real-life competitive work settings. The study will be carried out in the southeastern region of Norway and thereby be performed within the Norwegian welfare system. Patients aged 18–60 years with mild to moderate TBI who are employed in a minimum 50% position at the time of injury and sick-listed 50% or more for postconcussive symptoms 2 months postinjury will be included in the study. A comprehensive assessment of neurocognitive function, self-reported symptoms, emotional distress, coping style, and quality of life will be performed at baseline, immediately after CCT (3 months after inclusion), following the end of SE (6 months after inclusion), and 12 months following study inclusion. The primary outcome measures are the proportion of participants who have returned to work at 12-month follow-up and length of time until RTW, in addition to work stability as well as work productivity over the first year following the intervention. Secondary outcomes include changes in self-reported symptoms, emotional and cognitive function, and quality of life. Additionally, a qualitative RTW process evaluation focused on organizational challenges at the workplace will be performed. Discussion The proposed study will combine cognitive and vocational rehabilitation and explore the efficacy of increased cross-sectoral collaboration between specialized health care services and the labor and welfare system. If the intervention proves effective, the project will describe the cost-effectiveness and utility of the program and thereby provide important information for policy makers. In addition, knowledge about the RTW process for persons with TBI and their workplaces will be provided. Trial registration ClinicalTrials.gov, NCT03092713. Registered on 10 March 2017. Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-2218-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Emilie I Howe
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway. .,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - Knut-Petter S Langlo
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway.,Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway
| | | | - Cecilie Røe
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Anne-Kristine Schanke
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway.,Department of Research, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway
| | - Helene L Søberg
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway.,Faculty of Health Sciences, Oslo and Akershus University College of Applied Science, Oslo, Norway
| | - Unni Sveen
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway.,Faculty of Health Sciences, Oslo and Akershus University College of Applied Science, Oslo, Norway
| | - Eline Aas
- Department of Health Economics, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Heidi Enehaug
- The Work Research Institute, Oslo and Akershus University College of Applied Science, Oslo, Norway
| | - Daniele E Alves
- The Work Research Institute, Oslo and Akershus University College of Applied Science, Oslo, Norway
| | - Pål Klethagen
- The Work Research Institute, Oslo and Akershus University College of Applied Science, Oslo, Norway
| | - Kjersti Sagstad
- Department of Vocational Rehabilitation, Norwegian Labor and Welfare Administration, Oslo, Norway
| | - Christine M Moen
- Department of Vocational Rehabilitation, Norwegian Labor and Welfare Administration, Oslo, Norway
| | - Karin Torsteinsbrend
- Department of Vocational Rehabilitation, Norwegian Labor and Welfare Administration, Oslo, Norway
| | | | - Tonje Haug Nordenmark
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Birte Sand Rismyhr
- The Norwegian User Organization (Personskadeforbundet LTN), Oslo, Norway
| | - Grete Wangen
- Faculty of Health Sciences, Oslo and Akershus University College of Applied Science, Oslo, Norway
| | - Juan Lu
- Department of Family Medicine and Population Health, Division of Epidemiology, Virginia Commonwealth University, Richmond, VA, USA
| | - Jennie Ponsford
- School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Faculty of Medicine, Nursing and Health Sciences , Clayton, Victoria, Australia
| | - Elizabeth W Twamley
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, CA, USA.,Department of Psychiatry, University of California, San Diego, San Diego, CA, USA
| | - Helene Ugelstad
- Department of Vocational Rehabilitation, Norwegian Labor and Welfare Administration, Oslo, Norway
| | - Øystein Spjelkavik
- The Work Research Institute, Oslo and Akershus University College of Applied Science, Oslo, Norway
| | - Marianne Løvstad
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Oslo, Norway.,Department of Research, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway
| | - Nada Andelic
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway.,Center for Habilitation and Rehabilitation Models and Services (CHARM), Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
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Abstract
BACKGROUND Even people with mild to moderate stroke will experience changes in their abilities to perform everyday occupations. Group interventions may be appropriate in late-stage rehabilitation. The aim of this study was to explore how the participants involved themselves in person-centered lifestyle groups after stroke in Norway. METHOD Semi-structured interviews were performed with six older adults with mild-to-moderate stroke who had participated in lifestyle groups over a period of nine months. The interviews were analyzed using qualitative content analysis. RESULTS The participants involved themselves in the lifestyle groups in a variety of ways by creating enjoyable company in sharing stroke experiences, sharing knowledgeable interest, pushing and forcing each other forward and reflecting on self-worth. Through doing group activities together, they created various ways of being, belonging and becoming, addressing development of strategies for regaining self-belief and a sense of autonomy, and for adapting to everyday life post-stroke. CONCLUSION The participants were active contributors in the groups and pushed each other and themselves regarding involvement in meaningful occupations. This active participation seemed to bring the participants' resources into focus and contrasted with the frequent negative perceptions of people post-stroke as 'victims'.
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Affiliation(s)
- Anne Lund
- a Faculty of Health Sciences, Department of Occupational Therapy, Prosthetics and Orthotics , Oslo and Akershus University College of Applied Sciences (HiOA) , Oslo , Norway
| | - Mali Melhus
- a Faculty of Health Sciences, Department of Occupational Therapy, Prosthetics and Orthotics , Oslo and Akershus University College of Applied Sciences (HiOA) , Oslo , Norway
| | - Unni Sveen
- a Faculty of Health Sciences, Department of Occupational Therapy, Prosthetics and Orthotics , Oslo and Akershus University College of Applied Sciences (HiOA) , Oslo , Norway
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49
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Häggblom-Kronlöf G, Thordardottir B, Nygård L, Helle T, Sveen U. Editorial. Scand J Occup Ther 2017; 24:233-234. [PMID: 28573930 DOI: 10.1080/11038128.2017.1333672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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50
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Slomic M, Soberg HL, Sveen U, Christiansen B. Transitions of patients with traumatic brain injury and multiple trauma between specialized and municipal rehabilitation services—Professionals’ perspectives. Cogent Medicine 2017. [DOI: 10.1080/2331205x.2017.1320849] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Affiliation(s)
- Mirela Slomic
- Faculty of Health Sciences, Oslo and Akershus University College, Postboks 4 St. Olavs plass, Oslo, Norway
| | - Helene L. Soberg
- Faculty of Health Sciences, Oslo and Akershus University College, Postboks 4 St. Olavs plass, Oslo, Norway
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Unni Sveen
- Faculty of Health Sciences, Oslo and Akershus University College, Postboks 4 St. Olavs plass, Oslo, Norway
- Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway
| | - Bjørg Christiansen
- Faculty of Health Sciences, Oslo and Akershus University College, Postboks 4 St. Olavs plass, Oslo, Norway
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