| 1. |
- Marcheschi, Elizabeth, 1980, et al.
(författare)
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Home setting after stroke, facilitators and barriers: a systematic literature review
- 2018
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Ingår i: Health and Social Care in the Community. - : Hindawi Limited. - 1365-2524 .- 0966-0410. ; 26:4, s. e451-e459
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Forskningsöversikt (refereegranskat)abstract
- This paper seeks to improve the understanding of the interaction between patients with stroke and the physical environment in their home settings. Stroke care is increasingly performed in the patient’s home. Therefore, a systematic review was conducted to identify the existing knowledge about facilitators and barriers in the physical environment of home settings for the stroke rehabilitation process. Based upon Arksey and O’Malley’s framework, a Boolean search strategy was performed in the databases; CINAHL, Medline, Web of Science and Scopus. Fifteen articles were retained from the literature search conducted between August and November 2016, and two researchers independently assessed their quality based on the Swedish Council on Health Technology Assessment guidelines. The results suggest that despite the healthcare system’s ongoing shift towards home-based rehabilitation, the role played by the physical environment of home settings is still considered a side finding. Moreover, the research appears to focus mainly on how this environment supports mobility and activities of daily living, whereas information regarding the psychosocial and emotional processes that mediate the interaction between stroke survivors and their home setting are missing. A lack of information was also found with regard to the influence of different geographic locations on the stroke rehabilitation process. Future investigations are therefore needed to advance the understanding of the role played by the physical environment of home settings in supporting stroke recovery.
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| 2. |
- Eriksson, Johanna, 1978, et al.
(författare)
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User involvement in Swedish residential building projects : a stakeholder perspective
- 2015
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Ingår i: Journal of Housing and the Built Environment. - Dordrecht, Netherlands : Springer Netherlands. - 1566-4910 .- 1573-7772. ; 30:2, s. 313-329
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Tidskriftsartikel (refereegranskat)abstract
- One factor influencing quality in the building industry is the ability of users, such as residents, to identify and express their requirements for the product, i.e. the residential building. However, the handling of communication with users in building projects has been insufficiently specified and studied. Drawing on a study of user involvement in building project design, production, and management, this paper examines user involvement in Swedish residential projects. To map current perceptions and approaches, building industry actors met in four focus groups. Group participants were asked to reflect on the definition of users, communication handling, how information from users is used, and challenges and opportunities in user involvement. Our initial emphasis was front-end activities, but focus group results revealed that user involvement was a continuous process extending from project initiation to evaluating the finished project as a basis for future projects. Discussions indicated confusion about who constituted users in various situations but, regardless of level of experience, focus group participants agreed on the importance and potential of user involvement and on the need for specific methods to acquire useful input.
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| 3. |
- MacLachlan, Malcolm, et al.
(författare)
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Assistive technology policy: a position paper from the first global research, innovation, and education on assistive technology (GREAT) summit
- 2018
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Ingår i: Disability and rehabilitation. Assistive technology. - : Informa UK Limited. - 1748-3115 .- 1748-3107. ; 13:5, s. 454-466
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Tidskriftsartikel (refereegranskat)abstract
- Increased awareness, interest and use of assistive technology (AT) presents substantial opportunities for many citizens to become, or continue being, meaningful participants in society. However, there is a significant shortfall between the need for and provision of AT, and this is patterned by a range of social, demographic and structural factors. To seize the opportunity that assistive technology offers, regional, national and sub-national assistive technology policies are urgently required. This paper was developed for and through discussion at the Global Research, Innovation and Education on Assistive Technology (GREAT) Summit; organized under the auspices of the World Health Organization’s Global Collaboration on Assistive Technology (GATE) program. It outlines some of the key principles that AT polices should address and recognizes that AT policy should be tailored to the realities of the contexts and resources available. AT policy should be developed as a part of the evolution of related policy across a number of different sectors and should have clear and direct links to AT as mediators and moderators for achieving the Sustainable Development Goals. The consultation process, development and implementation of policy should be fully inclusive of AT users, and their representative organizations, be across the lifespan, and imbued with a strong systems-thinking ethos. Six barriers are identified which funnel and diminish access to AT and are addressed systematically within this paper. We illustrate an example of good practice through a case study of AT services in Norway, and we note the challenges experienced in less well-resourced settings. A number of economic factors relating to AT and economic arguments for promoting AT use are also discussed. To address policy-development the importance of active citizenship and advocacy, the need to find mechanisms to scale up good community practices to a higher level, and the importance of political engagement for the policy process, are highlighted. Policy should be evidence-informed and allowed for evidence-making; however, it is important to account for other factors within the given context in order for policy to be practical, authentic and actionable.Implications for Rehabilitation The development of policy in the area of asssitive technology is important to provide an overarching vision and outline resourcing priorities. This paper identifies some of the key themes that should be addressed when developing or revising assistive technology policy. Each country should establish a National Assistive Technology policy and develop a theory of change for its implementation.
