Karen La Cour - Academia.edu (original) (raw)
Papers by Karen La Cour
Advances in rehabilitation science and practice, 2024
BMJ Supportive & Palliative Care
ObjectivesTo identify and investigate different cohorts of cancer patients’ use of physical rehab... more ObjectivesTo identify and investigate different cohorts of cancer patients’ use of physical rehabilitation and specialised palliative care (SPC) services, focusing on patients with incurable cancer and the impact of social vulnerability.MethodsThe sample originated from patients diagnosed during 2013–2018 and alive 1 January 2015. Use of physical rehabilitation and/or SPC units were identified from contacts registered in population-based administrative databases. Competing-risks regression models were applied to investigate disparities with regard to social vulnerability, disease duration, gender and age.ResultsA total of 101 268 patients with cancer were included and 60 125 survived longer than 3 years after their diagnosis. Among the 41 143 patients, who died from cancer, 66%, survived less than 1 year, 23% survived from 1 to 2 years and 11% survived from 2 to 3 years. Contacts regarding physical rehabilitation services appeared in the entire cancer trajectory, whereas contacts re...
British Journal of Occupational Therapy, Dec 1, 2010
Introduction: This explorative study aimed to chart the participation experiences of children wit... more Introduction: This explorative study aimed to chart the participation experiences of children with disabilities enrolled in mainstream schools. Method: The participants were 14 students with disabilities, with good communication skills, aged between 8 and 11 years and attending school in Portugal. The data were collected through open-ended interviews and analysed employing a psychological phenomenological method. Findings: The findings suggest that participation at school took three forms: equal participation, special task participation and onlooker participation. Those three forms contrasted with situations of non-participation, in which the children felt completely excluded. Each form of participation and non-participation presented different performance characteristics and was influenced by the social environment. Conclusion: The findings of this study provide insights that enhance the understanding of children's inclusion in mainstream schools, as well as the individual's experience of participation.
Journal of Evaluation in Clinical Practice, Jan 26, 2023
RationaleFamily caregivers of persons with amyotrophic lateral sclerosis and cognitive and/or beh... more RationaleFamily caregivers of persons with amyotrophic lateral sclerosis and cognitive and/or behavioural impairments (PALS/CIs) experience various challenges and needs, including emotional and practical support from peers. Various forms of peer‐support have shown different strengths and weaknesses; however, little is known about how family caregivers of PALS/CIs interact with and perceive virtual face‐to‐face peer‐support.Aims and ObjectivesThe aim of this study was to understand how caregivers of PALS/CIs interact with and perceive virtual face‐to‐face peer‐support in a palliative rehabilitation programme designed to promote targeted palliative rehabilitation initiatives for caregivers of PALS/CIs.MethodA qualitative design using participant observations of 17 recorded virtual group‐facilitated meetings from two rounds of a 4‐month intervention was performed. The Medical Research Council framework, the inductive interpretive description methodology and the theoretical framework of Sense of Coherence guided the study. Nineteen participants, divided into four groups, were included.ResultsThree themes emerged: ‘Relating my situation to others’, ‘Making room for forbidden thoughts’ and ‘Longing for normalcy’. The themes reflected the various ways participants interacted in online group meetings and how the interactions evolved around practical, emotional and forbidden thoughts. Sharing personal and sorrowful concerns and frustrations engendered feelings of trust and a sense of belonging, which empowered the participants to address their genuine wish and longing for normalcy with all the trivialities of which ALS/CIs had robbed them.ConclusionVirtual face‐to‐face peer‐support can enable caregivers of PALS/CIs to share experiences of everyday life challenges that cannot always be shared elsewhere. Being able to relate to and learn from other's experiences alleviated feelings of loneliness, frustration, and concerns and thereby enhanced comprehensibility, manageability and meaningfulness. Online palliative rehabilitation interventions should provide an opportunity for caregivers to meet regularly in interactive group meetings. Familiarization takes time online and is necessary to improve their sense of feeling safe to share their deepest thoughts. Such group interventions, facilitated by trained healthcare professionals, offer a means to support dynamic group interactions and discussion of sensitive topics.
