Papers by Susanne Guidetti
Baggrund Der er behov for at udvikle evidensbaserede ergoterapeutiske interventioner, der sigter ... more Baggrund Der er behov for at udvikle evidensbaserede ergoterapeutiske interventioner, der sigter mod at forbedre evnen til at udføre almindelig daglig levevis (ADL) for personer med kroniske tilstande. I udviklingsprocessen bør forskellige former for information inddrages, herunder ergoterapeuters kliniske erfaringer samt klienternes præferencer. Formål At identificere, organisere og prioritere idéer til, hvordan ADL-evnen kan forbedres for personer, der lever med kroniske tilstande. Metode Group concept mapping blev anvendt, og følgende faser indgik i processen: brainstorming, sortering og prioritering, generering af cluster rating map, validering af cluster rating map og udvikling af konceptuel model. Deltagerne var personer med kroniske tilstande (n = ≤18) og ergoterapeuter (n = ≤23). Konklusion Der blev identificeret forskellige temaer, i forhold til hvordan ADL-evnen kan forbedres for personer med kroniske tilstande. Temaerne spænder bredt og illustrerer derved kompleksiteten i at løse ADL-problemer. Personer med kroniske tilstande og ergoterapeuter har forskellige prioriteter, i forhold til hvordan ADL-problemer løses. Derfor er det vigtigt, at ergoterapeuter i daglig praksis involverer klienter i beslutninger om mulige løsninger. Ligeledes er det vigtigt, at både ergoterapeuter og klienter involveres i udvikling af interventioner.
Scandinavian Journal of Occupational Therapy, Mar 24, 2019
Background: Integration of research-based knowledge in health care is challenging. Occupational t... more Background: Integration of research-based knowledge in health care is challenging. Occupational therapists (OTs) need to implement new research-based interventions in clinical practice. Therefore it is crucial to recognize and understand the factors of specific barriers and facilitators affecting the implementation process. Aim: To identify the key factors important for OTs during the implementation process of a complex intervention. Materials and methods: A cross-sectional study with a combination of qualitative and quantitative data in a mixed method design. Forty-one OTs and 23 managers from three county councils in Sweden, responded to a questionnaire one year after the OTs participation in a workshop to prepare for implementation of a client-centered activity of daily living intervention for persons with stroke. Results: Over 70% of the OTs benefitted from reading and discussing articles in the workshop; 60% had faith in the intervention; 69% reported usability of the intervention. High level of support from managers was reported, but less from team members. The therapists' interaction, perceptions of own efforts and contextual influence affected the implementation process. Conclusion: The workshop context with facilitation and access to evidence, supportive organizations and teams, sufficient interaction with researchers and satisfying self-image were successful key factors when involved in research.
BACKGROUND Home care is facing increasing demand due to an aging population. Several challenges h... more BACKGROUND Home care is facing increasing demand due to an aging population. Several challenges have been identified in the provision of home care, such as the need for support and tailoring support to individual needs. Goal-oriented interventions, such as reablement, may provide a solution to some of these challenges. The reablement approach targets adaptation to disease and relearning of everyday life skills and has been found to improve health-related quality of life while reducing service use. OBJECTIVE The objective of this study is to characterize home care system variables (elements) and their relationships (connections) relevant to home care staff workload, home care user needs and satisfaction, and the reablement approach. This is to examine the effects of improvement and interventions, such as the person-centered reablement approach, on the delivery of home care services, workload, work-related stress, home care user experience, and other organizational factors. The main focus was on Swedish home care and tax-funded universal welfare systems. METHODS The study used a mixed methods approach where a causal loop diagram was developed grounded in participatory methods with academic health care science research experts in nursing, occupational therapy, aging, and the reablement approach. The approach was supplemented with theoretical models and the scientific literature. The developed model was verified by the same group of experts and empirical evidence. Finally, the model was analyzed qualitatively and through simulation methods. RESULTS The final causal loop diagram included elements and connections across the categories: stress, home care staff, home care user, organization, social support network of the home care user, and societal level. The model was able to qualitatively describe observed intervention outcomes from the literature. The analysis suggested elements to target for improvement and the potential impact of relevant studied interventions. For example, the elements “workload” and “distress” were important determinants of home care staff health, provision, and quality of care. CONCLUSIONS The developed model may be of value for informing hypothesis formulation, study design, and discourse within the context of improvement in home care. Further work will include a broader group of stakeholders to reduce the risk of bias. Translation into a quantitative model will be explored.
