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  • 1.
    Ahlgren, Åsa
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Bergroth, Alf
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Ekholm, Jan
    Schüldt Ekholm, Kristina
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Selection of clients for vocational rehabilitation at six local social insurance offices.: a combined register and questionnaire study on rehabilitation measures and attitudes among social insurance officers.2008Ingår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 40, nr 3, s. 178-184Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: The aim of this study was to evaluate possible differences between local social insurance offices with regard to their selection of clients for vocational rehabilitation. A further aim was to determine whether social insurance officers from different local insurance offices have uniform attitudes regarding professional practice in their application of the insurance system. METHODS: A register-based investigation of 815 vocational rehabilitees served by 6 local social insurance offices in a Swedish county. The study was supplemented with a questionnaire to 30 officers about attitudes to social insurance. RESULTS: The office with the lowest rate of sick-listing periods exceeding one year, and a high frequency of employment training, showed the highest degree of work resumption and the lowest pension rate after vocational rehabilitation. There were wide differences in attitude among the local social insurance officers regarding professional practice in their application of the system. CONCLUSION: Intra-county differences occur in handling people on sick-leave who undergo vocational rehabilitation. The local social insurance offices with the highest and lowest outcome rates of work resumption and disability pension, respectively, select clients for vocational rehabilitation from different categories of cases. Social insurance officers from different local offices differ in their attitudes towards the social insurance system and its clients.

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  • 2.
    Björkman Randström, Kerstin
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Asplund, Kenneth
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Svedlund, Marianne
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Paulson, Margareta
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Activity and participation in home rehabilitation: Older people's and family members perspectives2013Ingår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 45, nr 2, s. 211-216Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To explore the experiences of older people and their supporting family members in relation to home rehabilitation, with a focus on activity and participation. Methods: Qualitative interviews were carried out with 6 older people and 6 family members at 1 and 6 months after the older person’s discharge to their home. Qualitative content analysis of the data was carried out. The International Classification of Functioning, Disability and Health provides a guiding framework for rehabilitation. Results: Informants’ experiences of home rehabilitation contributed to the formation of 6 categories: (i) living with a frail body; (ii) striving for well-being in daily life; (iii) being close at hand; (iv) feeling dependent in daily life; (v) struggling to carry on; and (vi) striving to be at home. Conclusion: Older people’s goals were to return to daily routines and to perform meaningful activities without feeling dependent on other people. Family members’ participation was crucial. Psychosocial support and autonomy were essential for facilitating activity and participation. Healthcare professionals should consider each individual’s unique experiences along with the significance of being at home.

  • 3.
    Björnhagen, Viveca
    et al.
    Karolinska University Hospital, Stockholm; Karolinska Institutet, Stockholm.
    Ekholm, Kristina Schüldt
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för hälsovetenskap. Karolinska Institutet, Danderyd University Hospital, Stockholm.
    Larsen, Flemming
    Karolinska Institutet, Stockholm; Karolinska University Hospital, Stockholm.
    Ekholm, Jan
    Danderyd University Hospital, Stockholm.
    Burn survivors' pulmonary and muscular impairment, exercise tolerance and return-to-work following medical-vocational rehabilitation: A long-term follow-up2018Ingår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 50, nr 5, s. 465-471Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To follow up the long-term outcome in return-to-work (RTW) rate in burn-injury patients, and to determine the degree of impairment in pulmonary and muscular function and exercise tolerance. Design: A prospective, longitudinal follow-up study without a control group. Patients: Twenty-five burn-injury patients referred for medical-vocational rehabilitation. Methods: Return-to-work rate was followed after completed medical-vocational rehabilitation. Pulmonary function was evaluated with spirometry, diffusing capacity and radio spirometry. Exercise capacity was determined using a bicycle ergometer. Muscle functions evaluated in the arms and legs were: isokinetic torque, isometric strength, endurance and muscular strength utilization. Results: Return-to-work rate was 87%. During bicycle exercise tests the patients, on average, reached their expected workloads. The dominating lung function abnormality observed on lung scintigraphy was delayed wash-out time of inhaled radioactive xenon gas, suggesting airway obstruction. All tests of shoulder-flexor and knee-extensor muscle function showed large minimum-maximum differences. Mean isometric endurance of shoulder flexors was lower than mean of references, and isokinetic knee extensor torques were slightly lower. Conclusion: High return-to-work rates can be achieved after burn injury requiring hospital-ward care. Despite measurable impairments in muscle strength/endurance and pulmonary function in a substantial proportion of these patients, overall normal bicycle exercise capacity was observed except for a few cases.

