| 1. |
- Fagerström, Cecilia, Docent, 1973-, et al.
(författare)
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Home Care in Denmark
- 2013. - 1
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Ingår i: Home care across Europe. - : World Health Organization. ; , s. 60-66
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Bokkapitel (refereegranskat)
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| 2. |
- Fagerström, Cecilia, Docent, 1973-, et al.
(författare)
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Home care in Norway
- 2013. - 1
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Ingår i: Home care across Europe. - : World Health Organization. ; , s. 207-213
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Bokkapitel (refereegranskat)
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| 3. |
- Fagerström, Cecilia, Docent, 1973-, et al.
(författare)
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Home care in Sweden
- 2013
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Ingår i: Home care across Europe. - : World Health Organization. ; , s. 272-279
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Bokkapitel (refereegranskat)
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| 4. |
- Hagell, Peter, et al.
(författare)
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Measurement properties of the Minimal Insomnia Symptom Scale (MISS) as an insomnia screening tool among adults and the elderly
- 2015
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Ingår i: The 6th International Conference on Probabilistic Models for Measurement in Education.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: The Minimal Insomnia Symptom Scale (MISS) has been suggested as a brief 3-item screening tool for detecting insomnia. Each item has an ordered 5-category (0-4) response scale and the instrument yields a total score between 0-12 (higher scores = more insomnia). Available MISS evaluations have been based on classical test theory (CTT) approaches. Different cut-offs for identifying insomnia have been suggested for adults (aged 20-64) and elderly (aged 65+). For adults, a cut-off of ≥6 has been suggested, while a cut-off of ≥7 has been suggested for the elderly, as determined from applications of the Youden index. Aim: To test the measurement properties of the MISS using the Rasch measurement model, with special emphasis on Differential Item Functioning (DIF) by age, and to explore implications for the two suggested cut-off scores. Design: Cross-sectional MISS data from adult (n=1075) and elderly (n=548) populations were analysed by the unrestricted polytomous Rasch measurement model using the RUMM2030 software program. To avoid an inflated type I error rate, sample size was algebraically adjusted to 500 in the calculation of P-values while leaving all other aspects of data (e.g., locations, fit residuals) unaltered. Results: Mean person location was -1.095 (SD, 1.28), i.e. items tend to represent more severe levels of insomnia than that experienced by the sample. However, for the purpose of screening this may be considered acceptable. There were no statistically significant deviations from model expectations, with a non-significant overall item-trait interaction (χ2 = 26.94, P=0.173). Reliability (PSI) was 0.59 suggesting that the MISS can separate approximately two statistically distinct groups of people (1.92 strata). The highest Information Function (IF) was found at -0.2 logits. There were no disordered response category thresholds. There was uniform DIF by age for all three items, which disappeared following adjustment (split by age group) for the most pronounced DIF, suggesting that DIF was artificial for two items. Examination of raw scores-to-location estimates between the two age groups revealed differences at the lower and higher ends of the scale. The raw score cut-off of ≥6 was associated with a smaller logit difference between age groups than the ≥7 cut-off (0.09 vs. 0.23). That is, at a raw score of 6 the two age groups were comparable regarding their logit location estimates. This raw score (representing a logit value of -0.03 for the pooled sample) was also the one closest to the location of the highest IF (i.e., -0.2 logits). Summary and implications: This study provides general support for the measurement properties of the MISS. However, caution should be exercised in comparing MISS scores between age groups, but applying a ≥6 raw score cut-off appears to allow for valid comparisons between adults and elderly regarding the presence of insomnia. Nevertheless, additional studies are needed to determine the clinically optimal cut-score for identification of insomnia.
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| 5. |
- Hellström, Amanda, et al.
(författare)
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Association between Sleep Disturbances and Leisure Activities in the Elderly : A Comparison between Men and Women
- 2014
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Ingår i: Sleep Disorders. - : Hindawi Limited. - 2090-3545 .- 2090-3553.
