Maria Larsson Lund

PERCEIVEd PARTICIPATIoN IN LIFE SITuATIoNS IN PERSoNS WITH LATE EFFECTS oF PoLIo

OBJECTIVE To investigate how persons with late effects of polio perceive their participation and problems with participation in life situations and to determine the association between perceived problems with participation and sex, age, marital status, use of mobility aids and access to instrumental support. DESIGN Cross-sectional. SUBJECTS A total of 160 persons with prior polio 6-30 months after an individualized, goal-oriented, comprehensive interdisciplinary rehabilitation programme. METHODS All subjects answered the Swedish version of the Impact on Participation and Autonomy Questionnaire. RESULTS A majority of the respondents perceived their participation as sufficient in most activities and 65% of the respondents perceived no severe problems with participation. The remaining 35% perceived 1-6 severe problems with participation. All 5 domains of participation were positively correlated with the 9 items for problem experience. Most restrictions in participation were reported in the domains of Family role, Autonomy outdoors, and Work and education. Insufficient instrumental support was most strongly associated with the perception of severe problems with participation. CONCLUSION Rehabilitation programmes for persons with late effects of polio need to focus on areas of participation that are perceived as a problem by these persons and to promote access to a supportive environment to enhance their participation.

Using everyday technology to compensate for difficulties in task performance in daily life: experiences in persons with acquired brain injury and their significant others

Purpose. The purpose of this study is to illuminate how persons with acquired brain injury (ABI) and their significant others experienced individualised occupation-based interventions using commonly available everyday technology (ET) to compensate for perceived difficulties with performance of tasks in daily life. Method. Qualitative research interviews were conducted with 10 persons with ABI and with one of their significant others. The data were analysed according to qualitative content analysis. Results. The persons with ABI experienced that they mastered their lives in a better way by the compensatory use of ET. They became capable of doing tasks independently and experienced themselves as being a new person. During the intervention process, persons with ABI became aware of the compensatory potential of familiar ET, and they were supported to use effective compensatory strategies and incorporate them into their habits. Their significant others felt a relief in daily life, and their mood was positively affected as they experienced reduced responsibility and need of control. Conclusions. This qualitative study has shown that persons with ABI, as well as their significant others, experienced a multitude of benefits from occupation-based interventions using commonly available ET to compensate for their difficulties in the performance of tasks in daily life and that the goals achieved affected their overall contentment with life.

Associations between perceptions of environmental barriers and participation in persons with late effects of polio

The aim of this pilot study was to assess the association between perceived environmental barriers and perceived participation in everyday life situations encountered by people with late effects of polio. A sample of 45 persons with clinically verified late effects of polio answered the Swedish versions of the Impact on Participation and Autonomy Questionnaire (IPA-S) and the Craig Hospital Inventory of Environmental Factors (CHIEF-S). The relationships between the perceived occurrence of a broad range of environmental barriers and perception of participation in life situations and problems with participation were explored. The majority of the respondents perceived that they encountered environmental barriers, but their occurrence was generally infrequent and their magnitude tended to be low. The barriers identified in the physical/structural subscale were generally most strongly related to problems with participation, compared with the four other environmental subscales. A high frequency of never encountering environmental barriers in the three subscales physical/structural, work and education, and policies in CHIEF-S were significantly related to more reports of good participation in IPA-S. These associations indicate that the participation of those with late effects of polio is influenced by their perception of the barriers they encounter. Further studies of these concepts can provide a greater understanding of disabilities and help us to promote participation in life situations for people with late effects of polio.

Influences of the social environment on engagement in occupations: The experience of persons with rheumatoid arthritis

The aim of this explorative study was to describe and enhance the understanding of how persons with rheumatoid arthritis (RA) experience the influence of the social environment on their engagement in occupations. Nine persons were interviewed and the data obtained were analysed using a comparative method. The findings revealed that other persons in the social environment influenced informants’ experiences of engaging in occupations in two ways, which formed the categories: “Constructive collaboration” and “Insufficient collaboration”. These categories had certain properties related to the actions the others undertook to assist the informants during their collaboration. These assisting actions influenced the informants’ possibilities to engage in occupations, and also their experience of engagement. The findings also showed that the “Conditions for collaboration” varied and influenced their collaboration, which thereby constituted a third category. The findings may contribute to a deeper understanding of how other persons can facilitate and restrict meaningful occupational experiences. This provides knowledge that can be used by occupational therapists when empowering their clients and those close to them to reflect on their actions and the consequences of these actions to enhance occupational engagement.

Improvements of task performance in daily life after acquired brain injury using commonly available everyday technology.

Purpose. To investigate how individualised occupation-based interventions with commonly available everyday technology (ET) can compensate for perceived difficulties with daily life tasks after an aquired brain injury (ABI) and improve satisfaction with occupational performance. Method. This intervention study was designed as a multiple case study according to Yin. Ten men and women with an ABI (traumatic or non-traumatic) participated. Data were collected through interviews, observations and field notes before and after the intervention and at follow-up (on average 11 weeks afterwards). The interventions focused on enabling each participants prioritised goals related to task performance in daily life. Results. All participants achieved all their goals by learning to use both new functions in their own familiar ET and new ET. The participants perceived difficulties in occupational performance decreased and their satisfaction with occupational performance increased with the use of ET. Conclusions. An individualised intervention process, involving the use of own familiar ET or ET off-the-shelf, has the potential to compensate for perceived difficulties following an ABI and improve satisfaction with occupational performance in daily life.

