| 1. |
- Jönsson, Marie, 1966-, et al.
(författare)
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Barriers and Opportunities in Daily Occupations : From the Perspective of the Older Readmitted People
- 2019
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Konferensbidrag (refereegranskat)abstract
- Introduction: Older people admitted to hospital are at risk of decreased ability to perform ADL, lower quality of life and dependency after discharge. There is also a higher risk for readmission to hospital shortly after discharge. To be old and repeatedly seeking acute care is also more than a medical problem. Their repeated contacts with the healthcare system may be due to a dependency on others that may affect daily occupations at home. The specific needs of this group of older people have been poorly described from these older persons perspective.Objectives: The objective of this study was to describe barriers and opportunities in daily occupations for older people repeatedly readmitted to hospital and now discharged to home.Methods: Sixteen participants (≥75 years) readmitted to hospital for the third time within a 12 -month period were interviewed in their homes after discharge from an acute medical ward about two weeks after their latest hospital stay. A qualitative content analysis was used for analysis.Results: An overarching theme was found, trying to manage an unpredictable everyday life. Three categories and seven subcategories were identified, which represented barriers and opportunities for their daily occupations. The categories were Dealing with an unstable day, Dealing with social relations and Dealing with the health care system. These categories were important for maintaining daily occupations for most of the participants.Conclusion: To the extent the older person had the opportunity to perform daily occupations, this was seen as important and contributed to maintain abilities. Close contact with relatives was essential to the performance of daily occupations at home, and for the old person without contact with relatives this was a barrier to occupation and increased their vulnerability. Therefore, occupational interventions and appropriate support are required in acute care and these must be communicated at discharge. Interventions and timed support are of particular importance for those who do not have close social relations at home.
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| 2. |
- Jönsson, Marie, 1966-, et al.
(författare)
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Close relatives' perspectives of everyday activities at home for older adults repeatedly readmitted to hospital : A qualitative study
- 2024
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Ingår i: British Journal of Occupational Therapy. - : Sage Publications. - 0308-0226 .- 1477-6006. ; :1, s. 39-48
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Relatives are important when older adults return home after a hospital stay. The aim of this study was to describe close relatives' perspectives of the everyday activities of older adults who are repeatedly readmitted to hospital and discharged to home.Methods: A semi-structured interview was performed to collect data from twenty relatives (aged 45-82 years). Data were analysed using a deductive qualitative content analysis based on the results of a previous study within this field.Results: The overall theme 'In need of support to manage an unpredictable everyday life' shows that the older adults often needed support in everyday activities. In the two categories 'Difficulties in dealing with an unstable day' and 'Managing an unstable day' and the 10 subcategories, close relatives described that the older adults needed support in various ways from relatives or other individuals. Close contact was important for how everyday activities worked at home and in maintaining social contacts and contact with healthcare.Conclusion: It was found that social needs, such as social contacts/activities, are just as important to assess at discharge as medical and functional needs.
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| 4. |
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| 5. |
- Jönsson, Marie, 1966-, et al.
(författare)
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Everyday activities at home : Experiences of older repeatedly readmitted people
- 2022
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Ingår i: Scandinavian Journal of Occupational Therapy. - : Informa Healthcare. - 1103-8128 .- 1651-2014. ; 29:7, s. 555-562
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Limitations in everyday activities are a risk factor for hospital readmission. Despite this, few studies have focussed on everyday activities of repeatedly readmitted older people. The experiences and specific needs of this group have been poorly described regarding their everyday activities at home. A deeper understanding may help occupational therapists and other health professions to facilitate readiness for this group at and after discharge. The aim of this study was, therefore, to describe the experiences of performing everyday activities of older people repeatedly readmitted to hospital and discharged to home.METHODS: A qualitative interview study was used to collect data from sixteen participants (75 years and older). Data were analysed using qualitative content analysis.RESULTS: One theme 'trying to manage an unpredictable everyday life' and two categories describe experiences of everyday activities at home. The participants expressed the importance of continuing everyday activities after discharge where support from relatives and healthcare seemed to be of importance.CONCLUSION: It was found that performance of everyday activities and contact with family members were of importance in their everyday life. Therefore, assessments and support were of particular importance for the group of older people who do not have close social relations at home.
