| 1. |
- Snellman, Marie-Louise, 1974-, et al.
(författare)
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Tillsammans för ett bättre liv – livet ut : forskningsöversikt om äldres självständighet och aktiva deltagande i samhällslivet samt hur kommuner kan förbättra sin samhällsplanering
- 2024
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Rapport (refereegranskat)abstract
- Rapporten är ett resultat av ett samverkansprojekt mellan Umeå kommun och Umeå Universitet. Syftet är att ta reda på vilka förhållanden som kan främja äldre invånares möjligheter att bo kvar hemma i eget boende och samtidigt möjliggöra förutsättningar till ett aktivt deltagande i samhällslivet, ökad självständighet och ett förlängt steg till vård- och omsorg. Rapporten innehåller en narrativ litteraturöversikt, där målsättningen är att sammanfatta och diskutera empiriska och teoretiska studier på ett område där det saknas en etablerad översikt och kunskapsläget är oklart. Översikten genomfördes i fyra faser: 1) Inledande litteratursökning, 2) Fokuserad litteratursökning, 3) Översiktlig analys av identifierade publikationer, samt 4) Kompletterande sökning och slutlig analys. För att identifiera relevanta publikationer gjordes datorbaserade sökningar i vetenskapliga databaser och etablerade sökmotorer. Det empiriska materialet består av 99 publikationer som slutligen valdes ut och analyserades systematiskt i fem steg.Resultaten presenteras i fem kapitel: 1) Förhållanden relaterade till den egna personen, 2) Social delaktighet, sociala relationer och nätverk, 3) Boende och bostaden, 4) Digital teknik, 5) Fysisk omgivning. Resultaten visar att för att äldre ska kunna bo kvar hemma krävs ett holistiskt perspektiv som inkluderar både bostaden och den sociala och fysiska miljön utanför. Viktiga faktorer inkluderar självständighet, trygghet och säkerhet inom hemmet, samt att ta hänsyn till äldres egna uppfattningar om stöd och service. Det finns begränsat med forskning med fokus på att främja äldres boende i eget hem, och i rapporten betonas att det är en komplex fråga som kräver insatser från olika discipliner och sektorer. Att se de äldre som individer med varierande behov, och att använda ett personcentrerat förhållningssätt är centralt, trots att många insatser ofta utformas utifrån en homogen bild av äldre.Baserat på resultaten diskuteras i det sista kapitlet tre huvudteman: Proaktiv bostads- och samhällsplanering, Social delaktighet och tredje rum, samt Digital teknik i den äldres vardag. Där belyses även bristen på studier som tar ett helhetsgrepp kring främjande av äldres vardag och självständighet i olika livssituationer.
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| 2. |
- Snellman, Marie-Louise, et al.
(författare)
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What needs must be met for older people to be able to stay at home longer? : A scoping review by multi-professional collaborators
- 2023
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Background: In Sweden and in many other countries, the proportion of older people will increase dramatically over the next ten years. Resources such as residential care will not be sufficient for the needs within the target group to the same extent as today. Organizations responsible for care needs to initiate new solutions to promote older people’s independence, active participation to extend the age of onset for elderly care interventions. This societal challenge was investigated through a scoping review with an overarching research question: What needs must be met for older people to be able to stay at home longer?Review: Sub-questions were designed informed by Maslow’s hierarchy of needs. Which conditions make it possible for older people to stay at home longer regarding: 1) the person her/himself?, 2) the housing?, 3) the social relations?, 4) the surroundings? Several databases and search engines were used to search for a range of literature published 2000-2021, in English and Scandinavian languages. The search resulted in approx. 2500 abstracts of which 386 publications were selected.Results: A preliminary assessment indicates that:- the research area is heterogeneous (many different disciplines, target groups, questions, designs and theories).- the publications include person-related factors (73%), environment-related factors (19%) and housing factors (8%).- person-related factors include physical conditions (35%), psychological conditions (24%) and social relationships (13%).We will present a compilation of preconditions that enable older people to stay at home longer, as well as demonstrate a model of how these preconditions are interrelated.
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| 3. |
- Jemberie, Wossenseged Birhane, 1985-, et al.
(författare)
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A Multidimensional Latent Class Analysis of Harmful Alcohol Use Among Older Adults : Subtypes Within the Swedish Addiction Severity Index Registry
- 2020
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Ingår i: Journal of addiction medicine. - : Wolters Kluwer. - 1932-0620 .- 1935-3227. ; 14:4, s. e89-e99
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The present study aimed to identify multidimensional typologies of harmful alcohol use based on the Swedish Addiction Severity Index (ASI) assessment data on individuals aged 50 years and above.Methods: Latent class analysis examined 11 indicators from ASI data on 1747 individuals (men = 1255, women = 492) who reported they were troubled by alcohol problem at least one day in the past 30 days before their assessment. The discriminative validity of the classes was assessed by comparing other measures of individual characteristics and problem severity of other ASI dimensions.Results: Five subtypes of harmful alcohol use were identified. Two classes with alcohol problems varying in psychosocial functioning, age composition and ages of onset of both regular and heavy drinking. Two with psychiatric comorbidity but varying in violence, criminality, gender composition and ages of onset of regular and heavy drinking. One with high prevalence of concurrent use of other substances, psychiatric, legal, and employment problems.Conclusions: The analysis identified, in a national sample, heterogeneous risk groups of older adults with harmful alcohol use. These findings suggest a need for healthcare providers to assess older adults not only for their substance use but also for associated problems and needs. Given these findings, the Addiction Severity Index is a valuable assessment tool for older adults with harmful alcohol use.
