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- Eldh, Ann Catrine, et al.
(författare)
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Supporting first-line managers in implementing oral care guidelines in nursing homes
- 2018
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Ingår i: Nordic Journal of Nursing Research. - : SAGE Publications. - 2057-1585 .- 2057-1593. ; 38:2, s. 87-95
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Tidskriftsartikel (refereegranskat)abstract
- This study investigated first-line managers’ experience of and responses to a concise leadership intervention to facilitate the implementation of oral care clinical practice guidelines (CPGs) in nursing homes. Leadership is known to be an important element in knowledge implementation but little is known as to what supports managers to facilitate the process. By means of a process evaluation with mixed methods, the context and a three-month leadership program was explored, including activities during and in relation to the program, and the effects in terms of oral care CPG implementation plans. While the managers appreciated the intervention and considered improved oral care to be a priority, their implementation plans mainly focused the dissemination of an oral care checklist. The findings suggest that extended implementation interventions engaging both managers and clinical staff are needed, and that a concise intervention does not facilitate first-line managers to adopt behaviors known to facilitate knowledge implementation.
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- Hägglund, Doris, et al.
(författare)
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Enabling and inhibitory factors that influenced implementation of evidence-based practice for urinary incontinence in a nursing home
- 2017
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Ingår i: Nordic journal of nursing research. - : SAGE Publications. - 2057-1585 .- 2057-1593. ; 37:2, s. 109-116
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Tidskriftsartikel (refereegranskat)abstract
- The aim of the present follow-up study was to describe staff perceptions of enabling and inhibitory factors that influenced implementation of evidence-based practice (EBP) for urinary incontinence in a nursing home. Focus group interviews were carried out and the text was deductively analyzed using the PARIHS framework and qualitative content analysis. Factors believed to be most enabling for implementation were the EBP being considered as relevant and as a social process and visiting the lavatory being considered as a right for all. One determinant of successful implementation was having clear and involved leaders who had a continuous positive attitude toward the EBP and demanded results. Staffs who were given the role of continence agents were important facilitators. The factor believed to inhibit implementation most was staff having to carry out pad-weight tests before prescribing individual incontinence aids. The EBP offers a successful concept for caring for older persons with urinary incontinence in nursing homes. The EBP should be spread, both local and more widely.
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- Hägglund, Patricia, et al.
(författare)
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Older people with swallowing dysfunction and poor oral health are at greater risk of early death
- 2019
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Ingår i: Community Dentistry and Oral Epidemiology. - : John Wiley & Sons. - 0301-5661 .- 1600-0528. ; 47:6, s. 494-501
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: We investigated the associations between swallowing dysfunction, poor oral health and mortality among older people in intermediate care in Sweden.Methods: This prospective cohort study investigated 391 older people in 36 intermediate care units (clusters). Swallowing function was assessed with the timed water swallow test (TWST), and oral health with the revised oral assessment guide (ROAG) at baseline. Data were collected on age, sex, education level, multimorbidity, cognitive impairment, care dependency and body mass index (BMI). Time to mortality was recorded during the following year. The mixed effects Cox regression model with cluster as a random factor was used to estimate hazards ratios (HR) with 95% confidence intervals (CI).Results: The median age of the participants was 84 years (interquartile range [IQR]: 11), and 53.3% were females. Mortality within one year was 25.1%. In the adjusted model, swallowing dysfunction and poor oral health were both independently associated with mortality (adjusted HR [aHR]: 1.67, 95% CI 1.02‐2.75; P = .041 and aHR: 1.98, 95% CI 1.07‐3.65; P = .029, respectively). Participants with combined swallowing dysfunction and poor oral health showed the highest mortality (35.0%) and 2.6 (95% CI 1.15‐5.89; P = .022) times higher mortality risk than those with normal swallowing function and good oral health (13.0%).Conclusions: Swallowing dysfunction and poor oral health were identified as independent risk factors for mortality in older people in intermediate care. Although further studies are required to verify these findings, they suggest that systematic assessment of swallowing function and oral health status should be performed for care considerations.
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- Hägglund, Patricia, et al.
