| 1. |
- 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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| 2. |
- 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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| 3. |
- Beck, Ingela, et al.
(författare)
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An intervention applying a palliative care approach in residential care-effects on care provision and caring climate
- 2013
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: The palliative care approach aims to integrate psychosocial and existential aspects as well as relationship aspects in the care and can be used in all care contexts. In residential care, nurse assistants (NAs) are the ones who are closest to the residents, but have limited prerequisites to work in accordance with the palliative care approach. We aimed to investigate the effects of an intervention applying a palliative care approach in residential care, on NAs experience of care provision and caring climate. Method: In this quasi-experimental study we evaluated the intervention involving NAs (n=75) and their leaders (n=9), focusing on emotional, existential and relationship aspects within the palliative care approach, in comparison with controls (n=110). Data consisted of a questionnaire that the NAs answered at three time points. Results: In the intervention group, effects were seen concerning the NAs reports of the care provision in that they focused more on to ease for residents to narrate about their lives, and on communication with residents in what gives them meaning in life. In the intervention group effects were also seen in that the NAs rated the residents medical and nursing care needs being less met at the facility after the intervention. No effects were seen concerning the caring climate or the possibilities to provide a more person-centered care. Conclusion: The intervention seemingly facilitated for the NAs to focus on relationship aspects with the residents. But the intervention was not sufficient to change the organizational prerequisites for the staff to provide a more person-centered care.
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| 4. |
- Beck, Ingela, et al.
(författare)
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Applying a palliative care approach in residential care : effects on nurse assistants' experiences of care provision and caring climate
- 2014
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley-Blackwell Publishing Ltd. - 0283-9318 .- 1471-6712. ; 28:4, s. 830-841
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Tidskriftsartikel (refereegranskat)abstract
- Background A palliative care approach aims to integrate psychosocial and existential as well as relationship aspects in the care and is an approach that can be used in residential care. Nurse assistants are the ones who are closest to the residents but have limited prerequisites for working in accordance with the palliative care approach. We aimed to investigate the effects on nurse assistants' experiences of care provision and the caring climate of an intervention applying a palliative care approach in residential care. Methods An intervention involving nurse assistants (n = 75) and their leaders (n = 9), in comparison with controls (n = 110), was evaluated using a questionnaire at three points in time. Results In the intervention group, positive effects were seen concerning the nurse assistants' reports of the care provision in that they focused more on the residents' stories about their lives and on communicating with the residents about what gave meaning to their lives. Also, negative effects were seen when the nurse assistants rated that the residents' needs for medical and nursing care had not been met at the facility directly after the intervention. No effects were seen concerning the caring climate or the prerequisites of providing more person-centred care. Conclusion The intervention seemed to have encouraged the nurse assistants to focus on relationship aspects with the residents. So as not to jeopardise the NAs' well-being and to support NAs in keeping themselves involved in existential issues, their support most certainly needs to be continuous and ongoing. However, in spite of the leaders' involvement, the intervention was not sufficient for changing the organisational prerequisites for more person-centred care.
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| 5. |
- Beck, Ingela, et al.
(författare)
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Applying a palliative care approach in residential care: Effects on nurse assistants' work situation.
- 2015
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Ingår i: Palliative & Supportive Care. - 1478-9515. ; 13:3, s. 543-553
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The aim was to investigate the effects of an intervention that applies a palliative care approach in residential care upon nurse assistants' level of strain, job satisfaction, and view of leadership. Method: A quasi-experimental, pretest and posttest design was used. Study circles with workshops involving nurse assistants (n = 75) and their superiors (n = 9) focusing on emotional and existential issues in palliative care were evaluated using a questionnaire answered by the nurse assistants at baseline (November 2009), post-intervention (May 2010), and six-month follow-up (November 2010) in comparison with controls (n = 110). Results: Directly after the intervention, the job satisfaction of the nurse assistants decreased and they perceived the leadership more negatively than before the intervention. Six months later, strain as a result of criticism from residents and their superiors and having difficulty in balancing emotional involvement had decreased. Significance of results: The intervention initially seemed to decrease the well-being of the nurse assistants, which could be the result of their increased awareness of the residents' and relatives' needs, in combination with limited support. More emphasis should be placed on the role of leadership when implementing changes in practice.
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| 6. |
- Borglin, Gunilla, 1959-, 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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| 7. |
- Borglin, Gunilla, et al.
(författare)
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Self-reported health complaints and their prediction of overall and health-related quality of life among elderly people
- 2005
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Ingår i: International Journal of Nursing Studies. - : Elsevier BV. - 1873-491X .- 0020-7489. ; 42:2, s. 147-158
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To describe and compare self-reported health complaints, overall and health-related quality of life and to investigate how health complaints, age, gender, marital status, living and dwelling conditions and socio-economy predicted overall and health-related quality of life. Data and Method: A sample of 469 persons (aged 75-99) responded to a postal questionnaire. Multiple linear regression analysis was used to examine possible predictors. Result: Self-reported health complaints such as pain, fatigue and mobility impairment significantly predicted low overall and health-related quality life. Women had significantly lower overall and health-related quality of life than men, and a significantly higher degree of self-reported health complaints. The regression models had more similarities than differences, implying that the overall quality of life instrument were sensitive to physical influences only supposed to be detected by health-related quality of life instruments. Several of the health complaints predicting low quality of life are amenable for being relieved by nursing care. In the care of older people nurses need to assess for several health complaints simultaneously and be aware of their possible interaction when outlining interventions. Nurses are able to facilitate early detection of health complaints negatively affecting quality of life by implementing more pro-active preventive work as well as a higher degree of thorough and systematic assessments. It also seems important to consider that older woman's and men's needs for high quality of life may differ.