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| 4. |
- Jemberie, Wossenseged Birhane, 1985-, et al.
(författare)
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"Ageing with an alcohol problem is not what I envision" : reclaiming agency in shaping personal ageing trajectory and recovery from alcohol problems
- 2023
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Ingår i: BMC Geriatrics. - : BioMed Central (BMC). - 1471-2318. ; 23
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Tidskriftsartikel (refereegranskat)abstract
- Background: Eliciting and understanding older persons’ descriptions of their resources for healthy ageing and the interaction of these resources with alcohol use and alcohol problems can facilitate health promotion. It can also inform clinicians when identifying areas of recovery capital that present risks and strength for older people seeking alcohol treatment. The objective of this study was to illuminate the experiences and perspectives of older persons on ageing, alcohol use, treatment, and recovery from alcohol problems, as well as their understanding of healthy ageing.Methods: Eight men and two women, aged 61 to 73 years, with moderate drinking as a treatment goal and treated at an outpatient alcohol clinic in Sweden, participated in semi-structured audio-recorded virtual interviews. A qualitative content analysis examined the transcribed interviews.Results: Three themes were identified: “Tipping the balance”, “Staying behind a veil” and “Lifting the vail”. First, participants understood healthy ageing as a personal and multidimensional process that involved actively expanding, maintaining or adjusting to the resources needed to lead an active and meaningful life while preserving autonomy, dignity and independence for as long as possible. Second, most participants viewed moderate alcohol use as a contributor to healthy ageing. They sought treatment when their drinking became unsustainable and an immediate threat to their healthy ageing resources. Stigma, ambivalence and a lack of treatment options, however, contributed to delayed treatment. Third, the participants responded to treatment approaches that elicited their concern, incorporated their expertise and treatment and life goals, appreciated their autonomy and agency, and considered them partners in goal setting and decision making. Reduced drinking helped participants regain their agency and improved their healthy ageing capital which in turn catalyzed continuing recovery.Conclusions: Older persons in non-abstinent recovery perceive healthy ageing and alcohol recovery as personal and interacting multidimensional processes involving their agency to improve biopsychosocial functioning. Treatment approaches that recognize older persons’ desire for healthy ageing, incorporate their treatment goals and respect their autonomy are likely to be acceptable and effective.
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| 5. |
- Jemberie, Wossenseged Birhane, 1985-
(författare)
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Alcohol and aging : a multimethod study on heterogeneity and multidimensionality
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background and Objectives: With an ageing population, the number of older persons with substance use problems, particularly problematic alcohol use, is increasing. Despite growing recognition of the negative consequences of problematic alcohol use on older persons, there is a dearth of knowledge about the alcohol use profiles and the dimensionality of alcohol problems in older people. Moreover, little is known about older persons’ experiences and perspectives on alcohol use in relation to their ageing and their personal goals regarding treatment and recovery. This thesis aimed to (i) describe the characteristics of older persons who accessed municipal substance use treatment and care services (addiction services) and to investigate their future hospitalization; (ii) examine the heterogeneity and multidimensionality of problematic alcohol use among older persons; and (iii) to shed light on the experiences and perspectives of older persons regarding ageing, alcohol problems and recovery.Methods: For studies I-III, municipal Addiction Severity Index (ASI) assessment data (between 2003 and 2017) from adults aged 50 years and older were used to select the study samples. Generalized linear regression models investigated hospitalization related outcomes among 3624 older persons in Study-I. In Study-II, a latent class analysis was applied on ASI data from 1747 individuals with alcohol problems. Study-III linked the ASI data from Study-II to hospital discharge and mortality data forming time-to-repeated-event dataset; Andersen-Gill regression model with a robust variance estimator was used for the analysis. Study-IV applied qualitative content analysis on interview data from ten older persons recruited from a specialist outpatient clinic for alcohol treatment. Results: Nearly three-fourth of older persons assessed for substance use severity at municipal addiction services were later hospitalized (Study-I). Individuals diagnosed with substance use disorders, psychiatric or dual diagnoses had more cumulative hospitalized days, higher rates of hospital readmissions, and shorter time to first admission following an initial ASI assessment at municipal addiction services (Study-I). Five distinct groups of older persons with comparable alcohol problem severity but with variation in onset age, psychiatric comorbidities, polysubstance use, social support and gender composition were identified (Study-II). The five groups varied in risks of repeated hospitalizations due to substance use and psychiatric disorders (Study-III). Older persons experienced their ageing and alcohol use having a dynamic interplay (Study-IV). They needed to constantly negotiate with their environment to maintain a positive ageing trajectory. They perceived moderate alcohol use fosters healthy ageing, but over time, experienced their alcohol use as unsustainable and a threat to their pursuit of healthy ageing. Stigma and ambivalence delayed treatment seeking (Study-IV). They accessed treatment programs which respected their preferences and autonomy, engaged them in goal setting and strengthened their agency. After reducing their alcohol use, positive changes in their biopsychosocial functioning encouraged them to continue their recovery journey even in the presence of setbacks (Study-IV).Conclusion: Most older persons who access municipal addiction services are hospitalized repeatedly. Many older persons with alcohol problems live with medical and psychiatric comorbidities suggesting multiple care needs from health and social care services. Incorporating older persons’ desire for healthy ageing into alcohol treatment plan can facilitate treatment engagement and recovery. Many older persons aim to moderate their alcohol consumption. Clinicians can deliver person-centered care for older persons, by considering their heterogeneity in treatment goals, biopsychosocial functioning, and available resources. A multidimensional identification of alcohol use profiles could improve treatment by establishing the variation in alcohol problems among older treatment seekers. Older persons stay engaged in alcohol treatment programs which value their experiences and expertise, incorporate their personal treatment and life goals, respect their autonomy and agency, and involve them as active participants. Sensitizing service providers on old age substance use problems could provide multiple points of contact for screening of older persons and earlier referral to treatment. A streamlined data sharing within and between health and social care services fosters timely and equitable care and facilitates an integrated and person-centered care across the continuum.
