| 1. |
- Lethin, Connie, et al.
(författare)
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Support needs and expectations of people living well with dementia and their informal carers in everyday life: An European study
- 2019
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Ingår i: Social Sciences. - : MDPI AG. - 2076-0760. ; 8:7
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to describe the needs and expectations of support within everyday life among community-dwelling people living well with an early stage dementia and their informal carers. The study employed a qualitative design. Data were collected in 2018, via four focus group interviews with, in total, 17 people with dementia and 21 informal carers, transcribed and analyzed with manifest content analysis. Needs and expectations of support among persons with dementia were expressed as the importance of “Participation in my own care,” “Attitude of the informal carers,” and “Trusting relationships with informal carers.” Informal carers’ needs and expectations of support were expressed as the importance of “Formal care and services,” “Getting out of a carer mindset,” and “Family context.” The findings from this study highlighted that persons with dementia were well aware of their cognitive impairments and tried to maintain their independence, with both formal and informal care to help remain “being themselves.” Health professionals should acknowledge persons with dementia and informal carers’ well-being, and acknowledge the importance of their needs together with an understanding of the importance of continuity of frontline carers to building trusting relationships.
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| 2. |
- Lethin, Connie, et al.
(författare)
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Support Needs and Expectations of People Living with Dementia and Their Informal Carers in Everyday Life : A European Study
- 2019
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Ingår i: Social Sciences. - : MDPI. - 2076-0760. ; 8:7
-
Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to describe the needs and expectations of support within everyday life among community-dwelling people living well with an early stage dementia and their informal carers. The study employed a qualitative design. Data were collected in 2018, via four focus group interviews with, in total, 17 people with dementia and 21 informal carers, transcribed and analyzed with manifest content analysis. Needs and expectations of support among persons with dementia were expressed as the importance of "Participation in my own care," "Attitude of the informal carers," and "Trusting relationships with informal carers." Informal carers' needs and expectations of support were expressed as the importance of "Formal care and services," "Getting out of a carer mindset," and "Family context." The findings from this study highlighted that persons with dementia were well aware of their cognitive impairments and tried to maintain their independence, with both formal and informal care to help remain "being themselves." Health professionals should acknowledge persons with dementia and informal carers' well-being, and acknowledge the importance of their needs together with an understanding of the importance of continuity of frontline carers to building trusting relationships.
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| 3. |
- Balducci, Francesco, et al.
(författare)
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“How Far Is the Closest Bus Stop?” : An Evaluation of Self-Reported versus GIS-Computed Distance to the Bus among Older People and Factors Influencing Their Perception of Distance
- 2023
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Ingår i: Geomatics. - 2673-7418. ; 3:4, s. 580-596
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Tidskriftsartikel (refereegranskat)abstract
- Previous research showed that living closer to bus stops could be a factor in promoting a healthy and active lifestyle. However, most of the studies relied on self-reported measures of distance, which might be affected by several confounders. In this study, self-reported distances among study participants were compared to actual ones, computed by the use of GIS (Geographic Information System) technology and routing algorithms. We tested whether distance to the bus stop is associated with health and socioeconomic conditions of the respondents, using data among 2398 older people (75–90 years) in three cities in Sweden. We found that several variables including older age, female gender, living alone, and worse health status are associated with an over-estimation of bus stop distance. People who use public transport daily or several times a week and are satisfied with the walking environment in the neighbourhood tend to underestimate bus stop distances. Evidence based on self-reported measures only should be treated cautiously. Considering the limitations still present in open-data-based routing algorithms, the best indication is to combine the subjective with the objective measure of distance. Having the possibility to combine the two measures appears as a sound strategy to overcome the limitations associated with each single measure.
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| 4. |
- Barbabella, Francesco, 1984-, et al.
(författare)
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A theoretical framework for assessing the impact of ICT-based interventions for carers
- 2012
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Ingår i: Gerontechnology. - 1569-1101 .- 1569-111X. ; 11:2, s. 393-393
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Tidskriftsartikel (refereegranskat)abstract
- Purpose Initiatives using information and communication technologies (ICTs) as support for carers of dependent older people are reported since the early 1990s, mainly in form of phone services, computer networks, and video respite. Although the role of ICTs in home care gained increasing relevance in the last decades – for instance in the areas of social integration, care coordination and ambient assisted living (AAL) – few attempts have been made to systematically understand the potentialities of such technologies, overcoming single technology or intervention domains. In this respect, the issues of terminology ambiguity and lack of comparability represented major barriers, so that most of evaluation studies in this area led to mixed and/or inconclusive results. Drawing on the findings of the CARICT-project, this paper discusses the development of a theoretical and conceptual framework to assess the impact ofI CT-based interventions for carers. Method Literature review and a mapping exercise of 52 ICT-based initiatives for carers in 8 countries. Results & Discussion We will provide the results of a mapping exercise of 52 case studies, showing the diversity of existing good practices across Europe and carrying out a review of available impact assessment of these initiatives from a social ecological perspective (at micro-, meso- and macro-level). Subsewquently, we will discuss a theoretical and conceptual framework that is built on the basis of available evidence, leading toa proper classification of ICT-based interventions in relation to types of interactions between actors they support: an attempt is made to group the solutions in coherent and comprehensive classes, with related implications for impact assessments and comparative analysis. Main classes include: alarms, home automation, auto-communication, meta-services, information and training, cognitive stimulations and mental exercises, support group sessions, individual care and support services, and social participation tools. Finally, recommendations for future research in the field are formulated with regard to the assessment and comparability of these services, as well as to the testing and development of new solutions.