How a group of disabled persons experience rehabilitation over a period of time

The purpose of this study was to describe how a group of mainly elderly disabled persons experienced their rehabilitation over a period of time focusing on their interactions with professionals, ...

Perceived difficulty in the use of everyday technology : relationships with everyday functioning in people with acquired brain injury with a special focus on returning to work

Abstract Purpose: The aim was to explore the relationships between difficulties in the use of everyday technology (ET) and the ability to perform activities of daily life (ADL) in the home and in society and in the workplace in people with acquired brain injury (ABI). Method: The investigation comprises an explorative cross-sectional study of 74 people with ABI. The short version of the Everyday Technology Use Questionnaire (S-ETUQ) and a revised version of the ADL taxonomy were used to evaluate the participants. Rasch-generated person ability measures of ET use and ADL were used in correlation analyses, in group comparisons by ANOVA and in logistic regressions. Results: Difficulty in the use of ET was significantly correlated with ADL limitations. People who worked full- or part-time had significantly higher ability to use ET than those with some type of full-time, long-term sickness compensation. The ability to use ET, ADL ability and age were significantly related to return to work. Conclusion: The ability to use ET is related to all areas of everyday functioning in people with ABI. Therefore, a patient’s ability to use ET needs to be considered in rehabilitation strategies following an ABI to enhance the patient’s performance of activities in the home and in society and to support his or her likelihood of returning to work. Implications for Rehabilitation Ability to use everyday technology (ET) needs to be considered in rehabilitation following an ABI as difficulty in ET use is significantly related to the abilities of people with acquired brain injury (ABI) in all areas of everyday functioning (P/I ADL, leisure and work). The assessment S-ETUQ can assist professionals in screening and identifying ET that clients perceive supporting or challenging their everyday functioning. With respect to the Information and communication society of today, the match between users abilities and ET is important knowledge in designing an e-accessible and e-inclusive society for people with disabilities.

Perceived difficulty in use of everyday technology in persons with acquired brain injury of different severity: a comparison with controls.

OBJECTIVE To compare the perceived difficulty in use of everyday technology in persons with acquired brain injury with different levels of severity of disability with that of controls. METHODS This comparison study recruited 2 samples of persons with acquired brain injury and controls, comprising a total of 161 participants, age range 18-64 years. The long and short versions of the Everyday Technology Use Questionnaire and the Extended Glasgow Outcome Scale were used to evaluate participants. RESULTS Persons with acquired brain injury demonstrated lower mean levels of perceived ability in use of everyday technology than controls (F = 21.84, degrees of freedom = 1, p < 0.001). Further analysis showed a statistically significant mean difference in perceived difficulty in use of everyday technology between persons with severe disability and good recovery, between persons with severe disability and controls, and between persons with moderate disability and controls. No significant mean difference was found between persons with severe disability and moderate disability, between persons with moderate disability and good recovery, and between persons with good recovery and controls. CONCLUSION Perceived difficulty in using everyday technology is significantly increased among persons with acquired brain injury with severe to moderate disability compared with controls. Rehabilitation services should consider the use of everyday technology in order to increase participation in everyday activities after acquired brain injury.

Ability to manage everyday technology after acquired brain injury

Abstract Purpose: To investigate and describe how persons with an acquired brain injury (ABI) manage everyday technology (ET) in their daily activities and to explore whether the ability to manage ET was related to the severity of the disability. Method: Eighty-one persons with ABI were observed while managing ET by using the Management of Everyday Technology Assessment (META). The Glasgow Outcome Scale-Extended (GOSE) was used to assess the severity of disability after the ABI. A computer application of a Rasch measurement model was used to generate measures of the participants’ ability to manage ET and the measures were compared groupwise with analysis of covariance (ANCOVA). Results: The degree of severity of disability had a significant main effect on the ability to manage ET. The groups with severe and moderate disability exhibited a significantly lower ability to manage ET compared to the group with good recovery. Conclusion: The result indicates that the ability to manage ET in daily activities can be related to the global severity of disability after ABI. This demonstrates the importance of considering the ability to manage ET to support the performance of activities at home, at work and in society in persons with ABI.

Participation after acquired brain injury: Associations with everyday technology and activities in daily life

Abstract Background: The development of the information society has led to increased use of everyday technology and changed the conditions for participation. Enabling participation in everyday life situations is an important rehabilitation goal after acquired brain injury (ABI). Identifying factors associated with individuals’ experienced participation and problems therein is therefore essential. Objective: This study aimed at exploring the relationship between perceived difficulty in everyday technology use, perceived ability in the activities of daily living (ADL), and perceived participation, and participation problems in persons with ABI. Methods: Eighty-one persons with ABI participated in the study and were assessed by the Impact on Participation and Autonomy questionnaire, the Everyday Technology Use Questionnaire, and the ADL taxonomy. Results: Findings showed that the combined model of difficulty in everyday technology (ET) use, ADL ability, and the interaction between them explained both participation in various domains of everyday life, and also overall level of perceived participation and the perceived problems. Conclusions: The findings underscore the importance of evaluating individuals’ ability in both ET use and ADL after ABI to increase the probability of explaining these persons’ participation in desired everyday life situations and, also, for rehabilitation design.