BACKGROUND AND PURPOSE:  Measuring patient satisfaction after total hip (THA) and total knee arthroplasty (TKA) is important. We aimed to cross-culturally adapt and examine the psychometric properties of the self-reported Goodman Satisfaction Score (GSS) in a sample of Norwegian patients following primary THA and TKA.

METHODS:  The GSS was translated and adapted into Norwegian (GSS-NO) following standard guidelines. 800 patients from the Norwegian Arthroplasty Register who had undergone surgery 6-11 months prior were invited to complete GSS-NO and questions on sociodemographic factors, pain, and function in a cross-sectional study. We examined validity in relation to internal structure, response processes, and precision using Rasch analysis, relationships between the GSS-NO and pain and function using Pearson's correlation coefficients, and test-retest reliability using linear weighted kappa statistics.

RESULTS:  The GSS-NO was adapted with few challenges. 404 patients (49% THA, 51% TKA) returned complete answers. The GSS-NO met all criteria regarding the rating scale functioning. Local independence among items and unidimensionality was supported and there was acceptable goodness-of-fit. The internal consistency was 0.94. We found no systematic differential item functioning by age, sex, work status, education, cohabitation status, or hip or knee surgery. The correlation coefficients between GSS-NO and pain and function outcomes were 0.79 (95% confidence interval [CI] 0.76-0.82) and 0.79 (CI 0.76-0.82), respectively. Test-retest reliability with weighted kappa ranged from 0.43-0.55 for THA and 0.54-0.81 for TKA.

CONCLUSION:  The cross-cultural adaptation of GSS-NO proved to be a valid and reliable measure for use in Norwegian-speaking patients following primary THA and TKA.

The Paediatric Evaluation of Disability Inventory (PEDI), has been revised as a computer adaptive test; the PEDI-CAT. Many items have been added making it relevant for children and youth from birth to 20 years of age. The PEDI-CAT measures performance in the Functional Skills domains of Daily Activities, Mobility and Social/Cognitive. The PEDI-CAT's Responsibility domain measures the extent to which the caregiver or child takes responsibility for managing complex, multi-step life tasks. In this exploratory study the normative scores of children with typical development of Switzerland (n = 51) and Germany (n = 61) were compared with the American normative sample to investigate its applicability. The mean age of the children was 5.78 years with a standard deviation of 1.39 years and a range of 4.10 years. Statistically significant differences in comparison with the mean normative scores with moderate to strong effect were found in all domains. Still, 95% or more of all scores from the participants were within a 2 standard deviation range from the mean normative scores. The results indicate that the normative scores should right now be applied to the German version of the PEDI-CAT with caution. Further studies are needed to further investigate applicability of the normative values.

Purpose: To evaluate the psychometric properties of a Fall Concerns Scale for people who use Wheelchairs and Scooters (FCS-WC/S).

Materials and methods: Developed by fall prevention experts, FCS-WC/S underwent refinement through interdisciplinary reviews and focus groups with researchers, clinicians, and individuals who use WC/S full-time. The psychometric evaluation involved adults who used WC/S for ≥1 year and had ≥1 fall in the previous 3 years, recruited between April and September 2022.

Results: The FCS-WC/S evaluates fall concerns among people with various health conditions who use WC/S full-time across 33 daily activities. One hundred and twenty-four participants responded to the baseline survey. A subgroup of 63 people repeated the FCS-WC/S a week later. The FCS-WC/S demonstrated excellent internal and good test-retest reliability (α ≥ 0.90, ICC = 0.86-0.9), as well as concurrent validity (Spearman's rho = 0.72) with the Spinal Cord Injury Falls Concern Scale (SCI-FCS). It effectively differentiated fear of falling levels from an established measure (ORs 4.1, 25.8, 46.7). Factor and parallel analysis revealed three factors, two of which were retained for further analysis.

Conclusions: Preliminary findings support FCS-WC/S validity and reliability for assessing fall concerns among individuals with various conditions who use WC/S. Further scale construction analysis is recommended.

