| 6021. |
- Hallgren, Jenny, et al.
(författare)
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Factors associated with hospitalization among older people in Sweden : Results from the Satsa Study
- 2015
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Ingår i: The Gerontologist. - : Oxford University Press. - 0016-9013 .- 1758-5341. ; 55, s. 678-679
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Tidskriftsartikel (refereegranskat)abstract
- Background: Hospitalization among older people is common and associated with risk of adverse outcomes such as iatrogenic disorders and physical impairments. Knowledge about personal characteristics and social factors related to hospitalization is scarce. In order to understand which factors that are related to hospitalization risk, a prospective study with a multifactorial approach was conducted.Methods: In 2003, 794 Swedish persons (mean age 70.1 years, 60.7% females) answered a postal questionnaire as a part of the population-based longitudinal Swedish Adoption/Twin Study of Aging (SATSA). Participants were asked about physiological and psychological health, personality and socio economic factors. During seven years of follow-up, information on hospitalizations and the associated diagnoses were obtained from the Swedish National Inpatient Register.Results: Preliminary results show that 484 persons (61.0%) had at least one hospital admission during the follow-up period. The most common causes of admission were cardiovascular diseases and tumors. Cox proportional hazard regression model controlling for age, sex and dependency within twin pairs, showed that higher locus of control (HR=0.89, 95% CI=0.83-0.96), marital status (widow/widower (HR=0.64, 95 % CI=0.50-0.81) and unmarried (HR=0.67, 95% CI=0.50-0.90)), and support from friends (HR=0.93, 95% CI=0.87-0.99) were associated with lower risk of hospitalization, while greater numbers of diseases (HR=1.11, 95% CI=1.03-1.20) and negative life events (HR=1.16, 95% CI=1.00-1.34) were associated with increased risk of hospitalization.Discussion: Our results show that both personal and social factors were important for the risk of hospitalization. This might be used in future interventions for understanding health care utilization.
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| 6022. |
- Hallgren, Jenny, 1978-, et al.
(författare)
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Factors associated with hospitalization risk among community living middle aged and older persons : Results from the Swedish Adoption/Twin Study of Aging (SATSA)
- 2016
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Ingår i: Archives of gerontology and geriatrics (Print). - : Elsevier. - 0167-4943 .- 1872-6976. ; 66, s. 102-108
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Tidskriftsartikel (refereegranskat)abstract
- The aims of the present study were to: (1) describe and compare individual characteristics of hospitalized and not hospitalized community living persons, and (2) to determine factors that are associated with hospitalization risk over time. We conducted a prospective study with a multifactorial approach based on the population-based longitudinal Swedish Adoption/Twin Study of Aging (SATSA). A total of 772 Swedes (mean age at baseline 69.7 years, range 46–103, 59.8% females) answered a postal questionnaire about physical and psychological health, personality and socioeconomic factors. During nine years of follow-up, information on hospitalizations and associated diagnoses were obtained from national registers. Results show that 484 persons (63%) had at least one hospital admission during the follow-up period. The most common causes of admission were cardiovascular diseases (25%) and tumors (22%). Cox proportional hazard regression models controlling for age, sex and dependency within twin pairs, showed that higher age (HR = 1.02, p < 0.001) and more support from relatives (HR = 1.09, p = 0.028) were associated with increased risk of hospitalization, while marital status (unmarried (HR = 0.75, p = 0.033) and widow/widower (HR = 0.69, p < 0.001)) and support from friends (HR = 0.93, p = 0.029) were associated with lower risk of hospitalization. Social factors were important for hospitalization risk even when medical factors were controlled for in the analyses. Number of diseases was not a risk in the final regression model. Hospitalization risk was also different for women and men and within different age groups. We believe that these results might be used in future interventions targeting health care utilization.
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| 6023. |
- Hallgren, Jenny, 1978-, et al.