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| 4. |
- 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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| 5. |
- Berghauser Pont, Meta, 1972, et al.
(författare)
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Förtätning av stationsnära områden för god tillgänglighet. Utveckling av en analys - och utvärderingsmetod
- 2022
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Det finns en vilja att förtäta i närheten av stationer för att öka användningen av kollektivtrafik och därmed minska klimatpåverkan kopplad till transpor- ter. Förtätning bidrar bland annat till att skapa levande stationssamhällen, med blandade funktioner, god tillgäng- lighet och miljöer som är trygga och vistelsevänliga där olika grupper och behov möts. Potentialerna är många men så även utmaningarna. Förtätning av stationsnära områden kan också leda till oönskade konsekven- ser för social, ekonomisk och ekologisk hållbarhet. Den här rap- porten kan förhoppningsvis ge ökad förståelse för förtätning i relation till regional tillgänglighet samt för positiva och negativa konsekvenser av förtätning i stationsnära områden. Den kan också skapa insikter om hur olika alternativ för utveckling av stations- nära områden kan värderas utifrån Agenda 2030, särskilt Mål 11: Hållbara städer och samhällen. Rapporten är framtagen inom projektet Urbana stationssamhäll- en – förtätning av stationsnära områden för god tillgänglighet (2020–2022) som finansierats av Trafikverket och bedrivits i sam- verkan mellan Urban Futures vid GMV (projektägare), Arkitektur och samhällsbyggnadsteknik vid Chalmers tekniska högskola, Gö- teborgsregionen (GR), Samhällsplanering vid Högskolan Dalarna och Samhällsplanering och miljö vid KTH.
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| 6. |
- Elf, Marie, 1962, et al.
(författare)
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A systematic review of the psychometric properties of instruments for assessing the quality of the physical environment in healthcare
- 2017
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Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 73:12, s. 2796-2816
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Tidskriftsartikel (refereegranskat)abstract
- Aim. To identify instruments measuring the quality of the physical healthcare environment, describe their psychometric properties. Background. The physical healthcare environment is regarded as a quality factor for health care. To facilitate evidence-based design there is a need for valid and usable instruments that can evaluate the design of the healthcare environment. Data sources. A systematic literature search in Medline, CINAHL, Psychinfo, Avery index and reference lists of eligible papers (1990-2016). Review method. Consensus based standards for selection of health measurement instruments guidelines were used to evaluate psychometric data reported. Results. Twenty-three instruments were included. Most of the instruments are intended for healthcare environments related to the care of older people. Many of the instruments were old, lacked strong, contemporary theoretical foundations, varied in the extent to which they had been used in empirical studies and in the degree to which their validity and reliability had been evaluated. Conclusions. Although we found many instruments for measuring the quality of the physical healthcare environment, none met all of our criteria for robustness. Of the instruments, The Multiphasic environmental assessment procedure, The Professional environment assessment protocol and The therapeutic environment screening have been used and tested most frequently. The Perceived hospital quality indicators are user centred and combine aspects of the physical and social environment. The Sheffield care environment assessment matrix has potential as it is comprehensive developed using a theoretical framework that has the needs of older people at the centre. However, further psychometric and user-evaluation of the instrument is required.
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| 7. |
- Elf, Marie, 1962, et al.
