Maria Müllersdorf

High prevalence of cardio-metabolic risk factors among adolescents with intellectual disability.

Adults with intellectual disabilities (IDs) have poor lifestyle‐related health compared with the general population. Our aim was to study whether such differences are present already in adolescents.

Aspects of health, physical/leisure activities, work and socio-demographics associated with pet ownership in Sweden

Aims: The aim of the work presented here was to explore differences between pet owners and non-pet-owners concerning aspects of health, physical/leisure activities, work and socio-demographics. Methods: The study was based on nationally representative data from the Swedish population (n = 43,589). Associations between pet ownership and background variables were investigated using logistic regression analysis. Results: A total of 39,995 respondents were included in the analysis (non-pet-owners = 25,006; pet owners = 14,989). Pet ownership was associated with both positive and negative aspects of health, physical/leisure activities and socio-demographics. Pet owners had better general health but suffered more from mental health problems than non-pet-owners. Their leisure activities involved a greater interest in nature life and/or gardening than those of non-pet-owners. The logistic regression analysis showed that people who were self-employed, in the age range 35 to 49, of female sex, and suffering from pain in the head, neck and shoulders were more likely to own a pet than others. People physically active at a level sufficient to have a positive effect on their health more often owned a pet than people who were less active. Conclusions: Pet owners differ from non-pet-owners in aspects of socio-demographics, health, physical/leisure activities and work situation. This study, based on a general regional population in Sweden, showed differences of both a positive and a negative kind between non-pet-owners and pet owners concerning aspects of health, physical and leisure activities, and work situation.

The actual state of the effects, treatment and incidence of disabling pain in a gender perspective - a Swedish study

Purpose : The purpose of the study was to elicit the actual state of self-perceived experience of long-term and/or recurrent pain and its effects as reported by women and men with disabilities due to pain, in order to determine criteria for assessing the need for measures in rehabilitation/occupational therapy. Methods : The study used a comparative design with a sample randomized from the Swedish population aged 18-58 years (n = 10000). The inclusion criterion was that the respondents had or had had pain causing activity limitation or restricting participation in daily life. A special questionnaire including items concerning demography, pain, coping, occupations in daily life, work, treatments, care institutions and hospital/care staff visited, was posted to 1849 persons and was answered by 1448 respondents (study group n = 1305, control group n = 117). Results : Gender differences were found in the overall prevalence of pain, women reporting more frequent episodes of pain than men did. Differences were also found in pain variables, in daily occupations, days of sick-leave and work variables. Women completed more varied treatment than men. The incidence rate of long-term/recurrent pain in the population studied was 0.07. Conclusions : As a conclusion from this study, three essential components are suggested for use when assessing the need for rehabilitation/occupational therapy: (1) shoulder/arm or lower back pain of aching, tensed and/or searing character, particularly among women; (2) emotional/affective pain effects causing restlessness and depression, particularly among women; and (3) limitations in daily occupations assessed by FSQ and the demand/control/support model with results falling within the warning zones plus long sick-leave periods.PURPOSE The purpose of the study was to elicit the actual state of self-perceived experience of long-term and/or recurrent pain and its effects as reported by women and men with disabilities due to pain, in order to determine criteria for assessing the need for measures in rehabilitation/occupational therapy. METHODS The study used a comparative design with a sample randomized from the Swedish population aged 18-58 years (n = 10,000). The inclusion criterion was that the respondents had or had had pain causing activity limitation or restricting participation in daily life. A special questionnaire including items concerning demography, pain, coping, occupations in daily life, work, treatments, care institutions and hospital/care staff visited, was posted to 1,849 persons and was answered by 1,448 respondents (study group n = 1,305, control group n= 117). RESULTS Gender differences were found in the overall prevalence of pain, women reporting more frequent episodes of pain than men did. Differences were also found in pain variables, in daily occupations, days of sick-leave and work variables. Women completed more varied treatment than men. The incidence rate of long-term/recurrent pain in the population studied was 0.07. CONCLUSIONS As a conclusion from this study, three essential components are suggested for use when assessing the need for rehabilitation/occupational therapy: (1) shoulder/arm or lower back pain of aching, tensed and/or searing character, particularly among women; (2) emotional/affective pain effects causing restlessness and depression, particularly among women; and (3) limitations in daily occupations assessed by FSQ and the demand/control/support model with results falling within the warning zones plus long sick-leave periods.