Palliative care and social practice, 2022
Aims and objectives: To explore reflections of family caregivers and health professionals regardi... more Aims and objectives: To explore reflections of family caregivers and health professionals regarding the challenges involved in caring for persons with amyotrophic lateral sclerosis and cognitive and/or behavioral impairments (PALS/CIs). Background: Family caregivers of PALS/CIs are highly burdened and at great risk of psychological sequela. Professionals working with these families can be negatively affected on their well-being and are at risk of burnout. Design: The design was a qualitative interview study. Methods: One focus group and 10 individual semi-structured interviews were conducted with seven family caregivers and nine professionals after the death of a PALS/CIs. The analysis was guided by the interpretive description methodology and the theory of sense of coherence. This study adheres to the COREQ guidelines and the ICMJE recommendations. Results: The family caregivers’ challenges regarding coping with everyday needs related to the sick person were associated with ‘Accepting that nothing else matters’, ‘Adjusting to new roles while balancing’, and ‘Realizing different values in relationships’; whereas the professionals’ challenges were related to ‘Collaboration a balancing act’, ‘Working in a home of sorrow’, and ‘Coordinating threads to tie’. Conclusion: Family caregivers found coping with the complexity of the diseases a challenge, and their everyday life needed constant adjustment to new roles, coping with inappropriate behavior, and navigating through the progression of the diseases of their sick relatives while collaborating with numerous professionals. The professionals struggled with coordinating and collaborating with the families and with other colleagues due to the severeness and complexity of diseases. Relevance to clinical practice: Findings point to the importance of relationships for caregivers and professionals and a need to provide support through an online palliative rehabilitation program that encompass coping strategies in relation to the diseases. Trial registration details: Id no. NCT 04638608.
The overall aim of this thesis was to increase knowledge about how people with advanced cancer ex... more The overall aim of this thesis was to increase knowledge about how people with advanced cancer experience their engagement in activities and how such activities may be useful when living with life-threatening illness. This is explored with regard to creative activities in palliative occupational therapy and to self-chosen activities in everyday life. Given that improved treatment allows people with advanced cancer to live increasingly longer periods of time, it becomes important to support them in such circumstances. Gaining insight into the potential and the challenges of engagement in activities from the perspective of people with life-threatening illness may generate knowledge that can complement theoretical and practical foundations for the use of activities in therapeutic intervention and everyday life. The thesis includes four studies. In Study I the aim was to discover and characterize components of engagement in creative activity as occupational therapy for elderly people dealing with life-threatening illness from the perspective of clients and therapists (n = 15). This study was based on qualitative interviews analyzed using a constant comparative method. Study II aimed to investigate the meanings that people with advanced cancer ascribed to engaging in creative activity in palliative occupational therapy (n = 8). The data from qualitative interviews were analyzed using a phenomenological method. In Study III the aim was to describe and explore the daily activities of people with advanced cancer in relation to time, location, social interaction and experience (n = 45). The data were collected using semistructured diaries and qualitative interviews according to the Time Geographical Method. These data were analyzed using a constant comparative method. Study IV aimed to explore and understand how people with advanced cancer create meaning and handle everyday life through activity (n = 7). The data collection was based on a combination of qualitative interviews and participant observation. In this study an interpretive narrative approach was used for the analysis. The findings in Study I identified how clients and therapists contributed jointly in constructing a generous environment supporting engagement in activities. The findings suggested that engagement in creative activity enabled clients to create connections of past experiences with their present situation and connections reaching into a possible future. In Study II engagement in creative activities was found to ease living in proximity to death and to provide opportunities for creating new ways of living. This entailed ongoing processes for the participants, which involved confronting the consequences of advanced cancer, experimenting with ways to handle current challenges and acknowledging personal resources. Study III identified that the participants with advanced cancer spent most of their time at home. Their daily lives consisted primarily of self-care and leisure activities with limited social engagement. Establishing and maintaining rhythms of routine and change was found to be significant for the participants' sense of satisfaction with daily life. The results of Study IV showed how the participants fashioned stories through daily activity that were useful to them in handling everyday life with advanced cancer. These narratives illustrated the challenges faced by the participants' in creating desired stories in negotiation with their socio-cultural environment. Activities were identified as an arena for exploring contrasting feelings of health and severe illness and, in addition, for providing a familiar framework stimulating agency and life-confirming experiences. Taken together the findings identified various ways in which engagement in activities may provide opportunities to explore and work through consequences of advanced cancer. Engagement in activity was identified as stimulating the discovery of individual and sociocultural resources that the affected person could draw upon in daily life by taking agency, transcending grief and experiencing enrichment and completion in the face of impending death. These studies may contribute to the development of palliative care and to the support of people with advanced cancer as they explore ways to engage and use activities in the remainder of their lives.