(författare)
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The built environment and its impact on health outcomes and experiences of patients, significant others and staff—A protocol for a systematic review
- 2020
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Ingår i: Nursing Open. - : Wiley. - 2054-1058. ; 7:3, s. 895-899
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Tidskriftsartikel (refereegranskat)abstract
- Aim: This review will identify, evaluate and synthesize the literature related to evidence-based design of healthcare environments and to identify impacts of the built environment on the outcomes and experiences of patients, significant others and staff. Design: A mixed-method systematic review of literature 2010–2018. Methods: Database searches for evidence in peer-reviewed journals will be conducted electronically using CINAHL, Medline, SCOPUS and Web of Science. Abstract, full-text screening and data extraction will be completed independently by the reviewers. Quality assessment will follow Swedish Agency for Health Technology Assessment and Social Services Assessment. Results: This review will offer knowledge for informed decisions about the design of the healthcare environment. The review is comprehensive, includes a large volume of literature various research designs and will highlight the knowledge gap in evidence-based design and provide a breadth of knowledge about the built environments and its impact on health and well-being.
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| 8. |
- Lozano, Rafael, et al.
(författare)
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Measuring progress from 1990 to 2017 and projecting attainment to 2030 of the health-related Sustainable Development Goals for 195 countries and territories: a systematic analysis for the Global Burden of Disease Study 2017
- 2018
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Ingår i: The Lancet. - : Elsevier. - 1474-547X .- 0140-6736. ; 392:10159, s. 2091-2138
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Tidskriftsartikel (refereegranskat)abstract
- Background: Efforts to establish the 2015 baseline and monitor early implementation of the UN Sustainable Development Goals (SDGs) highlight both great potential for and threats to improving health by 2030. To fully deliver on the SDG aim of “leaving no one behind”, it is increasingly important to examine the health-related SDGs beyond national-level estimates. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017), we measured progress on 41 of 52 health-related SDG indicators and estimated the health-related SDG index for 195 countries and territories for the period 1990–2017, projected indicators to 2030, and analysed global attainment. Methods: We measured progress on 41 health-related SDG indicators from 1990 to 2017, an increase of four indicators since GBD 2016 (new indicators were health worker density, sexual violence by non-intimate partners, population census status, and prevalence of physical and sexual violence [reported separately]). We also improved the measurement of several previously reported indicators. We constructed national-level estimates and, for a subset of health-related SDGs, examined indicator-level differences by sex and Socio-demographic Index (SDI) quintile. We also did subnational assessments of performance for selected countries. To construct the health-related SDG index, we transformed the value for each indicator on a scale of 0–100, with 0 as the 2·5th percentile and 100 as the 97·5th percentile of 1000 draws calculated from 1990 to 2030, and took the geometric mean of the scaled indicators by target. To generate projections through 2030, we used a forecasting framework that drew estimates from the broader GBD study and used weighted averages of indicator-specific and country-specific annualised rates of change from 1990 to 2017 to inform future estimates. We assessed attainment of indicators with defined targets in two ways: first, using mean values projected for 2030, and then using the probability of attainment in 2030 calculated from 1000 draws. We also did a global attainment analysis of the feasibility of attaining SDG targets on the basis of past trends. Using 2015 global averages of indicators with defined SDG targets, we calculated the global annualised rates of change required from 2015 to 2030 to meet these targets, and then identified in what percentiles the required global annualised rates of change fell in the distribution of country-level rates of change from 1990 to 2015. We took the mean of these global percentile values across indicators and applied the past rate of change at this mean global percentile to all health-related SDG indicators, irrespective of target definition, to estimate the equivalent 2030 global average value and percentage change from 2015 to 2030 for each indicator. Findings: The global median health-related SDG index in 2017 was 59·4 (IQR 35·4–67·3), ranging from a low of 11·6 (95% uncertainty interval 9·6–14·0) to a high of 84·9 (83·1–86·7). SDG index values in countries assessed at the subnational level varied substantially, particularly in China and India, although scores in Japan and the UK were more homogeneous. Indicators also varied by SDI quintile and sex, with males having worse outcomes than females for non-communicable disease (NCD) mortality, alcohol use, and smoking, among others. Most countries were projected to have a higher health-related SDG index in 2030 than in 2017, while country-level probabilities of attainment by 2030 varied widely by