Sofi Fristedt

Test–retest reliability of the Swedish version of the Life-Space Assessment Questionnaire among community-dwelling older adults:

Objective: To examine the test–retest reliability of the Swedish version of the Life-Space Assessment Questionnaire. Design: Test–retest reliability study. Subjects: A total of 298 community-dwelling subjects between 75 and 90 years of age. Methods: The Life-Space Assessment Questionnaire was translated into Swedish. By personal interviews during home visits and two weeks later by telephone interviews the subjects were asked about their life-space mobility during the past four weeks, and how often and whether they were independent or needed assistance from another person or equipment to reach different life-space levels. Results: None of the four scoring methods showed significant difference between test sessions. The mean (SD) total scores were 65 (22) and 65 (23) out of the maximum possible score of 120 at the two sessions. High levels were found for independent, assisted, and maximal life-space at both sessions. Intraclass correlation coefficients and weighted Kappa-values between 0.84–0.94 were found for the total score, the independent, and the assisted life-space levels, indicating good to excellent reliability. A lower Kappa-value was observed for the maximal life-space level, mainly owing to skewed distributions. The method error values showed that a change of 10 in the total score and a change of one level in any of the three life-space levels can be considered to indicate a real change in clinical practice. Conclusion: The Swedish version of the Life-Space Assessment Questionnaire can be reliably used among community-dwelling older adults.

Changes in community mobility in older men and women. A 13-year prospective study.

Community mobility, defined as “moving [ones] self in the community and using public or private transportation”, has a unique ability to promote older peoples’ wellbeing by enabling independence and access to activity arenas for interaction with others. Early predictors of decreased community mobility among older men and women are useful in developing health promoting strategies. However, long-term prediction is rare, especially when it comes to including both public and private transportation. The present study describes factors associated with community mobility and decreased community mobility over time among older men and women. In total, 119 men and 147 women responded to a questionnaire in 1994 and 2007. Respondents were between 82 and 96 years old at follow-up. After 13 years, 40% of men and 43% of women had decreased community mobility, but 47% of men and 45% of women still experienced some independent community mobility. Cross-sectional independent community mobility among men was associated with higher ratings of subjective health, reporting no depression and more involvement in sport activities. Among women, cross-sectional independent community mobility was associated with better subjective health and doing more instrumental activities of daily living outside the home. Lower subjective health predicted decreased community mobility for both men and women, whereas self-reported health conditions did not. Consequently, general policies and individual interventions aiming to improve community mobility should consider older persons’ subjective health.

Concurrent validity of the Swedish version of the life-space assessment questionnaire

BackgroundThe Life-Space Assessment (LSA), developed in the USA, is an instrument focusing on mobility with respect to reaching different areas defined as life-spaces, extending from the room where the person sleeps to mobility outside one’s hometown. A newly translated Swedish version of the LSA (LSA-S) has been tested for test-retest reliability, but the validity remains to be tested. The purpose of the present study was to examine the concurrent validity of the LSA-S, by comparing and correlating the LSA scores to other measures of mobility.MethodThe LSA was included in a population-based study of health, functioning and mobility among older persons in Sweden, and the present analysis comprised 312 community-dwelling participants. To test the concurrent validity, the LSA scores were compared to a number of other mobility-related variables, including the Short Physical Performance Battery (SPPB) as well as “stair climbing”, “transfers”, “transportation”, “food shopping”, “travel for pleasure” and “community activities”. The LSA total mean scores for different levels of the other mobility-related variables, and measures of correlation were calculated.ResultsHigher LSA total mean scores were observed with higher levels of all the other mobility related variables. Most of the correlations between the LSA and the other mobility variables were large (r = 0.5–1.0) and significant at the 0.01 level. The LSA total score, as well as independent life-space and assistive life-space correlated with transportation (0.63, 0.66, 0.64) and food shopping (0.55, 0.58, 0.55). Assistive life-space also correlated with SPPB (0.47). With respect to maximal life-space, the correlations with the mobility-related variables were generally lower (below 0.5), probably since this aspect of life-space mobility is highly influenced by social support and is not so dependent on the individual’s own physical function.ConclusionLSA was shown to be a valid measure of mobility when using the LSA total, independent LS or assistive LSA.

The inter-rater and test–retest reliability of the Self-care and Transfer scales, and intra-rater reliability of all scales of the Swedish Translation of the Australian Therapy Outcome Measures for Occupational Therapy (AusTOMs-OT-S)

Abstract Objective: The Australian Therapy Outcome Measures for Occupational Therapy (AusTOMs-OT) are used internationally to measure the outcomes of occupational therapy services across diagnoses, ages, and health care settings. This study reports on the inter-rater and test–retest reliability of the Self-care and Transfer scales as well as the intra-rater reliability of all scales of the Swedish (AusTOMs-OT-S) translation. Methods: Fifteen occupational therapists rated 11 case study clients on two occasions, separated by two weeks. Test–retest reliability and inter-rater reliability were calculated for the Self-care scale and Transfer scales. Moreover, intra-rater reliability was calculated for each of the 15 therapists across all 12 scales. Results: The inter-rater reliability intraclass correlation coefficients (ICCs) were all found to be high to very high, ranging from ICC 0.762 to 0.904; the intra-rater reliability coefficients were also very good with 11 of the 15 therapists achieving ICCs of 0.745 or over, and finally the test–retest ICCs were also found to be high, ranging from 0.705 to 0.920. Conclusions: Although further research is required to confirm reliability, preliminary reliability of the AusTOMs-OT Swedish translation has been demonstrated and therapists can have confidence when using the scales.

