| 1. |
- Borglin, Gunilla, et al.
(författare)
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Older people in Sweden with various degrees of present quality of life : their health, social support, everyday activities and sense of coherence.
- 2006
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Ingår i: Health & Social Care in the Community. - : Blackwell Publishing. - 0966-0410 .- 1365-2524. ; 14:2, s. 136-146
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Tidskriftsartikel (refereegranskat)abstract
- Public health policies in most European countries are concerned with how to keep older people living independently with a qualitatively good life in the community as long as possible. However, knowledge about what may characterise those seemingly 'healthy' older people is sparse. The aim of the study was to investigate the characteristics of a sample of people (75+) reporting various degrees of Quality of Life (QoL) with respect to QoL in different areas, as well as self-rated health, health problems, social support, everyday activities and sense of coherence. A postal questionnaire was sent out in spring 2001 to a randomly selected population-based sample (n= 600) in the southern parts of Sweden. A two-step cluster analysis was performed (n= 385, mean age 84.6, SD = 5.7) with 'present QoL' as clustering attribute. Three groups were disclosed, classified as high, intermediate and low present QoL, of which 33.8% could be regarded being at risk of low QoL. Those with low present QoL (18.4%) were the oldest and most vulnerable, a majority were women with 'poor or bad' self-rated health, high frequencies of health problems, low total QoL, low social support and sense of coherence and less physically active. Those with high present QoL (47.8%) reported more 'excellent or good' self-rated health, physical activity, satisfactory social support and higher sense of coherence and total QoL than the other two groups. Those with intermediate present QoL (33.8%) had more of 'poor or bad' self-rated health, more health problems were less physically active, had lower total QoL and sense of coherence, and less social support than those with high present QoL. The sample seemed to reflect the ageing process in that the respondents were at different stages of ageing. However, the fact that the level of social support, sense of coherence and self-rated health followed the same curve as QoL may indicate that some are more vulnerable to low present QoL given the same health and these should be targeted in preventive programmes since they report low QoL.
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| 2. |
- Karlsson, Staffan, et al.
(författare)
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Functional ability and health complaints among older people with a combination of public and informal care vs. public care only
- 2008
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Ingår i: Scandinavian Journal of Caring Sciences. - Chichester : Wiley-Blackwell Publishing Inc.. - 0283-9318 .- 1471-6712. ; 22:1, s. 136-148
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the study was to investigate functional ability and health complaints of people, 65+, living in special accommodation (equivalent to nursing home) and their counterparts who live at home and receive municipal care or a combination of municipal and informal care. Persons (n = 1958) receiving municipal care were assessed in terms of functional ability, health complaints, and level of informal and municipal care and services. The results showed that more home care, services and help with Instrumental Activities of Daily Living (IADL) were provided to those receiving only municipal care at home, while more home care and services associated with Personal Activities of Daily Living (PADL) as well as nursing care were provided to those receiving informal care in addition to formal care. Cohabitation was a predictor of a combination of municipal and informal care in the home (OR: 5.935), while assistance with IADL provided by municipal home care and services predicted municipal care only (OR: 0.344). Care in special accommodation was predicted by advanced age (OR: 1.051), dependency in IADL (OR: 19.883) and PADL (OR: 2.695), and impaired cognitive ability (OR: 3.849) with receiving municipal care only as a reference. Living alone (OR: 0.106), dependency in IADL (OR: 11.348) and PADL (OR: 2.506), impaired cognitive ability (OR: 3.448), impaired vision or blindness (OR: 1.812) and the absence of slowly healing wounds (OR: 0.407) were predictors of special accommodation with a combination of informal and municipal care at home as a reference. The distribution of municipal care divided older people into three distinct groups. The most frail and elderly people who had no cohabitants received care in special accommodation, determined by their level of physical and cognitive dependency. The frailest individuals living at home were cohabiting and received a combination of municipal and informal care, while those who were less dependent mainly had help with IADL from municipal care only. The results indicate that there is a shift from the substitution to the complementary model and highlights that attention to the family carers is needed.
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| 3. |
- Karlsson, Staffan, et al.
