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A 10-year follow-up study on subjective well-being and relationships to person-environment (P-E) fit and activity of daily living (ADL) dependence of older Swedish adults.

https://arctichealth.org/en/permalink/ahliterature154920
Source
Arch Gerontol Geriatr. 2009 Jul-Aug;49(1):e16-22
Publication Type
Article
Author
Monica Werngren-Elgström
Gunilla Carlsson
Susanne Iwarsson
Author Affiliation
Department of Health Sciences, Lund University, Box 157, SE-221 00 Lund, Sweden.
Source
Arch Gerontol Geriatr. 2009 Jul-Aug;49(1):e16-22
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Aged, 80 and over
Environment
Female
Follow-Up Studies
Humans
Interpersonal Relations
Male
Middle Aged
Quality of Life - psychology
Questionnaires
Sweden
Abstract
In order to investigate how well-being and ill health is affected by the process of aging, the main aim was to investigate these self-perceived aspects of health over a 10-year period among older Swedish adults. The aim was also to study how these aspects correlated with objectively assessed functional limitations, use of mobility device, person-environment (P-E) fit (also denoted accessibility), problems in housing, and activity of daily living (ADL) dependence. Using the Swedish national population register, a baseline sample of persons aged 75-84 years was identified. Out of the 133 participants at baseline (1994), the 31 participants still available 10 years later were included. The data were collected by means of interview and observation at home visits. Overall, the participants rated their subjective well-being as high and a stable prevalence of ill-health symptoms over time was reported. Changes in subjective well-being as related to changes in functional aspects seem to mainly occur earlier in the aging process, while as time goes by these relations weaken. ADL dependence, however, is more influential in more advanced age. The results confirm the complexity of the construct of health. A main contribution is that the results shed light on the importance of taking the impact of environmental factors into consideration.
PubMed ID
18829123 View in PubMed
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Accessibility and usability in housing: construct validity and implications for research and practice.

https://arctichealth.org/en/permalink/ahliterature182854
Source
Disabil Rehabil. 2003 Dec 2;25(23):1316-25
Publication Type
Article
Date
Dec-2-2003
Author
Agneta Fänge
Susanne Iwarsson
Author Affiliation
Department of Clinical Neuroscience, Division of Occupational Therapy, Lund University, Sweden. angeta.fange@arb.lu.se
Source
Disabil Rehabil. 2003 Dec 2;25(23):1316-25
Date
Dec-2-2003
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Adult
Age Factors
Aged
Aged, 80 and over
Architectural Accessibility
Disabled Persons
Female
Housing
Humans
Male
Middle Aged
Questionnaires
Residence Characteristics
Sex Factors
Sweden
Abstract
The aim of this study was to validate the conceptual definitions of accessibility and usability, and to explore differences between objective accessibility assessments and subjective ratings of usability in different client groups.
The Housing Enabler and the Usability in My Home instruments were used for 131 persons above 18 years of age, living in ordinary housing and receiving a housing adaptation grant. Covariation between accessibility in four different housing sections and three different usability aspects were explored, for the total sample and for six sub-samples reflecting person-environment-activity transactions or demographic factors.
Significant correlations were found in the total sample, among clients aged 75-84, women, clients living alone, as well as among clients with high dependence in personal and instrumental ADL and in outdoor activities. Subjective usability evaluations of activity aspects and physical environmental aspects were correlated to accessibility indoors and outdoors, while personal and social aspects of usability were correlated to outdoor accessibility.
Accessibility and usability are concluded to be different but related concepts. The results indicate that e.g. age, civil status and ADL dependence affect how clients assess aspects of their housing situation. For efficient planning and evaluation of housing adaptations, assessment of housing accessibility, usability, and dependence in ADL is recommended.
PubMed ID
14617438 View in PubMed
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Accessibility to the public environment as perceived by teenagers with functional limitations in a south Swedish town centre.

