| 1. |
- 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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| 2. |
- 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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| 3. |
- 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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| 4. |
- 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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| 5. |
- 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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| 6. |
- 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.
- 2008
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Ingår i: International Journal of Nursing Studies. - : Elsevier BV. - 1873-491X .- 0020-7489. ; 45:6, s. 818-828
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Tidskriftsartikel (refereegranskat)abstract
- Background: Old people's life situation when receiving municipal help and care in their last period of life is sparsely investigated from their own perspective. Objective: The 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. Participants: Older 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. Methods: Qualitative 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. Results: The 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. Conclusion: This 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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| 7. |
- 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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| 8. |
- Borglin, Gunilla, et al.
(författare)
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Psychometric testing of a quality of life scale among Swedish people 75 years and above in need of help with activities of daily living or not
- 2006
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Ingår i: Clinical Effectiveness in Nursing. - : Elsevier BV. - 1361-9004. ; 9:Suppl. 1, s. 25-43
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Tidskriftsartikel (refereegranskat)abstract
- Few Quality of Life (QoL) instruments in use today were originally developed for older populations (75+). Information on their validity and reliability in this age group is sparse. The current study investigated the psychometric properties of the Life Quality Gerontological Centre Scale (LGC), a general QoL instrument designed for use among older people. A further aim was to describe and compare QoL with gender and in people needing help with Activities of Daily Living and those not needing such help. A postal questionnaire surveyed 1093 people (mean age 82.7, SD 5.3). Principal component analysis revealed that LGC was reasonably stable as the construct-and cross validation more or less replicated the suggested QoL factors. The instrument differentiated between needing help and not and between men and women. LGC needs further development with respect to reliability, face and content validity but is potentially useful as a diagnostic or an outcome assessment after interventions among older people. Individuals in need of help and women had lower scores in several QoL areas and in total QoL scores compared to those not needing help and men. Older people’s QoL may be improved by interventions directed to areas beyond health and physical functioning. Men and women might also benefit from different interventions directed towards QoL.
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| 9. |
- 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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| 10. |
- Borglin, Gunilla, et al.
(författare)
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The experience of quality of life among older people
- 2005
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Ingår i: Journal of Aging Studies. - : Elsevier BV. - 0890-4065 .- 1879-193X. ; 19:2, s. 201-220
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Tidskriftsartikel (refereegranskat)abstract
- Although quality of life has been in the focus of attention for over a decade there are few studies available investigating, how the old and the oldest old experience their quality of life or what quality of life actually means for them? To illuminate this, eleven in-depth interviews were conducted with six women and five men (80+) living in their home. An interpretative hermeneutic phenomenological analysis revealed that quality of life in old age meant a preserved self and meaning in existence. Maintained self-image meant that the older people experienced a coherent life with an intact meaning. How quality of life was valued depended on the meaning the old people attached to the areas of importance as well as how they were evaluated. Additionally, areas not generally included when measuring quality of life became discernible. The meaning of home, how life was viewed, thoughts about death and dying, and telling ones story proved to be areas of importance for their perception of quality of life. Thus, indicating that older people's view of quality of life is more complex than some of today's most commonly used quality of life instruments capture and that quality of life assessment tools needs to measure beyond pure health indices. For nursing care the use of life review in everyday care, and an open way towards existential topics as well as a family oriented care along with preventive work helping people to remain in their own homes may enhance their experience of quality of life.
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