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  • 4. Ekholm, Jan
    et al.
    Ekholm Schudt, Kristina
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Vocational rehabilitation: Editorial2009Ingår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 41, nr 3, s. 113-114Artikel i tidskrift (Övrigt vetenskapligt)
  • 5.
    Kärrholm, Jenny
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Ekholm, Karolina
    Jakobsson, Björn
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Ekholm, Jan
    Bergroth, Alf
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Schüldt Ekholm, Kristina
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Systematic co-operation between employer, occupational health service and social insurance office: A 6-year follow-up of vocational rehabilitation for people on sick-leave, including economic benefits2008Ingår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 40, nr 8, s. 628-636Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To evaluate the effects of systematic co-operation among municipal employees on the number of sick-leave days per month and the type of benefit granted by the Social Insurance Office. A further aim was to evaluate the economic consequences for society.Design: A 6-year follow-up study with a matched-pairs design.Methods: Days on sick-leave were calculated for each subject one year before the intervention started and yearly for the following 6-year period. Statistical mixed-model analysis was used. The economic benefit of the intervention was estimated as the increased production stemming from fewer days on sick-leave.Subjects: Sixty-four employees on long-term sick-leave were individually matched with controls from another Social Insurance Office in a county with a socioeconomic structure similar to that of the study group.Results: The study group had 5.7 fewer days on sick-leave per month and person over the 6-year period (p=0.003). The estimated average economic benefit of the intervention was (sic)36,600 per person over the 6-year period. In conclusion, those who received systematic co-operation in vocational rehabilitation had fewer days on sick-leave than their "treatment-as-usual" peers. This effect persisted over 6 years, generating substantial net economic gains for society.

  • 6.
    Landstad, Bodil J
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Schuldt, K
    Karolinska Inst, Dept Publ Hlth Sci, Div Rehabil Med, Stockholm.
    Ekholm, J
    Karolinska Inst, Dept Publ Hlth Sci, Div Rehabil Med, Stockholm.
    Broman, L
    Karolinska Inst, Dept Publ Hlth Sci, Div Rehabil Med, Stockholm.
    Bergroth, Alf
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Women at work despite ill health: Diagnoses and pain before and after personnel support - A prospective study of hospital cleaners/home-help personnel with comparison groups2001Ingår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 33, s. 216-224Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The present study sought to elicit the diagnoses behind the pain conditions causing complaints by female hospital cleaners and home-help personnel who were working despite their symptoms. We also wished to describe the prevalence of musculoskeletal diagnoses and the intensity, frequency and location of pain, and changes in the clinical picture and pain after personnel supporting interventions. A prospective study was carried out with intervention groups and non-randomized comparison groups. The hospital cleaners intervention programme comprised occupational organizational measures, competence development, physical and psychosocial working environmental measures and individual and rehabilitation measures on both an individual and a group basis. The home-help programme comprised a 2-week stay at an orthopaedic rehabilitation unit, training of supervisors, comrade massage, purchase of training equipment and stress management. Myalgia/tendinitis occurred in 61% of shoulder girdle elevators, 18% of rotator cuffs, 16% of dorsal neck muscles and 29% of hip muscles. There was musculoskeletal pain in the lower back in 28% of cases. Referred pain from a musculoskeletal focus occurred in about one-sixth to one-third of individuals with the diagnosis in question. Neurogenic pain occurred in 6% of cases. No fibromyalgia syndrome was found. One-third of individuals felt pain all the time or almost all the time. The mean rated perceived “worst pain” was 70 mm on a visual analogue scale of 1-100 mm. Comparisons between intervention and reference groups indicated that some improvement in the clinical picture can be attained using this kind of general support programme for employees.

