| 1. |
- Ali, Lilas, 1981-, et al.
(författare)
-
Effectiveness of Web-Based versus Folder Support Interventions for Young Informal Carers of Persons with Mental Illness : a Randomized Controlled Trial
- 2013
-
Konferensbidrag (refereegranskat)abstract
- Background: Changes in psychiatric services mean more young persons have to care for a mentally ill family member or friend while they themselves are in the sensitive transition to adulthood.Objective: Compare the impact of two interventions, a web-based support and a folder support, for young persons who care for people who suffer from mental illness.Method: This study was a randomized control trial, following the CONSORT statements and eConsort support. Primary outcome variable was stress, and secondary outcome variables were caring situation, general self-efficacy, well-being, health, and quality of life of young informal carers (N=241). Data were collected in June 2010 to April 2011, with self-assessment questionnaires three times, four months apart, comparing the two interventions and also to detect changes.Results: The result showed that stress levels were high in both groups at baseline, but decreased significantly in the folder group. The folder group had significant improvement in their caring situation (also significantly different from the web group), general self-efficacy, well-being, and quality of life. The web group show significant increase in well-being.Conclusion: Young informal carers who take on the responsibility for people close to them with mental illness; suffer consequences on their own health. They live in a life-situation characterized by high stress and low well-being. This signals a need for support for these young persons.Clinical relevance: The findings in this study are uniquely valuable because of the target group and the comparison of two different interventions to support them. The non-significant differences in the data show that each intervention can be effective, and that it depends upon the individual’s preferences. This highlights the importance of adopting person-centred approach, in which young persons can themselves choose support strategy
|
|
| 2. |
- Ali, Lilas, 1981, et al.
(författare)
-
Support for young informal carers of persons with mental illness : A mixed-method study
- 2013
-
Ingår i: Issues in Mental Health Nursing. - New York : Informa UK Limited. - 0161-2840 .- 1096-4673. ; 34:8, s. 611-618
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to explore how young (16-25 year old) informal carers of a person with a mental illness experience and use support. In a mixed method approach, we interviewed 12 young carers, and 241 completed a self-administered questionnaire. While the young carers strive to maintain control, their main support seems to be others in their lives, who often define the situation differently. The carers said web-support, counseling, and group counseling might be helpful, yet very few had any professional support. Young carers are greatly in need of support and it should be provided.
|
|
| 3. |
- Ali, Lilas, 1981, et al.
(författare)
-
Effectiveness of web-based versus folder support interventions for young informal carers of persons with mental illness: A randomized controlled trial
- 2014
-
Ingår i: Patient Education and Counseling. - Shannon, Irland : Elsevier BV. - 0738-3991 .- 1873-5134. ; 94:3, s. 362-371
-
Tidskriftsartikel (refereegranskat)abstract
- Objective: Compare the impact of two interventions, a web-based support and a folder support, for young persons who care for people who suffer from mental illness. Methods: This study was a randomized control trial, following the CONSORT statements, which compared the impact of two interventions. Primary outcome variable was stress, and secondary outcome variables were caring situation, general self-efficacy, well-being, health, and quality of life of young informal carers (N= 241). Data were collected in June 2010 to April 2011, with self-assessment questionnaires, comparing the two interventions and also to detect changes. Results: The stress levels were high in both groups at baseline, but decreased in the folder group. The folder group had improvement in their caring situation (also different from the web group), general self-efficacy, well-being, and quality of life. The web group showed increase in well-being. Conclusion: Young informal carers who take on the responsibility for people close to them; suffer consequences on their own health. They live in a life-situation characterized by high stress and low well-being. This signals a need for support. Practice implications: The non-significant differences show that each intervention can be effective, and that it depends upon the individual's preferences. This highlights the importance of adopting person-centered approach, in which young persons can themselves choose support strategy. © 2013 Elsevier Ireland Ltd.
|
|
| 4. |
- Alwin, Jenny, 1978-, et al.
