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| 3. |
- Borg, Johan, et al.
(författare)
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Implementation of welfare technology : a state-of-the-art review of knowledge gaps and research needs
- 2022
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Ingår i: Disability and Rehabilitation. - : TAYLOR & FRANCIS INC. - 1748-3107 .- 1748-3115.
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Forskningsöversikt (refereegranskat)abstract
- Purpose: To offer guidance for future welfare technology research, this review provides an overview of current knowledge gaps and research needs as reported in primary scientific studies addressing the implementation of welfare technology for older people, people with disabilities and informal caregivers.Materials and methods: This paper conducted a state-of-the-art review based on systematic searches in 11 databases followed by a descriptive qualitative analysis of 21 selected articles.Results: Knowledge gaps and research needs were identified concerning two categories: research designs and populations and focus of research. The articles reported needs for comparative studies, longitudinal studies, and demonstration trials as well as the development of co-design processes involving technology users. They also called for studies applying a social system theory approach, involving healthy and frail older adults, representative samples of users within and across countries, informal and formal caregivers, inter-and multidisciplinary teams, and care organizations. Moreover, there are reported needs for studies of acquirement, adoption and acceptance of welfare technology, attitudes, beliefs, and context related to welfare technology, caregiver perspectives on welfare technology, services to provide welfare technology and welfare technology itself.Conclusions: There are considerable knowledge gaps and research needs concerning the implementation of welfare technology. They relate not only to the research focus but also to research designs, a social system theory approach and study populations.
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| 4. |
- Elfström, Magnus, 1971-, et al.
(författare)
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Reablement for older persons by an interprofessional home rehabilitation team : An ongoing RCT
- 2018
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- The aim is to evaluate the effects of intensive home rehabilitation regarding multidimensional health perceptions and other quality of life domains, physical ability and capacity among older people (65+). The design is a randomized controlled study of a reablement intervention with controls receiving traditional home care. The intervention is goal- and user oriented, home-based, time limited (3 months), and organized by an interprofessional team consisting of the professions nurse, enrolled nurses, physiotherapists, social worker, and occupational therapists. The effects of the intervention are measured by self-reported health and quality of life (EQ-5D-5L, HACT) including psychological well-being (GP-CORE), physical capacity (SPPB, hand dynamometer test), activity performance (COPM), and home care hours needed. Data are collected at inclusion (T1; applying for home care), after the three months intervention (T2), and at six months (T3). Primary outcome analyses will be performed according to intention to treat; 2 x 3 mixed design (group x time) ANCOVA with each dependent variable at T1 as covariate. Based on a medium effect size in favour of the intervention in the pilot study, and a dropout of 20%, the power calculation indicated that 240 persons should be included. The project will contribute with evidence of the effects of interprofessional home rehabilitation for reablement, and consequences for older persons’ bio-psycho-social health. The project is ongoing with more than 120 persons included. The intervention may result in reduced costs for care, but especially individual gains in relation to reduced care needs, maintained independence and good health.
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| 5. |
- Eriksson, Hans-G., et al.
(författare)
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Sickness absence and self-reported health a population-based study of 43,600 individuals in central Sweden
- 2008
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Ingår i: BMC Public Health. - : Springer Science and Business Media LLC. - 1471-2458. ; 8, s. 426-
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUNDSickness absence is very high in Sweden. The reasons for this phenomenon are not well known. The aim of this study was to investigate the association between degree of self-reported sickness absence and health. The hypothesis was that individuals with long-term sickness absence would report more symptoms and lower self-rated health. Another hypothesis was that women are more likely to self-rate psychiatric diagnoses compared to men, who are more likely to self-rate musculoskeletal diagnoses.METHODSThe data was obtained with a postal survey questionnaire answered by 43,589 individuals, a Swedish random population sample of men and women aged 18-84 years. The response rate was 65%. This study included 19,826 individuals aged 18-64 years old and still at work. They were divided into four groups, based on the number of reported days of sickness absence during the past year.RESULTSApproximately 40% of the individuals at work mentioned that they had been absent due to illness sometime during the past year. Of those who had been absent 90 days or more, two thirds were women. There was a significant difference between the groups in self-rated health (p < 0.05). Every fifth woman (19.4%) and every fourth man (25.9%) in the group with a sickness absence of more than 89 days rated their health as poor or very poor, but a large proportion, 43.5% of the women and 31.6% of the men, rated their health as good. Long-term illnesses and complaints differed between the groups. The correlations between the groups and illness were mostly significant (p < 0.01). Two thirds of the subjects had both psychiatric and musculoskeletal symptoms. There was a significant difference among them, as men more often had musculoskeletal diagnoses. One third had only psychiatric or musculoskeletal symptoms and in those groups there were no significant diagnosis differences between the sexes.CONCLUSIONIndividuals with long-term sickness absence reported more symptoms and lower self-rated health than did those who had not been absent at all, and than those who had been ill 1-28 days. Men and women sick-listed 29 days or more generally reported more illness and complaints. No sex differences among psychiatric and musculoskeletal diagnoses were found, but when reported both psychiatric and musculoskeletal symptoms the musculoskeletal diagnoses were significant among men.
