Omfattningen av smärta och delaktighetsinskränkningar i viktiga aktiviteter hos män och kvinnor med RA som erhållit dagens moderna behandlingsstrategier, understryker att det fortfarande behövs multidisciplinär rehabilitering.
Frågeformuläret VLA, som innehåller personens preferenser gällande identifiering av viktiga livsaktiviteter, är användbart för att inkludera den unika individens perspektiv vid bedömning och behandling inom reumatologisk rehabilitering och även vid forskning.
Resultaten tyder på att smärta och delaktighetsbegränsningar bör behandlas med en medvetenhet om personliga faktorer för att uppnå ett optimalt resultat. En personcentrerad strategi förbättrar processen vid identifiering av individuella behov och krav i reumatologisk rehabilitering.
Utveckling av hanteringsstrategier för smärta och aktivitetsbaserade metoder bör användas i reumatologisk rehabilitering i syfte att stärka personliga faktorer och därigenom underlätta delaktighet, distrahera smärta, stödja balans i dagliga aktiviteter och förbättra smärtlindring. Användning av den teoretiska ramen och begrepp i ICF stödjer tydlighet i kommunikation om funktionshinder, inklusive hur delaktighet är relaterat till smärta vid rehabilitering i reumatologi.
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Acknowledgements
In the years before the work for this thesis started, my life took some overwhelming turns, which affected my outlook on life and also motivated me to take the chance to become a PhD student when the opportunity arose. This has been a challenging and amazing journey. I sincerely acknowledge the help and support from everyone who has been involved in my PhD studies.
The School of Health and Welfare, Jönköping University, for giving me the
chance and support to conduct my PhD studies. Many thanks for a great time at The Research School of Health and Welfare.
My excellent supervisors: Mathilda Björk, Torbjörn Falkmer, and Ingrid
Thyberg, for never ending patience and your enthusiasm for research. I
have learned a lot and I hope that we can continue our collaboration in the future.
My co-authors: Sharmila Vaz, Örjan Dahlström, and Björn Börsbo (partly supervisor), for your each outstanding competence in statistics or pain.
All of my colleagues, past and present, at the School of Health and Welfare,
particularly to the PhD students and colleagues at The Research School of
Health and Welfare and at the Department of Rehabilitation for fruitful
seminars and fika discussions.
ADULT research group at the School of Health and Welfare, Jönköping
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All persons with RA who participated in the studies and thus enabled this
thesis.
I acknowledge the Swedish Rheumatology Quality Register (SRQ) and SRQ
data collectors. I also acknowledge TIRA co-workers especially Ylva Billing
and Magnus Husberg and the TIRA Disability research group in Linköping.
Birgitta Stenström, Research partner, for valuable comments at different
stages in the research process.
Gunilla Brushammar, Jönköping University library, for excellent support
with references and EndNote.
Annette Joosten, Alison Blane, Julie Netto, Sharmila Vaz and maybe some
more staff at Curtin University Perth, Western Australia for language editing.
My classmates and friends from the beginning of the professional carrier
as occupational therapist. The weekend once a year in September are fruitful and lovely. Thanks for all the good meetings. It is so wonderful to have you with me through life.
Relatives and friends, no one mentioned and no one forgotten, thank you
for involving me in valued social activities for my own well-being. My family, Oskar, Emma, Elsa and little baby Astrid, those who really know which activities are valued for me and make sure that I participate in other things than work. I will be sure to have more time for you now. My life partner, Leif. You are always there in everyday life; we follow each other in both happiness and sorrow. Now this project is finished. What is the next?
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Financial support was obtained from The Medical Research Council of Southeast Sweden (FORSS), "Futurum - the academy for healthcare, Region Jönköping County", the Swedish Rheumatism Fund, Stig Thunes Fund, Norrbacka-Eugenia Foundation, Swedish Reuma Forum (SVEREFO), Swedish Association of Occupational Therapy (FSA) and Axel Fugl-Meyer Memorial fund.
83
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