European Heart Journal - Quality of Care and Clinical Outcomes, Nov 30, 2021
Aims: To examine the temporal trends and factors associated with national CR referral and compare... more Aims: To examine the temporal trends and factors associated with national CR referral and compare the risk of hospital readmission and mortality in those referred for CR versus no referral. Methods and results: This cohort study includes all adult patients alive 120 days from incident HF identified by the Danish Heart Failure Register (n=33,257) between 2010 and 2018. Multivariable logistic regression models were used to assess the association between CR referral and patient factors and acute all-cause hospital readmission and mortality at 1-year following HF admission. Overall, 46.7% of HF patients were referred to CR, increasing from 31.7% in 2010 to 52.2% in 2018. Several factors were associated with lower odds of CR referral: male sex (odds ratio (OR): 0.85; 95% CI, 0.80-0.89), older age, unemployment, retirement, living alone, non-Danish ethnic origin, low educational level, New York Heart Association (NYHA) class IV vs I. (OR: 0.75; 0.60-0.95), left ventricular ejection fraction (LVEF) >40% and comorbidity (stroke, chronic kidney disease, atrial fibrillation/flutter, and diabetes). Myocardial infarction, arthritis, coronary artery bypass grafting, percutaneous coronary intervention, valvular surgery, NYHA class II, and use of angiotensin-converting enzyme inhibitors were associated with higher odds of CR referral. CR referral was associated with lower risk of acute all-cause readmission (OR: 0.92; 0.87-0.97) and all-cause mortality (OR: 0.65; 0.58-0.72). Conclusion: Although increased over time, only one in two HF patients in Denmark were referred to CR in 2018. Strategies are needed to reduce referral disparities, focusing on subgroups of patients to be at highest risk of non-referral.
Journal of Comorbidity, 2020
Aim: To investigate the association between clusters of conditions and psychological well-being a... more Aim: To investigate the association between clusters of conditions and psychological well-being across age groups. Method: This cross-sectional study used data collected in the Danish population-based Lolland-Falster Health Study. We included adults over the age of 18 years. Self-reported chronic conditions were divided into 10 groups of conditions. The primary outcome was psychological well-being (the WHO-5 Well-Being Index). Factor analysis constructed the clusters of conditions, and regression analysis investigated the association between clusters and psychological well-being. Results: Of 10,781 participants, 31.4% were between 18 and 49 years, 35.7% were between 50 and 64 years and 32.9% were above !65 years. 35.2% had conditions represented in 1 and 32.9% in at least 2 of 10 condition groups. Across age groups, living with one or more chronic conditions was associated with poorer psychological well-being. Two chronic condition patterns were identified; one comprised cardiovascular, endocrine, kidney, musculoskeletal and cancer conditions, the second mental, lung, neurological, gastrointestinal and sensory conditions. Both patterns were associated with poorer psychological well-being (Pattern 1: À4.5 (95% CI: À5.3 to À3.7), Pattern 2: À9.1 (95% CI À13.8 to À8.2). For pattern 2, participants !65 years had poorer psychological well-being compared to younger (À12.6 (95% CI À14.2 to À11.0) vs À6.6 (95% CI: À7.8 to À5.4) for 18-49 years and À8.7 (95% CI: À10.1 to À7.3) for 50-64 years, interaction: p 0.001)
Scandinavian Journal of Occupational Therapy, 2005
Objective-The aim of this study was to discover and characterize components of engagement in crea... more Objective-The aim of this study was to discover and characterize components of engagement in creative activity as occupational therapy for elderly people dealing with life-threatening illness, from the perspective of both clients and therapists. Despite a long tradition of use in clinical interventions, key questions remain little addressed concerning how and why people seek these activities and the kinds of benefits that may result. Method-Qualitative interviews were conducted with 8 clients and 7 therapists participating in creative workshops using crafts at a nursing home in Sweden. Analysis of the interviews was conducted using a constant comparative method. Findings-Engaging in creative activity served as a medium that enabled creation of connections to wider culture and daily life that counters consequences of terminal illness, such as isolation. Creating connections to life was depicted as the core category, carried out in reference to three subcategories: (1) a generous receptive environment identified as the foundation for engaging in creative activity; (2) unfolding creations-an evolving process; (3) reaching beyond for possible meaning horizons. Conclusion-The findings suggest that the domain of creative activity can enable the creation of connections to daily life and enlarge the experience of self as an active person, in the face of uncertain life-threatening illness. Ultimately, the features that participants specify can be used to refine and substantiate the use of creative activities in intervention and general healthcare.