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| 5. |
- Barbabella, Francesco, 1984-, et al.
(författare)
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Alcuni profili dell’assistenza nelle regioni
- 2013
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Ingår i: L'assistenza agli anziani non autosufficienti in Italia. - Rimini : Maggioli Editore. - 8838735646 ; , s. 29-43
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Bokkapitel (refereegranskat)
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| 6. |
- Barbabella, Francesco, et al.
(författare)
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Deliverable 3.6: Final report on the “Methodological Framework”
- 2011
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- This report proposes a framework for Impact Assessment of ICT-enabled services to support informal carers, at family, organisational and national levels, and applies this framework to assess the evidence for impact in 12 cases from Europe and North America.
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| 7. |
- Barbabella, Francesco, Dr. 1984-, et al.
(författare)
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Ecological factors associated with Emergency Department use by older people in Italy.
- 2021
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Ingår i: Aging Clinical and Experimental Research. - : Springer. - 1594-0667 .- 1720-8319. ; 33, s. 659-668
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Many studies investigated factors associated with overuse of Emergency Department (ED) by older people. However, there is little evidence of how a better access to long-term care services can affect ED visit rates. Therefore, we estimated the association between ED use and contextual (distance to closest ED), need (priority level at admission and care deprivation), predisposing (socio-economic conditions) and enabling factors (availability of health services) at the municipal level.METHODS: We investigated ED visit rates by comparing the older population (aged 75 and more) to those aged less than 75 years among 233 municipalities and 13 health districts in the Marche Region, Central Italy. Administrative data were enriched by spatial dimensions. The outcomes were analysed using t-tests and ANOVA, while OLS and multilevel regressions have been used to identify independent correlates of ED visit rates.RESULTS: Mean ED visit rate was 56.3% and 25.3% among older people and the rest of the population (< 75 years), respectively. The multivariate analysis for older people showed that the presence of an ED within the municipality and living alone were positively associated with ED use, whereas greater availability of nursing homes was negatively associated. For general population (< 75 years), distance to closest ED, economic deprivation and bigger hospitals were negatively associated with ED visits.CONCLUSIONS: Our study shows that interventions to reduce frequent ED use by older people should include the availability of long-term care facilities in the area. As population ageing is progressing, our results suggest that investing in alternative care options for older people with long-term care needs might have the beneficial impact of reducing the overall ED rates and improving quality and appropriateness of care.
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| 8. |
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| 9. |
- Barbabella, Francesco, 1984-, et al.
(författare)
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Impact of ICT-based interventions on family caregivers : A cross-analysis of 54 good practices in Europe
- 2013
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Ingår i: The Journal of Nutrition, Health & Aging. - 1279-7707 .- 1760-4788. ; 17:Supplement, June/July, s. S447-S447
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Information and communication technologies (ICTs) have gained an increasing relevance for delivering innovative care and support services for dependent older people and their family caregivers. Although ICT-based interventions can vary remarkably in terms of functions, target users, operational aspects and technologies used, little knowledge is available concerning their implementationand impact in Europe, a gap that the CARICT project (http://is.jrc.es/pages/EAP/eInclusion/carers.html) has tried to fill.Method: 54 ICT-based interventions addressing needs of older peopleor their family caregivers have been identified in 12 European countries through internet search, literature review and expert interviews. Reports have been delivered for each case studied, and cross-analysed to better understand their potential impact at micro, meso and macro level.Results: Little evidence was found for positive outcomes at micro-level, including improvements in users’ health relatedquality of life and social inclusion. At meso-level, implementation of 1st/2nd generation telecare contributes to reduce hospitalization and institutionalization rates of older users, as well asto cost savings for local care providers. At macro-level, only one intervention shows concrete effects on a larger scale through a targeted program evaluation, while most ICT-based interventions do not useany tool to assess their impact, and can thus demonstrate only technology acceptance or users’ satisfaction.Conclusion: The lack of relevant evidence at all levels, as well as difficulties in comparing and generalising results, strongly urge practitioners to improve impact assessment methodologies and researchers to develop a better general framework of ICT potentials at a conceptual, theoretical and methodological level in this area.
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| 10. |
- Barbabella, Francesco, 1984-, et al.