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| 7. |
- Jemberie, Wossenseged Birhane, 1985-, et al.
(författare)
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Studying the trajectories and mediators of old-age problematic alcohol use and the agency of older persons
- 2023
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Annan publikationabstract
- Unit of analysis: IndividualPopulation: Older people aged between 61 and 73 years who have sought treatment for alcohol at a specialist outpatient clinic in a metropolitan city in Sweden.Time Method: Cross-sectionSampling procedure: Non-probability: PurposiveThe study participants were purposefully recruited from a specialist outpatient alcohol treatment clinic located in a Swedish metropolitan city. To be eligible for the study, participants had to be 55 years or older, had to self-report a history of problematic alcohol use and treatment for alcohol use after the age of 50. Individuals who were unable or unwilling to provide informed consent or participate in the interview via Zoom, Skype, or telephone were excluded from the study.Time period(s) investigated: 2021-12 – 2022-04Number of individuals/objects: 10Data format / data structure: Text
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| 8. |
- Jemberie, Wossenseged Birhane, 1985-, et al.
(författare)
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Substance Use Disorders and COVID-19 : Multi-Faceted Problems Which Require Multi-Pronged Solutions
- 2020
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Ingår i: Frontiers in Psychiatry. - : Frontiers Media S.A.. - 1664-0640. ; 11
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Tidskriftsartikel (refereegranskat)abstract
- COVID-19 shocked health and economic systems leaving millions of people without employment and safety nets. The pandemic disproportionately affects people with substance use disorders (SUDs) due to the collision between SUDs and COVID-19. Comorbidities and risk environments for SUDs are likely risk factors for COVID-19. The pandemic, in turn, diminishes resources that people with SUD need for their recovery and well-being. This article presents an interdisciplinary and international perspective on how COVID-19 and the related systemic shock impact on individuals with SUDs directly and indirectly. We highlight a need to understand SUDs as biopsychosocial disorders and use evidence-based policies to destigmatize SUDs. We recommend a suite of multi-sectorial actions and strategies to strengthen, modernize and complement addiction care systems which will become resilient and responsive to future systemic shocks similar to the COVID-19 pandemic.
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| 9. |
- Nygård, Mikael, 1966-, et al.
(författare)
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The (non)politicisation of age discrimination in Finland and Sweden
- 2014
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Ingår i: International journal of sociology and social policy. - : Emerald Group Publishing Limited. - 0144-333X .- 1758-6720. ; 34:9/10, s. 694-709
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The article aims at examining the politicisation of age discrimination in relation to the enactment of anti-discrimination legislation in Finland and Sweden in the early-2000s. By showing how politicians constructed the meaning of age discrimination, it seeks to highlight the drivers of country variation in terms of the implementation of directives from the European Union.Design/methodology/approach: The article uses a comparative design based on content analyses of parliamentary documents. Theoretically, it uses discursive institutionalism as a starting point but it also builds on previous research/theories on age discrimination.Findings: The findings show that although age was seen as a ground for discrimination in both countries, there was surprisingly little debate about discrimination as societal problem. There was however considerable differences between the countries suggesting that age discrimination was a much more heated subject in Sweden.Research limitations/implications: Although the analysis focuses on a small part of the policy-making process it highlights drivers (such as political culture) that may cause variation in the ways age discrimination is politicised, even within similar welfare state regimes. It also suggests that more research is needed to fully understand such drivers.Originality/value: By analysing the ways in which age discrimination was constructed as a problem within national policy-making frameworks, the article presents valuable insights as to the sources of country variation in relation to the implementation of EU directives
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