Cancer Epidemiology, Aug 1, 2023
Supportive Care in Cancer, Dec 22, 2022
Otjr-occupation Participation and Health, Oct 1, 2009
This study described and explored the everyday activities of people with advanced cancer in relat... more This study described and explored the everyday activities of people with advanced cancer in relation to time, location, social engagement, and experience. Forty-five adult participants with a diagnosis of advanced cancer were sampled from an oncology outpatient unit. Data were collected with a time use method that involved diaries and interviews. Data were analyzed using a software program describing time use combined with a constant comparative method. The results showed that the participants' days were spent mostly at home and were dominated by self-care and leisure, with social engagement limited to immediate family and close friends. The participants' daily rhythm was identified as closely linked to their experience of satisfaction and consisted of both routine and novel activities. For healthcare services, the results suggest a need for developing services to support people with severe illness in creating and maintaining personal rhythms.
American Journal of Hospice and Palliative Medicine, Jun 28, 2011
Living with advanced cancer can present an overwhelming challenge. It may impact the everyday lif... more Living with advanced cancer can present an overwhelming challenge. It may impact the everyday life of the individual with respect to an array of psychological, physical, social, and existential issues. We focus on ways in which people with advanced cancer experience and use their engagement in daily activities when confronting nearing death. Through a phenomenological analysis based on Heidegger’s thinking, we illuminate the complexities of “being toward death” and the human striving for authentic being through engagement in daily living. The main findings demonstrate how sensory experiences support being through an appreciation of everyday aesthetics. Furthermore, the making of material things was identified as a means to express the value of self and others in relation to the involved individual’s past, present, and future.
Advances in rehabilitation science and practice, 2024
BMJ Supportive & Palliative Care
ObjectivesTo identify and investigate different cohorts of cancer patients’ use of physical rehab... more ObjectivesTo identify and investigate different cohorts of cancer patients’ use of physical rehabilitation and specialised palliative care (SPC) services, focusing on patients with incurable cancer and the impact of social vulnerability.MethodsThe sample originated from patients diagnosed during 2013–2018 and alive 1 January 2015. Use of physical rehabilitation and/or SPC units were identified from contacts registered in population-based administrative databases. Competing-risks regression models were applied to investigate disparities with regard to social vulnerability, disease duration, gender and age.ResultsA total of 101 268 patients with cancer were included and 60 125 survived longer than 3 years after their diagnosis. Among the 41 143 patients, who died from cancer, 66%, survived less than 1 year, 23% survived from 1 to 2 years and 11% survived from 2 to 3 years. Contacts regarding physical rehabilitation services appeared in the entire cancer trajectory, whereas contacts re...
British Journal of Occupational Therapy, Dec 1, 2010
Introduction: This explorative study aimed to chart the participation experiences of children wit... more Introduction: This explorative study aimed to chart the participation experiences of children with disabilities enrolled in mainstream schools. Method: The participants were 14 students with disabilities, with good communication skills, aged between 8 and 11 years and attending school in Portugal. The data were collected through open-ended interviews and analysed employing a psychological phenomenological method. Findings: The findings suggest that participation at school took three forms: equal participation, special task participation and onlooker participation. Those three forms contrasted with situations of non-participation, in which the children felt completely excluded. Each form of participation and non-participation presented different performance characteristics and was influenced by the social environment. Conclusion: The findings of this study provide insights that enhance the understanding of children's inclusion in mainstream schools, as well as the individual's experience of participation.