  • 7.
    Marnetoft, Sven-Uno
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Selander, J
    Bergroth, Alf
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för hälsovetenskap.
    Ekholm, J
    Factors associated with successful vocational rehabilitation in a Swedish rural area2001Ingår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 33, s. 71-78Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The objective of this study was to identify factors associated with a positive outcome of vocational rehabilitation, and to identify groups that have been successfully rehabilitated in a Swedish rural area. In this study vocational rehabilitation is defined as medical multidisciplinary, psychological, social and occupational activities aiming to re-establish, among sick or injured people with previous work history, their working capacity and prerequisites for returning to the labour market. The study was based on 732 people on registered long-term sick-leave who, in a rural area in northern Sweden during 1992-94, became objects for vocational rehabilitation. Bivariate and stepwise logistic regression analysis was used to identify factors associated with the outcome. By successful vocational rehabilitation is meant reporting well (no economical benefit) at all three Lime-points 6, 12 and 24 months after termination of rehabilitation, or lowered benefit levels. The results indicate that younger, male, employed persons, with an early start on rehabilitation, in a programme entailing education, and partly sick-listed before the start of this programme, had the greatest chance of successful rehabilitation. In contrast, older, female, unemployed people, with a delayed start on rehabilitation, without education, and fully sick-listed before the start, greatly risked being unsuccessful with vocational rehabilitation. The results indicate how to improve the rehabilitation process: several process-related factors shown to be connected with successful vocational rehabilitation include time before the start of rehabilitation, partial instead of full sickness benefit, and education programmes.

  • 8.
    Styrke, Johan
    et al.
    Umea Univ, Dept Surg & Perioperat Sci, Div Surg, SE-90185 Umea, Sweden.
    Sojka, Peter
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för hälsovetenskap.
    Bjornstig, Ulf
    Umea Univ, Dept Surg & Perioperat Sci, Div Surg, SE-90185 Umea, Sweden.
    Bylund, Per-Olof
    Umea Univ Hosp, Emergency & Disaster Med Ctr, S-90185 Umea, Sweden.
    Stålnacke, Britt-Marie
    Umea Univ, Dept Community Med & Rehabil, SE-90185 Umea, Sweden.
    SEX DIFFERENCES IN SYMPTOMS, DISABILITY AND LIFE SATISFACTION THREE YEARS AFTER MILD TRAUMATIC BRAIN INJURY: A POPULATION-BASED COHORT STUDY2013Ingår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 45, nr 8, s. 749-757Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To investigate sex differences in symptoms, structure of symptoms, disability and life satisfaction 3 years after mild traumatic brain injury. Secondary aims were to find risk factors for adverse outcome. Design: Population-based cohort study. Patients: The cohort comprised 137,000 inhabitants at risk in a defined population served by a single hospital in northern Sweden. Patients attending the emergency department following a mild traumatic brain injury in 2001 were included. Methods: Of 214 patients aged 18-64 years, 163 answered a questionnaire on symptoms, disability, and life-satisfaction 3 years post-injury. The instruments were analysed with descriptive statistics. A principal component analysis of the Rivermead Post-Concussion Symptoms Questionnaire was conducted. Risk factors were identified using logistic regression. Results: Post-concussion syndrome was found in 50% of the women and 30% of the men. Disability was found in 52% of the women and 37% of the men, and 57% of the women and 56% of the men were satisfied with their lives. For both genders, high frequency of symptoms was a risk factor for disability and low life satisfaction. Back pain was a risk factor for disability. Living alone was a risk factor for low levels of life satisfaction. The principal component analysis revealed differences between the sexes. Conclusion: There are sex differences in outcome 3 years after mild traumatic brain injury. Women and men should be analysed separately.

