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- Kihlgren, Annica Larsson, 1957-, et al.
(författare)
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Referrals from home care to emergency hospital care : basis for decisions.
- 2003
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 12:1, s. 28-36
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Tidskriftsartikel (refereegranskat)abstract
- The Swedish government implemented a reform, the Adel reform, in the care of older citizens in 1992, so that the communities where older people live became responsible for their care and housing. Nurses were appointed to make sure that older people were given accurate care and to act as supervisors for nurses' aides. In this study, 10 Registered Nurses from community home care services and four consultant head physicians in primary care were interviewed in order to illuminate what they thought influenced nurses' decisions to refer patients for emergency treatment and what support they requested to facilitate the decision. Content analysis showed the necessity of feeling secure in one's role as a community nurse. The categories that developed were: own competence, knowledge about the patient and a supportive working environment. The main theme was To feel safe in one's role - a basis for decision-making. High demands were put on the nurses' competence and their burden of responsibility became too great. This influenced decision-making negatively, if nurses felt that they were lacking in their own personal competence. Training in documentation for the nurses was required, as well as the need for organizations to provide staff with sufficient time for accurate documentation. A greater input of nursing and medical care was required to make it possible for patients to be cared for at home if they so wished. Respondents described considerable deficiencies in their working environment and in co-workers' competence, and nurses' professional roles within the community were not made clear. If these problems were remedied, this would improve working conditions, increase understanding, and reduce feelings of uncertainty among decision-makers.
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| 2. |
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| 3. |
- Olsson, Annakarin, et al.
(författare)
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Persons with early-stage dementia reflect on being outdoors : a repeated interview study
- 2013
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Ingår i: Aging & Mental Health. - : Informa UK Limited. - 1360-7863 .- 1364-6915. ; 17:7, s. 793-800
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The aim of this study was to describe how persons with early-stage dementia reflect on being outdoors. Method: Data were collected through repeated interviews with a purposive sample of 11 persons with early-stage dementia in Sweden during the period 2009-2010 and were analysed using qualitative content analysis. Results: Informants described being outdoors as a confirmation of the self. Confirmation of their ability to maintain desired activities, despite the dementia disease, was important to the informants. However, some confirmations were not positive; the realisation that one could no longer perform certain activities could be devastating. Two sub-themes emerged: shifting between still being part of it all' and a sense of grief and loss and striving to keep on despite perceived barriers. Past, but no longer possible, outdoor activities were greatly missed and the informants longed to be able to perform these activities once again. To resolve possible difficulties associated with being outdoors, the informants used various adaptation strategies. Despite the described barriers, being outdoors was of great value to them. Conclusion: Independent outdoor activities seem to contribute to the well-being and feelings of self-worth among persons with early-stage dementia who want to be and are able to be outdoors. If a person with dementia, despite cognitive limitations, wants and is able to engage in outdoor activities, it is important for relatives and health-care staff to encourage and facilitate this, for example, by discussing adaptation strategies to deal with orientation problems.
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| 5. |
- Quell, Robin, et al.
(författare)
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Using tactile stimulation in a dementia care facility with plasma prolactine as an outcome measure : a pilot study
- 2008
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Ingår i: Archives: the international journal of medicine. - 1791-4000. ; I:3, s. 123-129
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundThere is poor scientific documentation supporting tactile stimulations’ benefit as a nursing intervention. It has been theorized that older adults with dementia experience high anxiety and stress levels. High prolactin levels are associated with psychosomatic reactions and have been used to measure stress levels in adults.AimTo evaluate tactile stimulation’s effectiveness on anxiety and stress in older adults, with dementia diagnosis or signs of dementia and living in a dementia care facility, as manifested by plasma prolactin levels.Materials and MethodsTactile stimulation was given weekly by trained staff members to half the residents of a Swedish dementia care facility.The subjects were randomly selected (n=20) and were tracked in the study for a minimum of 28 weeks. The remaining half elders made up the control team (n=20). Diagnostic groups were formed according the severity of dementia. Plasma prolactin levels were drawn at baseline and post intervention. Medications caused the exclusion of 12 residents and seven dropped out due to other causes. ResultsThere was no difference in plasma prolactin levels between the intervention (n=11) and control (n=12) group. A significant main effect between the diagnostic groups was found as well as a trend towards a positive correlation between age and plasma prolactin levels. There was no gender difference in plasma prolactin levels.ConclusionsOur hypothesis that reduced plasma prolactin levels could be detected in elders treated with tactile stimulation, indicating alleviated stress, was not supported by the preliminary results of the present study. Further evaluation of tactile stimulation with larger study groups and a better understanding of prolactin’s sensitivity, complexity and interaction with medications could contribute to the outcome and problems of the study. The use of neuropsychological assessment could enrich the research data and help the evaluation.