Journal of Evaluation in Clinical Practice, Jan 26, 2023
RationaleFamily caregivers of persons with amyotrophic lateral sclerosis and cognitive and/or beh... more RationaleFamily caregivers of persons with amyotrophic lateral sclerosis and cognitive and/or behavioural impairments (PALS/CIs) experience various challenges and needs, including emotional and practical support from peers. Various forms of peer‐support have shown different strengths and weaknesses; however, little is known about how family caregivers of PALS/CIs interact with and perceive virtual face‐to‐face peer‐support.Aims and ObjectivesThe aim of this study was to understand how caregivers of PALS/CIs interact with and perceive virtual face‐to‐face peer‐support in a palliative rehabilitation programme designed to promote targeted palliative rehabilitation initiatives for caregivers of PALS/CIs.MethodA qualitative design using participant observations of 17 recorded virtual group‐facilitated meetings from two rounds of a 4‐month intervention was performed. The Medical Research Council framework, the inductive interpretive description methodology and the theoretical framework of Sense of Coherence guided the study. Nineteen participants, divided into four groups, were included.ResultsThree themes emerged: ‘Relating my situation to others’, ‘Making room for forbidden thoughts’ and ‘Longing for normalcy’. The themes reflected the various ways participants interacted in online group meetings and how the interactions evolved around practical, emotional and forbidden thoughts. Sharing personal and sorrowful concerns and frustrations engendered feelings of trust and a sense of belonging, which empowered the participants to address their genuine wish and longing for normalcy with all the trivialities of which ALS/CIs had robbed them.ConclusionVirtual face‐to‐face peer‐support can enable caregivers of PALS/CIs to share experiences of everyday life challenges that cannot always be shared elsewhere. Being able to relate to and learn from other's experiences alleviated feelings of loneliness, frustration, and concerns and thereby enhanced comprehensibility, manageability and meaningfulness. Online palliative rehabilitation interventions should provide an opportunity for caregivers to meet regularly in interactive group meetings. Familiarization takes time online and is necessary to improve their sense of feeling safe to share their deepest thoughts. Such group interventions, facilitated by trained healthcare professionals, offer a means to support dynamic group interactions and discussion of sensitive topics.
Palliative care and social practice, 2022
Aims and objectives: To explore reflections of family caregivers and health professionals regardi... more Aims and objectives: To explore reflections of family caregivers and health professionals regarding the challenges involved in caring for persons with amyotrophic lateral sclerosis and cognitive and/or behavioral impairments (PALS/CIs). Background: Family caregivers of PALS/CIs are highly burdened and at great risk of psychological sequela. Professionals working with these families can be negatively affected on their well-being and are at risk of burnout. Design: The design was a qualitative interview study. Methods: One focus group and 10 individual semi-structured interviews were conducted with seven family caregivers and nine professionals after the death of a PALS/CIs. The analysis was guided by the interpretive description methodology and the theory of sense of coherence. This study adheres to the COREQ guidelines and the ICMJE recommendations. Results: The family caregivers’ challenges regarding coping with everyday needs related to the sick person were associated with ‘Accepting that nothing else matters’, ‘Adjusting to new roles while balancing’, and ‘Realizing different values in relationships’; whereas the professionals’ challenges were related to ‘Collaboration a balancing act’, ‘Working in a home of sorrow’, and ‘Coordinating threads to tie’. Conclusion: Family caregivers found coping with the complexity of the diseases a challenge, and their everyday life needed constant adjustment to new roles, coping with inappropriate behavior, and navigating through the progression of the diseases of their sick relatives while collaborating with numerous professionals. The professionals struggled with coordinating and collaborating with the families and with other colleagues due to the severeness and complexity of diseases. Relevance to clinical practice: Findings point to the importance of relationships for caregivers and professionals and a need to provide support through an online palliative rehabilitation program that encompass coping strategies in relation to the diseases. Trial registration details: Id no. NCT 04638608.