(författare)
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Factors associated with increased hospitalisation risk among nursing home residents in Sweden : a prospective study with a three-year follow-up
- 2016
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Ingår i: International Journal of Older People Nursing. - : John Wiley & Sons. - 1748-3735 .- 1748-3743. ; 11:2, s. 130-139
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundHospitalisation of nursing home residents might lead to deteriorating health.AimTo evaluate physical and psychological factors associated with hospitalisation risk among nursing home residents.DesignProspective study with three years of follow-up.MethodsFour hundred and twenty-nine Swedish nursing home residents, ages 65–101 years, from 11 nursing homes in three municipalities were followed during three years. The participants' physical and psychological status was assessed at baseline. A Cox proportional hazards model was used to evaluate factors associated with hospitalisation risk using STATA.ResultsOf the 429 participants, 196 (45.7%) were hospitalised at least once during the three-year follow-up period, and 109 (25.4%) during the first six months of the study. The most common causes of hospitalisation were cardiovascular diseases or complications due to falls. A Cox regression model showed that residents who have had previous falls (P < 0.001), are malnourished (P < 0.001), use a greater number of drugs (P < 0.001) and have more diseases (P < 0.001), are at an increased risk of hospitalisation.ConclusionNursing home residents are frequently hospitalised, often due to falls or cardiovascular diseases. Study results underscore the relationships between malnutrition, previous falls, greater numbers of drugs and diseases and higher risk of hospitalisation.Implications for practicePreventive interventions aimed at malnutrition and falls at the nursing home could potentially reduce the number of hospitalisations. With improved education and support to nurses concerning risk assessment at the nursing homes, it may be possible to reduce the numbers of avoidable hospitalisation among nursing home residents and in the long run improve quality of life and reduce suffering.
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| 6024. |
- Hallgren, Jenny, et al.
(författare)
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Health- and social care in the last year of life among older adults in Sweden
- 2020
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Ingår i: BMC Palliative Care. - : BioMed Central. - 1472-684X. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: In the last years of life, burden of disease and disability and need of health- and social care often increase. Social, functional and psychological factors may be important in regard to social- and health care utilization. This study aims to describe use of health- and social care during the last year of life among persons living in ordinary housing or in assisted living facilities. METHODS: A retrospective study examining health- and social care utilization during their last year of life, using a subsample from the Swedish twin registries individually linked to several Swedish national quality registries (NQR). Persons that died during 2008-2009 and 2011-2012 (n = 1518) were selected. RESULTS: Mean age at death was 85.9 ± 7.3 (range 65.1-109.0). Among the 1518 participants (women n = 888, 58.5%), of which 741 (49%) were living in assisted living facilities and 1061 (69.9%) had at least one hospitalization during last year of life. The most common causes of death were cardiovascular disease (43.8%) and tumors (15.3%). A multivariable logistic regression revealed that living in ordinary housing, younger age and higher numbers of NQR's increased the likelihood of hospitalization. CONCLUSIONS: Persons in their last year of life consumed high amount of health- and social care although 12% did not receive any home care. Married persons received less home care than never married. Persons living in ordinary housing had higher numbers of hospitalizations compared to participants in assisted living facilities. Older persons and persons registered in fewer NQR's were less hospitalized.
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| 6025. |
- Hallgren, Jenny, 1978-, et al.
(författare)
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In Hospital We Trust : Experiences of older peoples' decision to seek hospital care
- 2015
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Ingår i: Geriatric Nursing. - : Elsevier. - 0197-4572 .- 1528-3984. ; 36:4, s. 306-311
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Tidskriftsartikel (refereegranskat)abstract
- The purpose of this study was to explore how older people experience and perceive decisions to seek hospital care while receiving home health care. Twenty-two Swedish older persons were interviewed about their experiences of decision to seek hospital while receiving home health care. The interviews were analyzed using qualitative content analysis. The findings consist of one interpretative theme describing an overall confidence in hospital staff to deliver both medical and psychosocial health care, In Hospital We Trust, with three underlying categories: Superior Health Care, People's Worries, and Biomedical Needs. Findings indicate a need for establishing confidence and ensuring sufficient qualifications, both medical and psychological, in home health care staff to meet the needs of older people. Understanding older peoples' arguments for seeking hospital care may have implications for how home care staff address individuals' perceived needs. Fulfillment of perceived health needs may reduce avoidable hospitalizations and consequently improve quality of life.
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| 6026. |
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| 6027. |
- Hallgren, Jenny, 1978-, et al.