Maintaining professional confidence–monitoring work with obese schoolchildren with support of an action plan.

School nurses meet obese children in their everyday work. Although school nurses acknowledge the importance of getting hold of school childrens obesity, they seem to lack strategies enabling them to handle the delicacy of the problem. The aim of this study was to describe how school nurses perceive their work with obese children with support of an action plan. Qualitative in-depth interviews were performed with six school nurses working in a municipality, where an action plan for the work with obese school-age children had been implemented. The transcribed data was analysed by a manifest content analysis. The results showed that the informants perceived having a key role in the obesity work, which they experienced as meaningful, but full of pitfalls. They found themselves suitable for the task, but perceived lacking deeper knowledge about specific modes of work such as motivational conversation. As the task was considered delicate, there were great demands for guidelines, education and cooperation. The action plan served as support for maintaining professional confidence throughout the process, but there was room for improvements.

Use of Creative Activities in Occupational Therapy Practice in Sweden

The aim of this study was to describe the prevalence of creative activities in occupational therapy in Sweden and how often Swedish occupational therapists use creative activities as a means of intervention. A web-mail survey was sent to 2975 Swedish occupational therapists working in health care at regional, county council or primary health care level, and those working in vocational rehabilitation. A total of 1867 (63%) answered the questionnaire and showed that 44% did use creative activities as a means of intervention and most often by practitioners working in psychiatric health care. The most commonly used form of creative activity was arts and crafts followed by gardening. This web-mail survey was based on a limited amount of items regarding creative activities. Further research should focus on in-depth inquiries about how occupational therapists and their patients perceive the use of creative activities as a means of treatment in occupational therapy.

Struggling for sense of control: everyday life with chronic pain for women of the Iraqi diaspora in Sweden.

Background: As dispersed ethnic populations in Swedish society expand, the healthcare system need to adapt rehabilitation services according to their needs. The experiences of trauma and forced resettlement have a continuing impact on health and musculoskeletal pain, as well as the intersecting structures that prerequisite the possibilities in the new country. To understand the specific needs of women from the Iraqi diaspora in Sweden, there is a need to elucidate the effects of pain on their everyday life. Aims: To elucidate everyday life with chronic pain from the perspective of women from the Iraqi diaspora in Sweden. Methods: Qualitative interview study according to Glaser’s grounded theory. Results: The results from 11 interviews suggest that pain was associated with dependency on society as well as on family. It resulted in a struggle for sense of control, framed by faith in God, influenced by the healthcare system, and with support from family. The women’s testimony of lack of continuity of care, resulting in recollection of lived traumas in every visit, is a vital sign of the unconscious power relations within health care and how representatives from health care, instead of being the ones who help the women forward, become the ones who hold them back. Conclusions: The results show the importance of challenging the normative assumptions embedded in health care and treatment for patients with chronic pain and of including the voice of “others”.

An integrative review combined with a semantic review to explore the meaning of Swedish terms compatible with occupation, activity, doing and task

The aims of this study were to explore the intended meaning of the terms “occupation”, “activity”, “doing”, and “task” used in international occupational therapy literature and from this perspective explore which Swedish terms best capture these meanings. A literature review of occupational therapy-related journals was performed to gain a basic understanding of the term occupation and related terms. In addition, a semantic review was used: English and Swedish dictionaries were reviewed to explore the semantic meaning of the English terms “occupation”, “activity”, “doing”, and “task”, and the Swedish terms “aktivitet”, “syssla/sysselsättning”, “görande”, and “uppgift”. A comparison was also performed by searching for parallels between the results of the literature review, the semantic definitions of the English and Swedish terms and the comprehensive meaning of the Swedish terms aktivitet and syssla/sysselsättning. An overarching idea of the concept of occupation was found in the literature review and for the purposes of this study we have identified this as Occupation for survival. From this overarching idea, three themes were identified: The feature of occupation, Impact of occupation and Occupation an occupational therapy concept. Each theme could be subdivided into sub-themes. The Swedish term aktivitet was found to have more power, strength, and spirit connected to the synonyms found in the semantic analysis than to those connected with the Swedish term syssla/sysselsättning. According to the findings in this study we found that the term “aktivitet” is the best comparable term in Swedish to the English term “occupation”.