The overall aim of this thesis was to increase knowledge about how people with advanced cancer ex... more The overall aim of this thesis was to increase knowledge about how people with advanced cancer experience their engagement in activities and how such activities may be useful when living with life-threatening illness. This is explored with regard to creative activities in palliative occupational therapy and to self-chosen activities in everyday life. Given that improved treatment allows people with advanced cancer to live increasingly longer periods of time, it becomes important to support them in such circumstances. Gaining insight into the potential and the challenges of engagement in activities from the perspective of people with life-threatening illness may generate knowledge that can complement theoretical and practical foundations for the use of activities in therapeutic intervention and everyday life. The thesis includes four studies. In Study I the aim was to discover and characterize components of engagement in creative activity as occupational therapy for elderly people dealing with life-threatening illness from the perspective of clients and therapists (n = 15). This study was based on qualitative interviews analyzed using a constant comparative method. Study II aimed to investigate the meanings that people with advanced cancer ascribed to engaging in creative activity in palliative occupational therapy (n = 8). The data from qualitative interviews were analyzed using a phenomenological method. In Study III the aim was to describe and explore the daily activities of people with advanced cancer in relation to time, location, social interaction and experience (n = 45). The data were collected using semistructured diaries and qualitative interviews according to the Time Geographical Method. These data were analyzed using a constant comparative method. Study IV aimed to explore and understand how people with advanced cancer create meaning and handle everyday life through activity (n = 7). The data collection was based on a combination of qualitative interviews and participant observation. In this study an interpretive narrative approach was used for the analysis. The findings in Study I identified how clients and therapists contributed jointly in constructing a generous environment supporting engagement in activities. The findings suggested that engagement in creative activity enabled clients to create connections of past experiences with their present situation and connections reaching into a possible future. In Study II engagement in creative activities was found to ease living in proximity to death and to provide opportunities for creating new ways of living. This entailed ongoing processes for the participants, which involved confronting the consequences of advanced cancer, experimenting with ways to handle current challenges and acknowledging personal resources. Study III identified that the participants with advanced cancer spent most of their time at home. Their daily lives consisted primarily of self-care and leisure activities with limited social engagement. Establishing and maintaining rhythms of routine and change was found to be significant for the participants' sense of satisfaction with daily life. The results of Study IV showed how the participants fashioned stories through daily activity that were useful to them in handling everyday life with advanced cancer. These narratives illustrated the challenges faced by the participants' in creating desired stories in negotiation with their socio-cultural environment. Activities were identified as an arena for exploring contrasting feelings of health and severe illness and, in addition, for providing a familiar framework stimulating agency and life-confirming experiences. Taken together the findings identified various ways in which engagement in activities may provide opportunities to explore and work through consequences of advanced cancer. Engagement in activity was identified as stimulating the discovery of individual and sociocultural resources that the affected person could draw upon in daily life by taking agency, transcending grief and experiencing enrichment and completion in the face of impending death. These studies may contribute to the development of palliative care and to the support of people with advanced cancer as they explore ways to engage and use activities in the remainder of their lives.
European Heart Journal - Quality of Care and Clinical Outcomes, Nov 30, 2021
Aims: To examine the temporal trends and factors associated with national CR referral and compare... more Aims: To examine the temporal trends and factors associated with national CR referral and compare the risk of hospital readmission and mortality in those referred for CR versus no referral. Methods and results: This cohort study includes all adult patients alive 120 days from incident HF identified by the Danish Heart Failure Register (n=33,257) between 2010 and 2018. Multivariable logistic regression models were used to assess the association between CR referral and patient factors and acute all-cause hospital readmission and mortality at 1-year following HF admission. Overall, 46.7% of HF patients were referred to CR, increasing from 31.7% in 2010 to 52.2% in 2018. Several factors were associated with lower odds of CR referral: male sex (odds ratio (OR): 0.85; 95% CI, 0.80-0.89), older age, unemployment, retirement, living alone, non-Danish ethnic origin, low educational level, New York Heart Association (NYHA) class IV vs I. (OR: 0.75; 0.60-0.95), left ventricular ejection fraction (LVEF) >40% and comorbidity (stroke, chronic kidney disease, atrial fibrillation/flutter, and diabetes). Myocardial infarction, arthritis, coronary artery bypass grafting, percutaneous coronary intervention, valvular surgery, NYHA class II, and use of angiotensin-converting enzyme inhibitors were associated with higher odds of CR referral. CR referral was associated with lower risk of acute all-cause readmission (OR: 0.92; 0.87-0.97) and all-cause mortality (OR: 0.65; 0.58-0.72). Conclusion: Although increased over time, only one in two HF patients in Denmark were referred to CR in 2018. Strategies are needed to reduce referral disparities, focusing on subgroups of patients to be at highest risk of non-referral.
