| 1. |
- Berglund, Mia, 1964-, et al.
(författare)
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Fluctuation between Powerlessness and Sense of Meaning : A Qualitative Study of Health Care Professionals’ Experiences of Providing Health Care to Older Adults with Long-Term Musculoskeletal Pain
- 2015
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Ingår i: BMC Geriatrics. - : BioMed Central. - 1471-2318. ; 15
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Tidskriftsartikel (refereegranskat)abstract
- Background: There is an increasing number of older adults living with long-term musculoskeletal pain and related disabilities. These problems are frequently unrecognized, underreported, and inadequately treated. Since many older adults desire to remain at home for as long as possible, it is important that individualized and holistically tailored care is provided in these settings. However, there is a complexity in providing care in this context.The aim of this study was to describe health care professionals’ experiences of providing health care to older adults living with long-term musculoskeletal pain at home.Methods: The phenomenon, “To provide health care to older adults living with long-term musculoskeletal pain at home”, was studied using reflective lifeworld research (RLR) which is based on phenomenological epistemology. Ten health care providers (nurse, physiotherapists, and occupational therapists) were interviewed and data was analysed.Results: The health care professional’s emotions fluctuated between powerlessness and meaningfulness. Needs, opportunities, understanding and respect had to be balanced in the striving to do good in the provision of health care in differing situations. Caring for older adults with long-term pain required courage to remain in the encounter despite feelings of insecurity and uncertainty about the direction of the dialogue. The essence of caring for older adults with long-term pain consisted of the following constituents: Sense of powerlessness; striving to provide good health care; and understanding and respect.Conclusions: The findings indicated that the health care professionals strived to do good and to provide health care that was holistic and sensitive to the older adults’ needs. A significant sense of powerlessness in the situation was experienced by the health care professionals. These findings address and support the need to develop methods that can be used to guide health care providers who support older adults in the context of their homes.
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| 2. |
- Berglund, Mia, 1964-, et al.
(författare)
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Keys to person-centred care to persons living with dementia : Experiences from an educational program in Sweden
- 2019
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Ingår i: Dementia. - : Sage Publications. - 1471-3012 .- 1741-2684. ; 18:7-8, s. 2695-2709
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Tidskriftsartikel (refereegranskat)abstract
- Growing old entails an increased risk of disabilities and illnesses such as dementia. The orientation in Sweden on national level is that individuals remain in their own homes if desired and receive person-centred home care. The aim of this study was to describe the experience of an educational program and its influence on daily provision of care to persons with dementia. A lifeworld approach was used. Data were collected through group interviews with care providers in the context of home. The findings are presented in five themes: Increased knowledge about dementia and treatment, Relationship-building in order to provide good care, Open and flexible approach conveys calm, Continuity and flexibility are cornerstones in the care and Perceived improvements. This person-centred educational intervention resulted in a care that was based on each individual’s personality, preferences and priorities in life. Education given with continuity over time is key to improving provision of care to person with dementia.
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| 3. |
- Berglund, Mia, et al.
(författare)
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Older Adults' Experiences of Reflective STRENGTH-Giving Dialogues: An Interview Study.
- 2016
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Ingår i: Journal of Gerontology & Geriatric Research. - : OMICS Publishing Group. - 2167-7182.
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Tidskriftsartikel (refereegranskat)abstract
- Background: A major health problem that frequently accompanies old age is long-term pain, but pain must be acknowledged by older adults and health care providers. Interventions are needed to alleviate pain and suffering while holistically providing health care that promotes wellbeing. The intervention project, Reflective STRENGTHGiving Dialogues© (STRENGTH) was implemented to increase health and wellbeing among community dwelling older adults living with long-term musculoskeletal pain at home. Aim: The aim of this study was to describe the older adults' experiences of the intervention Reflective STRENGTH-Giving Dialogue. Method: A life world hermeneutic approach was used in collection and analysis of data. Twenty community dwelling older adults participated were interviewed in their homes after the intervention. Findings: The findings consisted of five themes and showed that the older adults experienced the Reflective STRENGTH-Giving Dialogues as a continuous and trusting relationship that alleviates the pain and breaks the loneliness. They expressed it as a new way to talk about life with pain. The dialogues supported reflection and memory and resulted in a transition in orientation in life. Conclusion: The Reflective STRENGTH-Giving Dialogues helped the older adults to increase their intellectual, emotional, and physical engagement in daily living. The dialogues facilitated a transition in orientation from past to present, to the future, and from obstacles to opportunities. The dialogues were oriented towards enjoyments, meaning, courage and strength in life as a whole which promoted the older adults’ sense of well-being and vitality. The dialogues also facilitated carrying out small and large life projects. The Reflective STRENGTH-Giving Dialogues created a deepened caring relationship that contributed to an increased sense of security, strength and courage, all of which enhanced the potential for better health and wellbeing.
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| 4. |
- Berglund, Mia, et al.
(författare)
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Reflekterande KRAFT-givande samtal
- 2017. - 1
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Ingår i: Vägen till patientens värld och personcentrerad vård. - Stockholm : Liber. - 9789147112715 ; , s. 317-334
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Bokkapitel (refereegranskat)
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| 5. |
- Berglund, Mia, 1964-, et al.
