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Örebro, Sweden

Forsberg A.,Family Medicine Research Center | Forsberg A.,Orebro University | Nilsaga rd Y.,Orebro University | Nilsaga rd Y.,Center for Health Care science | Bostrom K.,Orebro County Council
Disability and Rehabilitation | Year: 2015

Purpose: Our aim was to describe experiences of using Nintendo Wii Fit™ for balance exercise, from the perspectives of patients with multiple sclerosis (MS) and their physiotherapists (PT). Methods: Individual interviews with 15 patients with MS were conducted, recruited from a multi-centre study investigating the effects of balance exercising using Wii Fit. We also conducted a single focus group interview with nine PT involved in the study. The interviews were audio-recorded, transcribed, and analysed using content analysis. Results: Both patients and PT said that exercising with Wii Fit games was fun, and that it challenged the patients' physical and cognitive capacities. The competitive content in the games provided motivation to continue playing. Patients and PT reported improved body control and, more importantly, positive effects on balance and walking in daily life. The PT regarded Wii training as an effective alternative to other balance training, but some felt unsure in how to manage the video game. The patients regarded Wii training as a possible home training solution. Conclusions: Patients with MS and their PT considered Wii Fit exercises to be fun, challenging, and self-motivating. Exercising with Wii games can address balance impairments in MS, and can be performed at home as well as in rehabilitation settings. Implications for Rehabilitation • Nintendo Wii Fit™ can be used as a fun and challenging way to perform balance exercises. • The competitive content embedded in the games triggers continued playing and exercising. • The positive effect on balance control can improve standing and walking in everyday activities. © 2015 Informa UK Ltd. All rights reserved. Source


Brunnberg E.,Malardalen University | Bostrom M.L.,Orebro County Council | Berglund M.,Lund University
Child Abuse and Neglect | Year: 2012

The aims of this study are first to compare the incidence of force on the first occasion of sexual intercourse reported by participants with disabilities to that of students without disabilities; second to determine whether there are significant differences in mental health, substance abuse, and school performance as reported by participants forced into their sexual debut as opposed to those who were not forced, analysed by gender; and finally to identify the significant variables that predict girls reporting force at sexual debut as opposed to girls not reporting force, as well as to identify similar variables within the male group. There were no data on sexual abuse prior to the first occasion of full sexual intercourse. Method: This cross-sectional study is based on 2 surveys: Life and Health---Young People 2005 and 2007. All 17/18-year-old adolescents in upper-secondary schools in a county in Sweden were asked the same questions both years. A total of 2,254 students completed the survey in 2005 and 2,641 in 2007. Results: The main finding is that force at sexual debut (intercourse) is more common among adolescents with a disability (4.0%) than those not reporting any disability (1.6%), and is most common among those reporting multiple disabilities (10.4%). This was found both for girls and boys, even if the rates for girls were several times higher. Other findings are that girls and boys reporting force at sexual debut (disability and non-disability groups taken together) reported different profiles. For girls, their country of origin and who they live with are significant. This background data is not significant for boys. Boys report a strong psychosomatic reaction. Conclusion: Culture-, functionality-, and gender-sensitive studies of adolescents' reactions to sexual abuse are needed to help determine relevant and effective interventions. © 2012 Elsevier Ltd. Source


Wallin A.-M.,Orebro County Council | Wallin A.-M.,Health Science University | Ahlstrom G.,Health Science University
Scandinavian Journal of Caring Sciences | Year: 2010

Objective: Being diagnosed as having a chronic disease gives rise to emotions. Beliefs about health are culturally constructed and affect people's decisions regarding treatment. No studies have been reported that focus on the health beliefs of immigrants of Somalian origin with diabetes and how these people experiences the diagnosis. Therefore the aim of the present study was to investigate how immigrants from Somalia living in Sweden experienced receiving the diagnosis and describe their beliefs about health. Method: The sample consisted of 19 adults with diabetes born in Somalia and now living in Sweden who were interviewed with the aid of an interpreter. The interviews were subjected to qualitative content analysis. Results: From the analysis of what the participants said about their experiences of the diagnosis there emerged three themes: 'Existential brooding', 'Avoiding the diagnosis' and 'Accepting what is fated'. Three themes also emerged from the analysis of what they said about beliefs about health: 'Health as absence of disease', 'Health as general well-being' and 'Fated by a higher power'. A major finding was that women when they communicated their experiences regarding the diagnosis and health beliefs made more use of supernatural beliefs than men did. The participants, irrespective of gender, did not immediately respond with shock or other strong emotion when they received the diagnosis. Conclusions: The study provides health-care staff with knowledge concerning a minority group's experiences of being diagnosed as having diabetes and their beliefs about health. The findings indicate that men and women differ in how they experiences the diagnosis and how they described their health beliefs. The quality improvement of health education and nursing for patients with diabetes calls for consideration of the variation of beliefs related to cultural background and gender. © 2010 The Authors. Journal compilation © 2010 Nordic College of Caring Science. Source