  • 9.
    Svensson, G. L.
    et al.
    Department of Orthopaedics, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden .
    Wendt, G. K.
    Department of Orthopaedics, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden .
    Thomeé, R.
    Department of Orthopaedics, Institute of Clinical Sciences, University of Gothenburg, Gothenburg, Sweden .
    Danielson, Ella
    Mittuniversitetet, Fakulteten för humanvetenskap, Avdelningen för omvårdnad.
    Patients' experience of health three years after structured physiotherapy or surgery for lumbar disc herniation2013Ingår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 45, nr 3, s. 293-299Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To describe the experience of health among patients 3 years after treatment with a structured physiotherapy model or surgery for lumbar disc herniation. Design: A qualitative research study. Subjects/patients: Patients were referred to the orthopaedic clinic at Sahlgrenska University Hospital with sciatica due to lumbar disc herniation. Twenty patients who were eligible for surgery were treated either with a structured physiotherapy model or with surgery. Methods: Open-ended interviews were conducted and analysed using content analysis. Results: Findings were grouped into two themes: feeling of well-being and feeling of ill-being. In the group treated with structured physiotherapy there were a high number of codes in the feeling of well-being theme. In the group treated with surgery there were a high number of codes in the feeling of ill-being theme. Conclusion: Patients treated with structured physiotherapy or surgery experienced feelings of well-being and ill-being 3 years after treatment. Patients treated with physiotherapy and surgery described varying experiences of health 3 years after treatment for lumbar disc herniation. It can be speculated that the experience of well-being may be explained by the ability of structured physiotherapy treatments to empower patients.

  • 10.
    Söderman, Eva
    et al.
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för samhällsvetenskap.
    Lisspers, Jan
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för samhällsvetenskap.
    Sundin, Örjan
    Mittuniversitetet, Fakulteten för humanvetenskap, Institutionen för samhällsvetenskap. Karolinska Institute, Stockholm.
    Impact of Depressive Mood on Lifestyle Changes in Patients with Coronary Artery Disease2007Ingår i: Journal of Rehabilitation Medicine, ISSN 1650-1977, E-ISSN 1651-2081, Vol. 39, nr 5, s. 412-417Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    OBJECTIVE: The aims of this study were to investigate the time-course of depressive mood in patients with coronary artery disease during a secondary prevention rehabilitation program, and to analyse how different pre-treatment levels of depressive mood during a treatment phase were related to the degree of lifestyle change at 36 months follow-up. SUBJECTS: The study group comprised 109 of the original 183 consecutive coronary artery disease patients (91 male and 18 female) of whom 48 recently had experienced an acute myocardial infarction, 36 had been treated with coronary bypass surgery, 13 with percutaneous transluminal coronary angioplasty, and 12 had angina pectoris that had not been invasively treated. The subjects were divided into 3 subgroups based on their pre-treatment level of depressive mood. METHODS: Depressive mood was assessed at baseline, after 4 weeks and 12 months, using the depression subscale of the Hospital Anxiety and Depression scale. Lifestyle changes analysed included diet, smoking, relaxation (stress management) and exercise. RESULTS: Overall depressive mood ratings were significantly lower, both at the 4-week and 12-month assessments, compared with baseline, with the greatest improvements in patients with higher Hospital Anxiety and Depression measured depression. Original levels of depressive mood were not found to influence change of lifestyle habits during a 36-month follow-up period. CONCLUSION: Depressive mood might not be an obstacle to lifestyle changes when participating in a behaviourally oriented rehabilitation program including exercise-training, which might be a component important for improved depressive mood.

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