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New ways of doing in daily life: Valuebased, Client-centered and ICT-supported primary and secondary stroke prevention and rehabilitation after stroke

The overall aim of this program is to develop, evaluate, and implement assessment and intervention models aiming to enable Engaging Activities in Daily Life (EADL) with the support of a client-centered approach and Information and Communication Technology (C-ICT).


A central tenet in this research program is the enabling of engaging occupations in order to translate into new and healthy activity patterns among persons at risk for stroke or who have had a stroke. Professional support and guidance is critical when changing or creating new, sustainable and healthy activity patterns in daily life; this is particularly important in disease prevention or as part of rehabilitation after functional restrictions due to disease. Risk factors related to stroke can broadly be described as non-modifiable or modifiable. Modifiable risk factors such as high cholesterol, atrial fibrillation, hypertension, tobacco use, excessive alcohol consumption, obesity, physical inactivity, and hypertension, are of particular interest for prevention in this program. Modifiable factors can be treated pharmacologically and/or in combination with changes in lifestyle. Studies addressing primary and secondary stroke prevention with a focus on non-pharmacological aspects, as in this program, are scarce and therefore an important part of research today.


This program builds on the medical research council (MRC) guidance framework for developing and evaluating complex interventions, which are “inter­ventions that contain several interacting components, but have other characteristics that evaluators should take into account” (p.979); other characteristics include things such as behaviors required by those delivering and receiving the intervention, organizational levels targeted by the intervention, as well as number and variability of outcomes.

The MRC framework consists of four elements: a) development, b) feasibility and piloting, c) evaluation, and d) implementation of an intervention.

Ongoing data-gathering includes open-ended interviews, focus group interviews, and standardized assessments. Analyses consist of both qualitative and quantitative methods.

Financial Support

Vårdal Foundation Dnr-2014-0108 (K. Tham – PI)
Doctoral School in Health Care Sciences at Karolinska Institutet (S. Guidetti – PI, Martha Gustavsson – Doctoral student)

National Aging Research Foundation (E. Asaba – PI)

Stroke Foundation (S. Guidetti – PI)
Vetenskapsrådet (S. Guidetti – PI)

Research program management team

Associate Professor

Eric Asaba

Telefon: 08-524 838 38
Enhet: Sektionen för arbetsterapi

Associate Professor

Susanne Guidetti

Enhet: Sektionen för arbetsterapi

Associate Professor, Docent

Anders Kottorp

Enhet: Sektionen för arbetsterapi

Associate Professor

Ann-Helen Patomella

Telefon: 08-524 837 26
Enhet: Sektionen för arbetsterapi

Research team

Aileen Bergström, Gunnar Nilsson, Gunilla Eriksson, Hans Jonsson, Lotta Ytterberg, Martha Gustavsson, Bo Christer Bertilson, Christina Olsson, Maria Hagströmer, Elisabeth Åkesson, Uno Fors, Emelie Mälstam, Christina Eriksson, samt två forskningsassistenter Gustav Mickols och Kristin Elstad Norefors.

Affiliated student projects

Gustav Mickols (Medical student)

Kristin Elstad Norefors (Masters student in occupational therapy)

Selected publications from project management

Patomella, A-H, Tham, K., Kottorp, A (2006). P-drive - an assessment of driving performance after stroke. Journal of Rehabilitation Medicine, 38, 273-279.

Eriksson, G., Tham, K. & Borg, J. (2006) Occupational gaps in everyday life 1-4 years after acquired brain injury. Journal of Rehabilitation Medicine, 38, 159-165.

Johansson, U., & Tham, K. (2006). The meaning of work after acquired brain injury. American Journal of Occupational Therapy, 60-69.

Ekstam, L., Uppgard, B., Kottorp, A., & Tham, K. (2007). Relationship between awareness of disability and occupational performance during the first year after a stroke. American Journal of Occupational Therapy, 61, 503–511.

Wohlin Wottrich, A. v Koch, L. & Tham, K. (2007). The meaning of rehabilitation in the home environment after acute stroke from the perspective of a multiprofessional team. American Journal of Physical Therapy, 87, 778-788.

Guidetti, S., Asaba, E., & Tham, K. (2007). The Lived experiences of Recapturing Self-Care. Am J Occup Ther. 61(3):303-10.

Ekstam, L. Uppgard, B. v Koch, L. & Tham, K. (2007). Functioning in everyday life after stroke: A longitudinal study of elderly people receiving rehabilitation at home. Scandinavian Journal of Caring Sicences. 21, 434-446

Boman, I-L. Tham, K. Granqvist, A, Bartfai, A. & Hemingsson, H. (2007). Using electronic aids to daily living after acquired brain injury: A study of the learning process and the usability. Disability and Rehabilitation: Assistive Technology, 2, 23 – 33.

Patomella, AH, Kottorp, A, & Tham, K (2008). Awareness of driving disability in people with stroke tested in a simulator. Scandinavian Journal of Occupational Therapy, 15, 184-192.