Journal of Comorbidity, 2020
Aim: To investigate the association between clusters of conditions and psychological well-being a... more Aim: To investigate the association between clusters of conditions and psychological well-being across age groups. Method: This cross-sectional study used data collected in the Danish population-based Lolland-Falster Health Study. We included adults over the age of 18 years. Self-reported chronic conditions were divided into 10 groups of conditions. The primary outcome was psychological well-being (the WHO-5 Well-Being Index). Factor analysis constructed the clusters of conditions, and regression analysis investigated the association between clusters and psychological well-being. Results: Of 10,781 participants, 31.4% were between 18 and 49 years, 35.7% were between 50 and 64 years and 32.9% were above !65 years. 35.2% had conditions represented in 1 and 32.9% in at least 2 of 10 condition groups. Across age groups, living with one or more chronic conditions was associated with poorer psychological well-being. Two chronic condition patterns were identified; one comprised cardiovascular, endocrine, kidney, musculoskeletal and cancer conditions, the second mental, lung, neurological, gastrointestinal and sensory conditions. Both patterns were associated with poorer psychological well-being (Pattern 1: À4.5 (95% CI: À5.3 to À3.7), Pattern 2: À9.1 (95% CI À13.8 to À8.2). For pattern 2, participants !65 years had poorer psychological well-being compared to younger (À12.6 (95% CI À14.2 to À11.0) vs À6.6 (95% CI: À7.8 to À5.4) for 18-49 years and À8.7 (95% CI: À10.1 to À7.3) for 50-64 years, interaction: p 0.001)
Scandinavian Journal of Occupational Therapy, 2005
Objective-The aim of this study was to discover and characterize components of engagement in crea... more Objective-The aim of this study was to discover and characterize components of engagement in creative activity as occupational therapy for elderly people dealing with life-threatening illness, from the perspective of both clients and therapists. Despite a long tradition of use in clinical interventions, key questions remain little addressed concerning how and why people seek these activities and the kinds of benefits that may result. Method-Qualitative interviews were conducted with 8 clients and 7 therapists participating in creative workshops using crafts at a nursing home in Sweden. Analysis of the interviews was conducted using a constant comparative method. Findings-Engaging in creative activity served as a medium that enabled creation of connections to wider culture and daily life that counters consequences of terminal illness, such as isolation. Creating connections to life was depicted as the core category, carried out in reference to three subcategories: (1) a generous receptive environment identified as the foundation for engaging in creative activity; (2) unfolding creations-an evolving process; (3) reaching beyond for possible meaning horizons. Conclusion-The findings suggest that the domain of creative activity can enable the creation of connections to daily life and enlarge the experience of self as an active person, in the face of uncertain life-threatening illness. Ultimately, the features that participants specify can be used to refine and substantiate the use of creative activities in intervention and general healthcare.
Cancer Epidemiology, Aug 1, 2023
Supportive Care in Cancer, Dec 22, 2022
Otjr-occupation Participation and Health, Oct 1, 2009
This study described and explored the everyday activities of people with advanced cancer in relat... more This study described and explored the everyday activities of people with advanced cancer in relation to time, location, social engagement, and experience. Forty-five adult participants with a diagnosis of advanced cancer were sampled from an oncology outpatient unit. Data were collected with a time use method that involved diaries and interviews. Data were analyzed using a software program describing time use combined with a constant comparative method. The results showed that the participants' days were spent mostly at home and were dominated by self-care and leisure, with social engagement limited to immediate family and close friends. The participants' daily rhythm was identified as closely linked to their experience of satisfaction and consisted of both routine and novel activities. For healthcare services, the results suggest a need for developing services to support people with severe illness in creating and maintaining personal rhythms.
American Journal of Hospice and Palliative Medicine, Jun 28, 2011
Living with advanced cancer can present an overwhelming challenge. It may impact the everyday lif... more Living with advanced cancer can present an overwhelming challenge. It may impact the everyday life of the individual with respect to an array of psychological, physical, social, and existential issues. We focus on ways in which people with advanced cancer experience and use their engagement in daily activities when confronting nearing death. Through a phenomenological analysis based on Heidegger’s thinking, we illuminate the complexities of “being toward death” and the human striving for authentic being through engagement in daily living. The main findings demonstrate how sensory experiences support being through an appreciation of everyday aesthetics. Furthermore, the making of material things was identified as a means to express the value of self and others in relation to the involved individual’s past, present, and future.