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| 6. |
- Skovdahl, Kirsti, 1964-, et al.
(författare)
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Demanding behaviours and workload in elderly care in Sweden : occurrence at two time points within a decade
- 2008
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Ingår i: Scandinavian Journal of Caring Sciences. - Oxford : Blackwell. - 0283-9318 .- 1471-6712. ; 22:3, s. 323-330
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to investigate the occurrence of demanding behaviours in persons ‡65 years receiving home care or living in sheltered accommodation at two points in time, 1993 and 2002. Another aim was to investigate whether the perceived workload in staff had changed during this period. All persons ‡65 years living at home and utilizing home care services or those who lived in some form of sheltered housing were included and assessed by staff using a three-part questionnaire, in two cross-sectional studies. The study group comprised 1187 and 1017 participants which equals 77% and 99% respectively. Symptoms and degree of behavioural and psychiatric symptoms common in dementia that were assessed with a subscale in The Gottfries-Bra°ne-Steen Scale, demonstrated an all over increase from 1993 to 2002. Items from The Multi Dimensional Dementia Assessment Scale (MDDAS) measured a decrease in ‘daily’ occurrences of dementia symptoms but an increase in ‘sometimes per week’. A mixed pattern was seen concerning behaviours where increases as well as decreases were found. The behaviours ‘constantly seeking attention’ and ‘shrieking continuously’ increased significantly. The number of individuals showing restless, aggressive or shrieking behaviours increased significantly over the decade. Two items from the MDDAS were used to measure the workload. The physical workload increased significantly over the decade whereas the rising tendencies of the psychological workload were not statistically significant. The mean age over the decade had increased from 83 to 86 years, which together with the findings make the recipients of home care and sheltered housing a very vulnerable group. The demanding problems place considerable pressure on staff.
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| 7. |
- Skovdahl, Kirsti, 1964-, et al.
(författare)
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Tactile stimulation associated with nursing care to individuals with dementia showing aggressive or restless tendencies : an intervention study in dementia care
- 2007
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Ingår i: International Journal of Older People Nursing. - Oxford : Blackwell Publishing. - 1748-3735 .- 1748-3743. ; 2, s. 1-9
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Tidskriftsartikel (refereegranskat)abstract
- Aim. This study aimed to describe from documentation both the caregivers' experiences of giving tactile stimulation to five people with moderate-to-severe dementia and who showed aggressive or restless tendencies, and the changes seen in them. Background. Clinical experiences indicate that tactile stimulation can contribute to a feeling of trust and confirmation as well as to improving communication, promoting relaxation and easing pain. There is, however, very little scientific documentation of the effects of touch massage for people with dementia. Design. From caregivers' documentation (28 weeks) of experiences, the giving of tactile stimulation to five randomly selected people with dementia showing aggressive or restless tendencies and the subsequent changes noticed. Method. The documentation was analysed by using qualitative content analysis. Results. All residents displayed signs of positive feelings and relaxation. The caregivers stated that they felt able to interact with the residents in a more positive way and that they felt they had a warmer relationship with them. Conclusion. Tactile stimulation can be seen as a valuable way to communicating non-verbally, of giving feedback, confirmation, consolation or a feeling of being valuable and taken care of. Relevance to clinical practice. Tactile stimulation has to be administered with respect and care, and given from a relational ethics perspective. Otherwise, there is a risk that tactile stimulation will be used merely as a technique instead of as a part of an effort to achieve optimal good, warm nursing care.
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