(författare)
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Increasing inclusion and participation of the young-old and the old-old
- 2013
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Ingår i: The Journal of Nutrition, Health & Aging. - 1279-7707 .- 1760-4788. ; 17:Supplement, June/July, s. S132-S132
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: While healthy ageing represents a pre-condition for older people to enjoy a longer and disability-free life span, quality of life in older age is dependent also upon society’s ability to grant individuals social protection, as well as to promote their active participation in the community until the very end of life. These issues constitute a challenge for current and future research on ageing.Method: A 2-year consultation process with over 70 international experts was conducted within the FUTURAGE work-stream focussedon social and economic resources in ageing research. This process allowed a comprehensive discussion on most relevant social participation and protection issues involving scientists, users’ organisations, policy makers and other stakeholders, which led to a set of specific research priorities.Results: The main challenges identified for future ageing research concerning social participation are: ageism; migration; life-long learning; digital divide; spirituality; volunteering; mobility and accessibility; discrimination in the labour market; consumption and access to products and services; and work-life balance. As for social protection, the following core issues have been spotted: sustainability; support to informal carers (also through ICT-based services); efficiency; access to care; cost-effectiveness and quality of interventions; initiatives to improve intergenerational solidarity.Conclusion: Societal challenges related to social participation and sustainability of social protection systems clearly urge new actions in research, practices and policy on ageing. In particular, the identification of over-arching issues, barriers and enablers contributes to strengthen scientific research in the field, as well as to support policy makers in improving social life and quality of life of older people.
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| 11. |
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| 12. |
- Barbabella, Francesco, 1984-, et al.
(författare)
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La bussola di NNA : lo stato dell'arte basato sui dati
- 2015
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Ingår i: L'assistenza agli anziani non autosufficienti in Italia. - Rimini : Maggioli Editore. - 8891614068 - 9788891614063 ; , s. 15-33
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Bokkapitel (refereegranskat)
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| 13. |
- Barbabella, Francesco, 1984-, et al.
(författare)
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Opportunities and challenges of migrant work in the Italian long-term care system
- 2013
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Ingår i: The Journal of Nutrition, Health & Aging. - 1279-7707 .- 1760-4788. ; 17:Supplement, Juny/july, s. S133-S133
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Italy is one of the most aged countries in the world, with a longstanding tradition of family care of the dependent elderly. Inrecent times, however, Italy has been witnessing in-depth social and cultural changes, which have been negatively impacting on informal care provision. In addition, the public long-term care (LTC) system highly relies on cash-for-care schemes for supporting older people, whereas “formal” care services are characterised by weak coverage and intensity. This situation has led to a remarkable increase in theprivate employment of migrant care workers (MCWs), whose number increased by four times in the last two decades.Method: An overview of MCWs phenomenon in Italy is provided through the analysis of empirical data retrieved by available official sources at national level, as well as by results from own surveys conducted in recent years on large samples of MCWs.Results: The following opportunities and challenges concerning MCWs’ employment in the LTC sector were identified: improve MCW’s capacity to deliver quality care; reduce therisk of elder abuse and neglect and of meeting MCWs’ own care needs; increase their social integration in destination countries and reduce “care drain” in sending countries; and how to improve stakeholders’ involvement for a better exchange of good practices and more effective policy measures.Conclusion: In these years, privately employed MCWs have contributed to change the traditional Italian “family care model” into a new “migrant-in-the-family care model”. However, the issue concerning the sustainability of this model within the Italian LTC system in the future is still open.
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| 14. |
- Barbabella, Francesco, et al.
(författare)
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Socioeconomic Predictors of the Employment of Migrant Care Workers by Italian Families Assisting Older Alzheimer's Disease Patients : Evidence From the Up-Tech Study
- 2016
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Ingår i: The journals of gerontology. Series B, Psychological sciences and social sciences. - : Oxford University Press (OUP). - 1079-5014 .- 1758-5368. ; 71:3, s. 514-525
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The availability of family caregivers of older people is decreasing in Italy as the number of migrant care workers (MCWs) hired by families increases. There is little evidence on the influence of socioeconomic factors in the employment of MCWs.METHOD: We analyzed baseline data from 438 older people with moderate Alzheimer's disease (AD), and their family caregivers enrolled in the Up-Tech trial. We used bivariate analysis and multilevel regressions to investigate the association between independent variables-education, social class, and the availability of a care allowance-and three outcomes-employment of a MCW, hours of care provided by the primary family caregiver, and by the family network (primary and other family caregivers).RESULTS: The availability of a care allowance and the educational level were independently associated with employing MCWs. A significant interaction between education and care allowance was found, suggesting that more educated families are more likely to spend the care allowance to hire a MCW.DISCUSSION: Socioeconomic inequalities negatively influenced access both to private care and to care allowance, leading disadvantaged families to directly provide more assistance to AD patients. Care allowance entitlement needs to be reformed in Italy and in countries with similar long-term care and migration systems.
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| 15. |
- Barbabella, Francesco, 1984-, et al.
(författare)
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Volontariato in età matura : opportunità, barriere e best practices per il coinvolgimento degli anziani
- 2011
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Ingår i: Quaderni Europei sul Nuovo Welfare. - 1972-4543. ; 16
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Tidskriftsartikel (refereegranskat)abstract
- L’articolo propone una rassegna sulle opportunità e i maggiori ostacoli in merito alla partecipazione delle persone anziane alle attività di volontariato. A livello internazionale, il dibattito sul volontariato in età matura si è sviluppato principalmente negli Stati Uniti, mentre l’Europa appare ancora indietro nella ricerca: oltre che auspicare un aumento delle indagini sull’argomento a livello nazionale, sarebbe utile promuovere ricerche comparative e trasversali, presenti ancora in numero esiguo. Tra le evidenze attualmente disponibili, risulta che gli anziani più propensi a svolgere attività di volontariato sono quelli “più giovani”, in buona salute, con un livello di istruzione ed una posizione socio-economica elevati, impegnati principalmente in organizzazioni religiose che operano nel settore dei servizi alla persona. Le principali barriere sono invece rappresentate da pratiche discriminatorie legate all’età. A livello internazionale si rivela controverso il rapporto tra l’impegno degli anziani nel volontariato e in altre importanti attività quali il lavoro e la cura informale. Ad ogni modo, emerge con forza l’esigenza di implementare politiche di reclutamento dei volontari senior, dal momento che le poche esistenti sono spesso poco incisive: in questo senso, un supporto importante può essere fornito dalle esperienze realizzate nel contesto statunitense, le quali hanno prodotto negli ultimi anni delle best practices.