Research Square (Research Square), Jun 26, 2023
Aim To investigate and describe the process of using Experience-based Co-design (EBCD) to adapt a... more Aim To investigate and describe the process of using Experience-based Co-design (EBCD) to adapt and develop mobile/tablet applications to support a person-centred and empowering stroke rehabilitation. Setting Two cross-sectoral stroke rehabilitation settings in Denmark comprising six rehabilitation units. Participants Stroke survivors (n=23), signi cant others (n=18), occupational therapists (n=12), physiotherapists (n=9), representative of a patient organization (n=1), application developers (n=3) and researchers (n=2). Method A structured, facilitated EBCD approach comprising six stages was used to co-produce a service that aimed to address the priorities and needs of all relevant end-users. Data were collected by interviews, participant observations, notes on " ip sheets" and written feedback on the content in the apps and on the instruction pages. Data were analyzed descriptively and with a constructivist grounded theory analysis. Results The application platforms "Mit Sygehus" and "Genoptraen.dk" were adapted and new functions were developed to support the needs identi ed by all end-users. Relevant evidence-based knowledge, person-centred exercises and guidelines using video recordings were the most important among the developed solutions in the applications to support person-centred and empowering stroke rehabilitation. Furthermore, easy, and seamless communication were considered important. Conclusions EBCD facilitated the adaptation and development of applications to support a person-centred and empowering stroke rehabilitation. Participants experienced that their contribution was considered important and valued.
JMIR human factors, Jun 30, 2023
Journal of Rehabilitation Medicine, May 18, 2022
Objective: To compare changes in the perceived impact of stroke on everyday life over time in a r... more Objective: To compare changes in the perceived impact of stroke on everyday life over time in a rehabilitation sample that received a client-centred activities of daily living (CADL) intervention or usual ADL (UADL) intervention. Design: Longitudinal follow-up of a randomized controlled trial. Methods: A total of 145 persons with stroke were assigned into CADL or UADL. Groups were assessed using the Stroke Impact Scale (SIS) at 3 months, 12 months and 5 years post-intervention. Changes in SIS domain scores over time were compared within and between groups. Results: Changes in the impact of stroke over time were not related to which intervention the groups received. There were no significant differences in the SIS domains or stroke recovery between groups at the 3-month, 12-month and 5-year follow-ups. Despite an increased impact of stroke over time in some domains in both groups, both groups perceived a decreased impact of stroke in the Participation domain at 12 months. Perceived participation was sustained at the same level at 12 months as at 5 years in both groups. Conclusion: These findings stress the importance of access to follow-up rehabilitation interventions 1-year post-stroke to enable participation in daily activities. Such follow-up and enablement would support the use of self-management strategies in the performance of persons' valued activities, which might be difficult to perform, due to, for example, impact on hand function or mobility. The results of this study emphasize the importance of prioritizing participation in activities that are meaningful from a personal perspective.
BMC Health Services Research, Dec 29, 2022
The author group has been updated above and the original article [1] has been corrected.
Disability and Rehabilitation, Apr 9, 2019
The use of information and communication technology in healthcare to improve participation in eve... more The use of information and communication technology in healthcare to improve participation in everyday life: a scoping review, Disability and Rehabilitation,
Scandinavian Journal of Occupational Therapy, Mar 4, 2022
Background: Information and communication technology (ICT) has been proven to have effect in term... more Background: Information and communication technology (ICT) has been proven to have effect in terms of providing alternative ways to deliver rehabilitation services. The intention with this paper is to serve as a foundation for discussions regarding the future development, design, and delivery of home-based rehabilitation, including ICT.Aim: To reflect on and discuss the possibilities and challenges of using ICT in home-based rehabilitation services.Method and material: We use experiences and results from various projects to reflect on and discuss possibilities and challenges related to the use of ICT in home-based rehabilitation.Findings and discussion: We exemplify how ICT present new possibilities that can increase the quality of the rehabilitation process and improve access to services. We reflect on some challenges in the use of ICT, related to non-user-friendly solutions, to the specific rehabilitation situation, and a lack of technical support. At an organisational level, readiness to use ICT can impact the extent to which new solutions are integrated into practice.Conclusion: We emphasise that ICT has the potential to develop and improve service delivery and contribute to increased quality and accessibility of home-based rehabilitation.