(författare)
-
Health economic and process evaluation of AT interventions for persons with dementia and their relatives - A suggested assessment model
- 2007
-
Ingår i: Technology and Disability. - 1055-4181. ; 19:2-3, s. 61-71
-
Tidskriftsartikel (refereegranskat)abstract
- There is growing interest in assistive technology (AT) as a means of enabling participation in everyday activities for persons with dementia and their relatives. Health economic assessment of AT in dementia is of importance due to the consequences of the disease for both patients and relatives and to the high societal costs for dementia care. The aim of this article is to outline a model for assessment of AT interventions for persons with dementia. The model expands existing assessment models as it also includes evaluation of the intervention process. Methodological challenges and possibilities in making health economic assessments, including outcomes and costs, as well as process evaluation, are discussed in the article. © 2007 IOS Press. All rights reserved.
|
|
| 5. |
- Alwin, Jenny, 1978-, et al.
(författare)
-
Teknik för personer med demens : En utvärderingsstudie av teknikintervention för personer med demenssjukdom och deras närstående
- 2008
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Denna rapport är framtagen av Centrum för utvärdering av medicinsk teknologi (CMT), Institutionen för medicin och hälsa, vid Linköpings universitet på uppdrag av Hjälpmedelsinstitutet. Utvärderingsstudien1 som presenteras i rapporten har gjorts av en intervention som utvecklats inom ramen för projektet ”Teknik och Demens”.Författarna till rapporten vill tacka medarbetare i Teknik och Demensprojektet:Arbetsterapeuter på de kliniska enheterna: Barbro Askenborg, Carina Boström, Ulla Haraldson, Malin Lundberg, Anna Rosshagen, Sofia Starkhammar samt Inger Lindblad från Stockholms sjukhem och Margret Rosenberg från Arbetsterapeuterna primärvården Gästrikland.Medarbetare på FoU-enheterna: Ulla Johansson, Staffan Josephsson och Åke Seiger.Projektledningsgruppen: Susann Forsberg och Ingela Månsson från Hjälpmedelsinstitutet, Inge Dahlenborg från Demensförbundet och Kerstin Lundström från Alzheimerföreningen i Sverige.Vi vill även tacka Magnus Husberg, CMT, för konsultinsatser vad gäller analys och databehandling samt Olle Eriksson, LiU, som rådgivare vad gäller statistiska beräkningar. Tack till alla personer som bidragit med synpunkter på rapporten.Slutligen ett varmt tack till alla deltagare i Teknik och Demensprojektet som under studiens gång besvarat många frågor.Linköping 2008-04-22Jenny Alwin Jan Persson Barbro Krevers
|
|
| 6. |
- Balducci, C, et al.
(författare)
-
Negative impact and positive value in caregiving : Validation of the COPE index in a six-country sample of carers
- 2008
-
Ingår i: The Gerontologist. - 0016-9013 .- 1758-5341. ; 48:3, s. 276-286
-
Tidskriftsartikel (refereegranskat)abstract
- Purpose: The present study attempts to further validate the COPE Index on a large sample of carers drawn from six European countries. Design and Methods: We used a cross-sectional survey, with approximately 1,000 carers recruited in each of six countries by means of a common standard evaluation protocol. Our saturation recruitment of a designated quota of carers occurred by means of several channels, in identified geographical zones within countries. Interviews were carried out with primary informal carers by use of a common assessment tool. We subjected items of the COPE Index to principal component analysis and we assessed emergent components through the use of Cronbach's alpha reliability procedures. We examined factor components as summative scales for confirmatory correlations with caregiving and psychological variables. Results: Three components emerged, which we identified as the negative impact of caregiving, the positive value of caregiving, and the quality of support for caregiving. Internal consistency was good for negative impact and satisfactory for positive value and quality of support. Negative value was most consistently and strongly correlated with caregiving and psychological variables, although we did find diverse associations between these variables and the COPE Index subscales. Implications: The COPE Index is a brief, first-stage assessment of some sophistication that can enable health and social care professionals to develop appropriately targeted interventions to enhance the positive aspects of the caregiving experience and quality of support, as well as reduce the negative impacts of caregiving. Copyright 2008 by The Gerontological Society of America.