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- Gusdal, Annelie K, 1963-, et al.
(författare)
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Prerequisites for a healthy and independent life among older people : a Delphi study
- 2021
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Ingår i: Ageing & Society. - : Cambridge University Press. - 0144-686X .- 1469-1779. ; 41:9, s. 2171-2187
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Tidskriftsartikel (refereegranskat)abstract
- The number of older people (aged 65+) will more than double by 2050 in Sweden. The ageing population is an increasing concern due to rising health-care costs and a shortage of health professionals. Older people generally prefer ageing in place, as long as they feel confident and comfortable. However, preventive and supportive measures are needed to maintain older people's independence and active participation in society. The aim of this study is to explore the prerequisites for a healthy and independent life among older people in Sweden. A Delphi study was conducted in three rounds. In round 1, seven focus group interviews were performed with older persons aged 65-79, older persons aged >= 80, next of kin of older persons, health professionals in primary and home health care, assistant nurses in home care, care managers and local politicians. The data were analysed using thematic analysis, resulting in 35 statements of the prerequisites needed for a healthy and independent life. These statements were sent to the participants from round 1, who were asked to evaluate the degree to which they agreed with each statement in round 2, and again in round 3. There was an agreement of at least 80 per cent for 31 of the 35 statements. When asked to identify the three prerequisites of most importance for a healthy and independent life, most participants stated: to have a social life, to have freedom of choice and power over one's own situation, and to have the possibility to choose independently one's type of housing. There was an overall high group agreement on the prerequisites needed for a healthy and independent life among older people. The main areas of importance were to have a social life, several dimensions of feeling safe and to retain one's personal control.
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| 7. |
- Gusdal, Annelie K, 1963-, et al.
(författare)
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Preventing Falls and Malnutrition among Older Adults in Municipal Residential Care in Sweden : A Registry Study
- 2021
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Ingår i: Sage Open Nursing. - : SAGE Publications Inc.. - 2377-9608. ; 7
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Older adults in municipal residential care are among the most vulnerable and in need of most care. The prevalence of negative events, such as falls and malnutrition, is increased among these older adults. The need for strategies to prevent falls and malnutrition is emphasized in guidelines and systematic, individualized risk assessments are prerequisites for adequate interventions. Objectives: The overall purpose of this study was to investigate the assessed risks of, and risk factors for, falling and malnutrition and the correlations between these assessed risks among older women and men in residential care. Further, the purpose was to investigate the consistency between planned and performed interventions among women and men assessed as at risk. Methods: A cross-sectional registry study based on risk assessment data in the Swedish national quality registry, Senior Alert. Altogether, 5,919 older adults ≥65 in nursing homes and dementia care units in 19 municipalities in Sweden were included. Results: Of the older adults, 77% were at risk of falls, and 59% were at risk of malnutrition. The most prevalent risk factors for falls were previous falls and not being cognitively oriented; and for malnutrition were having mild or severe dementia or depression. A significant positive correlation between the risk of falling and the risk of malnutrition was found. Less than half of the planned interventions for falls and malnutrition were performed. Care staff’s least common interventions to prevent falls were balance, muscular function, and strength training, which contrasts with the recommendations; interventions to prevent malnutrition were only partially adhering to recommendations. Conclusions: This cross-sectional registry study points towards the importance of using an evidence-based approach, based on adherence to recommended guidelines, in the prevention of falling and malnutrition. Further, the implementation of clinical practice guidelines is needed, which requires educational training for care staff and supportive leadership.
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| 8. |
- Gustafsson, Lena-Karin, 1966-, et al.
(författare)
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Actions taken to safeguard the intended health care chain of older people with multiple diagnoses-a critical incident study
- 2022
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Ingår i: BMC Nursing. - : BMC. - 1472-6955. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Older people with multiple diagnoses often have problems coping with their daily lives at home because of lack of coordination between various parts of the healthcare chain during the transit from hospital care to the home. To provide good care to those persons who have the most complex needs, regions and municipalities must work together. It is of importance to develop further empirical knowledge in relation to older persons with multiple diagnoses to illuminate possible obstacles to person-centred care during the transition between healthcare institutions and the persons livelihood. The aim of the present study was to describe nurses' experienced critical incidents in different parts of the intended healthcare chain of older people with multiple diagnoses.Methods: The sample consisted of 18 RNs in different parts of the healthcare system involved in the care of older people with multiple diagnoses. Data were collected by semi structured interviews and analysed according to Critical Incident Technique (CIT). A total of 169 critical incidents were identified describing experiences in recently experienced situations.Results: The result showed that organizational restrictions in providing care and limitations in collaboration were the main areas of experienced critical incidents. Actions took place due to the lack of preventive actions for care, difficulties in upholding patients' legal rights to participation in care, deficiencies in cooperation between organizations as well as ambiguous responsibilities and roles. The RNs experienced critical incidents that required moral actions to ensure continued person-centred nursing and provide evidence-based care. Both types of critical incidents required sole responsibility from the nurse. The RNs acted due to ethics, 'walking the extra mile', searching for person-centred information, and finding out own knowledge barriers.Conclusions: In conclusion and based on this critical incident study, home-based healthcare of older people with multiple diagnoses requires a nurse that is prepared to take personal and moral responsibility to ensure person-centred home-based healthcare. Furthermore, the development of in-between adjustments of organizations to secure cooperation, and transference of person-centred knowledge is needed.