https://arctichealth.org/en/permalink/ahliterature190137
Source
Disabil Rehabil. 2002 Apr 15;24(6):318-26
Publication Type
Article
Date
Apr-15-2002
Author
Agneta Fänge
Susanne Iwarsson
Asa Persson
Author Affiliation
Department of Clinical Neuroscience, Division of Occupational Therapy, Lund University, Sweden. agneta.fange@arb.lu.se
Source
Disabil Rehabil. 2002 Apr 15;24(6):318-26
Date
Apr-15-2002
Language
English
Publication Type
Article
Keywords
Adolescent
Adolescent Psychology
Architectural Accessibility
Disabled Persons - psychology
Humans
Interviews as Topic
Public Facilities - standards
Sweden
Abstract
Owing to physical inaccessibility persons with mobility restrictions and other functional limitations often face problems in public environments, leading to restrictions in activity and participation. To investigate general accessibility and perceived problems of accessibility to the public environment in a town centre, as well as visiting preferences to public facilities, among teenagers with functional limitations.
An interview questionnaire specific to a south Swedish town was constructed and used with 33 Swedish teenagers with functional limitations.
To a varying degree, all 33 teenagers commented on accessibility problems, e.g. concerning uneven surface material outdoors, steps at entrances, heavy doors and restricted space indoors. The results also indicated that teenagers with functional limitations to a high extent want to visit the same environments as other teenagers, but that it is often impossible owing to accessibility problems. Furthermore, because of accessibility problems, many of the teenagers were dependent on personal assistance.
Inaccessibility results in dependence, which might affect personal development negatively, and much effort are required in order to ensure activity and societal participation. Efficient priorities in public environment accessibility matters and discussions with the actors involved require valid and reliable data on local accessibility problems.
PubMed ID
12017465 View in PubMed
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Aspects of housing and perceived health among ADL independent and ADL dependent groups of older people in three national samples.

https://arctichealth.org/en/permalink/ahliterature113316
Source
Aging Clin Exp Res. 2013 Jun;25(3):317-28
Publication Type
Article
Date
Jun-2013
Author
Signe Tomsone
Vibeke Horstmann
Frank Oswald
Susanne Iwarsson
Author Affiliation
Department of Health Sciences, Faculty of Medicine, Lund University, Box 157, 221 00, Lund, Sweden. Signe.Tomsone@med.lu.se
Source
Aging Clin Exp Res. 2013 Jun;25(3):317-28
Date
Jun-2013
Language
English
Publication Type
Article
Keywords
Activities of Daily Living - psychology
Aged
Aged, 80 and over
Aging - psychology
Dependency (Psychology)
Female
Geriatric Assessment
Germany
Health status
Housing
Humans
Independent Living - psychology
Latvia
Male
Regression Analysis
Residence Characteristics
Self Concept
Sweden
Abstract
Good housing solutions are important for the ageing population in order to promote health and maintain functional ability. The objective of this study was to investigate whether and how objective and perceived aspects of housing were related to perceived health among ADL independent and ADL dependent groups of older, single-living people within three national samples.
The current study was based on national samples (German, n = 450; Latvian, n = 303; Swedish, n = 397) from the European ENABLE-AGE Project, using data on ADL dependence, perceived health, objective and perceived aspects of housing. Descriptive statistics, correlations and multivariate ordinal regression models were used to analyze the data.
The participants in the ADL dependent groups generally were older, had more functional limitations and perceived their health as poorer compared to ADL independent groups. With regard to perceived housing, usability as well as meaning of home indicators was often lower in the ADL dependent groups, housing satisfaction was at the same level while housing-related external control beliefs were higher. The differences among the national samples were highly significant for both ADL groups, for all variables except number of outdoor environmental barriers in the ADL independent groups. The relations between perceived health on one hand and objective and perceived aspects of housing on the other show great diversities among the ADL groups and the national samples.
The results serve to alert health care practitioners that it is important to draw attention to how older people perceive their housing situation and to the fact that different levels of functional independence demand different interventions.
PubMed ID
23740591 View in PubMed
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Aspects of quality of life in persons with pre-lingual deafness using sign language: subjective wellbeing, ill-health symptoms, depression and insomnia.

https://arctichealth.org/en/permalink/ahliterature45903
Source
Arch Gerontol Geriatr. 2003 Jul-Aug;37(1):13-24
Publication Type
Article
Author
Monica Werngren-Elgström
Ove Dehlin
Susanne Iwarsson
Author Affiliation
Department of Clinical Neuroscience, Division of Occupational Therapy, Lund University, Box 157, SE-221 00 Lund, Sweden. mwe@arb.lu.se
Source
Arch Gerontol Geriatr. 2003 Jul-Aug;37(1):13-24
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Analysis of Variance
Chi-Square Distribution
Deafness - psychology
Depression - epidemiology - psychology
Female
Health status
Humans
Male
Prevalence
Psychiatric Status Rating Scales
Quality of Life
Research Support, Non-U.S. Gov't
Sign Language
Sleep Initiation and Maintenance Disorders - epidemiology - psychology
Sweden - epidemiology
Abstract
This study investigated health-related quality of life, expressed as subjective wellbeing and the prevalence of depressive symptoms and insomnia, among elderly pre-lingually deaf persons using sign language. Comparisons were made with elderly hearing people. Forty-five pre-lingually deaf persons, 65 years or older, took part (a response rate of 46%). Subjective wellbeing was assessed with the Gothenburg Quality of Life (GQL) instrument. Depressive symptoms were rated with the 15-item version of the geriatric depression scale (GDS), and insomnia was measured with Livingston's sleep scale. Ratings of subjective wellbeing among elderly pre-lingually deaf people were generally high. One third of the deaf persons demonstrated depressive symptoms and nearly two thirds suffered from insomnia. There was substantial correlation between insomnia, depressive symptoms and lower subjective wellbeing. The results strengthened the assumption that depressive symptoms and sleep disturbance are more frequent among elderly pre-lingually deaf people using sign language than among hearing people. On the other hand, and contrary to our expectations, this did not imply significantly lower perceived subjective wellbeing compared with hearing elderly people. Results must be interpreted with caution due to limitations in the study.
PubMed ID
12849069 View in PubMed
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Challenges in implementation of research methodology in community-based occupational therapy: the Housing Enabler example.