(författare)
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Reflekterande KRAFT-givande samtal i vården av äldre som lever med långvarig smärta i hemmet
- 2015
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Ingår i: Ä. Riksföreningen för Sjuksköterskan inom äldrevård. - Sigtuna : Jld & Kompani. - 2001-1164. ; :1, s. 14-16
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Tidskriftsartikel (populärvet., debatt m.m.)abstract
- Reflekterande KRAFT-givande samtal är en metod utvecklad för att användas som ett verktyg i vården. Syftet är att stärka människors hälsa och välbefinnande samt den egna förmågan att bemästra sin situation på ett sätt som ger glädje och mening i livet. För den äldre kan det innebära en möjlighet att kunna bo kvar längre i det egna hemmet. Metoden har utvecklats utifrån resultaten av två avhandlingar, en om hemmets betydelse och att leva med långvarig smärta samt en om lärande vid långvarig sjukdom.
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| 6. |
- Bouwmeester Stjernetun, Björn, doktorand, 1983-, et al.
(författare)
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Effects of an age suit simulation on nursing students’ perspectives on providing care to older persons - an education intervention study
- 2024
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Ingår i: Educational gerontology. - : Taylor & Francis Group. - 0360-1277 .- 1521-0472. ; 50:3, s. 240-253
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Tidskriftsartikel (refereegranskat)abstract
- Nursing students are important future health care providers to the growing number of older persons in society. However, two barriers are their common ageist attitudes and lack of interest in geriatrics. This is a concern in light of the global demand for nurses and a challenge that need to be addressed in nurse education. Age suit simulation has been shown to affect the attitudes of students toward older persons, but the important context of home is often missing from studies. Accordingly, the present study employed a quantitative approach with the goal of investigating the effects of aging simulation with an age suit in a home context as a part of experiential learning among second-year nursing students. The age simulation allowed the students to experience both specific and common health problems from the patient’s point of view in a controlled environment and a relevant context: the home. Data were collected using a questionnaire in a quasi-experimental pretest – posttest design with a control group. Results showed that the intervention had a positive effect on various aspects of the nursing students’ perspectives on caring for older persons. Work experience was associated with more positive attitudes. The control group was more negative toward geriatrics as a career choice than the intervention group. In conclusion, age suit simulation can be an innovative part of nurse education because it raises awareness and understanding of the health challenges of older persons, which are important in combating ageism among future nurses.
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| 7. |
- Bouwmeester Stjernetun, Björn, doktorand, 1983-, et al.
(författare)
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”It´s like walking in a bubble”, nursing students´ perspectives on age suit simulation in a home environment – group interviews from reflection seminars
- 2024
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Ingår i: BMC Nursing. - : BioMed Central (BMC). - 1472-6955. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundOlder persons with age-related and complex health problems will increasingly depend on care provision from nurses in their own homes. However, a barrier to quality care is ageism and nursing students´ disinterest in geriatrics. In addition, nurse education often falls short in preparing students for the complexity of geriatric care. Welfare technology (WT) is progressively implemented in home care to help older persons live at home despite their health problems. However, this process is intricate and requires acceptance and digital literacy among caregivers and older persons. Despite these challenges, nurse education can address and change negative attitudes through innovative teaching methods such as age suit simulation. Therefore, the study aims to describe nursing students´ experiences of age suit simulation in a home-like environment with WT and technical aids, and will reveal their perspective on ageing and providing care to older adults.MethodsA qualitative explorative design using semi-structured group interviews (n=39) among nursing students. Data was analysed through reflexive thematic analysis.ResultsThe analysis generated three main themes; “It’s like walking in a bubble”, “An eye opener” and “Concerns about ageing and the current structure of geriatric care”. The main themes included eight subthemes. Adapting to the sensory and physical limitations of the age suit was an immersive experience and caused feelings of frustration, loneliness and disconnection. A prominent result was a raised awareness of cognitive loss, especially impaired vision, and students felt the simulations had made them aware of the everyday challenges older persons faced. Students highlighted the importance of patience and giving enough time in care situations by being present and having a critical perspective of WT. The students were mostly negative towards their own ageing and could better relate to older persons´ vulnerability.ConclusionsAge suit simulation was described as an embodied and eye-opening experience, raising nursing students´ awareness of older persons´ functional limitations and the consequences for dignity and independence. Coping with cognitive loss was especially difficult. Students were motivated to apply their new knowledge to clinical practice. Age suit simulation can complement geriatric education, preparing students for the complex care needs of older persons.
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| 8. |
- Curtin, Alicia, et al.