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| 6. |
- Jönsson, Marie, 1966-
(författare)
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Everyday activities in older adults readmitted to hospital
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The coordination of health care and social care at discharge are particularly important for older adults with complex health and social needs, as approximately 30 % of these persons are readmitted to hospital on an unplanned basis within three months of discharge. In order to provide adequate care for this group of older adults, we need a deeper understanding of their experiences regarding their functional ability at hospital and at home.The overall aim of this thesis was to describe older readmitted adults in terms of their abilities at hospital, everyday activities at home and of healthcare professionals’ conception of the care of older adults. Four studies were conducted using descriptive design. Data were gathered using four different methods of data collection. In this thesis, older readmitted adults are, defined as persons aged 75 years or older who have been readmitted to hospital on an unplanned basis three or more times within 12 months. In Study I, older adults readmitted to hospital (n=60), were assessed regarding personal activities of daily living, cognitive function, risk of falls, pressure sores and malnutrition. They were compared with samples from the general population. In order to describe everyday activities at home, semi-structured interviews were carried out with older readmitted adults (n=16) in Study II, and with close relatives (n=20) in Study III. In Study IV, focus group interviews were performed with healthcare professionals (n=29) about care at discharge and which measures that may be appropriate in order to prevent readmission.The major findings were that the participants had a higher risk of pressure sores, falls and dependency on ADL at hospital compared to age-matched samples. 40% of the participants had a cognitive limitation. At home, older adults strived to perform everyday activities but the ability was limited. Close relatives described that social relations were fundamental to perform everyday activities and social activities at home. Healthcare professionals stated that older readmitted adults were vulnerable. Multidisciplinary teamwork and geriatric expertise were fundamental but were perceived as lacking. Medical resources and rehabilitation resources should be developed and include rapid follow-up appointments at home in order to prevent readmission.Overall, health care and social care must identify this group and offer preventive assessments and interventions.
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| 7. |
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| 8. |
- Jönsson, Marie, 1966-, et al.
(författare)
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Possibilities and hindrances in daily occupations for older readmitted people discharged to home
- 2018
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Konferensbidrag (refereegranskat)abstract
- Introduction: Older people admitted to hospital are at risk of decreased ability to perform ADL, lower quality of life and dependency after discharge. There is also a higher risk for readmission to hospital shortly after discharge. The specific needs of this group of older people have been poorly described from these older peoples’ perspective. A deeper understanding may help the occupational therapist and other health professions to choose interventions in order to maintain daily occupations for this group. The aim of this study was to describe barriers and opportunities in daily occupations for older people repeatedly readmitted to hospital and now discharged to home.Methods: Sixteen participants 75 years and older were interviewed in their homes after discharge from an acute medical ward. A qualitative content analysis was used to analyze barriers and opportunities in daily occupations.Results: An overarching theme was found trying to manage an unpredictable everyday life. Three categories and seven subcategories were identified representing barriers and opportunities. The categories were Dealing with an unstable day, Dealing with social relations and Dealing with the health care system. These were important for maintaining daily occupations for most of the participants.Conclusion: The result indicates that daily occupations and contact from relatives were of importance. Therefore, appropriate support and occupational interventions are required in acute care and these must be communicated at discharge. Occupational therapy interventions and timed support are of particular importance for the group of older people who do not have close social relations at home.
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| 9. |
- Dellenmark-Blom, Michaela, 1983, et al.