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| 16. |
- Boström, Lovisa, et al.
(författare)
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Health-related quality of life among people applying for housing adaptations : Associated factors
- 2018
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 15:10
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Tidskriftsartikel (refereegranskat)abstract
- Housing adaptations (HA) clients are a heterogeneous group of people with disabilities experiencing restricted performance and participation in everyday life. While health-related quality of life is a common and relevant outcome in health care research, associated factors among HA clients are largely unknown. Thus, the aim of this study was to investigate which factors are associated with health-related quality of life among HA clients in Sweden. The study has a cross-sectional design, using baseline data collected among 224 participants in three municipalities in Sweden. The main outcome was health-related quality of life measured by the EQ-5D. Factors investigated as potentially associated were age, sex, living conditions, cognitive impairment, usability of the home, activities of daily living (ADL) dependence, participation, and fear of falling. The associations were explored using multiple linear regression analysis. Younger age and higher dependence in ADL were associated with lower scores on the EQ-5D. The social aspect of usability in the home had a positive association with the EQ VAS. Results suggest that certain groups of HA clients might be at risk for low health-related quality of life. Knowledge of their characteristics can potentially improve development and implementation of tailored interventions aiming at increasing their health-related quality of life.
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| 17. |
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| 18. |
- Carlsson, Gunilla, et al.
(författare)
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Falls and Fear of Falling among Persons Who Receive Housing Adaptations-Results from a Quasi-Experimental Study in Sweden
- 2017
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Ingår i: Healthcare. - : MDPI AG. - 2227-9032. ; 5:4
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Tidskriftsartikel (refereegranskat)abstract
- While health might deteriorate through the ageing and disablement process, the impacts of disability can be reduced by adapting the environment. This study aimed to investigate the effects of applying a standardized research-based strategy to housing adaptation as compared to ordinary practice with respect to falls and fear of falling. Another aim was to investigate the overall effects of housing adaptations on fall-related outcomes over time. In total, 196 clients were included at baseline, with follow-up at 3 and 6 months after the housing adaptation was implemented. The only significant difference between the two approaches was identified with respect to fear of falling at 3 months after the housing adaptation, but not after 6 months. The number of clients reporting actual falls increased over time in both sites, whereas the number of reported near-falls decreased most in the intervention site, but without significant differences. Thus, the patterns of differences between the sites are inconsistent, as are the patterns of change in fall-related outcomes. An overall conclusion is that if the goal is to improve fall-related outcomes, housing adaptation should be complemented with other interventions preventing falls and explicitly address the clients' activity limitations. In addition, longer follow-up times are necessary.
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| 19. |
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| 20. |
- Chiatti, Carlos, et al.
(författare)
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Access to public mobility services and health in old age : A cross-sectional study in three Swedish cities
- 2017
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Ingår i: Journal of Transport and Health. - : Elsevier BV. - 2214-1405. ; 7:Part B, s. 218-226
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Tidskriftsartikel (refereegranskat)abstract
- Background: Little evidence is available on how public transport features can impact on older people's health. The overarching aim of this paper is to evaluate socio-demographic, health and mobility-related factors correlated with health-related quality of life among people aged between 75 to 90 years old in three Swedish Municipalities. Methods: Within the SEBEM study, a cross-sectional survey using a self-administered postal questionnaire was conducted among 2398 older people aged between 75 and 90 years. Primary outcome of the study was health-related quality of life measured using the SF12 which distinguishes two dimensions of health, i.e. the Physical Composite Score (PCS) and the Mental Component Score (MCS). Descriptive statistics were used to analyze the variability study outcomes. Multilevel regression models were used to investigate factors independently correlated with health, controlling for the influence of potential confounders. Results: Higher physical and mental self-reported health is associated with walking more than 500. m on a daily basis, use of a private car and frequent engagement in social activities. Access to the car is only associated with physical health. Mental health scores are significantly lower among those living far from the closest bus stop and never using public transport. Discussion: We provide evidence of epidemiological associations between access to public mobility services and good health in older age. Given the cross-sectional design of our analyses, and the related limitations, the associations found should be investigated more thoroughly by future studies using longitudinal and/or experimental designs.
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| 21. |
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| 22. |
- Chiatti, Carlos, et al.