(författare)
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Ageing out of place : The meaning of home among hispanic older persons living in the United States
- 2017
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Ingår i: International Journal of Older People Nursing. - : John Wiley & Sons. - 1748-3735 .- 1748-3743. ; 12:3
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Tidskriftsartikel (refereegranskat)abstract
- AimTo explore the meaning of home among older Hispanic immigrants who are “aging out of place.”BackgroundEmerging evidence supports the concept of older persons ageing in place. Nurse researchers have demonstrated that older person who age in place have better physical, psychological and cognitive outcomes. Less, however, is known about older persons who are “aging out of place,” meaning out of their country of origin. With the growth of home health care, there is a need to understand the older immigrants' meaning of home when ageing out of their country of origin.Design and MethodAn inductive, qualitative descriptive research design was used. Seventeen Hispanic participants, ranging in age from 65 to 83 years were interviewed using a semi-structured interview protocol.FindingsTwo major finding of the study focused on participants' descriptions of home in their country of origin and in the USA. The majority of participants described their home in their native country as the community, countryside or town (pueblo) and in the U.S.A. as family. The level of social isolation and loneliness among participants was evident.ConclusionsOlder Hispanic immigrants who are “aging out of place” integrate their past experiences of sense of place in their native country with their present experiences of home in the USA. The need to understand the role of the community and the family in the provision of nursing care in the home may be more important than the physical structure or setting in which it is delivered. Further intra- and cross-national studies are needed to provide a framework for understanding the issues of ageing and immigration globally.Implications for PracticeGerontological nurses need to recognise the complexity of family relationships for older Hispanic persons who are ageing out of place of origin and their risk of depression, social isolation, and loneliness.
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| 9. |
- Dalheim Englund, Ann-Charlotte, et al.
(författare)
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Life without professional work : perceptions about one’s self, interpersonal relations and social life after retirement
- 2019
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Ingår i: Healthy Aging Research. - : Wolters Kluwer. - 2261-7434. ; 8:1
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study is to understand how healthy, older adults in Sweden perceive their life situation after retirement. The study is based on a lifeworld approach, and a phenomenographic method was used. Eighteen participants were interviewed, and data were analysed according to the phenomenographic principle of qualitatively different categories. Two categories were developed. The first category, “perceptions that draw attention inward, towards one’s self”, was further described in three subcategories: Sense of decreased status in society, the desire to keep aging at a distance, and contemplation of one’s own existence. The second category, “perceptions that draw attention outward, away from one’s self” was further described in the following four subcategories: caretaking of family members, involvement in social relationships, finding of deep meaning in animals and nature and engagement with society. In the discussion, the findings are further illuminated through comparisons with concepts such as maturity, wisdom and gerotranscendence, and reflections on the findings ‘relevance to a caring context follow. The conclusion suggests this study can provide knowledge that will allow healthcare providers to bridge the gap between generations in order to provide high-quality care. However, for a more profound caring dialogue, for example, about the end of life, a deeper analysis is required.
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| 10. |
- Emmesjö, Lina, et al.
(författare)
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Home health care professionals’ experiences of working in integrated teams during the COVID-19 pandemic : a qualitative thematic study
- 2022
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Ingår i: BMC Primary Care. - : BioMed Central (BMC). - 2731-4553. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Since COVID-19 emerged, over 514 million COVID-19 cases and 6 million COVID-19-related deaths have been reported worldwide. Older persons receiving home health care often have co-morbidities that require advanced medical care, and are at risk of becoming severely ill or dying from COVID-19. In Sweden, over 10,000 COVID-19-related deaths have been reported among persons receiving municipal home health and social care. Home health care professionals have been working with the patients most at risk if infected. Most research has focused on the experiences of professionals in hospitals and assistant nurses in a home care setting. It is therefore valuable to study the experiences of the registered nurses and physicians working in home health care during the COVID-19 pandemic to learn lessons to inform future work.Method: A thematic qualitative study design using a semi-structured interview guide.Results: The health care professionals experienced being forced into changed ways of working, which disrupted building and maintaining relationships with other health care professionals, and interrupted home health care. The health care professionals described being forced into digital and phone communication instead of in-person meetings, which negatively influenced the quality of care. The COVID-19 pandemic brought worry about illness for the health care professionals, including worrying about infecting patients, co-workers, and themselves, as well as worry about upholding the provision of health care because of increasing sick leave. The health care professionals felt powerless in the face of their patients’ declining health. They also faced worry and guilt from the patients’ next of kin.Conclusion: Home health care professionals have faced the COVID-19 pandemic while working across organizational borders, caring for older patients who have been isolated during the pandemic and trying to prevent declining health and feelings of isolation. Due to the forced use of digital and phone communication instead of in-person visits, the home health care professionals experienced a reduction in the patients’ quality of care and difficulty maintaining good communication between the professions.
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| 11. |
- Emmesjö, Lina, et al.
(författare)
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Patients’ and next of kin’s expectations and experiences of a mobile integrated care model with a home health care physician : a qualitative thematic study
- 2023
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Ingår i: BMC Health Services Research. - : BioMed Central (BMC). - 1472-6963. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: The organizational principle of remaining at home has offset care from the hospital to the home of the older person where care from formal and informal caregivers is needed. Globally, formal care is often organized to handle singular and sporadic health problems, leading to the need for several health care providers. The need for an integrated care model was therefore recognized by health care authorities in one county in Sweden, who created a cross-organisational integrated care model to meet these challenges. The Mobile integrated care model with a home health care physician (MICM) is a collaboration between regional and municipal health care. Descriptions of patients’ and next of kin’s experiences of integrated care is however lacking, motivating exploration.Method: A qualitative thematic study. Data collection was done before the patients met the MICM physician, and again six months later.Results: The participants expected a sense of relief when admitted to MICM, and hoped for shared responsibility, building a personal contact and continuity but experienced lack of information about what MICM was. At the follow-up interview, participants described having an easier daily life. The increased access to the health care personnel (HCP) allowed participants to let go of responsibility, and created a sense of safety through the personalised contact and continuity. However, some felt ignored and that the personnel teamed up against the patient. The MICM structure was experienced as hierarchical, which influenced the possibility to participate. However, the home visits opened up the possibility for shared decision making.Conclusion: Participants had an expectation of receiving safe and coherent health care, to share responsibility, personal contact and continuity. After six months, the participants expressed that MICM had provided an easier daily life. The direct access to HCP reduced their responsibility and they had created a personalised contact with the HCP and that the individual HCP mattered to them, which could be perceived as in line with the goals in the shift to local health care. The MICM was experienced as a hierarchic structure with impact on participation, indicating that all dimensions of person-centred care were not fulfilled.
