Perceived needs among asylum seekers in Sweden: a mixed methods study

The health and well-being of asylum seekers in high-income countries is a concern from both individual and community perspectives. This study aims to describe the perceived needs of adult asylum seekers in Sweden. A mixed methods study was conducted that combined a non-randomized descriptive cross-sectional assessment of perceived serious needs using the Humanitarian Emergency Settings Perceived Needs Scale (HESPER) Web with 85 adult asylum seekers and focus group discussions with 14 adult asylum seekers in Sweden. Descriptive and comparative statistics were used for the quantitative part, and thematic analysis for the qualitative part. The total number of perceived serious needs reported by respondents ranged from zero to 13 needs per person with a mean of four needs (SD 2.71). The most commonly perceived serious needs were related to income or livelihood, separation from loved ones, being displaced from home, distress, and concerns about accessing adequate health care services. Many of the perceived needs appeared to be related to experiences of being dependent, in limbo, and vulnerable. Addressing people’s current perceived needs can contribute to resilience and well-being and therefore should be considered in health care systems that cater to immigrants

The reliability and feasibility of the HESPER web to assess perceived needs in a population affected by a humanitarian emergency

Needs assessment is essential in the humanitarian response, and perceived needs can be associated with the levels of health in populations affected by humanitarian emergencies. This study aimed to evaluate the reliability and feasibility of The Humanitarian Emergency Settings Perceived Needs Web (HESPER Web) in a humanitarian context and to compare perceived needs of a random walk study sample with a self-selected study sample recruited though social media. The study context was the Dadaab refugee camp in Kenya. An alternate forms reliability evaluation and a feasibility evaluation was conducted. In total, 308 refugees participated in the study. HESPER Web was found to be reliable and usable for assessing needs, with an intraclass correlation coefficient (ICC) of 0.88, Cohen’s κ between 0.43 and 1.0 and a first priority need rating match of 81%. The HESPER Web was positively experienced, and the self-recruited study sample reported similar levels of needs and similar demographics as the randomized sample. The participants reported several unmet needs. HESPER Web offers a reliable tool for needs assessment in humanitarian emergencies where web-based surveys are considered as practical and suitable. It offers new possibilities for conducting remote assessments and research studies that include humanitarian populations that are rarely included in such evaluations

One-year follow-up after the time management group intervention let’s get organized

BACKGROUND: Time management skills are essential to maintain occupations in everyday life. People with neurodevelopmental or mental disorders often experience persistent difficulties with managing time and organizing daily life, consequently, there is a need to establish interventions with sustainable results. AIM: The aim was to perform a one-year post-intervention follow-up after the intervention Let’s Get Organized (LGO-S) for people with neurodevelopmental or mental disorders. METHODS: The study is a one-year follow-up of a single group pre-test–post-test design. Thirtyeight persons with difficulties in time management due to neurodevelopmental or mental disorders participated. Instruments to collect data were Assessment of Time Management Skills; Weekly Calendar Planning Activity and the Satisfaction with Daily Occupations instrument. Wilcoxons’s signed-rank test was used to compare data over time. RESULTS: There were no significant differences in the participants’ outcomes between post-intervention and one-year follow-up in time management skills and regulation of emotions, satisfaction with daily occupations, and global satisfaction. A significant improvement could be seen in the subscale organization and planning at the one-year follow-up compared to post-intervention. CONCLUSIONS: Improvements in time management skills, organization, and planning, regulation of emotions, and satisfaction with daily occupations after the LGO-S can be maintained in the long term.The Centre for Clinical Research Dalarna, Falun, the Faculty of Medicine and Health, Orebro University, the Regional Research Council in the Uppsala-Orebro Region, and the Research Committee in Region Orebro County.https://www.tandfonline.com/toc/iocc20pm2022Centre for Augmentative and Alternative Communication (CAAC

The assisting hand assessment : Continued development, psychometrics and longitudinal use

