Lars-Olov Lundqvist

Prevalence and risk markers of behavior problems among adults with intellectual disabilities: A total population study in Örebro County, Sweden

The aim of the present study was to investigate the prevalence of behavior problems among people with administratively defined intellectual disability (ID) and identify possible risk markers for behavior problems using the Behavior Problems Inventory (BPI). Sixty-two percent of the ID population (n=915) had a behavior problem (self-injurious, stereotyped, or aggressive/destructive behavior) and 18.7% had a behavior problem identified as challenging behavior, resulting in a prevalence of 80.3 per 100,000 in the base population. The most pronounced risk markers for behavior problems were severity of ID, autism, night sleep disturbances, sensory hypersensitivity, communication dysfunction, social deficits, psychiatry involvement, and psychotropic medication. About 50% of people with behavior problems were on psychotropic drugs. Protective markers were Downs syndrome and, to some extent, cerebral palsy. The results were largely consistent with those reported in previous studies. Findings not previously reported were that prevalence of aggressive/destructive behavior peaked among those ≥70 years. Highlighting groups within a population at particular risk has implications for management and treatment of individuals with behavior problems.

Eye-neck interactions triggered by visually deficient computer work

OBJECTIVES To study the joint occurrence of eye-and-neck/scapular area symptoms and their association with occupational risk factors in a cross-sectional sample of professional information technology users. STUDY POPULATION The participants consisted of 3,971 employees who worked with computers for a minimum of one hour a day. 2,551 (73%) were men and 945 (27%) women, with an age range of 18 up to 64 years. The mean age was 38.1 (SD=10.7) for men and 37.6 (SD=12.0) for the women. The measures were obtained via a self-administered survey in combination with a visual examination conducted by an optometrist. METHODS Two complementary logistic regression analyses with forced entry was conducted on n=3,496 (88% adjusted response rate) cases. The effect of ocular symptoms on the risk of reporting musculoskeletal symptoms, or vice versa, was examined first in two separate binominal logistic regression analyses. Age, Gender, Near work variable and Visual functioning variables were included in these analyzes. Variables associated with the risk of developing an increase in either symptom category were also examined in two additional binomial logistic regression analyses. RESULTS Exposure to spectacles (single vision, multifocal, or progressive correction) in combination with a visual acuity <1 surfaced as a key mediator of symptoms from the neck/scapular area (p<0.01). A vergence disparity (uncompensated vergence error) similarly was associated with an augmented risk of developing an increase in neck/scapular area symptoms (p<0.05). The most influential risk factor for neck/scapular area symptoms were ocular symptoms and vice versa (p<0.0001). CONCLUSIONS The results support the hypothesis which postulates that eye-neck/scapular area symptoms interaction may be due to a functional coupling from and between the eye-neck/scapular area muscles [28].

The Quality in Psychiatric Care-Forensic In-Patient Instrument: Psychometric properties and patient views of the quality of forensic psychiatric services in Sweden

ABSTRACT The aim of this study was to evaluate the psychometric properties and dimensionality of the instrument Quality in Psychiatric Care-Forensic In-Patient and to describe the quality of psychiatric care among forensic in-patients. The study group consisted of patients all receiving care during 2 weeks in September 2009 and meeting the inclusion criteria. A sample of 134 in-patients from 34 forensic wards in Sweden participated. Confirmatory factor analysis revealed a seven-factor structure, and 69% of the patients reported the quality of care as high. The highest rating was for the secluded environment dimension, and the lowest was for the participation dimension. The Quality in Psychiatric Care-Forensic In-Patient is a reliable and valid measurement instrument recommended for use in evaluating quality in forensic in-patient care.

Psychometric properties and factor structure of the Behavior Problems Inventory (BPI-01) in a Swedish community population of adults with intellectual disability

The aim of the present study was to evaluate the psychometric properties and factor structure of the Behavior Problems Inventory (BPI-01) in a community population. The Swedish version of the BPI-01 was administered by interviewing care staff of all adults (n = 915) with administratively defined intellectual disabilities (IDs) living in Örebro County, Sweden. Sixty-two percent of the participants had at least one behavior problem. Altogether, 30.9% showed self-injurious behavior, 41.3% stereotyped behavior, and 34.8% aggressive/destructive behavior. All but the self-injurious behavior scale reached acceptable levels of internal consistency. Confirmatory factor analysis supported the unidimensionality of the subscales as well as the proposed three factor structure of the original BPI-01. The present study demonstrates that the three subscales are highly similar constructs across different language and cultural settings, and that the BPI-01 is applicable in research on populations with varying mental functioning, diagnoses, ages, and living arrangements.

Opportunities and barriers for successful return to work after acquired brain injury: A patient perspective

BACKGROUND: Many people who suffer an acquired brain injury (ABI) are of working age. There are benefits, for the patient, the workplace, and society, to finding factors that facilitate successful return to work (RTW). OBJECTIVE: The aim was to increase knowledge of opportunities and barriers for a successful RTW in patients with ABI. METHOD: Five men and five women with ABI participated. All had successfully returned to work at least 20 hours a week. Their experiences were gathered by semi-structured interviews, which were subsequently subjected to qualitative content analysis. RESULTS: Three themes that influenced RTW were identified: individually adapted rehabilitation; motivation for RTW; and cognitive and social abilities. An individually adapted rehabilitation was judged important because the patients were involved in their own rehabilitation and required individually adapted support from rehabilitation specialists, employers, and colleagues. A moderate level of motivation for RTW was needed. Awareness of the person’s cognitive and social abilities is essential, in finding compensatory strategies and adaptations. CONCLUSIONS: It seems that the vocational rehabilitation process is a balancing act in individualized planning and support, as a partnership with the employer needs to be developed, motivation needs to be generated, and awareness built of abilities that facilitate or hinder RTW.