indicator. Under-5 mortality, neonatal mortality, maternal mortality ratio, and malaria indicators had the most countries with at least 95% probability of target attainment. Other indicators, including NCD mortality and suicide mortality, had no countries projected to meet corresponding SDG targets on the basis of projected mean values for 2030 but showed some probability of attainment by 2030. For some indicators, including child malnutrition, several infectious diseases, and most violence measures, the annualised rates of change required to meet SDG targets far exceeded the pace of progress achieved by any country in the recent past. We found that applying the mean global annualised rate of change to indicators without defined targets would equate to about 19% and 22% reductions in global smoking and alcohol consumption, respectively; a 47% decline in adolescent birth rates; and a more than 85% increase in health worker density per 1000 population by 2030. Interpretation: The GBD study offers a unique, robust platform for monitoring the health-related SDGs across demographic and geographic dimensions. Our findings underscore the importance of increased collection and analysis of disaggregated data and highlight where more deliberate design or targeting of interventions could accelerate progress in attaining the SDGs. Current projections show that many health-related SDG indicators, NCDs, NCD-related risks, and violence-related indicators will require a concerted shift away from what might have driven past gains—curative interventions in the case of NCDs—towards multisectoral, prevention-oriented policy action and investments to achieve SDG aims. Notably, several targets, if they are to be met by 2030, demand a pace of progress that no country has achieved in the recent past. The future is fundamentally uncertain, and no model can fully predict what breakthroughs or events might alter the course of the SDGs. What is clear is that our actions—or inaction—today will ultimately dictate how close the world, collectively, can get to leaving no one behind by 2030.
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| 9. |
- Shannon, Michelle M, et al.
(författare)
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Application of Theory in Studies of Healthcare Built Environment Research
- 2020
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Ingår i: Health Environments Research & Design Journal. - : SAGE Publications. - 1937-5867 .- 2167-5112. ; 13:3, s. 154-170
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Tidskriftsartikel (refereegranskat)abstract
- We aimed to examine the nature and extent of theory application in studies of built environment attributes and impact on adults in healthcare facilities. Many varied theories are described when providing the rationale for research into built environments in healthcare. Uncertainty exists around the right theory to frame a research question, alignment with measurement tools, and whether healthcare setting makes a difference. This poses challenges to researchers seeking to build the evidence base for built environment design that benefits patients and staff. Our multidisciplinary review team scoped the literature to determine how theories are used to inform research investigating the impact of the built environment of healthcare on adults. When researchers recorded theory at development of the study question, in data collection, and in data analysis/interpretation, we called this explicitly theory-based application. Synthesis occurred using a narrative approach. Overall, we found 17 diverse theories named in studies. Explicitly theory-based use occurred with eight theories, comprising 47% of all theories used. Five theories were named more frequently in studies out of all theories identified. In 20% of studies, theory was not used explicitly during the research inquiry. We argue that researchers must continue to strive toward explicit use of theories, similar to development of other health interventions that employ multifactorial components.
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| 10. |
- Udo, Camilla, et al.
(författare)
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A qualitative study of assistant nurses’ experiences of palliative care in residential care
- 2018
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Ingår i: Nursing Open. - : Wiley. - 2054-1058. ; 5:4, s. 527-535
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Tidskriftsartikel (refereegranskat)abstract
- AimTo explore assistant nurses' experiences and perceptions of both positive and negative aspects of providing palliative care for older people in residential care facilities.DesignA qualitative explorative study.MethodsCritical incidents were collected through semi‐structured face‐to‐face interviews and analysed by performing a qualitative content analysis.ResultsA total of 40 critical incidents from daily work was described by assistant nurses. The results showed that close cooperation between unlicensed and licensed professionals was crucial to provide good care but was sometimes negatively affected by the organizational structure. The availability of professionals was identified as a critical factor in providing good care at the end of life in a consultative organization. The most prominent findings were those that indicated that, especially in a consultative organization, there seems to be a need for clear roles, comprehensive and clear care plans and a solid support structure to ensure continuity of care.
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