For most people, using both hands together is a natural part of everyday activities. But for children with a unilateral disability in the arm and hand, activities requiring two hands are often a challenge. In order to evaluate interventions that optimize the use of the affected or assisting hand, valid and reliable measures are needed. The Assisting Hand Assessment (AHA) is a newly developed test with the expressed purpose of measuring and describing how effectively children with a unilateral disability in arm and hand use their assisting hand during bimanual tasks. An AHA assessment involves a video-taped play session, which elicits spontaneous use of the hands by using toys that require bimanual handling. The play session is scored using a 4-point rating scale for 22 items which are describing object-related hand actions. The AHA was initially validated for children aged 18 months to 5 years with unilateral cerebral palsy (CP) or obstetric brachial plexus palsy (OBPP) (Small Kids AHA). A test kit for older children containing two board games suitable for children aged 6-12 years has been developed (School Kids AHA). The aim of this thesis was to evaluate the psychometric properties of the AHA including the expanded age group and to describe the longitudinal development of assisting hand use in children with unilateral CP. The validity of the AHA for ages ranging from 18 months to 12 years was investigated. Using a Rasch measurement model, 409 AHA s of children with unilateral CP or OBPP were analyzed. Results showed that the items measure a unidimensional construct and that the four-point rating scale overall functions well. An excellent targeting between the item difficulties and the children s abilities was found. A high person separation indicates that the AHA can effectively separate between children of different ability into seven distinct ability strata. Differential item functioning between diagnostic groups was identified in some items and discussed. The reliability of the AHA as regards the inter- and intrarater, retest and alternate forms reliability was investigated. In all trials high reliability coefficients (Intraclass Correlation Coefficients) were found, ranging from 0.97 to 0.99. The retest evaluation indicated that the smallest detectable difference measurable with the AHA is a change of 4 points (6% of the scale). It was further found that all tested versions, the Small Kids vs. School Kids AHA and the two board games in School Kids AHA, produce equal results and measure the same construct. The development of assisting hand use between the ages 18 months and 8 years was investigated among 43 children with unilateral CP. The children were regularly assessed using the AHA for on average 4.5 years. All children increased their assisting hand use during the course of the study. A non-linear mixed model was used to create separate average development curves for children at different levels on the Manual Ability Classification System (MACS). The maximum level (limit) of development differed between children in MACS levels I-III. The rate of change was similar in levels I and II and significantly slower in children at level III. The children were also divided into two groups based on their AHA-score at 18 months. The limit and rate of change differed significantly between the groups. The AHA score at 18 months can be used for approximate prediction of future development of assisting hand use

Everyday activities at home : Experiences of older repeatedly readmitted people

INTRODUCTION: Limitations in everyday activities are a risk factor for hospital readmission. Despite this, few studies have focussed on everyday activities of repeatedly readmitted older people. The experiences and specific needs of this group have been poorly described regarding their everyday activities at home. A deeper understanding may help occupational therapists and other health professions to facilitate readiness for this group at and after discharge. The aim of this study was, therefore, to describe the experiences of performing everyday activities of older people repeatedly readmitted to hospital and discharged to home. METHODS: A qualitative interview study was used to collect data from sixteen participants (75 years and older). Data were analysed using qualitative content analysis. RESULTS: One theme 'trying to manage an unpredictable everyday life' and two categories describe experiences of everyday activities at home. The participants expressed the importance of continuing everyday activities after discharge where support from relatives and healthcare seemed to be of importance. CONCLUSION: It was found that performance of everyday activities and contact with family members were of importance in their everyday life. Therefore, assessments and support were of particular importance for the group of older people who do not have close social relations at home.Funding Agency:Regions Örebro County </p

Use of the HESPER Web to assess perceived needs immediately after multiple disaster events in Fiji

Objective: In January 2022, Fiji was hit by multiple natural disasters including a cyclone causing flooding, an underwater volcanic eruption and tsunami. This study aimed to investigate perceived needs among the disaster-affected people in Fiji and to evaluate the feasibility of the Humanitarian Emergency Settings Perceived Needs Scale (HESPER Web) during the early stage after multiple natural disasters. Methods: A cross-sectional study using a self-selected, non-representative study sample was conducted. The HESPER Web was used to collect data. Results: In all, 242 people participated. The number of perceived serious needs ranged between 2 and 14 (out of a possible 26), with a mean of 6 (SD 3). The top three most reported needs were access to toilets (60%), care for people in the community who are on their own (55%), and distress (51%). Volunteers reported fewer needs than the general public. Conclusions: The top three needs reported were related to water and sanitation and psychosocial needs. Such needs should not be underestimated in the emergency phase after natural disasters, and may require more attention from responding actors. The HESPER Web was be considered as a usable tool for needs assessment in a sudden onset disaster

Test-retest reliability of the Swedish version of the Weekly Calendar Planning Activity - a performance-based test of executive functioning