(författare)
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Professional's and older person's assessments of functional ability, health complaints and received care and service : a descriptive study
- 2010
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Ingår i: International Journal of Nursing Studies. - : Elsevier. - 0020-7489 .- 1873-491X. ; 47:10, s. 1217-1227
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The aim of the study was to investigate the level of agreement between the needs assessment made by professional on the one hand, and the older person's views on the other. A further aim was to explore if the estimations made by the professional were systematically lower or higher compared to the views of the older person.PARTICIPANTS: The study included 152 individuals, 65+, who received public care and services in southern Sweden. The concept public care and services include home help, home nursing care, rehabilitation and special accommodation.METHODS: Standardised needs assessments were performed by home help officers, registered nurses and one physiotherapist. Subsequently to the needs assessment, the older person's view was collected in a personal interview. Standardised assessment form was used covering items about demographic data, functional ability, health complaints, adaptation in housing, public and informal care. The concept informal care includes care from spouse and children. Cohen's Kappa was used for analysis of level of agreement and Chi-square tests for differences in estimation.RESULTS: Level of agreement for dependency in instrumental activities of daily living (IADL) and personal activities of daily living (PADL) varied between good (kappa=0.78) and moderate (kappa=0.43). Poor agreement was found for occurrence of dizziness (kappa(w)=0.17) and fair agreement for impaired hearing (kappa(w)=0.27), urinary incontinence (kappa(w)=0.38), pain (kappa(w)=0.21), anxiety (kappa(w)=0.37) and depressed mood (kappa(w)=0.37). Older persons reported more health complaints than in the professional's assessments, significantly lower estimation was found for incontinence and vision. Level of agreement for provided public care at home (home help and home nursing care) was poor, for informal care it varied between very good and moderate.CONCLUSIONS: Needs assessments appeared to focus on older persons ADL, cognition and informal care, while health complaints and social needs were less in focus. A more comprehensive view including preventive and palliative approach may improve quality of life for older persons receiving care and service.
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| 4. |
- Andersson, Magdalena, et al.
(författare)
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The experience of being next of kin to an older person in the last phase of life
- 2010
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Ingår i: Palliative & Supportive Care. - : Cambridge University Press. - 1478-9515 .- 1478-9523. ; 8:1, s. 17-26
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The aim of the study was to investigate the experience of being next of kin to an older person in the last phase of life as narrated after the older person's death.METHOD: Qualitative interviews were performed with the next of kin (n = 17) to people aged 75 years and older who had recently died and had received help and/or care from the municipality in the last phase of life. Eleven women and six men participated, of whom seven were spouses, nine were children, and one was a grandchild. The interviews were analysed using qualitative content analysis.RESULTS: The experience of the next of kin could be understood as being a devoted companion during the transition toward the inevitable end, embracing the categories of living in the shadow of death; focusing on the needs of the dying person, making adjustments to everyday life; feeling the major responsibility; struggling with the health and social care system; and gaining strength from support.SIGNIFICANCE OF RESULTS: Being next of kin to an old person at the end of life means being a devoted companion during the transition toward the inevitable end, including the feeling of bearing the major responsibility and the need to be acknowledged by professionals. This study points to the importance of having access to professional care when it is needed, to complement and support the next of kin when his or her own resources and strength falter. This also includes support to enable the next of kin to remain involved in the care of his or her loved ones, thereby fulfilling their own wishes.
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| 5. |
- Andersson, Magdalena, et al.
(författare)
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The experience of being next of kin to an older person in the last phase of life.
- 2010
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Ingår i: Palliative & Supportive Care. - 1478-9515. ; :Mar 3, s. 1-10
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Tidskriftsartikel (refereegranskat)abstract
- Objective:The aim of the study was to investigate the experience of being next of kin to an older person in the last phase of life as narrated after the older person's death.Method:Qualitative interviews were performed with the next of kin (n = 17) to people aged 75 years and older who had recently died and had received help and/or care from the municipality in the last phase of life. Eleven women and six men participated, of whom seven were spouses, nine were children, and one was a grandchild. The interviews were analysed using qualitative content analysis.Results:The experience of the next of kin could be understood as being a devoted companion during the transition toward the inevitable end, embracing the categories of living in the shadow of death; focusing on the needs of the dying person, making adjustments to everyday life; feeling the major responsibility; struggling with the health and social care system; and gaining strength from support.Significance of results:Being next of kin to an old person at the end of life means being a devoted companion during the transition toward the inevitable end, including the feeling of bearing the major responsibility and the need to be acknowledged by professionals. This study points to the importance of having access to professional care when it is needed, to complement and support the next of kin when his or her own resources and strength falter. This also includes support to enable the next of kin to remain involved in the care of his or her loved ones, thereby fulfilling their own wishes.