(författare)
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Evaluation of housing adaptation interventions: integrating the economic perspective into occupational therapy practice
- 2014
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Ingår i: Scandinavian Journal of Occupational Therapy. - : Informa UK Limited. - 1651-2014 .- 1103-8128. ; 21:5, s. 323-333
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Tidskriftsartikel (refereegranskat)abstract
- Objective: The home environment is a key determinant of health, quality of life, and well-being. Given its relevance for such aspects, the scarcity of evaluations of housing adaptation (HA) interventions aimed at removing environmental barriers and accessibility problems in the homes of people with disabilities is surprising. This article aims to contribute to the development of strategies for economic evaluations of HA interventions, by stimulating the dissemination and application of the concepts of effectiveness, cost, and cost-effectiveness as used within health economics. Methods: The focus is limited to three overarching questions for the evaluation of HA interventions. Considering X and Y as two hypothetical interventions for the same individual case, the article asks: (i) Will X be more effective than Y?; (ii) Will X cost more than Y?, and (iii) Will X be more cost-effective than Y? Vignette-like descriptions of fictional cases are used to exemplify the economic concepts explained in the article. Results and conclusion: In the conclusion, the need is stressed for new experimental data regarding both costs and outcomes of HA interventions, in order to realize sound evaluations with the potential to inform policy and professionals in this field. Given the heterogeneity among national contexts, systematic approaches applied in a coherent manner could strengthen cross-national research and collaborations.
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| 23. |
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| 24. |
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| 25. |
- Chiatti, Carlos, et al.
(författare)
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ISSA 2012 : The medium-term impact of the first ISSA in the eyes of its participants
- 2015
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Ingår i: Irish Ageing Studies Review. - 1649-9972. ; 6:1, s. 44-44
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Tidskriftsartikel (refereegranskat)abstract
- Background: This contribution aims at illustrating the perspective of students attending the first International Summer School on Ageing (ISSA), highlighting the midterm impact exerted by this initiative on their own educational career.Methods: The reported findings are based on a follow-up assessment questionnaire sent out to and filled-in by ISSA participants (n= 20) six months after the Summer School’s conclusion, with the aim of identifying whether participation in the ISSA had brought any advantage to each participant's professional and educational life.Results: Among the ISSA-related aspects identified as “important” for their future research activity, the main ones were “interacting with established researchers” (100%) and “being part of a research network” (85%), followed by “use of different approaches” and “training environment”. As for the aspects “influenced” by the ISSA, the “development of a professional network” was the most frequently mentioned (100%), followed by “research training” (84%), “research interest” (79%) and “career” (71%). The majority of participants reported that, since their ISSA attendance, had remained in contact with each other for study-related (65%) or work-related (60%) purposes. This networking activity has led to joint scientific collaborations with both mentors (one joint conference presentation and two peer-review publications) and fellow students (preparation of a project proposal in response toa research call and organisation of a scientific event).Conclusions: The reported findings show that the ISSA has been useful in creating a collaborative multidisciplinary network of younger and older researchers on ageing-related issues, which is likely to bear more fruitin the long-term.
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| 26. |
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| 27. |
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| 28. |
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| 29. |
- Chiatti, Carlos, et al.
(författare)
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Migrant care work for elderly households in Italy
- 2013
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Ingår i: Ageing in the Mediterranean. - Bristol : Policy Press. - 9781447301066 ; , s. 235-256
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Bokkapitel (övrigt vetenskapligt/konstnärligt)abstract
- This paper aims at pointing out the need for a more equitable, internationally driven approach to solve elder care staff shortages, on the background of the implications deriving from the widespread phenomenon of employing migrant care workers in the Italian elder care sector. The paper describes at first how this form of care provision has become so popular in this country to face the long term care needs characterising its ageing population. Main reasons are identified, on the one hand, in the decreasing availability of informal care, due to the increasing female participation in the labor market, a longer working life and a reduction in the support provided by social networks. On the “formal” side, a major role has been played also by the lack of appropriate long term care services, such as residential and public home care, as well as by a chronic shortage of nursing staff and a shorter length of hospital stays. The traditionally “cash-oriented” profile of the Italian welfare system – more based on cash-for-care measures rather than in-kind services – has ended up with perpetuating familistic tendencies stimulating the employment of foreign migrant care workers, often on a live-in, undeclared basis. The paper’s conclusions focus on the analysis of the main opportunities and challenges raised by this phenomenon, trying to catch all involved parties’ perspectives: the older care recipients’ families; the migrant care workers; the receiving and the sending societies. This approach allows to identify core advantages of this solution in the possibility to increase ageing in place opportunities (thus reducing institutionalisation rates) and to provide a more personalised home care at reasonable costs. On the other hand, drawbacks can occur in terms of low quality of care, risk of widespread undeclared labour conditions, possible exploitation of foreign migrants and abuse of older people, as well as “brain and care drain” effects in sending countries. A more neutral, internationally driven governance is therefore suggested in order to minimize these risks and promote equitable solutions to solve care provision shortages in some countries without “plundering the future” of other nations.
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| 30. |
- Chiatti, Carlos, et al.