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| 12. |
- Emmesjö, Lina
(författare)
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Within an integrated home health care model : Registered nurses’, physicians’, patients’ and their next of kin’s perspectives
- 2024
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Many older patients receive health care from several different healthcare organizations, which may lead uncertainty about the responsibility for their healthcare needs. Integrated care has been argued to aid the healthcare system by addressing the challenge of the complex care needs of older patients with multiple health problems. Previous research has stated that integrated care models often have been developed with a focus on a single diagnosis, which risks overlooking the extensive and complex care needs of older patients. Prior research has also expressed the need to deepen knowledge about how integrated care models influence health care professionals, patients and their next of kin. Moreover, it is important to understand how the COVID-19 pandemic affected integrated care models which may expand knowledge about integrated home health care in crisis situations.The overall aim is to study expectations, perceptions and experiences of integrated home health care through the perspective of registered nurses, physicians, patients and their next of kin.Inductive qualitative designs where data was collected through interviews and field notes in the setting of the mobile integrated care model with a home health care physician (MICM) with registered nurses, physicians and patients and next of kin. Analysis was conducted using qualitative content analysis, phenomenography, and thematic analysis.The emphasis on person-centered care in the MICM was evident in the perceptions of the healthcare professionals about the patients and their next of kin, whom they viewed as persons, not simply recipients of health care. Differences were found in the health care provided in the MICM and in comparison, to other healthcare organizations which did not align with the person-centered care ethics. However, providing health care to patients in their own home benefited the provision of person-centered care – the value base of the MICM. The MICM was created with the goal of implementing individually tailored and coherent health care with increased continuity. The healthcare professionals viewed individual medical healthcare plans as co-created with each patient, and yet no patient could recall participating in this co-creation. The coherency of the MICM was regarded as having been improved by teamwork between the registered nurse and the home healthcare physician. Collaborations with other healthcare professionals rarely occurred and should be improved in the future. Participants reported varying experiences of continuity in the MICM, which influenced the possibility of building relationships. Providing continuity with a home healthcare physician for patients is therefore preferable. The work described in this thesis was conducted during the COVID-19 pandemic. The thesis provides unique insights into an integrated care model during a crisis situation, which the healthcare system may face in similar or different ways in the future. The MICM was upheld as the best way to work in home health care, especially as patients and their next of kin regarded the model as making their daily lives easier.
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| 13. |
- Eriksson, Irene, et al.
(författare)
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Holistic health care : Patients' experiences of health care provided by an Advanced Practice Nurse
- 2018
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Ingår i: International Journal of Nursing Practice. - : Wiley-Blackwell. - 1322-7114 .- 1440-172X. ; 24:1
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Advanced Practice Nurse (APN) is a fairly new role in the Swedish health care system.AIM: To describe patients' experiences of health care provided by an APN in primary health care.METHODS: An inductive, descriptive qualitative approach with qualitative open-ended interviews was chosen to obtain descriptions from 10 participants regarding their experiences of health care provided by an APN. The data were collected during the spring 2012, and a qualitative approach was used for analyze.RESULTS: The APNs had knowledge and skills to provide safe and secure individual and holistic health care with high quality, and a respectful and flexible approach. The APNs conveyed trust and safety and provided health care that satisfied the patients' needs of accessibility and appropriateness in level of care.CONCLUSION: The APNs way of providing health care and promoting health seems beneficial in many ways for the patients. The individual and holistic approach that characterizes the health care provided by the APNs is a key aspect in the prevailing change of health care practice. The transfer of care and the increasing number of older adults, often with a variety of complex health problems, call for development of the new role in this context.
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| 14. |
- Fabisiak, Beata, et al.
(författare)
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Preferences of seniors living in selected Baltic Sea region countries towards the use of indoor public space furniture
- 2021
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Ingår i: PLOS ONE. - : Public Library of Science. - 1932-6203. ; 16:12 December 9
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Tidskriftsartikel (refereegranskat)abstract
- Demographic changes can be observed all over the world. The number of seniors located in the societies of well-developed countries continues to rise. Both enterprises and governments need to be prepared for such changes. Consequently, public spaces need to evolve to reduce problems related to ageism and be friendly to all. Much attention is currently being paid to finding solutions for redesigning public spaces and adjusting them to the needs and requirements of senior citizens. To identify the preferences of seniors in relation to the characteristics of furniture in indoor public spaces, a survey study with 1539 respondents aged 60+ was conducted in Denmark, Finland, Latvia, Poland, Russia and Sweden. The gathered data were coded and implemented to the unified database. The statistical grouping method was used to recognize the characteristics of the needs and attitudes of seniors related to the use of public space furniture. The main variables taken into consideration in the analysis were the age and gender of respondents and their country of living. Among the most important findings are those indicating the necessity to provide the increased number of furniture for sitting in the public spaces and making sure they are not located too far away from each other. As the main disadvantages of public space furniture respondents indicated the lack of armrests or other solutions to facilitate getting up and/or sitting down, as well as profiled backrests that constitute solid support for the spine. The implementation of these data in the process of rethinking and redesigning public spaces may support the adaptation of indoor public furniture according to the requirements of a very large group of customers, namely, seniors.