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Tidskriftsartikel (refereegranskat)abstract
- It has been suggested that physical or social activity is associated with fewer sleep disturbances among elderly people. Women report more sleep disturbances than men, which could indicate a variation in activity patterns between the genders. The aim of this study was to investigate associations between sleep disturbances and leisure activities in men and women (n = 945) aged ≥60 years in a Swedish population. Sleep disturbances were measured using eight dichotomous questions and seventeen variables, covering a wide range of leisure activities. Few leisure activities were found to be associated with sleep disturbances and their importance decreased when the models were adjusted for confounders and gender interactions. After clustering the leisure activities and investigating individual activities, socio-intellectual activities were shown to be significant for sleep. However, following adjustment for confounders and gender interactions, home maintenance was the only activity significant for sleep. Being a female increased the effect of home maintenance. Besides those leisure activities, poor/fair self-rated health (OR 7.50, CI: 4.27-11.81) and being female (OR 4.86, CI: 2.75-8.61) were found to have the highest association with poor sleep. Leisure activities pursued by elderly people should focus on activities of a socio-intellectual nature, especially among women, to promote sleep.
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| 6. |
- Hellström, Amanda, et al.
(författare)
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How to measure and classify insomnia in elderly persons
- 2010
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Ingår i: Journal of Clinical Nursing. - Rotterdam : Wiley. - 0962-1067 .- 1365-2702. ; 19:suppl 1, s. 147-148
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Since sleep is found to be a fundamental part in experiencing quality of life and health it is of importance that nurses and other health care personnel strive to improve sleep and prevent sleep disturbances. Insomnia, which is the most common form of sleep disturbances, has also been found to be related with cardiac disorders. Elderly people are especially vulnerable for poor sleep; prevention of sleep disturbances should be of regard when caring for older persons. The Minimal Insomnia Symptom Scale (MISS) is a three item screening instrument previously found to be psychometrically sound and capable of identifying insomnia in the general population (20-64 years). However, its measurement properties have not been studied in an elderly population. Our aim was to test the measurement properties of the MISS among people aged 65+ in Sweden.Methods and materials: Data from a cross-sectional survey of 548 elderly individuals were analyzed in terms of assumptions of summation of items, reliability and optimal cut-off score by means of ROC-curve analysis and compared with self-reported insomnia criteria. The items of MISS describes the major features of insomnia, i.e. difficulties initiating sleep, waking at night and not feeling refreshed by sleep. A total score ranging between 0 and 12 is calculated, where higher scores indicate more severe insomnia.Results: Reliability was found to be 0.81. ROC analysis where MISS was compared with self-reported insomnia criteria (i. e. day-time sleepiness, not feeling refreshed by sleep, experiencing sleep difficulties). Optimal cut-off score was identified as more or equal to 7, and sensitivity 93%, specificity 84%.Conclusions: Data support the measurement properties of MISS as an insomnia screening instrument among elderly persons and its brevity as well as the easy scoring system makes it appealing in clinical practice.
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| 7. |
- Hellström, Amanda, et al.
(författare)
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Promoting sleep by nursing interventions in health care settings : A systematic review
- 2011
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Ingår i: Worldviews on Evidence-Based Nursing. - : Wiley. - 1545-102X .- 1741-6787. ; 8:3, s. 128-142
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Tidskriftsartikel (refereegranskat)abstract
- Background: Sleep disturbances are a common problem among individuals in hospitals and institutions. Although several studies have explored this phenomenon, there is still a lack of knowledge about the effectiveness of sleep-promoting nursing interventions. This systematic review aims to describe and evaluate the effectiveness of sleep-promoting nursing interventions in health care settings. Design: A systematic review was performed. Method: In June 2009, a literature search was carried out in the following databases: Academic Search Elite, CINAHL, the Cochrane Library and MedLine/PubMed. Fifty-two references were identified and after critical appraisal nine studies were selected. A compilation of the results and the outcomes of the interventions were carried out. Further, the evidence strength of the interventions was assessed. Findings: Evidence for the nursing interventions sleep hygiene, music, natural sound and vision, stimulation of acupoints, relaxation, massage and aromatherapy, is found to be low or very low. Still large effects of interventions where found when using massage, acupuncture and music, natural sounds or music videos. The use of sleep hygiene and relaxation on the other hand showed only small effects. Conclusion: The paucity of studies implies that the confidence in the effects shown, and the lack of high evidence strength for many nursing interventions, most certain will change if further studies are carried out. The uncertainty about the effects calls for more research before implementing the interventions into clinical practice.