(författare)
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Utilization of Formal and Informal Care by Community-Living People with Dementia : A Comparative Study between Sweden and Italy
- 2018
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1660-4601. ; 15:12
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Tidskriftsartikel (refereegranskat)abstract
- Background: Dementia is a public health priority with a dramatic social and economic impact on people with dementia (PwD), their caregivers and societies. The aim of this study was to contribute to the knowledge on how utilization of formal and informal care varies between Sweden and Italy. Methods: Data were retrieved from two trials: TECH@HOME (Sweden) and UP-TECH (Italy). The sample consisted of 89 Swedish and 317 Italian dyads (PwD and caregivers). Using bivariate analysis, we compared demographic characteristics and informal resource utilization. Multiple linear regression was performed to analyze factors associated with time spent on care by the informal caregivers. Results: Swedish participants utilized more frequently health care and social services. Informal caregivers in Italy spent more time in caregiving than the Swedish ones (6.3 and 3.7 h per day, respectively). Factors associated with an increased time were country of origin, PwD level of dependency, living situation, use of formal care services and occupation. Conclusions: Care and service utilization significantly varies between Sweden and Italy. The level of formal care support received by the caregivers has a significant impact on time spent on informal care. Knowledge on the factors triggering formal care resources utilization by PwD and their caregivers might further support care services planning and delivery across different countries.
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| 31. |
- Di Rosa, Mirko, et al.
(författare)
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Private employment of home care workers and use of health services by disabled older people in Italy
- 2013
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Ingår i: Euroregional Journal of Socio-Economic Analysis. - 2344-6404. ; 1:1, s. 33-42
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Tidskriftsartikel (refereegranskat)abstract
- Home care workers privately employed by households have become today the “third rail” of longtermcare policies in several industrialised countries. In Italy, estimates suggested that they might be asmany as over 840,000, most of them being foreign-born migrants living with the cared for person. So far, littleattention has been paid to the integration and coordination of these workers within the formal care sector.We analysed a cross-sectional sample of 4,814 disabled older Italians living in the community to assess theassociation between the private employment of home care workers and the likelihood of using other formalservices. After controlling for possible confounding effects of predisposing characteristics and need factors,we found that using private assistance at home is strongly associated with the use of all services. Thesecorrelations suggests that a “crowding-in” effect exists between the use of private care and public formalservices, and a clear pattern of care tasks allocation can be identified in Italy, where family and privatecarers are responsible for assisting the older person with basic tasks of daily living, while the residualcompetences of public formal sector relate to specialised health care services.
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| 32. |
- Ekstam, Lisa, et al.
(författare)
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A research-based strategy for managing housing adaptations: study protocol for a quasi-experimental trial
- 2014
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Ingår i: BMC Health Services Research. - : Springer Science and Business Media LLC. - 1472-6963. ; 14
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Tidskriftsartikel (refereegranskat)abstract
- Background: The primary aim of this paper is to describe the design of a project evaluating the effects of using a research-based strategy for managing housing adaptations (HAs). The evaluation targets clients' perspectives in terms of activity, participation, usability, fear of falling, fall incidence, use of mobility devices, and health-related quality of life, and determines the societal effects of HAs in terms of costs. Additional aims of the project are to explore and describe this strategy in relation to experiences and expectations (a) among clients and cohabitants and (b) occupational therapists in ordinary practice. Methods/design: This study is a quasi-experimental trial applying a multiphase design, combining quantitative and qualitative data. At the experimental sites, the occupational therapists (OTs) apply the intervention, i.e. a standardized research-based strategy for HA case management. At the control site, the occupational therapists are following their regular routine in relation to HA. Three municipalities in south Sweden will be included based on their population, their geographical dispersion, and their similar organizational structures for HA administration. Identical data on outcomes is being collected at all the sites at the same four time points: before the HA and then 3, 6, and 12 months after the HA. The data-collection methods are semi-structured qualitative interviews, observations, clinical assessments, and certificates related to each client's HA. Primary outcomes are the usability of the home and the client's independence in daily activities (ADL). Cross-sectional and longitudinal data analyses will be conducted as well as statistical analyses, health-economic analyses, and qualitative analyses. Qualitative and quantitative data will be sequentially analyzed, and case studies will be developed. Discussion: The intervention in this study has been developed and tested through many years of research and in collaboration with practitioners. This process includes methodological development and testing research aimed at identifying the most important outcomes and research targeting current HA case-management procedures in Swedish municipalities. When the study is completed, the results will be used for further optimization of the practice strategy for HA, in close collaboration with the data-collecting OTs.
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| 33. |
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| 34. |
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| 35. |
- Fänge, Agneta Malmgren, et al.
(författare)
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Care Home and Home Care Staff’s Learning during the COVID-19 Pandemic and Beliefs about Subsequent Changes in the Future : A Survey Study in Sweden, Italy, Germany and the United Kingdom
- 2022
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Ingår i: Healthcare. - Basel : MDPI. - 2227-9032. ; 10:2, s. 1-13
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to compare perceptions of learning from the COVID-19 pandemic and beliefs in subsequent changes for the future, among care home and home care staff, in four European countries. A 29-item on-line questionnaire was designed in English and later translated into Swedish, Italian, and German on the impact of the pandemic on stress and anxiety. Anonymous data from care staff respondents was collected in four countries between 07.10.2020 and the 17.12.2020: Sweden (n = 212), Italy (n = 103), Germany (n = 120), and the United Kingdom (n = 167). While care staff in all countries reported learning in multiple areas of care practice, Italy reported the highest levels of learning and the most agreement that changes will occur in the future due to the pandemic. Conversely, care staff in Germany reported low levels of learning and reported the least agreement for change in the future. While the pandemic has strained care home and home care staff practices, our study indicates that much learning of new skills and knowledge has taken place within the workforce. Our study has demonstrated the potential of cross-border collaborations and experiences for enhancing knowledge acquisition in relation to societal challenges and needs. The results could be built upon to improve future health care and care service practices.
