| 1. |
- Ekerstad, Niklas, et al.
(författare)
-
Clinical frailty scale – skörhet är ett sätt att skatta biologisk ålder
- 2022
-
Ingår i: Lakartidningen. - 0023-7205. ; 119, s. 1-5
-
Forskningsöversikt (refereegranskat)abstract
- The term frailty denotes a multi-dimensional syndrome characterised by reduced physiological reserves and increased vulnerability. Frailty may be used as a marker of biological age, distinct from chronological age. There are several instruments for frailty assessment. The Clinical Frailty Scale (CFS) is probably the most commonly used in the acute care context. It is a 9-level scale, derived from the accumulated deficit model of frailty, which combines comorbidity, disability, and cognitive impairment. The CFS assessment is fast and easy to implement in daily clinical practice. The CFS is relevant for risk stratification, and may also be used as a screening instrument to identify frail patients suitable for further geriatric evaluation, i.e. a comprehensive geriatric assessment (CGA). By providing information on long-term prognosis, it may improve informed decision-making on an individual basis.
|
|
| 2. |
- Ekerstad, Niklas, 1969-, et al.
(författare)
-
Clinical frailty scale – skörhet ärett sätt att skatta biologisk ålder : [Clinical Frailty Scale - a proxy estimate of biological age]
- 2022
-
Ingår i: Läkartidningen. - : Sveriges Läkarforbund. - 0023-7205 .- 1652-7518. ; 119
-
Forskningsöversikt (refereegranskat)abstract
- The term frailty denotes a multi-dimensional syndrome characterised by reduced physiological reserves and increased vulnerability. Frailty may be used as a marker of biological age, distinct from chronological age. There are several instruments for frailty assessment. The Clinical Frailty Scale (CFS) is probably the most commonly used in the acute care context. It is a 9-level scale, derived from the accumulated deficit model of frailty, which combines comorbidity, disability, and cognitive impairment. The CFS assessment is fast and easy to implement in daily clinical practice. The CFS is relevant for risk stratification, and may also be used as a screening instrument to identify frail patients suitable for further geriatric evaluation, i.e. a comprehensive geriatric assessment (CGA). By providing information on long-term prognosis, it may improve informed decision-making on an individual basis.
|
|
| 3. |
- Johansson-Pajala, Rose-Marie, et al.
(författare)
-
Anxiety and loneliness among older people living in residential care facilities or receiving home care services in Sweden during the COVID-19 pandemic : a national cross-sectional study
- 2022
-
Ingår i: BMC Geriatrics. - : Springer Science and Business Media LLC. - 1471-2318 .- 1471-2318. ; 22:1
-
Tidskriftsartikel (refereegranskat)abstract
- Background: Older people were subjected to significant restrictions on physical contacts with others during the COVID-19 pandemic. Social distancing impacts older people’s experiences of anxiety and loneliness. Despite a large body of research on the pandemic, there is little research on its effects on older people in residential care facilities (RCF) and in home care services (HCS), who are the frailest of the older population. We aimed to investigate the effect of the first wave of the COVID-19 pandemic in March-May 2020 on experiences of anxiety and loneliness among older people living in RCF or receiving HCS and the impact of the progression of the pandemic on these experiences.Methods: A retrospective cross-sectional design using data from the national user satisfaction survey (March − May 2020) by the Swedish National Board of Health and Welfare. Survey responses were retrieved from 27,872 older people in RCF (mean age 87 years) and 82,834 older people receiving HCS (mean age 84 years). Proportional-odds (cumulative logit) model was used to estimate the degree of association between dependent and independent variables.Results: Loneliness and anxiety were more prevalent among the older persons living in RCF (loneliness: 69%, anxiety: 63%) than those receiving HCS (53% and 47%, respectively). Proportional odds models revealed that among the RCF and HCS respondents, the cumulative odds ratio of experiencing higher degree of anxiety increased by 1.06% and 1.04%, respectively, and loneliness by 1.13% and 1.16%, respectively, for 1% increase in the COVID-19 infection rate. Poor self-rated health was the most influential factor for anxiety in both RCF and HCS. Living alone (with HCS) was the most influential factor affecting loneliness. Experiences of disrespect from staff were more strongly associated with anxiety and loneliness in RCF than in HCS.Conclusion: Older people in RCF or receiving HCS experienced increasing levels of anxiety and loneliness as the first wave of the pandemic progressed. Older people’ mental and social wellbeing should be recognized to a greater extent, such as by providing opportunities for social activities. Better preparedness for future similar events is needed, where restrictions on social interaction are balanced against the public health directives.
|
|
| 4. |
- Johansson-Pajala, Rose-Marie, et al.