Occupation as described by novice occupational therapy students in Sweden: The first step in a theory generative process grounded in empirical data

A core assumption in occupational therapy is that occupation enhances health. This study is one of a series of planned studies carried out in Sweden, with the overall aim to develop a theory, based on empirical grounds, concerning the dimensions of occupation that may be useful in occupational therapy. The specific aim for this study is to examine the dimensions of occupation as generally understood among novice occupational therapy students. Grounded Theory was the chosen method. Data were collected among occupational therapy students. The students wrote down spontaneously what they considered to be included in activity. A preliminary core category “The what, why, and how of occupation” and five other categories emerged from the analysis: (1) The doing and context of occupation; (2) Motive for occupation; (3) Time and place for occupation; (4) Type of participation; and (5) Outcome of occupation. Relationships between the categories were established between the Motive for occupation and Outcome of occupation, which constitute a kind of prerequisite for occupation. The three remaining categories: The doing and context of occupation, Time and place for occupation, and Type of participation established a form for occupation. In conclusion, the study results illuminated the richness of the concept of occupation and support the core assumption in occupational therapy that occupation enhances health.

Occupation as described by academically skilled occupational therapists in Sweden: a Delphi study.

Abstract The aim of this study was to continue the process of exploring and understanding the concept of occupation in a Swedish occupational therapy context and from an expert perspective. Thirteen eligible occupational therapists active in Sweden, all academically skilled and who had published articles concerning the concept of occupation or activity, were invited to take part in the study. Eight were willing to participate representing different parts of Sweden. A three-round Delphi study was conducted in which the participants reflected on 46 statements derived from a core category and five categories concerning the concept of occupation, extracted from previous studies in this project. The participants gave 124 comments on 44 of the 46 statements. Results revealed new statements, mainly concerning the intentional aspect of occupation and occupation in a structural hierarchy. Comments also contributed with rephrased statements promoting clarity. A total of 54 statements were then ranked on a four-point Likert scale of which 47 reached consensus among participants. Seven statements were not supported to a level of consensus. Four of them dealt with how and if values and individual judgements influence what are viewed as occupations. To continue the developing process, studies in occupational therapy praxis have to be performed.

Exploring indicators for pain rehabilitation: a Delphi study using a multidisciplinary expert panel.

OBJECTIVE Lack of referral guidelines can cause delayed or even non-existent rehabilitation for chronic pain patients. Indicators signalling the need for interventions could counteract this delay for pain rehabilitation and thereby prevent deteriorating patient health. This study aimed to explore the indicators of need for pain rehabilitation using a multidisciplinary expert panel working with pain rehabilitation. METHODS A three-round Delphi study was conducted with a multidisciplinary expert panel (n = 23), each representing one pain rehabilitation unit in Sweden. The expert panel produced indicators, which were then ranked using a four-point Likert scale. RESULTS Twenty multi-faceted indicators for pain rehabilitation were identified. A major part concerned patient problems with activity level, catastrophizing, coping, existential problems, fear avoidance, high pain rating, medication, mental health, motivation, no pain relief, pain spread/increase, psychosocial problems combined with activity problems, psychosocial problems, recovery, and reduced physical function. Furthermore, indicators concerned demographic factors, sick leave, situation in primary health care and work. Finally, tacit knowledge was pointed out as an indicator. The results support previous research but also bring out less quantifiable indicators, such as relying on tacit knowledge while assessing a patients need for rehabilitation. CONCLUSION The indicators for pain rehabilitation were comprehensive, pointing out that needs assessment is complex. Despite reaching consensus on 19 out of 20 indicators, further research is needed to deepen knowledge in this area and to secure a fair assessment of a patients need for pain rehabilitation.