Journal of Rehabilitation Medicine, Apr 7, 2022
G lobally, stroke is a major cause of disability (1). Furthermore, as a consequence of improved m... more G lobally, stroke is a major cause of disability (1). Furthermore, as a consequence of improved medical care, with decreasing mortality rates and an ageing population, the number of people living with the consequences of stroke is likely to increase (2-4). Although most stroke survivors' recovery takes place largely during the first 3-6 months, the impact of the stroke and the need for rehabilitation may continue for years (2, 5). Long-term consequences, such as physical, cognitive, social and emotional deficits, can result in dependence and reduced participation in everyday life (3, 6, 7). Stroke severity can be categorized as mild, moderate, or severe in relation to cognitive, motor, sensory, and speech-related impairments (8).
International Journal of Environmental Research and Public Health
Incorporating and sustaining engaging everyday activities (EEAs) in everyday life holds potential... more Incorporating and sustaining engaging everyday activities (EEAs) in everyday life holds potential for improving health and wellbeing; thus, there is reason to explore EEAs as a behavioral change technique in stroke prevention. The aim of this study was to evaluate the feasibility of the stroke prevention program Make My Day (MMD) for people with moderate-to-high risk for stroke in a primary healthcare setting, where EEAs are utilized to promote healthy activity patterns. A randomized controlled pilot trial was designed to evaluate the feasibility of MMD. Twenty-nine persons at risk for stroke were recruited and randomized into either an intervention group (n = 14) receiving MMD or a control group (n = 15) receiving brief health advice and support with goal setting. The results suggest that MMD is feasible, with timely recruitment, overall high response rates and study completion, and sensitivity to change in key outcome measures. Moreover, the results demonstrate that the applicatio...
BMC Public Health
Background The global burden of stroke is increasing and persons with low socioeconomic status ar... more Background The global burden of stroke is increasing and persons with low socioeconomic status are among those worst affected. In Uganda, stroke is estimated to be the sixth highest ranking cause of death. The Ugandan healthcare system is reported to be inequitable, where poorer populations often live in rural areas with long distances to health care. Stroke rehabilitation is often scarce, with less financial and human resources. The aim of this study was to explore and describe the consequences of stroke in daily activities in everyday life for people in a rural part of Masaka in Uganda. Methods Qualitative study design. Fourteen persons who had had stroke and were living in their home environment were interviewed about their experiences of having a stroke and managing their lives after the stroke incident. The interviews were analysed using thematic analysis. In addition, sociodemographic data and level of independence (Barthel Index and Stroke Impact Scale 3.0) was collected to d...
Topics in Stroke Rehabilitation
Policy Press eBooks, Jan 26, 2023
BMC Health Services Research
Background Home care staff (HCS) provide essential service to enable older adults to age in place... more Background Home care staff (HCS) provide essential service to enable older adults to age in place. However, unreasonable demands in the work environment to deliver a safe, effective service with high quality has a negative impact on the individual employee’s well-being and the care provided to the older adults. The psychosocial work environment is associated with employees´ well-being, although, knowledge regarding which individual and organisational factors that contribute to job strain for HCS is limited. These factors need to be identified to develop targeted interventions and create sustainable work situations for HCS. This study aimed to explore how HCS´s perceived job strain is associated with, and to what extent can be explained by, individual and organisational factors of the psychosocial work environment and psychosomatic health. Method An explorative cross-sectional questionnaire survey design was used in a large Swedish county. Five home care agencies with a total of 481 ...
Läkartidningen, Nov 8, 2022
The term frailty denotes a multi-dimensional syndrome characterised by reduced physiological rese... more The term frailty denotes a multi-dimensional syndrome characterised by reduced physiological reserves and increased vulnerability. Frailty may be used as a marker of biological age, distinct from chronological age. There are several instruments for frailty assessment. The Clinical Frailty Scale (CFS) is probably the most commonly used in the acute care context. It is a 9-level scale, derived from the accumulated deficit model of frailty, which combines comorbidity, disability, and cognitive impairment. The CFS assessment is fast and easy to implement in daily clinical practice. The CFS is relevant for risk stratification, and may also be used as a screening instrument to identify frail patients suitable for further geriatric evaluation, i.e. a comprehensive geriatric assessment (CGA). By providing information on long-term prognosis, it may improve informed decision-making on an individual basis.
Niels A. Lassen dagen 2017, Dec 7, 2017
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Papers by Susanne Guidetti