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| 8. |
- Karlsson, Staffan, 1959-, et al.
(författare)
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Care satisfaction among older people receiving public care and service at home or in special accommodation
- 2013
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Ingår i: Journal of Clinical Nursing. - Chichester : Wiley-Blackwell Publishing Inc.. - 0962-1067 .- 1365-2702. ; 22:3-4, s. 318-330
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Tidskriftsartikel (refereegranskat)abstract
- Aims and objectives: To explore care satisfaction in relation to place of living, health-related quality of life, functional dependency and health complaints among people 65 years or older, receiving public care and service. The concept public care and service concerns formal care from the municipality, including home help, home nursing care, rehabilitation and a special accommodation.Background: To be able to provide care and service of high quality to older people, knowledge about factors influencing their experience of satisfaction with the care is essential.Design: Cross-sectional, including comparison and correlation.Methods: One-hundred sixty-six people receiving public care and service from the municipality were interviewed regarding demography, functional ability, perceived health complaints and care. Health-related quality of life was measured with SF-12, and self-rated care satisfaction was measured with a questionnaire.Results: Low self-rated care satisfaction was associated with dependency in Instrumental Activities of Daily Living, blindness, faeces incontinence and anxiety, while high self-rated care satisfaction was associated with dependency in Personal Activities of Daily Living. Those at home rated an overall higher care satisfaction and were more satisfied with care continuity and personal relations; they thought that the staff had more time and were more respectful and quiet, than the ratings by those in a special accommodation (equivalent to a nursing home).Conclusions: Care satisfaction and health-related quality of life among older people was more associated with functional impairment and health complaints than to whether care and service was received at home or in a special accommodation.Relevance to clinical practice: An approach using intervention focused on functional ability and health complaints is important for development of improved care satisfaction for older people receiving public care and service.
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| 9. |
- Karlsson, Staffan, 1959-, et al.
(författare)
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Care satisfaction among older people receiving public care and service, at home or in special accommodation
- 2012
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Ingår i: 21st Nordic Congress of Gerontology : Dilemmas In Ageing Societies. ; , s. 136-136
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Konferensbidrag (refereegranskat)abstract
- In order to be able to provide care and service of high quality to older people, knowledge about factors influencing their experience of satisfaction with the care is essential.Aim: The aim was to explore care satisfaction in relation to health related quality of life, functional dependency, health complaints and place of living among people 65 years or older, receiving formal care and service.Methods: 166 people receiving care and service from the municipality were interviewed regarding demography, functional ability, perceived health complaints and care. Health related quality of life was measured with SF-12, and care satisfaction was measured with a questionnaire.Results: The people were in mean 84 years old and those at home were more often cohabitating, less dependent in activities of daily living, less cognitively impaired and had fewer health complaints regarding mobility, faeces incontinence and pressure ulcer, compared to those in special accommodation (equivalent to nursing home). Low care satisfaction was associated with IADL dependency, blindness, faeces incontinence and anxiety, while high care satisfaction was associated with PADL dependency. Those at home rated an overall higher care satisfaction and were more satisfied with care continuity, personal relations and that staff have plenty of time, are respectful and quiet, than those in special accommodation.Conclusions: Care satisfaction and health related quality of life (HRQoL) among older people was found to be more associated to functional impairment and health complaints than to whether care and service is received at home or in special accommodation.
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| 10. |
- Karlsson, Staffan, 1959-, et al.
(författare)
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Care satisfaction among older people receiving public care and service, at home or in special accommodation
- 2011
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Ingår i: Positioning Nursing for the Future: Advancing Nurses´Role in Community and Home Care. ; , s. 100-100
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Konferensbidrag (refereegranskat)abstract
- In order to be able to provide care and service of high quality to older people, knowledge about factors influencing their experience of satisfaction with the care is essential.Purpose: To explore care satisfaction in relation to health related quality of life, functional dependency, health complaints and place of living among people 65 years or older, receiving formal care and service.Methods: 166 people receiving care and service from the municipality were interviewed regarding demography, functional ability, perceived health complaints and care. Health related quality of life was measured with SF-12, and care satisfaction was measured with a questionnaire.Results: The people were in mean 84 years old and those at home were more often cohabitating, less dependent in activities of daily living, less cognitively impaired and had fewer health complaints regarding mobility, faeces incontinence and pressure ulcer, compared to those in special accommodation (equivalent to nursing home). Low care satisfaction was associated with IADL dependency, blindness, faeces incontinence and anxiety, while high care satisfaction was associated with PADL dependency. Those at home rated an overall higher care satisfaction and were more satisfied with care continuity, personal relations and that staff have plenty of time, are respectful and quiet, than those in special accommodation.Conclusions: Care satisfaction and health related quality of life (HRQoL) among older people was found to be more associated to functional impairment and health complaints than to whether care and service is received at home or in special accommodation.
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