The aim of this paper is two-fold: to investigate development of a Construct Specification Equation (CSE) for UL task difficulty,, and a CSE for person UL ability,, in support of the validity of these two constructs. Measurements of UL task difficulty,, and person UL ability, were derived from applying the Rasch model on the Tetraplegia Upper Limb Activity Questionnaire (TUAQ). The formulations of CSEs as explanations of the two constructs were done using Principal Component Regression (PCR). The CSE for UL task difficulty,, was to a large degree explained by the number of joints involved and the CSE for person UL ability,, was dominated by grasp-related variables. Pearson coefficients of 0.94 and 0.73 were obtained between UL task difficulty and UL person ability from the CSE, respectively, when correlated with each empirical measure. The present work has both explored and extended the methodology for using more qualitative explanatory variables. Specifically, for UL measurements for people with tetraplegia a good CSE for task difficulty,, supports the validity of TUAQ when measuring person UL ability. Additionally, the CSE formulated for person ability,, can be used both for validation purposes as well as a clinical tool.

Background: Family sense of coherence (FSOC) seems to reduce distress in the family and promote the well-being of the family. Therefore, getting accurate measurements for families with long-term illnesses is of particular interest. This study explores dyadic data analysis from the dyadic- and single-informant perspectives, and the measurement properties of the FSOC-S12 according to the Rasch model. Methods: Racked and stacked data from 151 dyads were analyzed according to the polytomous Rasch model. Results: Notably, both the dyadic- and single-informant perspectives (i.e., racked and stacked data set-ups) showed measurement properties with minor deviations from the Rasch model according to fit statistics. However, most items had disordered thresholds and some problems with local dependency. Item hierarchies were similar in both set-ups and there was no differential item functioning (DIF) by role from the dyadic informant perspective. Four items showed DIF by informant role in the single-informant perspective. Conclusions: Our approach to handling dyadic data has shown both strengths and limitations in the evaluation of FSOC-S12, and the understanding of FSOC as a construct from the family’s view of the family’s ability as a whole (dyadic-informant perspective) and patient’s and family member’s separate views of the family’s ability as a whole (single-informant perspective).

Background and Aim: To address knowledge gaps in safe patient handling and mobility methods (SPHMM) among rehabilitation professionals in Sweden, a national knowledge center, HMC, provides training on SPHMM. The study’s aim was to report on outcomes at 3 months after training in terms of self-perceived competence in SPHMM and self-perceived utility of acquired competence in SPHMM. Methods: Training participants (occupational therapists and physiotherapists) completed a study-specific questionnaire, with 1065 doing so at 3 weeks before the training and 389 at 3 months after training. Linear mixed models were used for analyses. Results: Self-perceived competence improved significantly at 3 months after training (p < 0.001). Occupational therapists, specifically, and rehabilitation professionals generally with less clinical experience reported greater improvement compared to physiotherapists and those with longer experience (p < 0.001). Rehabilitation professionals overall with shorter clinical experience also reported higher self-perceived utility of the acquired SPHMM competence (p < 0.001), but occupational therapists and physiotherapists did not differ significantly (p = 0.369). Conclusion: Among rehabilitation professionals, greater self-perceived competence and self-perceived utility of the acquired competence in SPHMM is possible after HMC training. Improvements were greater for those with shorter clinical experience. By enhancing competence among rehabilitation professionals, HMC training has the potential to advance working person-centered and efficient transfer practices in interdisciplinary care settings.