https://arctichealth.org/en/permalink/ahliterature164602
Source
Scand J Occup Ther. 2007;14(1):54-62
Publication Type
Article
Date
2007
Author
Agneta Fänge
Ralf Risser
Susanne Iwarsson
Author Affiliation
Department of Health Sciences, Lund University, Lund, Sweden. agneta.fange@med.lu.se
Source
Scand J Occup Ther. 2007;14(1):54-62
Date
2007
Language
English
Publication Type
Article
Keywords
Architectural Accessibility
Environment Design
Housing
Humans
Marketing - organization & administration
Observer Variation
Occupational therapy
Organizations, Nonprofit
Research Design
Sweden
Abstract
This paper focuses on challenges in implementation of research in community-based occupational therapy practice. Based on a two-year project in a south Swedish municipality aiming at studying implementation of structured assessment procedures in the housing adaptation process, the first purpose is to provide a detailed project description, and the second is to report on first results identifying challenges in implementation of research in practice. The project was managed following a non-profit marketing model involving activities based on user needs, e.g. assessment training, support visits, and seminars with the users, i.e. occupational therapists. In order to collect data on implementation challenges, a multidimensional approach was utilized. Involving all occupational therapists in the municipality under study, 422 housing adaptation cases were assessed by means of the Housing Enabler. Good inter-rater reliability was demonstrated (kappa=0.62), but large differences between districts in the municipality were seen. Qualitative analyses of diaries, e-mail correspondence and minutes from workshops and seminars elucidated three categories reflecting research implementation challenges: Utilizing research in practice is not straightforward; Utilizing information technology is demanding; and Establishing cooperation and communication is challenging. The results can be utilized for planning of research implementation projects in practice not used to scientific work.
PubMed ID
17366078 View in PubMed
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Changes in accessibility and usability in housing: an exploration of the housing adaptation process.

https://arctichealth.org/en/permalink/ahliterature174266
Source
Occup Ther Int. 2005;12(1):44-59
Publication Type
Article
Date
2005
Author
Agneta Fänge
Susanne Iwarsson
Author Affiliation
Division of Occupationanl Therapy, Lund University, Lund, Sweden. aaf@arb.lu.se
Source
Occup Ther Int. 2005;12(1):44-59
Date
2005
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Adult
Aged
Aged, 80 and over
Data Collection
Disabled Persons
Environment Design
Facility Design and Construction
Female
Housing - standards
Humans
Male
Middle Aged
Occupational therapy
Self-Help Devices
Sweden
Abstract
The purpose of a housing adaptation is to enhance daily activities and to improve housing accessibility and usability by removing physical barriers in the home. The aim of this study was to investigate longitudinal changes in housing accessibility among clients receiving grants for housing adaptations. Baseline assessments were administered one month before the housing adaptation, with the first follow-up after two to three months, and the second follow-up after eight to nine months. The Housing Enabler and the Usability in My Home instruments were used to collect data from 131 consecutively enrolled clients living in general housing. Accessibility and usability improved significantly, the number of physical environmental barriers decreased and dependence on mobility devices increased, but at different times along the process. The results indicate the complexity of the housing adaptation process and the need to consider person-environment interactions over time. The methodology seems useful for quality development of assessment, intervention and evaluation processes in housing adaptations performed by occupational therapists.
PubMed ID
15962699 View in PubMed
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Changes in ADL dependence and aspects of usability following housing adaptation--a longitudinal perspective.