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| 8. |
- Hellström, Amanda, et al.
(författare)
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The rhythm of the unit is the pace of life : a study of everyday activities and sleep in Swedish residential care
- 2015
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Ingår i: Open Journal of Nursing. - Irvine : Scientific Research Publishing. - 2162-5336 .- 2162-5344. ; 5:8, s. 697-706
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Tidskriftsartikel (refereegranskat)abstract
- Social and physical activities can improve sleep in older people. However, living in a residential care facility has been associated with a limited potential for activities and increased inactivity, reflected in poor sleep among residents. In turn, poor sleep can impair physical and mental functions. This paper explores sleep habits and everyday activities at three residential care facilities and investigates the link between sleep habits and everyday activities from the perspective of the residents. Data were collected through observations of daily life and interviews with residents.The results showed that fixed times during the day reduced daytime sleep and motivated them to go to the day room, thus enabling social interaction. More impaired residents spent more time in the day room napping or being less active. The residents stated that going outdoors was a desired activity, thought to improve sleep. However, the activity did not occur to the extent the residents wished for. Maintaining mobility and influence over daily activities together with regularity seemed to improve sleep. Awareness among staff of the need for stimulating and enriching activities, as well as access to bright light is requisite. Specific consideration should be given to residents who have difficulties communicating their wishes and/or impaired mobility.
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| 9. |
- Hellström, Amanda, et al.
(författare)
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Usefulness of the Minimal Insomnia Symptom Scale (MISS) in elderly persons
- 2010
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Ingår i: 20th Nordic Congress of Gerontology. - Reykjavik : Nordisk Gerontologisk Forening.
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Konferensbidrag (refereegranskat)abstract
- Sleep is found to be a fundamental part in experiencing health. Sleep is needed for memory consolidation, metabolic balance, immune functioning and alertness at day time and experiencing quality of life. Insomnia has also been found to be associated with cardiac disorders. Elderly people are especially vulnerable for poor sleep, why prevention of sleep disturbances should be of regard when caring for older persons. MISS is a 3 item questionnaire, with a total-score of 0-12 that could be used to find insomnia in elderly persons. Aim: To test of the measurement properties of the Minimal Insomnia Symptom Scale in an elderly sample ≥65 years in Sweden. Study sample Persons participating in the Swedish National Study on Ageing and Care – Blekinge were invited. ● 548 participated (response-rate 61.4%) ● Mean age 77.8 (SD 8.63) years ● Female 57.5% Results Reliability was found to be 0.81. ROC analysis where MISS was compared with self-reported insomnia criteria (i.e. day-time sleepiness, not feeling refreshed by sleep, experiencing sleep difficulties) identified optimal cut-off score as ≥7, and sensitivity 93%, specificity 84%. Area under curve = 0.93. Conclusion Data support the measurement properties of MISS as an insomnia screening instrument among elderly persons and its brevity makes it appealing. Through insomnia-screening, older persons at risk of health problems can be found and offered treatment and thereby health and quality of life can be restored.
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| 10. |
- Holst, Göran, et al.
(författare)
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Quality of care : prevention of pressure ulcers - nursing students as facilitators of evidence based practice
- 2010
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Ingår i: Vård i Norden. - : Sage Publications. - 0107-4083 .- 1890-4238. ; 30:1, s. 40-42
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Tidskriftsartikel (refereegranskat)abstract
- This development project was aimed at engaging nursing students in a project targeting the prevention and reduction of pressure ulcers on an education based hospital ward. An intervention was implemented based on systematic assessment, skin observation, together with training and educational sessions, i.e. on how to make risk assessments and how to prevent and treat a pressure ulcer, were carried out. The project demonstrated the importance of offering nursing students an environment for clinical practice which supports them in participating and developing patient care starting from Evidence-Based Practice. During the project no patients developed pressure ulcers while on the ward. The opportunityto act as facilitators of evidence-based methods was found to enhance student ability to draw conclusions and make connections between quality of care and end result.
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