A digital decision aid for cancer screening can gather balanced information in one place and give individuals the opportunity to elucidate their knowledge, values and engage in shared decision-making. Research shows that ethnic minorities and individuals with various functional limitations participate in cancer screening to a lower extent, hence our ambition to make the decision aid as available and applicable as possible, regardless of end-users' traits. The aim was to describe the design and alpha phases of the development of a digital decision aid for CRC screening and tentative end-users' perceptions. Based on a scientific framework for development of decision aids, participants were recruited through multiple channels. The decision aid was evaluated in two steps, a paper version (design phase) and a website prototype (alpha phase), using the think-aloud approach. Data were rich with detailed suggestions for improvements of the decision aid and how it was perceived. A positive outlook on the decision aid was common. Certain words, wordings or visual features were considered difficult and worry or anxiety, related to the content, were expressed. The variation in the findings illustrates the challenges of decision aid development. Still, our findings emphasise the importance of designing a decision aid in co-creation with its end-users. Developing a digital decision aid is complex, why a well-established framework is essential. With the goal of an equal healthcare system, the inclusion of individuals with diverse backgrounds and functional limitations should not only be a fundamental aspect of all research, but a prerequisite.

Introduction: Participation is one of the core elements of health promotion, which means that approaches and methods should focus on involvement. The process of involving women with a migration background in health promotion needs to be further explored. Thus, the aim of this study was to explore the development process of a type 2 diabetes health-promotive community-based participatory research intervention among Middle Eastern women with a migration background, living in Sweden. Materials and methods: This study was performed within the context of a community-based participatory research program in Sweden. The design of this study followed the development process of a community-based participatory research conceptual model, including three of the original four dimensions, that is, the context, the partnership process, and the intervention and research dimension. Appropriate methods for data collection were used in the various dimensions. Participants from the community, active in the program, conducted dialogue cafés, together with the core partners of the program, to inventory existing needs as well as what actions were needed for promoting health and thereby prevent type 2 diabetes. Results: The two dialogue cafes resulted in one long term and three short term goals. The third short-term goal—create health circles around food and nutrition was decided to be in focus for this study together with cooperation with the local health care center. The partnership process made it possible to involve relevant collaborators, which resulted in a jointly developed nurse-led educational intervention. Participants and stakeholders were also involved in the process of modifying and elaborating evaluation tools appropriate for the intervention. Discussion/conclusions: The community-based participatory research approach enables the acknowledgement and use of the various kinds of knowledge of all stakeholders, including the community members. In this study, the community members’ knowledge was obtained through participation and dialogue, aimed at balancing power between stakeholders. This approach, that is, developing a community-based participatory research intervention, offers a possibility for the primary health care to engage with the community members and for other stakeholders to work in a health-promotive way.

Background: The relationship between doing and belonging is rooted in individuals' engagement in meaningful occupations, which contributes to their sense of connectedness. The meaningfulness of occupation relates closely to the context in which it is performed. However, despite its importance, context is often overlooked and underexplored.

Aim: To explore how older adults living in depopulated rural areas depict positive and negative features of their neighbourhoods and how belonging was connected to doing and participation.

Methods: We utilised data from photo-elicited interviews with 7 men and 10 women, aged 68 to 88 years, from depopulated rural areas in southern Sweden. Data were analysed using Rowles' place attachment framework with a thematic analysis.

Results: The participants expressed how belonging was connected to doing by depicting resources in the area, how community was created through interaction, the importance of past actions for present belonging, how they acted on pride and feelings of obligation, as well as how they experienced challenges for doing and belonging.

Discussion: Our study revealed a reciprocal relationship of doing and belonging. Specifically, doing strengthened participants' belonging, while feelings of belonging resulted in loyalty and motivated supportive community actions. Importantly, participants' actions were more driven by a collective interest in community welfare than personal gain.

Conclusions: This study contributes to occupational science by knowing how doing supports belonging and vice versa. Furthermore, our study showed that belonging can serve as a catalyst for older adults to engage in their community, which likely reduces the risk of social exclusion.