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| 6. |
- Condelius, Anna, Universitetslektor, 1976-, et al.
(författare)
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Hospital admissions among people 65+ related to multimorbidity, municipal and outpatient care
- 2008
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Ingår i: Archives of gerontology and geriatrics (Print). - Shannon : Elsevier. - 0167-4943 .- 1872-6976. ; 46:1, s. 41-55
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Tidskriftsartikel (refereegranskat)abstract
- This study aimed at examine the number of planned and acute hospital admissions during 1 year among people 65+ and its relation to municipal care, outpatient care, multimorbidity, age and sex. Four thousand nine hundred and seven individuals having one or more admissions during 2001 were studied. Data were collected from two registers and comparisons were made between those having one, two and three or more hospital stays and between those with and without municipal care and services. Linear regression was used to examine factors predicting number of acute and planned admissions. Fifteen percent of the sample had three or more hospital stays (range 3-15) accounting for 35% of all admissions. This group had significantly more contacts in outpatient care with physician (median number of contacts (md)=15), compared to those with one (md: 8), or two admissions (md: 11). Main predictors for number of admissions were number of diagnosis groups and number of contacts with physician in outpatient care. Those who are frequently admitted to hospital constitute a small group that consume a great deal of inpatient care and also tend to have frequent contacts in outpatient care. Thus interventions focusing on frequent admissions are needed, and this requires collaboration between outpatient and hospital care. © 2007 Elsevier Ireland Ltd. All rights reserved.
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| 7. |
- Condelius, Anna, Universitetslektor, 1976-, et al.
(författare)
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Utilization of medical healthcare among people receiving long-term care at home or in special accommodation
- 2010
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Ingår i: Scandinavian Journal of Caring Sciences. - Chichester : Wiley-Blackwell Publishing Inc.. - 0283-9318 .- 1471-6712. ; 24:2, s. 404-413
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Tidskriftsartikel (refereegranskat)abstract
- Aim: To investigate the utilization of medical healthcare, hospital care and outpatient care, during a 1-year period in relation to informal care, multimorbidity, functional status and health complaints and to long-term care at home or in special accommodation among people aged 65+, with one or more hospital admissions and receiving long-term care.Method: A total of 694 people receiving long-term care during the year 2001 were studied. Data were collected by means of the administrative registers Patient Administrative Support in Skåne and PrivaStat and through the study Good Ageing in Skåne. Those at home and those in special accommodation were compared regarding utilization of medical healthcare, informal care, multimorbidity, functional status and health complaints. Multiple logistic regression analysis was performed using at home vs. in special accommodation as the dependent variable and also two multiple linear regression analyses using the number of hospital stays and the number of contacts with the physician in outpatient care separately as dependent variables.Findings: Those at home were significantly younger (mean age: 81 vs. 84 years) and less dependent in personal and instrumental activities of daily living (PADL/IADL) than those in special accommodation. A larger proportion of those at home was admitted to hospital three times or more (21 vs. 14%) and they had significantly more contacts with physicians in outpatient care (md: 10 vs. md: 7). Informal care was associated with care at home (OR = 0.074) and with utilization of outpatient care (B = 2.045). Dependency in PADL was associated with care in special accommodation (OR = 1.375) and with utilization of hospital care (B = -0.060) and outpatient care (B = -0.581).Conclusion: Medical healthcare seems more accessible to those who live at home are younger, less dependent and who have access to informal caregivers.© 2009 Condelius et al. Journal compilation © 2009 Nordic College of Caring Science
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| 8. |
- Andersson, Edith, et al.
(författare)
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Nurses' experiences of the encounter with elderly patients in acute confusional state in orthopaedic care.
- 2003
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Ingår i: International Journal of Nursing Studies. - 1873-491X. ; 40:4, s. 437-448
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to illuminate nurses’ experiences of the encounter with elderly patients who developed acute confusional state (ACS) in orthopaedic care. Forty-eight nurses with professional background as registered (n=26) or licensed practical nurses (n=22) who took part in the nursing care of acute confused patients were involved. Open-ended unstructured interviews were conducted with regard to the course of events, experiences and interpretation of what had happened during the ACS as well as the nurses’ actions and encounter with the confused patient. The texts were analysed using manifest and latent content analysis, revealing that the nurses had difficulties in reaching the patients and their reality, and thus in understanding their experiences. Interpretation of the nurses’ experiences showed that the nurses found it difficult to reach the patients’ reality because the patients were in a divided and/or different world. They interpreted the patients as seeking solitude or company, keeping a distance or being suspicious of the nurses. The findings indicated that the interaction in the encounter between the acutely confused patients and the nurses indicated insufficient and/or broken reciprocity. The nurses used various strategies to meet the patients, being a companion and/or being a surrogate. They acted in the encounter based on their view of the patient and their ability to enter into and understand the patients’ situation. The strategies were more or less successful, sometimes resulting in contact and calming the patients and in other cases increasing the patients’ irritation and anger. The results were more successful when the strategies were derived from the nurses’ interpretation of the patients’ situation and the nurses paid attention to the patients and confirmed them.
