Elin Ekbladh

Practice models in Swedish psychiatric occupational therapy

In clinical settings, occupational therapists need models both from their own field, occupational therapy, and from other fields in order to offer the clients adequate treatment. It is unknown whic ...

Perceptions of the work environment among people with experience of long term sick leave

PURPOSE The aims were to describe and analyze how people with experience of long term sick leave perceive that factors in their work environment support or interfere with work performance, satisfaction, and well-being. METHOD The 53 participants were interviewed with the Work Environment Impact Scale (WEIS). The WEIS ratings and belonging notes were analyzed by descriptive statistics and qualitative analysis respectively. Differences in WEIS ratings between; women and men; participants with somatic and mental diseases; and participants working and on full-time sick leave were tested. RESULTS The most supportive factors concerned social interactions at work, and the value and meaning of work. The factors perceived as most interfering concerned work demands and rewards. The social relations at work were perceived as more supportive by the working group than by those on full-time sick leave. The participants with somatic diseases perceived physical work factors as more interfering than did participants with mental diseases, who in turn perceived the value and meaning of work as more interfering. CONCLUSION Knowledge about the interaction between the worker and the work environment could reveal useful information about the complex phenomenon of reducing sick leave. The WEIS seems useful in providing information about how alterations and accommodations in the work environment could support individual workers.

The combination of work organizational climate and individual work commitment predicts return to work in women but not in men

Objective: To analyze if the combination of organizational climate and work commitment can predict return to work (RTW). Methods: This prospective Swedish study was based on 2285 participants, 19 to 64 years old, consecutively selected from the employed population, newly sick-listed for more than 14 days. Data were collected in 2008 through postal questionnaire and from register data. Results: Among women, the combination of good organizational climate and fair work commitment predicted an early RTW with an adjusted relative risk of 2.05 (1.32 to 3.18). Among men, none of the adjusted variables or combinations of variables was found significantly to predict RTW. Conclusions: This study demonstrated the importance of integrative effects of organizational climate and individual work commitment on RTW among women. These factors did not predict RTW in men. More research is needed to understand the RTW process among men.

Work environment impact scale: Testing the psychometric properties of the Swedish version

BACKGROUND The Work Environment Impact Scale (WEIS) is an assessment that focuses on the fit between a person and his or her work environment. It is based on Kielhofners Model of Human Occupation and designed to gather information on how clients experience their work environment. OBJECTIVE The aim of this study was to examine the psychometric properties of the Swedish version of the WEIS assessment instrument. METHOD In total, 95 ratings on the 17-item WEIS were obtained from a sample of clients with experience of sick leave due to different medical conditions. Rasch analysis was used to analyze the data. RESULTS Overall, the WEIS items together cohered to form a single construct of increasingly challenging work environmental factors. The hierarchical ordering of the items along the continuum followed a logical and expected pattern, and the participants were validly measured by the scale. The three occupational therapists serving as raters validly used the scale, but demonstrated a relatively high rater separation index, indicating differences in rater severity. CONCLUSION The findings provide evidence that the Swedish version of the WEIS is a psychometrically sound assessment across diagnoses and occupations, which can provide valuable information about experiences of work environment challenges.

Validity of the school setting interview for students with special educational needs in regular high school – a Rasch analysis

BackgroundParticipation in education is a vital component of adolescents’ everyday life and a determinant of health and future opportunities in adult life. The School Setting Interview (SSI) is an instrument which assesses student-environment fit and reflects the potential needs for adjustments to enhance students’ participation in school activities. The aim of the study was to investigate the psychometric properties of the SSI for students with special educational needs in regular high school.MethodsA sample of 509 students with special educational needs was assessed with the SSI. The polytomous unrestricted Rasch model was used to analyze the psychometric properties of the SSI regarding targeting, model fit, differential item functioning (DIF), response category functioning and unidimensionality.ResultsThe SSI generally confirmed fit to assumptions of the Rasch model. Reliability was acceptable (0.73) and the SSI scale was able to separate students into three different levels of student-environment fit. DIF among gender was detected in item “Remember things” and in item “Homework” DIF was detected among students with or without diagnosis. All items had disordered thresholds. The SSI demonstrated unidimensionality and no response dependence was present among items.ConclusionThe results suggest that the SSI is valid for use among students with special educational needs in order to provide and evaluate environmental adjustments. However, the items with the detected DIF and the SSI rating scale with its disordered thresholds needs to be further scrutinized.

Clinical utility of the worker role interview: a survey study among Swedish users

Abstract Background: Work ability assessments are used to guide interventions designed to reduce or eliminate work disability and facilitate work participation. The clinical utility of assessments concerns the extent to which the assessment results support clinical decision-making. Aim: The aim was to investigate how users perceive the clinical utility of the Swedish version of the Worker Role Interview (WRI-S). An additional aim was to investigate differences in clinical utility related to the users’ level of WRI-S experience, attendance at courses on WRI-S application, and knowledge of the Model of Human Occupation. Material and methods: Data are based on 187 respondents’ answers to a web-based questionnaire and analysed through descriptive and inferential statistics. Results: In total, the respondents performed 12 000 WRI-S assessments. The respondents were mainly satisfied with the clinical utility of the WRI-S and experienced the assessment as supporting clinical practice. The main hindrance affecting clinical utility was the amount of time needed for conducting a WRI-S assessment. Experienced users and users with very good knowledge of MOHO conduct WRI-S assessments in a more time-effective manner. Conclusion: This study contributes to further development of the clinical utility of the Swedish version of the WRI-S, mainly focusing on time consumption.

Evaluating the psychometric properties of a clinical vocational rehabilitation outcome measurement: The assessment of work performance (AWP)

This study examined the validity and reliability of the Assessment of Work Performance (AWP) using Rasch analysis. The AWP was administered to 365 clients with a variety of work-related problems. Rasch analysis and principal component analysis were used to examine the appropriateness of the rating scales and unidimensionality of AWP items. The person-response validity, internal consistency, targeting appropriateness, and differential item function were also analyzed. The Rasch analysis confirmed the 4-point rating scale, and the item set met the criteria of unidimensionality. The AWP exhibited satisfactory person-response validity and internal consistency. Among the three subdomains, the targeting of item-difficulty was sufficient in the motor skills and process skills subdomains. Differential item functioning was found across gender and diagnoses. This study presented evidence to support that the AWP functioned as a reliable and valid assessment in assessing work performance.

Which students need accommodations the most, and to what extent are their needs met by regular upper secondary school? A cross-sectional study among students with special educational needs

ABSTRACT The aim of this study was twofold: (1) to identify factors associated with a high level of accommodation needs in school activities among students with special educational needs (SEN) in regular upper secondary education; and (2) to investigate the extent to which schools have met students’ perceived accommodation needs. Accommodation needs and their provision in school activities were assessed with the School Setting Interview for 484 students with SEN. Students’ mean age was 17.3 years and 50% did not have a diagnosis. A logistic regression analysis revealed that a high level of school absence, studying a vocational programme, and a neuropsychiatric disorder were associated with a high level of accommodation needs. In the majority of school activities, about 50% of students had not received any accommodation despite an experienced need for support. About 30% of students perceived a need for support even though they had been provided with accommodations, and around 25% stated they were satisfied with received accommodations. Regular upper secondary school students with SEN are insufficiently provided with accommodations to satisfactorily participate in education. Specific student characteristics, e.g. high level of school absence, should receive special attention when investigating and accommodating students’ needs for support in school activities.