The value of health care delivered via effective interprofessional teams has created an imperative for interprofessional education (IPE) and interprofessional collaborative practice (ICP). To inform IPE strategies, we investigated differences in perceived self-efficacy (SE) for competence in ICP among health professions students. Study data was collected between 2015-2019 from students from 13 different programs (N=3,496) before an annual institutional interprofessional program. Students completed the IPECC-SET, a validated instrument evaluating perceived SE for competence in ICP, and rated their 1) amount of previous contact with, and 2) perceived understanding of the role of different health professions.  Student groups were compared using parametric statistics. Regression analyses explored factors influencing SE for competence in ICP. Findings revealed significant differences in perceived SE for competence in ICP between programs (p<.05). Specifically, health information management/health informatics, dental, medicine, and nursing students expressed relatively higher SE, whereas physical and occupational therapy students expressed relatively lower SE. Perceived understanding of the role of health care professions (p<.01) and gender (p<.01) contributed significantly to predict perceived SE for competence in ICP, while amount of previous contact with other health professions did not (p=.42).  Findings highlight the value of IPE designed with consideration of specific learner needs.

Background and Purpose: Possibilities to age in place are increasingly important with the demographic shift toward aging populations. With the Person-Place Fit Measure for Older Adults (PPFM-OA), older adults self-assess how their home and community environments suit their needs. The aim of the study was to evaluate the psychometric properties of the Swedish version of PPFM-OA. Methods: Four hundred sixty community-living adults aged 65 and older answered the PPFM-OA. Rasch model was used for analyses. Results: A reduced 19-item version of PPFM-OA showed sufficient evidence of validity in response processes, internal structure, fairness in testing, and reliability/precision. Conclusions: The reduced version is recommended to use in Sweden to capture person-place fit, an aspect to consider when communities, healthcare, and elder care aim to facilitate aging in place.

INTRODUCTION: Research suggests that participating in after-school leisure activities has been related to promoting health, well-being and safety among children living in disadvantaged neighbourhoods. The United Nations Child Rights Convention emphasises the inclusion of children in decisions that concern them. However, children seldom are involved in designing implementing and evaluating health promotional environments. The aim of this programme is through a participatory process with children, parents/guardians, and peer-activity leaders explore, measure and evaluate the impact on children's overall well-being related to the social context in an already established health promotion environments in Southern Sweden.

METHODS AND ANALYSIS: The project is based on a previously implemented unique community-based participatory research (CBPR) model for equal health in three socially disadvantaged areas in Malmö. All activity house (AAH) is a meeting place for children established in schools but after school time by the culture department of the Malmö municipality. In AAH migrant children participate in need-driven after school activities that they themselves create and develop. To increase participation of the children and ensure that these environments are based on their needs, 30 children (10-12 years), parents/guardians (30), peer-activity leaders (15), and researchers create CBPR teams in the areas and engage in a participatory process. The children reflect, analyse and write about their well-being; identify and discuss key factors in an iterative process, which also includes a strategic group of stakeholders. The children then develop and validate (with 100 other children from AAH) the Socioculturally Aligned Survey Instrument for Children survey inspired by the KIDSSCREEN V.27. The survey tool so developed will further be used to evaluate AAH and will be distributed to all children participating in their activities.

ETHICS AND DISSEMINATION: This programme has been approved by the Swedish Ethical Review Authority. The results from this programme will be published as reports and scientific publication.

Purpose: There is need for a comprehensive measure of post-stroke fatigue with sound measurement properties. This study aimed to develop the Norwegian Fatigue Characteristics and Interference Measure (FCIM) and assess its content validity, structural validity, and internal consistency.

Method: This study consisted of three steps: (1) an expert panel developed version 1.0 of the Norwegian FCIM, (2) its content validity was assessed in cognitive interviews with stroke patients (N = 15), (3) a convenience sample of stroke patients (N = 169) completed an online questionnaire with the FCIM, Fatigue Severity Scale, and sociodemographic information; validity and reliability were assessed using Rasch analysis.

Results: FCIM version 1.0 included a 10-item characteristics subscale, a 20-item interference subscale, and two pre-stroke fatigue items. The cognitive interviews revealed content validity issues, resulting in two interference items being removed and five items being flagged but retained for Rasch analysis (version 2.0). Rasch analysis led to removal of four items from the characteristics subscale and six more from the interference subscale. The final six-item characteristics subscale and 12-item interference subscale (version 3.0) both showed adequate fit to the Rasch model with indications of unidimensionality and local independence. The interference subscale had a high person separation index. No significant differential item function (DIF) was found in relation to gender, but one item demonstrated DIF in relation to age.

Conclusion: The cognitive interviews and Rasch analysis demonstrated that the Norwegian version of the FCIM has high content validity, structural validity, and internal consistency. Future research should assess its construct validity, reliability, and responsiveness.