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| 15. |
- Gillsjö, Catharina, et al.
(författare)
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A concept analysis of home and its meaning in the lives of three older adults
- 2011
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Ingår i: International Journal of Older People Nursing. - : Wiley-Blackwell Publishing Inc.. - 1748-3735 .- 1748-3743. ; 6:1, s. 4-12
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Tidskriftsartikel (refereegranskat)abstract
- Aim. To identify and define the concept of home and its meaning in the lives of three older women. Background. For many older adults home is the centre of daily life and increasingly important as a place where health care is delivered. Yet, as a concept, home remains theoretically and empirically underdeveloped. Methods. The Hybrid Model of Concept Development was used to interface theoretical analysis and empirical observation with a focus on definition. A comprehensive, interdisciplinary literature review, semi-structured interviews with three older women and case and cross-case analysis were completed. Results. Interviewees spoke of childhood, community, residential, church and heavenly homes. Feelings of comfort and security were associated with residential homes, peace and quiet with church homes, safety and pleasure with heavenly homes. The experience of home as being taken for granted, unselfconscious and unrecognized, became obvious when one woman tried to consciously establish a sense of being at home in her new residence. Conclusion. No single comprehensive and measurable definition was found. However, three major components were identified (place, relationship and experience) and used to define home as a place to which one is attached, feels comfortable and secure and has the experience of dwelling. Relevance to clinical practice. Every day assumptions about the meaning of home and home as just another place where health care is provided are called into question. Increased awareness and dialogue is needed among health-care providers working with older adults in their homes. Future research needs to explore the impact of home care on the older adult’s meaning of home and its potential impact on recovery.
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| 16. |
- Gillsjö, Catharina, Senior Lecturer, 1963-, et al.
(författare)
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Balance in life as a prerequisite for community-dwelling older adults' sense of health and well-being after retirement : an interview-based study
- 2021
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Informa UK Limited. - 1748-2623 .- 1748-2631. ; 16:1
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE This study aimed to describe community-dwelling older adults’ perceptions of health and well-being in life after retirement.METHODS This study is part of a larger project using a mixed-methods design to address lifestyles’ influence on community-dwelling older adults’ health. Individual semi-structured interviews were conducted with 18 older adults in age 70 to 95 years. Data were analysed according to a phenomenographic approach.RESULTS The results encompass four categories describing variations in community-dwelling older adults’ perceptions of health and well-being after retirement: feeling well despite illness and disease, interacting with and being useful for oneself and others, independently embracing opportunities and engaging in life, and maintaining a healthy lifestyle.CONCLUSIONS The absence of illness and disease is not a clear prerequisite for a sense of health and well-being. To promote and preserve health and well-being after retirement, older adults strived for—and coached themselves to uphold—a balance in life, focusing on not burdening others. This life orientation after retirement must be acknowledged by society at large, especially from an ageist perspective, and in health and social care to preserve and promote health and well-being.
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| 17. |
- Gillsjö, Catharina, Senior Lecturer, 1963-, et al.
(författare)
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En utbildnings-intervention med simulering i äldredräkt i Skaraborgs Hälsoteknikcentrum för ökad insikt och förståelse för att åldras och leva med åldersrelaterade hälsoproblem
- 2021
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Ingår i: DAL-21 Det akademiska lärarskapet. - Skövde : Högskolan i Skövde. - 9789198366785 ; , s. 30-31
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Konferensbidrag (refereegranskat)abstract
- Världshälsoorganisationen, [1] belyser utmaningen att ge en vård som stödjer ett hälsosamt åldrande. Ett centralt hinder är den höga förekomsten av negativa attityder gentemot åldrandet, äldre personer och vård av äldre, särskilt bland vårdpersonal [2-4]. Vidare påvisas att sjuksköterskestudenter kan bära på negativa attityder till att vårda äldre och därför inte ser arbete inom äldrevård som ett önskvärt och framtida arbetsfält [5, 6]. Otillräcklig forskning avseende ålderism tillsammans med bristande utbildning inom området äldre, det normala åldrandet samt åldrandets hälsoproblem beskrivs som en bidragande faktor till ålderism [4]. Trots att interventioner kontinuerligt genomförs för att ändra attityder och minska ålderism i vården kvarstår dessa i betydande omfattning [3]. Det finns således ett behov av att skapa innovativa lösningar som bidrar till en ökad och hållbar förståelse för åldrandet, äldre och åldersrelaterade hälsoproblem. Detta adresseras i en ny utbildningsintervention med simulering i äldredräkt som utformats och genomförs i Skaraborgs Hälsoteknikcentrum (SHC), Högskolan i Skövde. Forskning [7] lyfter fram att simulering i utbildning, särskilt genom användande av utrustning som äldredräkt, är en framgångsrik väg att ändra studenters attityder gentemot äldre. Simulering i SHC ger även möjlighet att testa hälso- och välfärdsteknik vilket ytterligare kan inverka positivt på