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| 9. |
- Gustafsson, Lena-Karin, 1966-, et al.
(författare)
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‘Best fit’ caring skills of an interprofessional team inshort-term goal-directed reablement : older adults’perceptions
- 2019
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Ingår i: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 33:2, s. 498-506
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Tidskriftsartikel (refereegranskat)abstract
- This paper reports a study conducted to illuminate older adults’ perceptions of multiproffesional team's caring skills as success factors for health support in short-term goal-directed reablement. The fact that older adults are given perquisites to live in their own homes puts great demands on the professional care given them at home. An option offered could be short-term goal-directed reablement delivered by an interprofessional team. This means after periods in hospitals to strengthen their multidimensional health, older adults’ reablement processes are supported to return to their daily life as soon as possible. Crucial in making these intentions a reality seems to be identifying the professional's approach that works as success factors for health support in the reablement process. A descriptive qualitative design with a phenomenographic approach based on interviews with 23 older persons who had received short-term goal-directed reablement at home after a period at hospital was used. The study was approved by an ethical board. The analysis revealed four major referential aspects of multiproffesional team's caring skills as success factors for health-support in short-term goal-directed reablement: a motivating caregiver, a positive atmosphere-creating caregiver, a human fellowship-oriented caregiver and a caregiver that goes beyond the expected. In this study, all caring skills in the continuum are perceived as positively loaded necessities in different situations during the reablement process. Caring skills as success factors are initially shown at a practical level, such as how the professional caregivers encourage and motivate the older persons in different training situations. At a deeper level, the caregivers open their hearts and have the capacity to go beyond the expected in the professional caregiver–patient relationship. The multiproffesional team's best fit caring skills during the home reablement process need to be addressed as evidence base in the area of elderly home care.
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| 10. |
- Gustafsson, Lena-Karin, Docent, 1966-, et al.
(författare)
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Implementation of a New Integrated Healthcare Model; Quality Aspects to Support the Complex Home Care of Older Adults with Multiple Needs
- 2024
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Ingår i: Journal of Multidisciplinary Healthcare. - : DOVE MEDICAL PRESS LTD. - 1178-2390. ; 17, s. 2879-2890
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Tidskriftsartikel (refereegranskat)abstract
- Aim: This study aims to describe experiences of the implementation of a new integrated healthcare model for older adults with complex care needs due to multimorbidity, living at home, from a health and welfare personnel perspective. The goal was to diminish hospitalization and still carry out high quality care at home for older adults living with multimorbidity. The model was implemented by two organizations working in cooperation, the municipality, and the region that handles interprofessional social care and healthcare in people's homes. Materials and Method: Open-ended group interviews with personnel were carried out, three of the group interviews preimplementations of the model, and three of the group interviews post -implementation. The interviews were audiotaped and analysed according to the procedure of thematic analysis. Results: The quality of the integrated care model was based on care -chain cooperation, shared professionalism, and creating relations with the patient including closeness to next of kin, which was underlined by the participants. Unencumbered time gave the professionals the possibility to develop quality in integrated healthcare as part of integrated and person -centred care. The coproduction of education, research interviews and the follow-up meeting identified successes in diminishing hospitalization rates according to the participants' experiences of the post -implementation interviews. An identified failure was, however, that shared professionalism was not developed over time, rather the different responsibilities were accentuated according to the information retrieved at the follow-up meeting. Conclusion: Quality aspects of the model were identified in the present study. However, when implementation of a new model is completed, the organizations always have their own interpretation of how to further understand the model in question. Plain language summary: The intention of the present study was to follow the process of working with a new model of providing care at home, thus preventing increased numbers of hospital readmissions, based on the professionals point of view of what quality care is for older adults with complex care needs due to multimorbidity, living in their own home. The professionals were interviewed in group settings on several occasions during the implementation. The result showed hopeful expectations expressed by the professionals before the new model was implemented, such as a hope for getting more time for high -quality care for the older adults with multimorbidity. During the teamwork, the conversation within the team members was praised as a key factor that included shared professionalism from professionals with different levels of education and focus on their work. According to the staff, unnecessary hospital stays were reduced, while the interprofessional care -chain cooperation was improved through the work of the integrated care team. For many team members, the positive difference in both work and care satisfaction was highlighted in comparison to regular home care as they were able to use their multi -disciplinary skills and support.
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