Purpose:The Weekly Calendar Planning Activity is a performance test aiming to examine how subtle problems with executive functioning influence the performance of multi-step activities in daily life. The purpose of this study was to explore the Swedish version of the Weekly Calendar Planning Activity, regarding test-retest reliability and possible learning effects. Material and methods:Twenty-four adults with psychiatric, neurodevelopmental or mild intellectual disorders and with difficulties in executive functioning performed the test on three separate occasions, with two weeks apart. Test-retest reliability was determined using intraclass correlation coefficients. Possible learning effects were evaluated. The smallest detectable change was calculated to determine the precision of individual scores. Results and conclusion:The intraclass correlation coefficients between the first two test occasions were weak (0.42-0.66), but were acceptable to excellent (0.65-0.91) between test occasions 2 and 3. There was a considerable amount of random variation in the results, but little systematic variation, indicating no or possibly a small learning effect in the total number of accurately recorded appointments. This variation indicates a need to use two consecutive baseline measurements when the Swedish version of the Weelky Calendar Planning Acitivity is used as an outcome measure. Together, our results suggest that the Swedish version of the Weelky Calendar Planning Acitivity is a useful performance-based measure of how subtle problems in executive functioning affects activity performance

Patient preferences for patient participation : Psychometric evaluation of The 4Ps tool in patients with chronic heart or lung disorders

The Patient Preferences for Patient Participation tool (The 4Ps) was developed to aid clinical dialogue and to help patients to 1) depict, 2) prioritise, and 3) evaluate patient participation with 12 pre-set items reiterated in the three sections. An earlier qualitative evaluation of The 4Ps showed promising results. The present study is a psychometric evaluation of The 4Ps in patients with chronic heart or lung disease (n = 108) in primary and outpatient care. Internal scale validity was evaluated using Rasch analysis, and two weeks test–retest reliability of the three sections using kappa/weighted kappa and a prevalence- and bias-adjusted kappa. The 4Ps tool was found to be reasonably valid with a varied reliability. Proposed amendments are rephrasing of two items, and modifications of the rating scale in Section 2. The 4Ps is suggested for use to increase general knowledge of patient participation, but further studies are needed with regards to its implementation

The assisting hand assessment for children and youth with brachial plexus birth injury: a study of validity and item hierarchy of AHA-Plex

Objective: Functional assessments that focus on activity performance and that produce valid outcome measures for people with brachial plexus birth injury are lacking. The primary aim of this study was to re-evaluate the internal scale validity of the Assisting Hand Assessment specifically for children and adolescents with brachial plexus birth injury. Two further aims were investigating whether the scale could be shortened for this group while maintaining psychometric quality, and exploring and presenting its item difficulty hierarchy. Design: A cross-sectional psychometric study. Subjects: A convenience sample of 105 children and adolescents (aged 18 months to 18 years, mean 6 years, 7 months, standard deviation (SD) 4 years, 4 months) from Sweden, Norway, and the Netherlands with brachial plexus birth injury. Methods: Participants were assessed with the Assisting Hand Assessment. Data were analysed with Rasch measurement analysis. Results: The 20 Assisting Hand Assessment items together measured a unidimensional construct with high reliability (0.97) and the 4-level rating scale functioned well. Item reduction resulted in 15 items with good item fit, unidimensionality, reliability and acceptable targeting. Conclusion: Assisting Hand Assessment for people with brachial plexus birth injury, called AHA-Plex, has 15 items and good internal scale validity. A unique item hierarchy for people with brachial plexus birth injury is presented

Development of the Assisting Hand Assessment for adolescents (Ad-AHA) and validation of the AHA from 18 months to 18 years

AimTo develop and evaluate a test activity from which bimanual performance in adolescents with unilateral cerebral palsy (CP) can be observed and scored with the Assisting Hand Assessment (AHA), and to evaluate the construct validity of the AHA test items for the extended age range 18 months to 18 years. MethodA new test activity was developed and evaluated for its ability to elicit bimanual actions in adolescents with (n=20) and without (n=10) unilateral CP. The AHA scores of 126 adolescents (mean age 14y 3mo, SD 2y 6mo; 71 males, 55 females) and 157 children with unilateral CP (mean age 6y 1mo, SD 2y 10mo; 102 males, 55 females) were analysed using the Rasch measurement model. ResultsThe test activity elicited bimanual actions in 100% of typically developing adolescents and in 96.8% and 57.9% of adolescents with unilateral CP (moderately and severely limited hand function respectively). The scale demonstrated good construct validity; thus the same scoring criteria can be used for the age range studied. InterpretationThe new Assisting Hand Assessment for adolescents (Ad-AHA) activity is valid for use with 13- to 18-year-olds to elicit bimanual performance in adolescents with unilateral CP. The same AHA scoring criteria can be used both for children and for adolescents within the age range 18 months to 18 year