uppfattningar om dess nytta vid implementering av teknik i vården [8].Pågående utbildningsmoment i utbildning till sjuksköterska och distriktssköterskaUnder läsåret 2019-2020 har grupper av studerande inom omvårdnad deltagit i simulering i SHC. Vid denna simulering har äldredräkt använts för att återspegla upplevelsen av normalt åldrande och vanligt förekommande hälsoproblem. De studerande tilldelas en personas och genomför olika scenarier i SHC. I samband med detta besvaras enkät [9], före simulering samt efter simulering för att ta del av synen på åldrandet och att vårda äldre samt eventuell förändring efter genomgången simulering. Efter simuleringen reflekterar studenterna i grupp över upplevelsen av simuleringen, åldrandet och den vård som ges. Reflektionerna relateras sedan till centrala begrepp i omvårdnad samt sjuksköterskans kärnkompetenser. Vidare reflekterar de studerande över hur simuleringen påverkat deras insikt och förståelse samt hur det kommer att visa sig i den vård som ges.ForskningsprojektUtbildningsinterventionen beforskas som en del i ett longitudinellt projekt med övergripande syfte att studera hur en utbildningsintervention med simulering i äldredräkt inverkar på insikt och förståelse för åldrandet, att vara äldre och att leva med åldersrelaterade hälsoproblem i kontexten samt vård av äldre personer. Vidare är syftet att longitudinellt studera studenters syn på åldrandet, äldre och att vårda äldre personer. De hittills genomförda simuleringarna visar tecken på att studenters insikt och förståelse avseende åldrandet, att åldras och att leva med åldersrelaterade hälsoproblem förändras på ett positivt sätt. Det finns därför ett behov av att systematiskt utvärdera effekten och nyttan av den intervention som nu genomförs i SHC. Externa medel söktes hos Familjen Kamprads stiftelse och 3,5 miljoner erhölls för att genomföra projektet och att anställa en doktorand.Referenser1. WHO, Integrated care for older people (ICOPE) implementation framework: guidance for systems and services. 2019, Geneva: World Health Organization.2. Wyman, M.F., S. Shiovitz-Ezra, and J. Bengel, Ageism in the Health Care System: Providers, Patients, and Systems, in Contemporary Perspectives on Ageism, L. Ayalon and C. Tesch-Römer, Editors. 2018, Springer International Publishing: Cham. p. 193-212.3. Burnes, D., et al., Interventions to Reduce Ageism Against Older Adults: A Systematic Review and Meta-Analysis.American Journal of Public Health, 2019. 109(8): p. e1-e9.4. Wilson, D.M., et al., A critical review of published research literature reviews on nursing and healthcare ageism. Journal of Clinical Nursing, 2017. 26(23-24): p. 3881-3892.5. Szadowska-Szlachetka, Z., et al., Attitudes of students of nursing major towards people of geriatric age. Polish Journal of Public Health, 2019. 129(3): p. 95.6. Naughton, C., K.L. O’Shea, and N. Hayes, Incentivising a career in older adult nursing: The views of student nurses. International Journal of Older People Nursing, 2019. 14(4): p. e12256.7. Giner Perot, J., et al., Aging-simulation experience: impact on health professionals’ social representations. BMC Geriatrics, 2020. 20(1): p. 14.8. Frennert, S. and K. Baudin, The concept of welfare technology in Swedish municipal eldercare. Disability and Rehabilitation, 2019: p. 1-8.9. Burbank, P.M., G.J. Burkholder, and J. Dugas, Development of the Perspectives on Caring for Older Patients scale: Psychometric analyses. Applied Nursing Research, 2018. 43: p. 98-104
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| 18. |
- Gillsjö, Catharina, et al.
(författare)
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Home : The place the older adult can not imagine living without
- 2011
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Ingår i: BMC Geriatrics. - : BioMed Central. - 1471-2318. ; 11:10
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Tidskriftsartikel (refereegranskat)abstract
- Background: Rapidly aging populations with an increased desire to remain at home and changes in health policy that promote the transfer of health care from formal places, as hospitals and institutions, to the more informal setting of one's home support the need for further research that is designed specifically to understand the experience of home among older adults. Yet, little is known among health care providers about the older adult's experience of home. The aim of this study was to understand the experience of home as experienced by older adults living in a rural community in Sweden.Methods: Hermeneutical interpretation, as developed by von Post and Eriksson and based on Gadamer's philosophical hermeneutics, was used to interpret interviews with six older adults. The interpretation included a self examination of the researcher's experiences and prejudices and proceeded through several readings which integrated the text with the reader, allowed new questions to emerge, fused the horizons, summarized main and sub-themes and allowed a new understanding to emerge.Results: Two main and six sub-themes emerged. Home was experienced as the place the older adult could not imagine living without but also as the place one might be forced to leave. The older adult's thoughts vacillated between the well known present and all its comforts and the unknown future with all its questions and fears, including the underlying threat of loosing one's home.Conclusions: Home has become so integral to life itself and such an intimate part of the older adult's being that when older adults lose their home, they also loose the place closest to their heart, the place where they are at home and can maintain their identity, integrity and way of living. Additional effort needs to be made to understand the older adult's experience of home within home health care in order to minimize intrusion and maximize care. There is a need to more fully explore the older adult's experience with health care providers in the home and its impact on the older adult's sense of "being at home" and their health and overall well-being.