(författare)
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Postoperative morbidity and health-related quality of life in children with delayed reconstruction of esophageal atresia: a nationwide Swedish study
- 2022
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Ingår i: Orphanet Journal of Rare Diseases. - : Springer Science and Business Media LLC. - 1750-1172. ; 17:1
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Tidskriftsartikel (refereegranskat)abstract
- Background In 10-15% of children with esophageal atresia (EA) delayed reconstruction of esophageal atresia (DREA) is necessary due to long-gap EA and/or prematurity/low birth weight. They represent a patient subgroup with high risk of complications. We aimed to evaluate postoperative morbidity and health-related quality of life (HRQOL) in a Swedish national cohort of children with DREA. Methods Postoperative morbidity, age-specific generic HRQOL (PedsQL((TM)) 4.0) and condition-specific HRQOL (The EA-QOL questionnaires) in children with DREA were compared with children with EA who had primary anastomosis (PA). Factors associated with the DREA group's HRQOL scores were analyzed using Mann-Whitney U-test and Spearman's rho. Clinical data was extracted from the medical records. Significance level was p < 0.05. Results Thirty-four out of 45 families of children with DREA were included and 30 returned the questionnaires(n = 8 children aged 2-7 years; n = 22 children aged 8-18 years). Compared to children with PA(42 children aged 2-7 years; 64 children aged 8-18 years), there were no significant differences in most early postoperative complications. At follow-up, symptom prevalence in children aged 2-7 with DREA ranged from 37.5% (heartburn) to 75% (cough). Further digestive and respiratory symptoms were present in >= 50%. In children aged 8-18, it ranged from 14.3% (vomiting) to 40.9% (cough), with other digestive and airway symptoms present in 19.0-27.3%. Except for chest tightness (2-7 years), there were no significant differences in symptom prevalence between children with DREA and PA, nor between their generic or condition-specific HRQOL scores (p > 0.05). More children with DREA underwent esophageal dilatations (both age groups), gastrostomy feeding (2-7 years), and antireflux treatment (8-18 years), p < 0.05. Days to hospital discharge after EA repair and a number of associated anomalies showed a strong negative correlation with HRQOL scores (2-7 years). Presence of cough, airway infection, swallowing difficulties and heartburn were associated with lower HRQOL scores (8-18 years), p < 0.05. Conclusions Although children with DREA need more treatments, they are not a risk group for postoperative morbidity and impaired HRQOL compared with children with PA. However, those with a long initial hospital stay, several associated anomalies and digestive or respiratory symptoms risk worse HRQOL. This is important information for clinical practice, families and patient stakeholders.
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| 10. |
- Dellenmark-Blom, Michaela, 1983, et al.
(författare)
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Schooling experiences in children with long-gap esophageal atresia compared with children with esophageal atresia and primary anastomosis: a Swedish study
- 2023
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Ingår i: Orphanet Journal of Rare Diseases. - : BioMed Central (BMC). - 1750-1172. ; 18:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundChildren with long-gap esophageal atresia (LGEA) risk living with aerodigestive morbidity and mental health difficulties. No previous study has investigated their experiences of schooling, despite the importance of schools in children's development, learning and social relationships. We aimed to describe experiences of schooling in children with LGEA in Sweden in comparison with children with EA who had primary anastomosis.MethodChildren with LGEA aged 3-17 were recruited nationwide in Sweden. One parent completed a survey on their child's school-based supports (according to definitions from the Swedish National Agency for Education), school absence, school satisfaction, school functioning (PedsQL 4.0), mental health (Strength and Difficulties Questionnaire) and current symptomatology. School data were compared between 26 children with LGEA to that from 95 children with EA who had PA, a hypothesized milder affected group. Mental health level was determined using validated norms; abnormal & GE; 90 percentile. Data were analyzed using descriptives, correlation and Mann-Whitney-U test. Significance level was p < 0.05.ResultsFormal school-based support was reported in 17 (65.4%) children with LGEA and concerned support with nutritional intake (60%), education (50%) and medical/special health needs (35%). The prevalence of school-based support was significantly higher compared to children with PA overall (36.8%, p = 0.013) and regarding nutritional intake support (20%, p < 0.001). In children with LGEA, school-based support was related to low birth weight (p = 0.036), young child age (p = 0.014), height & LE; -2SD for age/sex (p = 0.024) and an increased number of aerodigestive symptoms (p < 0.05). All children with LGEA who had abnormal mental health scores had school-based support, except for one child. Nine children with LGEA (36%) had school absence & GE; 1times/month the past year, more frequently because of colds/airway infections (p = 0.045) and GI-specific problems compared to PA (p = 0.003). School functioning scores were not significantly different from children with PA (p = 0.34) but correlated negatively with school-based support (< 0.001) and school absence (p = 0.002). One parent out of 26 reported their child's school satisfaction as "not good".ConclusionsChildren with LGEA commonly receive school-based support, reflecting multifaceted daily needs and disease severity. School absence is frequent and related to poorer school functioning. Future research focusing on academic achievement in children with EA is needed.
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