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| 36. |
- Gual, Neus, et al.
(författare)
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IMAGINE study protocol of a clinical trial : a multi-center, investigator-blinded, randomized, 36-month, parallel-group to compare the effectiveness of motivational interview in rehabilitation of older stroke survivors
- 2020
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Ingår i: BMC Geriatrics. - : Springer Science and Business Media LLC. - 1471-2318. ; 20:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Rehabilitation pathways are crucial to reduce stroke-related disability. Motivational Interviewing (MI), as a person-centered complex intervention, aimed to empower and motivate, and could be a resource to improve rehabilitation outcomes for older stroke survivors. The IMAGINE project aims to assess the impact of MI, as a complement to standard geriatric rehabilitation, on functional improvement at 30 days after admission, compared to standard geriatric rehabilitation alone, in persons admitted to geriatric rehabilitation after a stroke. Secondary objectives include assessing the impact of MI on physical activity and performance, self-efficacy, safety, cost-utility, participants' experiences and functional status at 3 months. METHODS: We will conduct a multicenter randomized clinical trial in three geriatric rehabilitation hospitals in Spain. Older adults after mild-moderate stroke without previous severe cognitive impairment or disability will be randomized into the control or intervention group (136 per group, total N = 272). The intervention group will receive 4 sessions of MI by trained nurses, including the design of a personalized rehabilitation plan agreed between stroke survivors and nurses based on stroke survivors´ goals, needs, preferences and capabilities. Main outcome will be the Functional Independence Measure (FIM). In-hospital physical activity will be measured through accelerometers and secondary outcomes using validated scales. The study includes a process evaluation and cost-utility analysis. DISCUSSION: Final results are expected by end of 2020. This study will provide relevant information on the implementation of MI as a rehabilitation reinforcement tool in older stroke survivors. A potential reduction in post-stroke disability and dependence would increase person's health-related quality of life and well-being and reduce health and social care costs. IMAGINE has the potential to inform practice and policymakers on how to move forward towards shared decision-making and shared responsibilities in the vulnerable population of older stroke survivors. TRIAL REGISTRATION: ClinicalTrials.gov: NCT03434938 , registered on January 2018.
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| 37. |
- Heller, Christina, et al.
(författare)
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The Relationship Between Physical Housing Characteristics, Housing Accessibility and Different Aspects of Health Among Community-Dwelling Older People : A Systematic Review
- 2023
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Ingår i: Journal of Aging and Health. - : SAGE Publications Inc.. - 0898-2643 .- 1552-6887. ; 36:1-2, s. 120-132
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Forskningsöversikt (refereegranskat)abstract
- Objectives : To synthesize the evidence on the relationships between physical housing characteristics or housing accessibility and different aspects of health among community-dwelling people 60 years and older. Methods : A systematic review of recent evidence with a narrative synthesis was conducted. Results : We included 15 studies and found three themes covering physical housing characteristics or housing accessibility that are associated with aspects of health among community-dwelling older adults: (1) interventions by home modifications targeting housing features both at entrances and indoors; (2) non-interventions targeting indoor features; (3) non-interventions targeting entrance features, that is, the presence of an elevator or stairs at the entrance. The overall quality of evidence across studies was assessed as very low. Discussion : The findings highlight the need for studies with a stronger research design and higher methodological quality that address the physical housing environment in relation to health among older adults to strengthen the body of evidence.
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| 38. |
- Lamura, Giovanni, et al.
(författare)
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Current LTC challenges in Italy
- 2013
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Ingår i: The Journal of Nutrition, Health & Aging. - 1279-7707 .- 1760-4788. ; 17:Supplement 1, June/july, s. S227-S227
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: The rapid ageing of the Italian population is reflected by a growing demand for LTC services. As families are facing increasing difficulties in providing everyday elder care, the pressure on formal services is growing. At the same time, the current financial crisis is making the public response less and less able to provide the needed resources. As a consequence, the current approach of indirect public support to the private employment of migrant care workers (MCWs) through cash-for-care schemes is likely to continue.Method: The presentation is based on a detailed analysis of empirical findings and policy documents, outlining the crucial features characterising the Italian LTC system and describing also some of the main differences existing between different regional care approaches.Results: After adecade of increasing availability of publicly funded LTC services for older people, in some sectors, such as integrated home care, the audience of recipients has started receiving a lower number of hours of care. The mainly monetary focus of the Italian care regime has a clear incentivizing effect to employ foreign migrant care workers, often on an undeclared basis, to provide everyday elder care in Italian homes. Another crucial characteristic is the strong heterogeneity of Italian regions, according to which today different clusters of regions can beidentified, with strong inequalities in LTC provision.Conclusion : Thelack of a coherent national LTC policy has been recently accompaniedby an increasing focus on cash-for-care payments, which in the future will require a stronger attention to care quality issues.