(författare)
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Study protocol for the SOFIA project : Swallowing function, oral health, and food intake in old age
- 2017
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Ingår i: BMC Geriatrics. - : Springer Science and Business Media LLC. - 1471-2318. ; 17:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Extensive studies have shown that older people are negatively impacted by impaired eating and nutrition. The abilities to eat, enjoy food, and participate in social activities associated with meals are important aspects of health-related quality of life (HRQoL) and recovery after illness. This project aims to (i) describe and analyze relationships between oral health and oral HRQoL, swallowing ability, eating ability, and nutritional risk among older individuals admitted to short-term care; (ii) compare the perceptions that older individuals and staff report on care quality related to oral hygiene and eating; and (iii) study the feasibility and effects of a training program for people with impaired swallowing (i.e., dysphagia).METHODS/DESIGN: This project consists of two parts, which will be performed in five Swedish counties. It will include approximately 400 older individuals and 200 healthcare professionals. Part 1 is a cross-sectional, descriptive study of older people admitted to short-term care. Subjects will be assessed by trained professionals regarding oral health status, oral HRQoL, eating and nutritional risk, and swallowing ability. Swallowing ability will be measured with a teaspoon test and a swallowing capacity test (SCT). Furthermore, subjects and staff will complete a questionnaire regarding their perceptions of care quality. Part 2 is a cluster randomized intervention trial with controls. Older participants with dysphagia (i.e., SCT <10 ml/s, measured in part 1) will be recruited consecutively to either the intervention or control group, depending on where they were admitted for short-term care. At baseline, all subjects will be assessed for oral health status, oral HRQoL, eating and nutritional risk, swallowing ability, and swallowing-related QoL. Then, the intervention group will receive 5 weeks of training with an oral screen for neuromuscular training focused on orofacial and pharyngeal muscles. After completing the intervention, and at six months post-intervention, all assessments will be repeated in both study groups.DISCUSSION: The results will make important contributions to rehabilitation knowledge, including approaches for improving swallowing function, oral health, and food intake and for improving the quality of oral care for older people.TRIAL REGISTRATION: This trial was retrospectively registered at ClinicalTrials.gov, on July 4, 2016, identifier: NCT02825927 .
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- Hägglund, Patricia, et al.
(författare)
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Study protocol for the SOFIA project : Swallowing function, Oral health, and Food Intake in old Age: a descriptive study with a cluster randomized trial
- 2017
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Ingår i: BMC Geriatrics. - : BioMed Central (BMC). - 1471-2318. ; 17
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Tidskriftsartikel (refereegranskat)abstract
- Background: Extensive studies have shown that older people are negatively impacted by impaired eating and nutrition. The abilities to eat, enjoy food, and participate in social activities associated with meals are important aspects of health-related quality of life (HRQoL) and recovery after illness. This project aims to (i) describe and analyze relationships between oral health and oral HRQoL, swallowing ability, eating ability, and nutritional risk among older individuals admitted to short-term care; (ii) compare the perceptions that older individuals and staff report on care quality related to oral hygiene and eating; and (iii) study the feasibility and effects of a training program for people with impaired swallowing (i.e., dysphagia). Methods/Design: This project consists of two parts, which will be performed in five Swedish counties. It will include approximately 400 older individuals and 200 healthcare professionals. Part 1 is a cross-sectional, descriptive study of older people admitted to short-term care. Subjects will be assessed by trained professionals regarding oral health status, oral HRQoL, eating and nutritional risk, and swallowing ability. Swallowing ability will be measured with a teaspoon test and a swallowing capacity test (SCT). Furthermore, subjects and staff will complete a questionnaire regarding their perceptions of care quality. Part 2 is a cluster randomized intervention trial with controls. Older participants with dysphagia (i.e., SCT < 10 ml/s, measured in part 1) will be recruited consecutively to either the intervention or control group, depending on where they were admitted for short-term care. At baseline, all subjects will be assessed for oral health status, oral HRQoL, eating and nutritional risk, swallowing ability, and swallowing-related QoL. Then, the intervention group will receive 5 weeks of training with an oral screen for neuromuscular training focused on orofacial and pharyngeal muscles. After completing the intervention, and at six months post-intervention, all assessments will be repeated in both study groups. Discussion: The results will make important contributions to rehabilitation knowledge, including approaches for improving swallowing function, oral health, and food intake and for improving the quality of oral care for older people.
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