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| 19. |
- Gillsjö, Catharina, et al.
(författare)
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Klinisk undersökning och kliniskt beslutsfattande på en avancerad nivå
- 2011. - 1
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Ingår i: Avancerad klinisk sjuksköterska. - Lund : Studentlitteratur. - 9789144059471 - 9144059477 ; , s. 211-244
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Bokkapitel (refereegranskat)abstract
- KLINISK PRAXIS på avancerad nivå innebär för en avancerad klinisk sjuksköterska att självständigt ansvara för ett kliniskt beslutsfattande inom sitt kompetensområde och att utifrån omvårdnadsteoretiska perspektiv ge en god omvårdnad. Förvärvade kunskaper och färdigheter tillämpas för att lösa komplexa hälsoproblem genom att identifiera, bedöma, diagnostisera, ordinera, genomföra och utvärdera omvårdnad och medicinsk behandling utifrån patientens helhetssituation samt genomföra hälsofrämjande och förebyggande åtgärder. I detta kapitel ges en vägledning i hur en avancerad klinisk sjuksköterska på ett systematiskt sätt kan inhämta patientens hälsohistoria, genomföra en klinisk undersökning samt utifrån detta fatta kliniska beslut och slutligen dokumentera händelseförloppet.
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| 20. |
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| 21. |
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| 22. |
- Gillsjö, Catharina, Senior Lecturer, 1963-, et al.
(författare)
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Lifestyle's influence on community-dwelling older adults' health : A mixed-methods study design
- 2021
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Ingår i: Contemporary Clinical Trials Communications. - Amsterdam : Elsevier. - 2451-8654. ; 21
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Tidskriftsartikel (refereegranskat)abstract
- Background: Aging often involves health problems and difficulties, such as physical and psychological impairments, isolation, and loneliness, causing social and existential consequences. Studies have explored aging from different perspectives. However, few studies have examined healthy older adults’ genetic backgrounds, lifestyles, and meaning in life separately or in combination. This study aims to describe how healthy older adults experience aging, health, lifestyles, and meaning in life and explore potential genetic correlations.Methods and Design: The project will comprise three main parts: a quantitative section featuring the development and testing of a lifestyle questionnaire, a quantitative genetic analysis, and a qualitative interview study. Participants will be community-dwelling, healthy, older adults between 70 and 95 years of age. A sample size of 800 older adults will be invited to participate in seminars in collaboration with the national Swedish association Active Seniors. Data will be collected through lifestyle questionnaire, DNA extracted from saliva samples, and interviews. Based on questionnaire responses, profile groups will be created and compared statistically with variations in genetic backgrounds, providing the basis for recruiting participants to the qualitative interviews.Discussion: This study's expected outcome will be to gain knowledge about variations in genetic backgrounds correlated with individual experiences regarding aging, health, and meaning in life. This knowledge can improve the understanding of motivations for healthy lifestyle changes. The results can reveal potential implications for individual prerequisites to healthy aging and how health-promoting aging and lifestyle counseling can be adjusted to meet individual needs.
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| 23. |
- Gillsjö, Catharina
(författare)
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Older adults' conceptions of home and experiences of living with long-term musculoskeletal pain at home
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Worldwide there are an increasing number of older adults, many of whom desire to age in place, remaining at home. This makes home increasingly important for health care delivery. Long-term musculoskeletal pain often accompanies old age and is one of the most prevailing and disabling health problems among community dwelling older adults. However, limited research exists on older adults' conceptions of home and their experiences of living with musculoskeletal pain at home. Nurses need this kind of understanding for individualized and holistic care of older adults living at home.Three studies were conducted. The Hybrid Model for Concept Development was used to define the concept of home and its meaning in the lives of three older women. Home consisted of three components, place, relationship and experience and was defined as a place to which one is attached, feels comfortable and secure and has the experience of dwelling. Secondly, hermeneutical text interpretation was used to understand the experience of home from interviews with six older adults. Home was intimate and integral to one's sense of being and life itself. Participants could not really imagine living without it. There was an underlying tension and fear of being forced to leave home one day. Lastly, qualitative interviews with 19 older adults, phenomenography and content analysis, were used to describe differences and commonalities in the experience of living with long-term musculoskeletal pain at home. Four ways of dealing with daily life were identified: ignore, struggle, adjust and resign. Participants learned how to endure pain in their daily life. Common themes included: taking the pain as it comes, one day at a time; balancing the pain with activity, thoughts and emotions; self talking; trying to be less of a burden to family and others; capturing, enjoying and valuing moments of pleasure. Three major concepts in symbolic interactionism: role, negotiation and meaning making illuminated findings. Increased understanding of home among older adults and the enduring associated with living with long-term musculoskeletal pain may enhance the quality of life at home, preserve and promote the older adult's sense of being at home, health and overall well-being and maximize care and minimize intrusion.
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| 24. |
- Gillsjö, Catharina, et al.