(författare)
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Risk factors for hospital readmission among Swedish older adults
- 2018
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Ingår i: European Geriatric Medicine. - : Springer. - 1878-7649 .- 1878-7657. ; 9:5, s. 603-611
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Tidskriftsartikel (refereegranskat)abstract
- Introduction Hospital readmissions of older persons are common and often associated with complex health problems. The objectives were to analyze risk factors for readmission within 30 days from hospital discharge.MethodsA prospective study with a multifactorial approach based on the population-based longitudinal Swedish Adoption/ Twin Study of Aging (SATSA) was conducted. During 9 years of follow-up, information on hospitalizations, readmissions and associated diagnoses were obtained from national registers. Logistic regression models controlling for age and sex were conducted to analyze risk factors for readmissions.ResultsOf the 772 participants, [mean age 69.7 (±11.1), 84 (63%)] were hospitalized and among these 208 (43%) had one or several readmissions within 30 days during the follow-up period. Most of the readmissions (57%) occurred within the frst week; mean days from hospital discharge to readmission was 7.9 (±6.2). The most common causes of admission and readmission were cardiovascular diseases and tumors. Only 8% of the readmissions were regarded as avoidable admissions. In a multivariate logistic regression, falling within the last 12 months (OR 0.57, p=0.039) and being a male (OR 1.84, p=0.006) increased the risk of readmission.ConclusionsMost older persons that are readmitted return to hospital within the frst week after discharge. Experiencing a fall was a particular risk factor of readmission. Preventive actions should preferably take place already at the hospital to reduce the numbers of readmission. Still, it should be remembered that most readmissions were considered to be necessary.
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| 6028. |
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| 6029. |
- Hallgren, Jenny, 1978-, et al.
(författare)
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Trajectories of motor function and cognition in relation to hospitalization
- 2017
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Konferensbidrag (refereegranskat)abstract
- Background: Hospitalization among older people is common and associated with adverse outcomes. However, knowledge about long-term effects on motor functions and cognitive abilities in relation to hospitalization is scarce. In order to explore development of motor functions and cognition after hospitalization, a longitudinal study among middle-aged and older adults with up to 25 years of follow-up was conducted.Methods: Overall, 828 participants from the Swedish Adoption/Twin Study of Ageing (SATSA) were linked to the Swedish National Inpatient Register, which contains information on participants’ hospital admissions. Up to 8 assessments of cognitive performance and 7 assessments of motor functions i.e. fine motor, balance/upper strength, and flexibility, from 1986 to 2010 were available. Latent growth curve modelling was used to assess the association between hospitalization and subsequent motor function and cognitive performance.Results: A total of 735 (89 %) persons had at least one hospital admission during the follow-up. The mean age at first hospitalization was 70.2 (± 9.3) years. Persons who were hospitalized exhibited a lower mean level of cognitive performance in all domains and in motor functions compared with those who were not hospitalized. A significantly steeper decline was observed in motor function abilities as well as in processing speed, spatial/fluid, and general cognitive ability performance of hospitalized participants. These patterns remained even after comorbidities and dementia prevalence were controlled for.Discussion: We are the first to show that hospitalization is associated with steeper decline in both motor function and cognitive abilities across more than two decades of post-hospitalization follow-up.
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| 6030. |
- Hallgren, Mats, et al.
(författare)
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Exercise and internet-based cognitive-behavioural therapy for depression : Multicentre randomized controlled trial with 12-month follow-up
- 2016
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Ingår i: British Journal of Psychiatry. - : Cambridge University Press. - 0007-1250 .- 1472-1465. ; 209:5, s. 414-420
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Tidskriftsartikel (refereegranskat)abstract
- Background Evidence-based treatment of depression continues to grow, but successful treatment and maintenance of treatment response remains limited.Aims To compare the effectiveness of exercise, internet-based cognitive-behavioural therapy (ICBT) and usual care for depression.Method A multicentre, three-group parallel, randomised controlled trial was conducted with assessment at 3 months (posttreatment) and 12 months (primary end-point). Outcome assessors were masked to group allocation. Computer-generated allocation was performed externally in blocks of 36 and the ratio of participants per group was 1:1:1. In total, 945 adults with mild to moderate depression aged 18-71 years were recruited from primary healthcare centres located throughout Sweden. Participants were randomly assigned to one of three 12-week interventions: supervised group exercise, clinician-supported ICBT or usual care by a physician. The primary outcome was depression severity assessed by the Montgomery-Åsberg Depression Rating Scale (MADRS).Results The response rate at 12-month follow-up was 84%. Depression severity reduced significantly in all three treatment groups in a quadratic trend over time. Mean differences in MADRS score at 12 months were 12.1 (ICBT), 11.4 (exercise) and 9.7 (usual care). At the primary end-point the group x time interaction was significant for both exercise and ICBT. Effect sizes for both interventions were small to moderate.Conclusions The long-term treatment effects reported here suggest that prescribed exercise and clinician-supported ICBT should be considered for the treatment of mild to moderate depression in adults.
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