(författare)
-
Trust and easy access to home care staff are associated with older adults' sense of security : a Swedish longitudinal study
- 2024
-
Ingår i: Scandinavian Journal of Public Health. - 1403-4948 .- 1651-1905. ; , s. 36830-
-
Tidskriftsartikel (refereegranskat)abstract
- AIM: Older adults are increasingly encouraged to continue living in their own homes with support from home care services. However, few studies have focused on older adults' safety in home care. This study explored associations between the sense of security and factors related to demographic characteristics and home care services.METHODS: The mixed longitudinal design was based on a retrospective national survey. The study population consisted of individuals in Sweden (aged 65+ years) granted home care services at any time between 2016 and 2020 (n=82,834-94,714). Multiple ordinal logistic regression models were fitted using the generalised estimation equation method to assess the strength of relationship between the dependent (sense of security) and independent (demographics, health and care-related factors) variables.RESULTS: The sense of security tended to increase between 2016 and 2020, and was significantly associated with being a woman, living outside big cities, being granted more home care services hours or being diagnosed/treated for depression (cumulative odds ratio 2-9% higher). Anxiety, poor health and living alone were most strongly associated with insecurity (cumulative odds ratio 17-64% lower). Aside from overall satisfaction with home care services, accessibility and confidence in staff influenced the sense of security most.CONCLUSIONS: We stress the need to promote older adults' sense of security for safe ageing in place, as mandated by Swedish law. Home care services profoundly influence older adults' sense of security. Therefore, it is vital to prioritise continuity in care, establish trust and build relationships with older adults. Given the increasing shortage of staff, integrating complementary measures, such as welfare technologies, is crucial to promoting this sense of security.
|
|
| 5. |
- Lindh Mazya, Amelie, et al.
(författare)
-
Discordance in Frailty Measures in Old Community Dwelling People with Multimorbidity - A Cross-Sectional Study
- 2023
-
Ingår i: Clinical Interventions in Aging. - 1178-1998. ; 18, s. 1607-1618
-
Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: Assessment of frailty is a key method to identify older people in need of holistic care. However, agreement between different frailty instrument varies. Thus, groups classified as frail by different instruments are not completely overlapping. This study evaluated differences in sociodemographic factors, cognition, functional status, and quality of life between older persons with multimorbidity who were discordantly classified by five different frailty instruments, with focus on the Clinical Frailty Scale (CFS) and Fried's Frailty Phenotype (FP).PARTICIPANTS AND METHODS: This was a cross-sectional study in a community-dwelling setting. Inclusion criteria were as follows: ≥75 years old, ≥3 visits to the emergency department the past 18 months, and ≥3 diagnoses according to ICD-10. 450 participants were included. Frailty was assessed by CFS, FP, Short Physical Performance Battery (SPPB), Grip Strength and Walking Speed.RESULTS: 385 participants had data on all frailty instruments. Prevalence of frailty ranged from 34% (CFS) to 75% (SPPB). Nine percent of participants were non-frail by all instruments, 20% were frail by all instruments and 71% had discordant frailty classifications. Those who were frail according to CFS but not by the other instruments had lower cognition and functional status. Those who were frail according to FP but not CFS were, to a larger extent, women, lived alone, had higher cognitive ability and functional status.CONCLUSION: The CFS might not identify physically frail women in older community-dwelling people with multimorbidity. They could thus be at risk of not be given the attention their frail condition need.
|
|
| 6. |
- Marmstål Hammar, Lena, 1979-, et al.
(författare)
-
Being meet by dignity and respect in home care service- perceptions of persons with dementia
- 2020
-
Konferensbidrag (refereegranskat)abstract
- IntroductionStudies on the quality of home care services (HCS) offered to persons with dementia (PwD) reveal prevalence of unmet needs and dissatisfaction concerning encounters and lack of relationships with staff. The aim of this study was to enhance the knowledge about the perceptions from PwD regarding dignity and respect in relation to HCS staff over time.Material and methodsA mixed longitudinal study was designed to study any trend, over the period between 2016 and 2018, and to compare the results between PwD (case) and persons without dementia (control) living at home with HCS. An existing yearly HCS quality assessment survey of the Swedish National Board of Health and Welfare was used. Over the study period, 271.915 (PwD = 8.1%) respondents (all aged 65+ years) completed the survey. The focus was on questions concerning dignity and respect. We applied GEE logistic, and cumulative logit regression model to estimate any effects and trends of interest, after controlling for the effect of age, gender, health status, and the amount of HCS hours.ResultsThe results showed a significant 3-10% lower odds (and cumulative odds) for PwD to be satisfied on these issues, compared with control individuals. Also, that both groups’ experiences of satisfaction decreased over the years from 2016 to 2018. ConclusionsOur findings indicate that Swedish HCS will not reach the WHOs global action plan for PwD by 2025. HCS organization needs to shift from a task-oriented system to a person-centered approach by setting each older person in focus.
|
|
| 7. |
- Mazya, Amelie Lindh, et al.