Astrom A.N.,University of Bergen | Ekback G.,Orebro County Council | Nasir E.,University of Bergen | Ordell S.,Dental Commissioning Unit Ostergotland County Council | Unell L.,Malmo University
Community Dentistry and Oral Epidemiology | Year: 2013

Objectives Focusing on a Swedish 1942 birth cohort, this study describes the trend of dental health care utilization between age 50 and 65 and identifies major determinants of dental visiting habits using Andersen's model as adapted for dentistry as a theoretical framework. Method In 1992, a census of 50 year olds in two counties of Sweden was invited to participate in a longitudinal questionnaire survey. Of the total population of 8888 subjects, 6346 responded (71%). Of the 6346 subjects who completed the 1992 survey, 4143 (65%) completed postal follow ups in 1997, 2002 and 2007. Results 83.3% and 3.2% of the cohort remained stable with respect to use and nonuse of regular dental care. Cochran's Q test revealed that the proportions reporting regular use decreased from 93% at age 50-87% at age 65 (P < 0.001). Generalized estimated equations revealed the following covariates; gender (females), country of birth (native born), marital status (married), perceived quality of dental care (good perceptions), dental care utilization as a child, remaining teeth and perceived oral problems. The influence of the variable time, functioning as a measure of period/ageing, maintained a statistically significant relationship with regular utilization after adjusting for all covariates in the model. Conclusion Regular use of dental health care services decreased slightly but statistically significantly from age 50 to 65 and was most prevalent in socio-economically advantaged groups, among those with remaining own teeth, subjects who perceived oral problems and reported high quality dental care. The results have implications for planning of elderly dental health care and required dental workforce in Sweden and countries with similar welfare systems. © 2012 John Wiley & Sons A/S. Source


Hagberg L.A.,Orebro County Council | Hagberg L.A.,Umea University | Lindholm L.,Umea University
Cost Effectiveness and Resource Allocation | Year: 2010

Background: The cost of time spent on exercise is an important factor in societal-perspective health economic analyses of interventions aimed at promoting physical activity. However, there are no existing measuring methods for estimating time costs. The aim of this article is to describe a way to measure the costs of time spent on physical activity. We propose a model for measuring these time costs, and present the results of a pilot study applying this model to different groups of exercisers.Methods: We began this investigation by developing a model for measuring the time spent on exercise, based on the most important theoretical frameworks for valuing time. In the model, the value of utility in anticipation (expected health benefits) of performing exercise is expressed in terms of health-related quality of life. With this approach, the cost of the time spent on exercise is defined as the value of utility in use of leisure activity forgone minus the value of utility in use of exercise. Utility in use for exercise is valued in comparison with utility in use for leisure activity forgone and utility in use for work.To put the model into practice, we developed a questionnaire with the aim of investigating the valuations made by exercisers, and applied this questionnaire among more experienced and less experienced exercisers.Results: Less experienced exercisers valued the time spent on exercise as being equal to 26% of net wages, while more experienced exercisers valued this time at 7% of net wages (p < 0.001). The higher time costs seen among the less experienced exercisers correlated to a less positive experience of exercise and a more positive experience of the lost leisure activity. There was a significant inverse correlation between the costs of time spent on exercise, and the frequency and duration of regular exercise.Conclusion: The time spent on exercise is an important factor in interventions aimed at promoting physical activity, and should be taken into consideration in cost-effectiveness analyses. The proposed model for measuring the costs of the time spent on exercise seems to be a better method than the previously-used assumptions of time costs. © 2010 Hagberg and Lindholm; licensee BioMed Central Ltd. Source

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