Aim: This paper aims to report on two modifications made to improve the measurement precision of the Ms. Olsen test. Specifically, three items were added to the Ms. Olsen test and an extended scoring was applied to some items. Design: The competence assessment had a quantitative cross-sectional design comprising of test results from 111 Registered Nurses in four municipalities in South-Eastern Norway. Methods: The Rasch model was applied to evaluate the measurement properties in four versions: the Ms. Olsen test with 19 items and the same with three added items, and the Ms. Olsen test with 19 items with an expanded scoring for the original and expanded version, respectively. Results: The person separation indexes were improved from 0.50 to 0.62. Other measurement properties were not alternating between the four versions; all had shortcomings in terms of targeting (person measure means 3.02–3.87) and unidimensionality (% t-test >5% 9.01%–13.51%). Conclusion: The clinical relevance and relatively short time spent on testing makes the Ms. Olsen test a reasonable choice and a step in the right direction for assessing competence as a means of targeting continuous professional development of nurses throughout their career. Nevertheless, depending on what kind of decisions are to be made, reliability might still be too low and further development is suggested. Public Contribution: The initiative for the competence assessment came from nursing leaders in the four municipalities involved. The municipalities were represented in all stages of the research process through co-author LS, that is, design, data collection, data analysis, writing of the manuscript as well as dissemination of the results to the four municipalities. Implications for Practice: The Ms. Olsen test exemplifies a move towards objective assessments in nursing. Precise and reliable measurements are essential to support the ongoing professional development of nurses.

Purpose: To identify factors that contribute to the enhanced life of people with spinal cord injury (SCI) in Sweden. Materials and methods: This cross-sectional study combined workshops (n = 38) and survey data (n = 243) from people living with SCI and their relatives, health professionals, and personal care assistants working with people living with SCI. The data were first categorized using Bronfenbrenner’s bioecological model, followed by a conventional content analysis. Results: The factors that contribute to an enhanced life for people living with SCI are similar to those of the general population, including relationships, leisure activities, and occupation within the mesosystem. However, the unique components of the exosystem and macrosystem are specifically associated with people living with SCI. The exosystem, particularly in healthcare, plays a major role for medical reasons but also tends to obtrude and minimize the mesosystem. The macrosystem is essential, as it sets the rules that govern the actors in the other layers, creating prerequisites for meeting the needs of the mesosystem and exosystem. Conclusions: The needs that contribute to an enhanced life are multifaceted and individualized. Therefore, these systems must be flexible throughout the lifespan of individuals with SCI. 

Background: To provide both preventive and rehabilitative conditions in a workplace, one must understand how employees experience work demands. Such an understanding can be obtained from each individual with valid and quality-assured questionnaires. The Work Environment Impact Questionnaire (WEIQ) is a new questionnaire for measuring employees’ self-perceived work ability in relation to their specific workplace environment. The purpose of this study was to assess the measurement properties in terms of construct validity of the WEIQ. Methods: A cross-sectional survey study was conducted with 288 respondents from three different workplaces involving assisted living personnel, vocational rehabilitation personnel and personnel at a research institute. The measurement properties of the WEIQ were assessed according to Rasch Measurement Theory (RMT), including assessment of item-to-sample targeting, threshold ordering, item fit statistics, unidimensionality and reliability. Results: Item fit, i.e., fit residuals, item characteristic curves (ICC) and chi square values, were all satisfactory, and no disordered thresholds were present after collapsing the lowest response categories. However, issues with local dependent (LD) item correlations was present in 7.6% cases, four items showed statistically significant differential item functioning (DIF), where 11% of the respondents had person fit residuals outside the recommended range of ± 2.5 and the t-test for unidimensionality did not meet the criterion of 5%. Scale-to-sample targeting and reliability (0.92) were good. LD could be resolved with testlets and at the same time maintaining fit and improving dimensionality, but then the reliability decreased to 0.82. Conclusions: This study provides an initial validation of the WEIQ to be used for assessing employees’ self-perceived work ability. Most measurement properties were acceptable, but further exploration of LD, DIF and unidimensionality in additional work settings and with larger sample sizes is warranted. Trial registration: Not applicable.