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| 9. |
- Andersson, Edith, et al.
(författare)
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The meaning of acute confusional state from the perspective of elderly patients.
- 2002
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Ingår i: International Journal of Geriatric Psychiatry. - : Wiley. - 1099-1166 .- 0885-6230. ; 17:7, s. 652-663
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: The aim of this study was to illuminate lived experience of having been in an acute confusional state (ACS) as narrated by elderly patients in orthopaedic care. METHOD: Qualitative study with phenomenological hermeneutic method for analysing the data based on narrative interviews. Fifty patients (67-96 years of age) who developed ACS during hospitalisation and in all cases the ACS ceased during their stay on the ward were interviewed once lucid again regarding the course of the event, their experiences, memories and interpretation of what had happened during the ACS. RESULTS: The meaning of the patients' lived experiences of being and having been confused was interpreted as 'Being trapped in incomprehensible experiences and a turmoil of past and present and here and there', comprising the themes trying to get a grip on the experience of the confusion, encountering past, present and the realm of the imagination as reality during the period of confusion and confronting the idea of having been confused. Contradictory to earlier research the patients remembered and could tell in great detail about their ACS. While confused, the confusional state means that impressions of all kinds invade the mind of the person and are experienced as reality, making him/her a victim of these impressions rather than the one who controls what comes into his/her mind. While in the middle of these experiences the person simultaneously senses that the impressions are unreal, thus indicating that he/she is in some sort of borderland between understanding and not understanding. The things that come into the mind of the person can either be frightening or neutral or enjoyable scenarios that seem to be mainly familiar but can also be unknown. These scenarios seem to be a mixture of past and present, of events and people while they seem to float from location to location. CONCLUSIONS: The findings indicates that what takes place during the ACS is not nonsense but probably a mix of the patient's life history, their present situation and above all a form of communication concerning their emotional state and inner experiences in this new situation. The findings also indicated that one possible approach to the patients is to confirm and support the patients in narrating their experiences both during the confusion and also after the ACS had ceased.
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| 10. |
- Andersson, Magdalena, et al.
(författare)
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Old people receiving municipal care, their experiences of what constitutes a good life in the last phase of life : a qualitative study
- 2008
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Ingår i: International Journal of Nursing Studies. - : Elsevier. - 0020-7489 .- 1873-491X. ; 45:6, s. 818-828
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundOld people's life situation when receiving municipal help and care in their last period of life is sparsely investigated from their own perspective.ObjectiveThe aim of this study was to investigate the experiences of aspects that bring about a good life in the last phase of life among people (75+ years) receiving municipal care.ParticipantsOlder people living in a municipality in Southern Sweden being 75 years or older, receiving help and/or care from the municipality, and having a life-threatening disease and/or receiving palliative care were asked to participate. In all 17 people, 10 women and 7 men, aged 78–100 years were included.MethodsQualitative interviews, with the emphasis on their present life situation especially what brought about a good life, were performed. The interviews were analysed using qualitative content analysis.ResultsThe experience was interpreted to be Turning inwards to come to peace with the past, the present and approaching death while being trapped by health complaints. Six categories embraced the experience of aspects that constitute a good life in the last phase of life: Maintaining dignity, Enjoying small things, Feelings of “being at home”, Being in the hands of others, trying to adjust, Still being important for other people and Completing life while facing death.ConclusionThis study confirm theories suggesting that the last phase of life in old age meant focusing inwards, reflecting on the entire life as a way of completing it as well as enjoying small things and also viewing oneself in the perspective of contributing to the future. It also indicated that this phase of life meant being trapped by health complaints and functional limitations. The struggle to maintaining dignity as opposed to being in the hands of others implies that the concept of palliative care may be useful as a framework for providing nursing care to very old people, especially at the end of life.
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