Patomella, A-H, Johansson, K. & Tham, K. (2009). Lived experience of driving ability after stroke. Disability and Rehabilitation, 31, 726-733.

Guidetti, S, Asaba E & Tham K. (2009). The meaning of context in recapturing self-care after stroke or spinal cord injury. Am J Occup Ther. 63(3): 323-32.

Eriksson, G. Kottorp, A. Borg, J. & Tham, K (2009). Relationship between occupational gaps in everyday life, depression, mood and life-satisfaction after acquired brain injury. Journal of Rehabilitation Medicine. 41, 187-194.

Guidetti, S., Andersson, K., Andersson, M., Tham, K., & von Koch, L.Client-centred self-care interventionon after stroke - a randomized, controlled pilot study. Scand J Occup Ther. 2010 Dec;17(4):276-85

Eriksson, G, & Tham, K (2010). The meaning of occupational gaps in everyday life after the first year after stroke. OTJR: Occupation, Participation and Health, 30, 49-58.

Patomella, A-H, Tham, K, Johansson, K. & Kottorp, K (2010). P-Drive on-road: Internal scale validity and reliability of an assessment of on-road driving performance in people with neurological disorders. Scandinavian Journal of Occupational Therapy, 17, 86-93.

Asaba, E. & Jackson, E. (2011). Social ideologies embedded in everyday life: A narrative analysis about disability, identities, and occupation. Journal of Occupational Science, 18(2), 139-152.

Guidetti, S. & Ytterberg, L. (2010). A randomised controlled trial of a client-centred self-care intervention after stroke: a longitudinal feasibility study. Disabil Rehabil; 2011; 33(6):494-503.

Erikson, A., Park, M., Tham, K. (2010) Belonging a qualitative, longitudinal study of what matters for persons after stroke during one year of rehabilitation. Journal of rehabilitation medicine, 42, 831-838.

Heiwe, S., Nilsson Kajermo, K., Tyni-Lenne, R., Guidetti, S., Samuelsson, M., Andersson, IL. & Wengström, Y. (2011). Evidence-based practice: Attitudes, knowledge and behavior Among Allied Healthcare professionals. International Journal for Quality in Health Care. pp. 1-12

Bergstrom AL, Eriksson G, von Koch L & Tham K (2011). Combined life satisfaction of persons with stroke and their caregivers: Associations with caregiver burden and the impact of stroke. Health and Quality of Life Outcome, 9.

Fallapour M, Tham K, Joghataei MT, Eriksson G & Jonsson H. (2011). Occupational gaps in everyday life after stroke and the relation to functioning and perceived life satisfaction. OTJR-Occupation Participation and Health, 31, 200-208.

Patomella, A-H, Kottorp, A., Nygård, L. (2011) Factors that impact the level of difficulty of everyday technology in a sample of older adults with and without cognitive impairment. Technology and Disability, 23:243-250.

Fallahpour M, Tham K, Joghataei MT, Jonsson H. (2011). Perceived participation and autonomy: Aspects of functioning and contextual factors predicting participation after stroke. Journal of Rehabilitation Medicine, 43, 388-397.

Asaba, E., Petersson, I., Bontje, P., & Kottorp, A. (2012). The assessment of awareness of ability (A3) in a Japanese context: A rasch model application. Scandinavian Journal of Occupational Therapy. 19(4), 370-376.

Bergström A, Guidetti, S, Tistad M, Tham K, von Koch L, Eriksson G. (2012). Perceived occupational gaps one year after stroke – an explorative study. J Rehabil Med. 44(1):36-42

Bontje, P., Asaba, E., Josephsson, S. (2012). Japanese older adults perspectives on resuming daily life during hospitalization and after returning home. Occupational Therapy International. 19(2), 98-107.

Eriksson G, Aasnes M, Tistad M, Guidetti S, von Koch L. (2012). Occupational gaps in everyday life one year after stroke and the association to life satisfaction and impact of stroke. Top Stroke Rehabil. 19(3):244-55.

Eriksson C, Tham K, Guidetti S. (2013). Occupational therapists' experiences in integrating a new intervention in collaboration with a researcher. Scand J Occup Ther. 20(4):253-63

Johansson, K., Rudman, D., Mondaca, M., Park, M., Josephsson, S., Luborsky, M., Asaba, E. (2013). Moving beyond ‘aging in place’ to understand migration and aging: Place making and the centrality of occupation. Journal of Occupational Science. 20(2), 108-119.

Patomella, A-H, Kottorp, A., Nygård, L. (2013) Design and management features of everyday technology that challenge older adults. British Journal of Occupational Therapy, 76 (9), 390-399.

Bertilsson AS, Ranner M, von Koch L, Eriksson G, Johansson U, Ytterberg C, Guidetti S, Tham K. (2014). A client-centred ADL intervention: three-month follow-up of a randomized controlled trial. Scand J Occup Ther. Early Online, 1–15