(författare)
-
Translation and Validation of the Swedish Version of the Tilburg Frailty Indicator
- 2023
-
Ingår i: Healthcare. - 2227-9032. ; 11:16, s. 1-14
-
Tidskriftsartikel (refereegranskat)abstract
- The Tilburg Frailty Indicator (TFI) is a questionnaire with 15 questions designed for screening for frailty in community-dwelling older people. TFI has a multidimensional approach to frailty, including physical, psychological, and social dimensions. The aim of this study was to translate TFI into Swedish and study its psychometric properties in community-dwelling older people with multimorbidity. A cross-sectional study of individuals 75 years and older, with ≥3 diagnoses of the ICD-10 and ≥3 visits to the Emergency Department in the past 18 months. International guidelines for back-translation were followed. Psychometric properties of the TFI were examined by determining the reliability (inter-item correlations, internal consistency, test-retest) and validity (concurrent, construct, structural). A total of 315 participants (57.8% women) were included, and the mean age was 83.3 years. The reliability coefficient KR-20 was 0.69 for the total sum. A total of 39 individuals were re-tested, and the weighted kappa was 0.7. TFI correlated moderately with other frailty measures. The individual items correlated with alternative measures mostly as expected. In the confirmatory factor analysis (CFA), a three-factor model fitted the data better than a one-factor model. We found evidence for adequate reliability and validity of the Swedish TFI and potential for improvements.
|
|
| 8. |
- Olsen, Marie, 1967-, et al.
(författare)
-
Important aspects in home care service: an interview study with persons with dementia
- 2021
-
Ingår i: Dementia. - : SAGE Publications. - 1471-3012 .- 1741-2684. ; 20:5, s. 1649-1663
-
Tidskriftsartikel (refereegranskat)abstract
- AbstractBackground and aim: Because of the policy of ‘ageing in place’ and a decreased number of beds at residential settings, more persons with dementia are staying in their ordinary homes with assistance from home care services. However, previous studies reveal more unmet needs and a lower quality of life in this group than in other groups. Because few qualitative studies are done where persons with dementia have the opportunity to tell their own stories and describe what they find important, this study aimed to interview persons with dementia and describe their views of important aspects when receiving home care service.Methods: The study has a qualitative approach and 14 persons with dementia participated in interviews. The interviews were analysed using qualitative content analysis.Results: The results revealed one overarching theme: The importance of being supported as a unique and capable human, in that the persons with dementia described that despite their dementia diagnoses it was important to be seen as a person with capabilities although in need of support. The theme was built up by three subthemes: Being seen as a person, being involved and informed; and being part of a relationship.Conclusions: Our study showed that persons with dementia are able to express, formulate and reflect on their needs and preferences about their daily care and what is important to them when receiving home care service. Therefore, their points of view should be considered when planning, providing and examining care, and they need to be involved in decision making about their care.
|
|
| 9. |
- Olsen, Marie, et al.
(författare)
-
Important aspects of home care service : An interview study of persons with dementia.
- 2021
-
Ingår i: Dementia. - : SAGE Publications. - 1471-3012 .- 1741-2684. ; 20:5, s. 1649-1663
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND AIM: Because of the policy of 'ageing in place' and a decreasing number of beds in residential settings, more persons with dementia live at home with support from home care services. However, previous studies have revealed more unmet needs and a lower quality of life in this group than in other groups. Because few qualitative studies are performed in which persons with dementia have the opportunity to tell their own stories and describe what they find important, this study aimed to interview persons with dementia and describe their views on the important aspects of receiving home care service.METHODS: The study used a qualitative approach, and 14 persons with dementia participated in the interviews. The interviews were analysed using qualitative content analysis.FINDINGS: The findings revealed one overarching theme. The importance of being supported as a unique and capable human, that is the persons with dementia stated that despite their dementia diagnoses, it was important to be seen as a person with capabilities, although in need of support. This theme was built on three subthemes: being seen as a person, being informed and involved, and being part of a relationship.CONCLUSIONS: Our study showed that persons with dementia are able to express, formulate and reflect on their needs and preferences about their daily care as well as what is important to them when receiving home care service. Therefore, their point of view should be taken into consideration when planning, providing and evaluating care.
|
|
| 10. |
- Olsen, Marie, 1967-, et al.
(författare)
-
Older people’s views on the important values in home help provision: a Swedish study
- 2018
-
Konferensbidrag (refereegranskat)abstract
- Little is known about the values that older people consider important in receipt of home help. Therefore, this study aimed to explore which values older people hold in relation to home help services and their experiences of how these values are reflected in the delivery of help. Interviews were conducted from November 2015 to March 2016 with 16 older persons (age ≥65 years) who received home help at the time of the study. Data were analysed using qualitative content analysis. Results identified values that older people find important in home help and suggest behaviours that should underpin home help, such as supporting the older person’s independence, building a reciprocal relationship and promoting a sense of safety and security (e.g., by providing information about what home help entails for the recipient). We conclude that it is important that care staff recognise and integrate these values into their actions on an interpersonal level in daily care, adopting a relation-oriented rather than a task-focused approach in the provision of home help for older people.
|
|