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| 39. |
- Lamura, Giovanni, et al.
(författare)
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Filling the gap in long-term professional care through systematic migration policies : Synthesis Report
- 2014
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Bok (populärvet., debatt m.m.)abstract
- Many EU countries face the challenge of providing elderly care in the context of shortages of trained personnel. The Peer Review in Berlin (23-24 October) provided the opportunity for peer countries to explore the German approach of recruiting and training non-EU migrants. This report summarises the key issues discussed and the lessons learned. It is available in electronic format in English, French and German
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| 40. |
- Lamura, Giovanni, et al.
(författare)
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ISSA 2012 : Methodological, logistic and evaluation issues emerging from the first edition of the ISSA
- 2015
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Ingår i: Irish Ageing Studies Review. - 1649-9972. ; 6:1, s. 44-44
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Tidskriftsartikel (refereegranskat)abstract
- Background: This contribution presents the evaluation provided by the students participating in the first International Summer School on Ageing (ISSA), highlighting whether the educational goals of this initiative have been achieved and possible improvements for the future.Methods: The reported findings are based on the evaluation requested to ISSA participants on the very last day of the school, through a written questionnaires containing both closed and open questions. The 20 participants were on average just above 30-year-old, mostly females (70%) from European countries (80%), held a Master of Science in half of cases and were enrolled as PhD students in a social (35%) or medical (35%) discipline, with a record of 4 publications on average.Results: Participants appreciated the introductory lectures (on biomedical, socio-economic and other dimensions of ageing), defining them clear (100%) and appropriate (90%). Mentors’ capacity to stimulate discussion was appreciated (85% agreed), as did participants’ opportunity to fully participate and interact (94%), while two thirds of participants agreed to have obtained new ideas for their work (65% and 60% respectively). All modules received a good evaluation, especially in terms of learning material provided and of possibility to participate in the discussion, while the opportunity to develop new ideas varied across the modules, mainly due to the participants’ different disciplinary background.Conclusions: While the first ISSA seems to have fully achieved its original aims, future similar initiatives should have a stronger interactive approach and practical real-life group exercises.
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| 41. |
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| 42. |
- Lethin, Connie, et al.
(författare)
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Organizational Support Experiences of Care Home and Home Care Staff in Sweden, Italy, Germany and the United Kingdom during the COVID-19 Pandemic
- 2021
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Ingår i: Healthcare. - Basel : MDPI. - 2227-9032. ; 9:6, s. 2-16
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Tidskriftsartikel (refereegranskat)abstract
- The COVID-19 pandemic has affected care workers all over the globe, as older and more vulnerable people face a high risk of developing severe symptoms and dying from the virus infection. The aim of this study was to compare staff experiences of stress and anxiety as well as internal and external organizational support in Sweden, Italy, Germany, and the United Kingdom (UK) in order to determine how care staff were affected by the pandemic. A 29-item online questionnaire was used to collect data from care staff respondents: management (n = 136), nurses (n = 132), nursing assistants (n = 195), and other healthcare staff working in these organizations (n = 132). Stress and anxiety levels were highest in the UK and Germany, with Swedish staff showing the least stress. Internal and external support only partially explain the outcomes. Striking discrepancies between different staff groups’ assessment of organizational support as well as a lack of staff voice in the UK and Germany could be key factors in understanding staff’s stress levels during the pandemic. Structural, political, cultural, and economic factors play a significant role, not only factors within the care organization or in the immediate context.
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| 43. |
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| 44. |
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| 45. |
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| 46. |
- Luther, Anna, et al.
(författare)
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Identifying and validating housing adaptation client profiles–a mixed methods study
- 2020
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Ingår i: Disability and Rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 42:14, s. 2027-2034
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: An increasing number of people will live with disabilities in their homes and consequently, the need for home-based interventions will increase. Housing adaptations (HAs) are modifications to the physical home environment with the purpose to enhance independence for a heterogeneous group of people. Increasing the knowledge of the characteristics of HA clients by exploring their heterogeneity, could facilitate the planning of interventions and allocation of resources. The purpose of this article was to identify and validate HA client profiles. Materials and methods: This cross-sectional study applied a mixed methods design to identify profiles of HA clients through cluster analysis confirmed by qualitative interview data. The sample consists of 241 HA clients in Sweden with a mean age of 75.1 years. Results: A classification into five groups emerged as the one best describing the heterogeneity of characteristics among this sample of clients. Five client profiles were outlined based on their age and level of disability, and the variation between the profiles was confirmed through the qualitative interview data. Conclusions: The identified client profiles are a step towards a better understanding of how home-based interventions could be delivered more effectively to groups of HA clients, based on their different characteristics.Implications for rehabilitation Housing adaptations are structural modifications to the physical home environment with the purpose to enhance independence for people with disabilities. People applying for housing adaptations are a heterogeneous group with different needs. This study outlines five client profiles which can guide professionals on how to differentiate home-based interventions and follow-up processes among housing adaptation clients.
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| 47. |
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| 48. |
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| 49. |
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| 50. |
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