https://arctichealth.org/en/permalink/ahliterature174235
Source
Am J Occup Ther. 2005 May-Jun;59(3):296-304
Publication Type
Article
Author
Agneta Fänge
Susanne Iwarsson
Author Affiliation
Division of Occupational Therapy, Lund University, PO Box 157, S-221 00 Lund, Sweden. aaf@arb.lu.se
Source
Am J Occup Ther. 2005 May-Jun;59(3):296-304
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Adult
Aged
Aged, 80 and over
Female
Financing, Government
Housing
Humans
Longitudinal Studies
Male
Middle Aged
Occupational therapy
Sweden
Abstract
To investigate longitudinal changes in activities of daily living (ADL) dependence and aspects of usability in housing among clients receiving housing adaptation grants in Sweden.
The ADL Staircase and the Usability in My Home instruments were used to collect data on three occasions: at baseline 1 month before housing adaptation, at follow-ups 2 to 3 months after housing adaptation completion, and after another 6 to 7 months. In all, 131 clients, living in ordinary housing 24 to 93 years of age were consecutively enrolled.
Overall ADL dependence did not change significantly whereas dependence in "Bathing" decreased over time. "Activity aspects" and "Personal and social aspects" of usability improved at different phases in the process.
This study delivers new insights about the complexity of longitudinal person-environment-activity transactions, specifically targeting activity and usability. The results are useful for developing efficient strategies for evaluating housing adaptations within occupational therapy practice and research.
PubMed ID
15969277 View in PubMed
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Community Relocation in Very Old Age: Changes in Housing Accessibility.

https://arctichealth.org/en/permalink/ahliterature274575
Source
Am J Occup Ther. 2016 Mar-Apr;70(2):7002270020p1-9
Publication Type
Article
Author
Marianne Granbom
Björn Slaug
Charlotte Löfqvist
Frank Oswald
Susanne Iwarsson
Source
Am J Occup Ther. 2016 Mar-Apr;70(2):7002270020p1-9
Language
English
Publication Type
Article
Keywords
Aged, 80 and over
Architectural Accessibility
Environment
Environment Design
Female
Housing
Housing for the Elderly
Humans
Life Change Events
Longitudinal Studies
Male
Residence Characteristics
Surveys and Questionnaires
Sweden
Abstract
The objective of this study was to compare environmental barriers, housing accessibility, and usability before and after relocation of very old, single-living people in the community. It also examined whether accessibility improved after relocation compared with a simulated scenario in which participants would have remained in their former dwellings.
Data from the Swedish part of the longitudinal Enabling Autonomy, Participation, and Well-Being in Old Age: The Home Environment as a Determinant for Healthy Ageing database were analyzed with a before-and-after design (N = 29). Mean time from before to after data collection was 2.6 yr.
The number of environmental barriers was significantly reduced after relocation, especially barriers at entrances and in bathrooms. In addition, usability was stable and accessibility improved compared with the simulated scenario of remaining in the former dwelling.
Community-based moves to new dwellings may lead to fewer environmental barriers and stable levels of usability and accessibility. This relocation is a positive outcome, considering the expected functional decline in old age.
PubMed ID
26943110 View in PubMed
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Do Associations Between Perceived Environmental and Individual Characteristics and Walking Limitations Depend on Lower Extremity Performance Level?

https://arctichealth.org/en/permalink/ahliterature291084
Source
J Aging Health. 2017 Jun; 29(4):640-656
Publication Type
Comparative Study
Journal Article
Date
Jun-2017
Author
Ritva Sakari
Merja Rantakokko
Erja Portegijs
Susanne Iwarsson
Sarianna Sipilä
Anne Viljanen
Taina Rantanen
Author Affiliation
1 University of Jyvaskyla, Finland.
Source
J Aging Health. 2017 Jun; 29(4):640-656
Date
Jun-2017
Language
English
Publication Type
Comparative Study
Journal Article
Keywords
Activities of Daily Living
Aged
Aged, 80 and over
Cross-Sectional Studies
Disability Evaluation
Environment
Female
Geriatric Assessment - methods
Humans
Independent living
Interviews as Topic
Lower Extremity - physiopathology
Male
Mobility Limitation
Perception
Physical Fitness - physiology
Sweden
Task Performance and Analysis
Walking - physiology
Abstract
The aim of this study was to analyze whether the associations between perceived environmental and individual characteristics and perceived walking limitations in older people differ between those with intact and those with poorer lower extremity performance.
Persons aged 75 to 90 ( N = 834) participated in interviews and performance tests in their homes. Standard questionnaires were used to obtain walking difficulties; environmental barriers to and, facilitators of, mobility; and perceived individual hindrances to outdoor mobility. Lower extremity performance was tested using Short Physical Performance Battery (SPPB).
Among those with poorer lower extremity performance, the likelihood for advanced walking limitations was, in particular, related to perceived poor safety in the environment, and among those with intact performance to perceived social issues, such as lack of company, as well as to long distances.
The environmental correlates of walking limitations seem to depend on the level of lower extremity performance.
PubMed ID
27056910 View in PubMed
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50 records – page 1 of 5.