There is a ‘need to know’ for people who have acquired a spinal cord injury (SCI) and a ‘lack of knowledge’ is considered to be a barrier to coping with SCI. In-patient SCI care and rehabilitation have emphasized that information should be provided in the right amounts, at the right place and at the right time. Such needs and timing probably go beyond initial care and rehabilitation. Likewise, there is also, reasonably a need for knowledge for other groups of people meeting people with SCI, such as relatives, health professionals and personal care assistants1 as well as authorities, decision-makers, employers, architects and city planners etc. Our recent work, shows that more evidence is needed regarding the provision of specialist expertise in SCI by care services and to what extent they are therefore able to respond to the needs of people living with SCI. A Swedish need assessment project, including a priority setting partnership (PSP2 ) according to James Lind Alliance, has been implemented nationwide 2021–22 to address the needs which are most important for people with SCI to enhance their lives. The Swedish need assessment project comprises three parts: (a) needs to be met; (b) questions to be answered; (c) knowledge required. In part (b), which is the PSP we have identified research priorities (e.g. knowledge gaps); while in part (c), presented here, we report results from an online survey addressing knowledge translation gaps in order to shed light on the knowledge that is available yet which does not reach out. An online survey was released in November–December 2021 with people with SCI, relatives of people with SCI and health professionals and care assistants working with people with SCI. This survey included an open-ended question concerning knowledge translation gaps – what kind of knowledge is lacking and who needs the knowledge. In total, 242 persons responded the survey. Table 1 provides personal characteristics. Each respondent could state one to five knowledge needs, resulting in 480 inputs (statements with more than one need were treated separately in the total number of inputs). However, 84 statements were removed due to beyond the scope of the study (e.g., addressing general needs not related to needs for knowledge). The statements where further complemented with 64 statements from the PSP question (where these were asked for issues which were difficult to find answers to). Thus, this report is based on a total of 459 statements included in this study.

Background: Persons on the autism spectrum exhibit poorer body awareness than neurotypical persons. Since movement quality may be regarded as an expression of body awareness, assessment of movement quality is important. Sound assessments of measurement properties are essential if reliable decisions about body awareness interventions for persons on the autism spectrum are to be made, but there is insufficient research. Objective: To assess measurement properties of the Body Awareness Scale Movement Quality (BAS MQ) in an autism and a neurotypical reference group. Methods: Persons on the autism spectrum (n=108) and neurotypical references (n=32) were included. All were assessed with BAS MQ. Data were analyzed according to the Rasch model. Results: BAS MQ was found to have acceptable unidimensionality, supported by the fit statistics. The hierarchical ordering showed that coordination ability was the most difficult, followed by stability and relating. Response category functioning worked as intended for 19 out of 23 items. There were few difficult items, which decreased targeting. Reliability measures were good. BAS MQ discriminated between the autism and the reference groups, with the autism group exhibiting poorer movement quality, reflecting clinical observations and previous research. Conclusions: BAS MQ was found to have acceptable measurement properties, though suffering from problems with targeting item difficulty to person ability for persons on the autism spectrum. The BAS MQ may, along with experienced movement quality, contribute to clinically relevant information of persons on the autism spectrum, although we encourage refinements and further analyses to improve its measurement properties. 

BACKGROUND: Associations between longitudinal changes of plasma biomarkers and cerebral magnetic resonance (MR)-derived measurements in Alzheimer’s disease (AD) remain unclear. METHODS: In a study population (n = 127) of healthy older adults and patients within the AD continuum, we examined associations between longitudinal plasma amyloid beta 42/40 ratio, tau phosphorylated at threonine 181 (p-tau181), glial fibrillary acidic protein (GFAP), neurofilament light chain (NfL), and 7T structural and functional MR imaging and spectroscopy using linear mixed models. RESULTS: Increases in both p-tau181 and GFAP showed the strongest associations to 7T MR-derived measurements, particularly with decreasing parietal cortical thickness, decreasing connectivity of the salience network, and increasing neuroinflammation as determined by MR spectroscopy (MRS) myo-inositol. DISCUSSION: Both plasma p-tau181 and GFAP appear to reflect disease progression, as indicated by 7T MR-derived brain changes which are not limited to areas known to be affected by tau pathology and neuroinflammation measured by MRS myo-inositol, respectively. Highlights: This study leverages high-resolution 7T magnetic resonance (MR) imaging and MR spectroscopy (MRS) for Alzheimer’s disease (AD) plasma biomarker insights. Tau phosphorylated at threonine 181 (p-tau181) and glial fibrillary acidic protein (GFAP) showed the largest changes over time, particularly in the AD group. p-tau181 and GFAP are robust in reflecting 7T MR-based changes in AD. The strongest associations were for frontal/parietal MR changes and MRS neuroinflammation.