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- Andersson, Kristina Stefanovic, et al.
(författare)
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Vikten av mat i hemtjänsten
- 2008
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- BACKGROUND: The importance of food and meals, including the problem with malnutrition, has been discussed by caregivers, the government, the home care recipients themselves as well as their next of kin. There is a need for improvement which demands changes. AIM: *To investigate the knowledge and attitudes to food and nutrition, focussing on malnutrition among the personnel in the home care services and home help inspectors, before and after education. *To investigate food and nutrition, including the attitude towards it, among elderly in ordinary housing with assisted meal service and/or meal distribution, before and after education among the personnel. *To test nutrition routines among elderly in ordinary housing with assisted meal service and/or meal distribution. MATERIAL AND METHODS: The project was performed in four home care service groups in Malmö. Fifty-nine persons of the personnel participated in education at four occasions for three hour each. Of these, 52 persons answered questions regarding diet and nutrition at the first measuring and 45 persons answered questions at the seconds measuring. Sixty-three elderly home care recipients were interviewed regarding food and nutrition, of these 48 were also interviewed at the end of the project. RESULTS: The questionnaire showed that the knowledge of food and nutrition among the personnel was satisfying already before the education started. However, the self-perceived knowledge regarding food and nutrition for sick elderly as well as the knowledge of assessing nutritional status, increased. The interviews with the elderly receiving home care showed that they most often were satisfied with food service and food provided by the home care services. Usually, the elderly reported to consume breakfast, dinner (at noon), and an evening meal along with snack meals once or twice a day. Ready made and home delivered warm meals were the recipients’ first option over meals prepared by the personnel in recipients home. Ready made and home delivered cold meals (to be heated later) were the least preferred meal. For the elderly that had help from the homecare services with the evening meal, this consisted frequently of a prepared sandwich to be stored in the fridge until consumption time. Almost all of the personnel and every third elderly believed that two cooked meals should be offered every day. The reported intake from the elderly showed that there was a risk for a deficient intake of energy and nutrients. Almost 30% of the caretakers were considered underweight. The majority of the personnel agreed totally or partly that assessment of the nutritional status should be performed at all elderly to receive home care. Such a nutritional assessment should be a base for the nutritional treatment. In the present project, the caretakers have, for example, been offered to join personnel and participate in shopping the food, to get assistance with preparation of snack meals and having meals together with others. CONCLUSIONS: The prerequisite to manage on your own and to have a meaningful life, are an adequate intake of energy and nutrients, among other factors. The meal can, and should take time. Food and nutrition should be prioritized to an even larger extent by decision makers in Malmö as in other municipalities. This enables personnel to create a joyful meal situation for the elderly and an optimal state of nutrition. It is important to change and extend the options to include an evening meal, the possibility to get assisted snack meals permitted by care managers, and to establish routines that are systematic and uniform regarding diet and nutrition. This project showed that the suggested changes are possible to implement. The changes are of great importance to all elderly receiving home care, and especially elderly suffering from underweight.
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| 2. |
- Fridlund, Bengt, et al.
(författare)
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Essentials of teamcare in randomized controlled trials of multidisciplinary or interdisciplinary interventions in somatic care : A systematic review
- 2015
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Ingår i: Open Journal of Nursing. - : Scientific Research Publishing. - 2162-5336 .- 2162-5344. ; 5:12, s. 1089-1101
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Forskningsöversikt (refereegranskat)abstract
- Background: Teamcare should, like all patient care, also contribute to evidence-based practice (EBP). Randomized controlled trials (RCTs) focusing on teamcare have been performed but no study has addressed its essentials. How far this EBP has progressed in different health aspects is generally established in systematic reviews of RCTs.Aim: The aim is to determine the essentials of teamcare including the nurse profession in RCTs of multi- or interdisciplinary interventions in somatic care focusing on the stated context, goals, strategies, content as well as effectiveness of quality of care.Methods: A systematic review was performed according to Cochrane review assumptions to identify, appraise and synthesize all empirical evidence meeting pre-specified eligibility criteria. The PRISMA statement guided the data selection process of 27 articles from PubMed and CINAHL.Results: Eighty-five percent of RCTs in somatic care showed a positive effectiveness of teamcare interventions, of which interdisciplinary ones showed a greater effectiveness compared with the multidisciplinary approach (100% vs 76%). Also theory-based RCTs presented higher positive effectiveness (85%) compared with non-theory-based RCTs (79%). The RCTs with positive effectiveness showed greater levels for professional-centered ambition in terms of goals and for team-directed initiatives in terms of strategy, and a significantly higher level for patient-team interaction plans in terms of content was shown.Conclusions: Teamcare RCTs are still grounded in the multidisciplinary approach having a professional-centered ambition while interdisciplinary approaches especially those that are theory-based appear to be essential with regard to positive effectiveness and preferable when person-centered careis applied.
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| 3. |
- Stridsman, Caroline, et al.
(författare)
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Fatigue affects health status and predicts mortality among subjects with COPD-report from the population-based OLIN COPD study
- 2015
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Ingår i: COPD. - : Informa UK Limited. - 1541-2555 .- 1541-2563. ; 12:2, s. 199-206
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Tidskriftsartikel (refereegranskat)abstract
- Background: COPD is associated to increased fatigue, decreased health status and mortality. However, these relationships are rarely evaluated in population-based studies. Aims: To describe the relationship between health status, respiratory symptoms and fatigue among subjects with and without COPD. Further, to evaluate whether fatigue and/or health status predicts mortality in these groups. Methods: Data were collected in 2007 from the population-based OLIN COPD study. Subjects participated in lung function tests and structured interviews, and 434 subjects with and 655 subjects without COPD were identified. Fatigue was assessed by FACIT-Fatigue and health status by the generic SF-36 questionnaire including physical (PCS) and mental (MCS) components. Mortality data until February 2012 were collected. Results: Fatigue greatly impacts the physical and mental dimensions of health status, both among subjects with and without COPD. Among subjects with clinically significant fatigue, COPD subjects had significantly lower PCS-scores compared to non-COPD subjects. Fairly strong correlations were found between FACIT-F, SF-36 PCS and MCS, respectively. In multivariate models adjusting for covariates, increased fatigue, decreased physical and mental dimensions of health status were all associated to mortality in subjects with COPD (OR 1.06, CI 1.02-1.10, OR 1.04, CI 1.01-1.08 and OR 1.06, CI 1.02-1.10), but not in non-COPD. Conclusions: Fatigue and decreased health status were closely related among subjects with and without COPD. Not only physical health status, but also fatigue and mental health predicted mortality among subjects with COPD. Fatigue assessed by FACIT-F, can be a useful instrument of prognostic value in the care of subjects with COPD.
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