|
|
| 7. |
- Broqvist, Mari, 1958-
(författare)
-
Asking the public : Citizens´ views on priority setting and resource allocation in democratically governed healthcare
- 2018
-
Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Resource allocation in publicly funded healthcare systems is inevitably linked with priority setting between different patient groups and between different service areas, so-called meso level priorities. Behind every priority-setting decision (investments, reallocating or rationing), are values affecting both the content of the decisions and how the decisions are made. The importance for priority-setting to reflect social values, has been emphasised for the legitimacy of the healthcare systems and the decision makers. Also important, if supposed to provide enough guidance in practice, is that content values, expressed in ethical principles and criteria, are further operationalised. Few studies exist where Swedish citizens have been asked about priority setting and rationing at meso level, and findings from other countries cannot automatically be transferred to the Swedish context.The overall aim of this thesis is to extend and deepen the knowledge of the Swedish citizens´ views on acceptance of rationing in healthcare, on appropriate decision makers for rationing, and on the severity criterion for priority setting. Two qualitative and one mixmethod study were conducted, where citizens were interviewed. Citizens´ views on severity were also compared, both with a Severity Framework, derived from parliamentary-decided ethical principles and used for resource allocation, and with health professionals´ and politicians´ ranking of different aspects of severity in a quantitative, survey study.Study I shows that citizen participants perceived that acceptance of rationing at meso level is built on the awareness of priority-setting dilemmas between patient groups. No such spontaneous awareness was found. Depending on reactions of self-interest or solidarity, acceptance was also perceived to be built on acceptable principles for rationing and/or access to alternatives to public care. Study II shows that awareness of the meso level forms the basis for awareness of different risks of unfairness, linked with potential decision makers (even health professionals). Collaborative arrangements were promoted in order to control for such risks, especially the risk of self-interest. Politicians, in contrast to previous studies, were favoured as final decision makers for rationing healthcare. In study III, citizen participants identified the same severity aspects as health professionals and experts had done in the Severity Framework. They contributed with some possible refinements, but also promoted aspects not in line with established ethical criteria for priority setting in Sweden. Study IV shows that citizen respondents differ to a larger proportion compared to politicians´ ranking of severity aspects, than with that of health professionals´. The greatest number of significant differences was found between politicians and health professionals.This thesis has several implications. Politicians ought to strive for greater public awareness of the priority-setting dilemma at the meso level in healthcare, both according to the process and the content values behind the decisions. Social values not in accordance to the parliamentary decision indicate a need to facilitate an ongoing dialogue, reason-giving activities and promotion of content values of solidarity. To capture social values on priority setting and rationing, ambitious public deliberation is not the only way. Methodologically stringent research, with a variety of study designs, could contribute in many important ways.
|
|
| 8. |
- Broqvist, Mari, 1958-, et al.
(författare)
-
The meaning of severity - do citizenś views correspond to a severity framework based on ethical principles for priority setting?
- 2018
-
Ingår i: Health Policy. - : Elsevier. - 0168-8510 .- 1872-6054. ; 122:6, s. 630-637
-
Tidskriftsartikel (refereegranskat)abstract
- The importance for governments of establishing ethical principles and criteria for priority setting in line with social values, has been emphasised. The risk of such criteria not being operationalised and instead replaced by de-contextualised priority-setting tools, has been noted. The aim of this article was to compare whether citizenś views are in line with how a criterion derived from parliamentary-decided ethical principles have been interpreted into a framework for evaluating severity levels, in resource allocation situations in Sweden. Interviews were conducted with 15 citizens and analysed by directed content analysis. The results showed that the multi-factorial aspects that participants considered as relevant for evaluating severity, were similar to those used by professionals in the Severity Framework, but added some refinements on what to consider when taking these aspects into account. Findings of similarities, such as in our study, could have the potential to strengthen the internal legitimacy among professionals, to use such a priority-setting tool, and enable politicians to communicate the justifiability of how severity is decided. The study also disclosed new aspects regarding severity, of which some are ethically disputed, implying that our results also reveal the need for ongoing ethical discussions in publicly-funded healthcare systems.
|
|
| 9. |
- Bäckman, Karin, 1967-, et al.