Prevalence of orofacial dysfunction in cerebral palsy and its association with gross motor function and manual ability.

To investigate the prevalence of orofacial dysfunction (OFD) and explore factors associated with OFD in young individuals with cerebral palsy (CP).

A Danish adaptation of the quality in psychiatric care-forensic in-patient questionnaire : psychometric properties and factor structure

Objective: The aims of this study were to adapt and evaluate the psychometric properties and factor structure of the Danish version of the Quality in Psychiatric Care-Forensic In-Patient (QPC-FIP) questionnaire. Methods: A sample of 139 inpatients from 25 wards in Denmark who received care during 5 weeks in March and April 2012 participated in the study by completing the QPC-FIP instrument. Results: Confirmatory factor analysis revealed that the factor structure of the Danish version was equivalent to that of the original Swedish QPC-FIP. The results indicate that the concept of quality of care expressed in the QPC-FIP is equivalent among forensic inpatients in nationally different healthcare systems and cultural contexts. Conclusion: The Danish version of QPC-FIP is a reliable and valid measurement instrument recommended for use in evaluating quality of care in forensic inpatient care.

Is the Autism-Spectrum Quotient a Valid Measure of Traits Associated with the Autism Spectrum? A Rasch Validation in Adults with and Without Autism Spectrum Disorders

The Autism-Spectrum Quotient (AQ) is among the most widely used scales assessing autistic traits in the general population. However, some aspects of the AQ are questionable. To test its scale properties, the AQ was translated into Swedish, and data were collected from 349 adults, 130 with autism spectrum disorder (ASD) and 219 without ASD, and analysed with Rasch. Several scale properties of the AQ were satisfactory but it did not meet the criterion of a unidimensional measure of autistic traits. The Rasch analysis showed that the 50-item AQ could be reduced to a 12-item subset with little loss of explanatory power, with the potential to efficiently measure the degree to which adults with and without ASD show autistic traits.

Quality of community-based day centre services for people with psychiatric disabilities: psychometric properties of the Quality in Psychiatric Care - Daily Activities (QPC-DA).

Abstract Background/aims The aim of the present study was to test the psychometric properties and dimensionality of the instrument Quality in Psychiatric Care – Daily Activities (QPC–DA) and to briefly describe the day centre attendees’ perception of the quality at community-based day centre services. Methods A sample of 218 attendees from 14 community-based day centre services in seven municipalities in Sweden participated in the study. Results Confirmatory factor analysis revealed that the QPC–DA consists of six dimensions and has a factor structure that to a large extent corresponds to that found in other studies of quality in psychiatric care settings, such as inpatient, outpatient, forensic inpatient, and housing support for people with psychiatric disabilities. The internal consistency of the factors was satisfactory and thus the QPC–DA showed adequate psychometric properties. The attendees’ ratings of quality of community-based day centre services were generally high. The highest rating was for the encounter dimension and the lowest for the participation and the secluded environment dimensions, indicating areas for improvement. Conclusion/significance The QPC–DA includes important aspects of the attendees’ assessment of quality of community-based day centre services and offers a simple and inexpensive way to evaluate quality from their perspective.

Effects of Feldenkrais Method on Chronic Neck/Scapular Pain in People With Visual Impairment: A Randomized Controlled Trial With One-Year Follow-Up

OBJECTIVE To determine whether the Feldenkrais method is an effective intervention for chronic neck/scapular pain in patients with visual impairment. DESIGN Randomized controlled trial with an untreated control group. SETTING Low vision center. PARTICIPANTS Patients (N=61) with visual impairment (mean, 53.3 y) and nonspecific chronic (mean, 23.8 y) neck/scapular pain. INTERVENTIONS Participants were randomly assigned to the Feldenkrais method group (n=30) or untreated control group (n=31). Patients in the treatment group underwent one 2-hour Feldenkrais method session per week for 12 consecutive weeks. MAIN OUTCOME MEASURES Blind assessment of perceived pain (visual analog scale [VAS]) during physical therapist palpation of the left and right occipital, upper trapezius, and levator scapulae muscle areas; self-assessed degree of pain on the Visual, Musculoskeletal, and Balance Complaints questionnaire; and the Medical Outcomes Study 36-Item Short-Form Health Survey bodily pain scale. RESULTS Patients undergoing Feldenkrais method reported significantly less pain than the controls according to the VAS and Visual, Musculoskeletal, and Balance Complaints questionnaire ratings at posttreatment follow-up and 1-year follow-up. There were no significant differences regarding the Medical Outcomes Study 36-Item Short-Form Health Survey bodily pain scale ratings. CONCLUSIONS Feldenkrais method is an effective intervention for chronic neck/scapular pain in patients with visual impairment.