Descriptions of health by EU citizens begging abroad

ABSTRACT Poor citizens from European Union (EU) member countries begging to support themselves are now common in affluent EU countries. Their lack of basic amenities, such as access to a shelter and sanitation is not in line with human rights and also implies a risk for health issues. Despite this, we know little about how these vulnerable EU citizens, themselves, perceive their health situation. The aim of this study was to explore vulnerable EU citizens’ descriptions of their health. Eight females and 12 males from Romania, 19–64 years of age, participated in individual interviews that included health issues. Qualitative content analysis was used, identifying the main category “Begging abroad and health - for better and for worse” together with two categories and five subcategories. It is concluded that EU citizens begging abroad risk poorer health as a consequence of their attempts to improve their situation, both their own health and that of their relatives. Therefore, they need access to affordable health care as this may decrease the need for unwanted travelling abroad to beg.

Occupational therapy students’ views on addressing sexual health

Abstract Background: Sexual health is an important issue in daily life, but little is known about occupational therapy (OT) students’ views on these matters. Aim: To explore occupational therapy students’ views on addressing sexual health in their future professional role. Material and methods: A descriptive qualitative study involving 37 OT students in 5 focus groups was performed and analyzed using content analysis. Results: Three categories: ‘Sexual health is part of occupational therapy and but not of the OT educational program’; ‘Need for knowledge to identify and intervene related to sexual health problems’; and finally, ‘Communication about sexual health—unknown, untried, but necessary’, formed the theme, ‘Willing to try, wanting to know more, and recognizing not only the difficulties and challenges but also the importance of sexual health in OT practice’. Conclusions: OT-students consider sexual health as part of OT-practice, but experience lack of knowledge of sexual health related to disease/disability, cultural diversity, and age and sexual orientation. Educational programs need to cover these matters, including how to address sexual health in OT-practice, to enhance OT’s future competence related to promotion of sexual health for clients. Significance: Knowledge on students’ views are vital to guide education on this important, rather neglected, area.

Predicting decreased community mobility in older men and women. A 13-year prospective study.

Studies addressing multiple morbid conditions in elderlypopulations usually focus on disease and physiological indicatorsrelevant for the medical care system. Few studies include bothmedical and fu ...The UK’s population is ageing, and understanding the dynamics of living arrangements in later life and the implications for the provision and funding of appropriate housing and long-term care is critical given the current economic climate which can have an adverse impact on state support for older people. This paper investigates the dynamics of living arrangements amongst people aged 65 years old and over between 1991 and 2008, focussing on the two key housing and care pathways in later life: moving into sheltered accommodation and moving into residential care. The empirical research examines the rates of moving into sheltered accommodation and institutional care and investigates the determinants and probabilities of these transitions in the UK. The paper employs all 18 waves of the British Household Panel Survey data (1991-2008) and uses a discrete-time logistic regression model in order to model the probability of entering sheltered accommodation and residential care. After reading this poster, participants will be able to associate specific factors with each of the two transitions in later life. For example age, health and marital status are significant determinants of a move into residential care, while the move into sheltered accommodation is also associated with housing tenure and education. After reading this poster, participants will be able to discuss the prevalence of each the two kinds of transition at different stages of the latter part of the life course, and to understand the crucial implications for the design of social care provision for older people in the future.This pilot project aimed to try something different - rekindle positive memories of swimming in people with dementia who enjoyed swimming throughout their lives, and involve them in active swimming again using a swimming club intervention. Club members were recruited from two residential aged care facilities in Queensland, Australia (n=25 recruited, n=18 commenced, n=11 (median age=88.4, IQR=12.3; 1 male) completed the intervention). The 12 week program consisted of two, 45 minute sessions per week held at a municipal pool, using a trained instructor and assistants. Measures, taken at baseline, Week 6, Week 9 and post intervention included psychosocial and physical assessments such as the Revised Memory and Behavior Problems Checklist, Psychological Well-Being in Cognitively Impaired Persons, Seniors Physical Performance Battery and bioelectric impedance analysis. Stakeholder focus groups determined the barriers and facilitators for the club. Three outcomes have been achieved: 1) the development of a dementia specific, evidence-based, aquatic exercise program. This valuable resource will ensure that the benefits will be maximized with tailored exercises for strength, agility, flexibility, balance, relaxation and stress reduction, 2) improved quality of life for members, with statistically significant improvements in psychological wellbeing (χ2 =8.66, p<0.05), BPSD expression (χ2=16.91, p=0.001) and staff distress (χ2=16.86, p=0.001) and 3) an informative website with instructional video clips and a manual to assist others in implementing and maintaining a Watermemories Swimming Club. This pilot project has provided strong evidence that aquatic exercise can produce positive physical, psychosocial and behavioral outcomes for people with dementia.