(författare)
-
Prioriteringar över kommunala förvaltningsområden : ett utvecklingsarbete i Motala kommun
- 2017
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Motala kommun är den första kommunen som på ett systematiskt sätt tagit sig an prioritering och resursfördelning inom alla sina förvaltningsområden med utgångspunkt i de etiska principer och riktlinjer för prioriteringar som gäller för hälso- och sjukvård. Arbetet omfattar utveckling av ett verktyg för prioritering, anpassat till ett kommunalt sammanhang och att använda det i ett systematiskt prioriteringsarbete kombinerat med politiska mål och visioner. Avsikten är att prioriteringsarbetet ska utvecklas till en hållbar rutin, integrerad i befintlig budgetprocess.Syftet med denna rapport är att beskriva det första skedet i utvecklingsarbetet, med tillhörande arbetsprocesser samt att analysera det utifrån ett förbättringsoch implementeringsperspektiv. Rapporten omfattar åren 2013-2015.Prioriteringscentrums engagemang i Motala kommun har inneburit att vi genom s k aktionsforskning har studerat utvecklingen av prioriteringsarbetet samtidigt som vi gett stöd till kommunen och deltagit i utvecklingsarbetet av verktyg och processer. Datainsamling har skett genom observationer, dokument, enkäter och olika typer av kontakter.I Motala kommun har prioriteringsprocessen och dess verktyg utvecklats i nära samarbete med involverade aktörer, de som skulle bli användarna. Prioriteringsarbetet har integrerats i kommunens befintliga ledningssystem och rutiner. Utvecklingen har skett stegvis i små förbättringscykler. På detta sätt har kunskap och lärande byggts upp inom organisationen och arbetet har präglats av långsiktighet.Motala kommuns utveckling av verktyg och processer för prioritering visar att det är möjligt att vägledas av nationella etiska principer för prioritering inom hälso- och sjukvård och att det går att kombinera dessa med politiska mål och visioner. Det har också varit möjligt att inkludera kommunens alla förvaltningar i prioriteringsarbetet i en öppen, systematisk process som kopplats till ordinarie budgetarbete.
|
|
| 10. |
- Carlsson, Staffan, et al.
(författare)
-
Vägledning för prioriteringar i en behovsstyrd hälso- och sjukvård för god och jämlik hälsa i hela befolkningen.
- 2022
-
Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Sammanfattande synpunkter från deltagande regionerI projektet beskrev deltagarna hur prioritering och resursfördelning går till i respektive region idag och hur de skulle vilja utveckla arbetet framöver.Deltagarna beskrev ett antal viktiga förutsättningar för att på ett systematiskt sätt, med utgångspunkt från befolkningens hälsa och behov av hälso- och sjukvård, kunna prioritera och fördela resurser till de med störst behov.Ett tydligt uppdrag från politiken att leverera strukturerade underlag som underlättar diskussion och beslut om prioriteringar.En tydlig mottagare av underlag och analyser med uppdrag att agera vidare utifrån dessa.Ett strukturerat arbetssätt och tydliga roller för både förtroendevalda och tjänstepersoner.Skapa förutsättningar i organisationen för att genomföra hela processen.En god dialog mellan förtroendevalda, tjänstepersoner och vårdprofession.En gemensam förståelse för vad som ska uppnås med prioriteringarna.Behovsanalyser både avseende bredd (stora grupper) och djup (specifika tillstånd).Beskrivning av utfallet av hälso- och sjukvårdens åtgärder i form av hälsovinster i befolkningen samt kostnaderna för att åstadkomma dessa hälsovinster.Beslut om prioriteringar som grundas på fakta och framtagna underlag.Uppföljning av beslutade prioriteringar genom dialog på flera nivåer (politik, tjänsteperson, vårdprofession, patient och befolkning).För att få genomslag för politiska prioriteringar i en hel region har förtroendevalda i fullmäktige, styrelser och nämnder ett särskilt ansvar.Regiondirektör, hälso- och sjukvårdsdirektör, ekonomidirektör och budgetchef behöver vara engagerade och tjänstepersoner med kompetens från hälso- och sjukvård, regional utveckling, ekonomi och analys behöver bilda ett tvärprofessionellt team.Det är nödvändigt att säkra en gemensam förståelse för behovet av politiska prioriteringar i verksamheterna och hos befolkningen.
|
|