(författare)
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Older Adults Ways of Dealing With Daily Life While Living With Long-Term Musculoskeletal Pain at Home
- 2012
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Ingår i: Journal of Applied Gerontology. - : SAGE Publications (UK and US). - 0733-4648 .- 1552-4523. ; 31:5, s. 685-705
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Tidskriftsartikel (refereegranskat)abstract
- Long-term musculoskeletal pain is a global health problem among older adults. Yet little is known about how these older adults actually deal with daily life. This studys aim is to describe the ways these older adults dealt with daily life at home. Phenomenography is used to collect and analyze data from semistructured interviews with 19 older adults and to identify the range in which they dealt with daily life. Findings consist of an outcome space that encompassed four categories: ignore, struggle, adjust, and resign. The different ways older adults dealt with daily life when living with long-term pain at home strengthen the importance of individualized plans of care in the home and a holistic perspective. Findings contribute to enhanced understanding of a common health problem among older adults that can be used to promote quality of care and improve the quality of life of older adults.
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| 25. |
- Gillsjö, Catharina, 1963-, et al.
(författare)
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Reflective STRENGTH-Giving Dialogue Developed to Support Older Adults in Learning to Live with Long-Term Pain : A Method and a Study Design
- 2014
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Ingår i: Journal of Gerontology & Geriatric Research. - : Longdom. - 2167-7182. ; 3:5
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Tidskriftsartikel (refereegranskat)abstract
- Background: Long-term musculoskeletal pain is a major health problem that significantly impacts quality of life among older adults. Many lack professional guidance and must learn on their own to live with pain. This calls for a holistic method that addresses older adults’ needs in their situations. The developed method has its foundation in the didactic model: “The challenge – to take control of one’s life with long-term illness.Aim: The aim was to describe the method, Reflective STRENGTH-Giving Dialogue, and present a study design where the method is learned and used by health care providers to support older adults in learning to live their lives with long-term pain at home in a way that promotes health, well-being, meaning and strength in life.Methods: The pilot study design consists of an educational program including continuous supervision to health care providers during the accomplishment of dialogues with community dwelling older adults. The key dimensions in Reflective STRENGTH-Giving Dialogue are:Situation: Confront and ascertain the facticity in the current situation; Transition from “one to I” and Take charge in the situation; Reflect upon possibilities and choices; Engagement in fulfilling small and large life projects that gives joy and meaning in life; Get inner strength and courage; Tactful and challenging approach and Holistic perspective. Data will be collected through interviews and questionnaires. Qualitative and quantitative methods (NRS, BPI-SF, GDS, KASAM, MSQ) will be used for analysis. A control-group will be enrolled.Discussion and Relevance of Study: STRENGTH can be used to secure and enhance the quality of personcentered care. The method for dialogues can be a way to holistically and individually guide and support older adults in finding ways to live a meaningful life despite pain and to fulfill their desire to remain at home as long as possible .
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| 26. |
- Gillsjö, Catharina, Senior Lecturer, 1963-, et al.
(författare)
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Suffering in silence : a qualitative study of older adults’ experiences of living with long-term musculoskeletal pain at home
- 2021
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Ingår i: European Journal of Ageing. - Basel : Springer. - 1613-9372 .- 1613-9380. ; 18:1, s. 55-63
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Tidskriftsartikel (refereegranskat)abstract
- Long-term musculoskeletal pain is a major, disabling, and often undertreated health problem among the increasing number of older adults worldwide. However, there is limited knowledge of community-dwelling older adults’ experiences of living with this type of pain. The aim of the study was to deepen the understanding of the phenomenon: how older adults experience living with long-term musculoskeletal pain at home. The study design was an inductive qualitative Reflective Lifeworld Research approach grounded in phenomenological epistemology. Data were obtained from 20 community-dwelling older adults, aged 72–97 years. Data were collected through open-ended interviews and analyzed to understand the meanings of the phenomenon. The essence of the phenomenon entailed suffering in silence and encompassed the following constituents: loneliness and restrictions in daily living; ways to endure and distract from pain; not being taken seriously; fear of the future; and valuing joy and meaning in life. Living with long-term musculoskeletal pain restricts access to the world and leads to a suffering in silence. Finding ways to endure and distract from pain and to focus on issues that give joy and meaning in life is predominant in efforts to balance restraints from pain in life. Suffering is reinforced by loneliness, a sense of not being taken seriously by health care providers and fear of an uncertain future. It is necessary to foster increased attentiveness and sensitivity in meeting the needs of each older adult and provide a care that alleviates suffering and preserves and promotes health and well-being. © 2020, The Author(s).
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| 27. |
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| 28. |
- Hallgren, Jenny, et al.
(författare)
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Health- and social care in the last year of life among older adults in Sweden
- 2020
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Ingår i: BMC Palliative Care. - : BioMed Central. - 1472-684X. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: In the last years of life, burden of disease and disability and need of health- and social care often increase. Social, functional and psychological factors may be important in regard to social- and health care utilization. This study aims to describe use of health- and social care during the last year of life among persons living in ordinary housing or in assisted living facilities. METHODS: A retrospective study examining health- and social care utilization during their last year of life, using a subsample from the Swedish twin registries individually linked to several Swedish national quality registries (NQR). Persons that died during 2008-2009 and 2011-2012 (n = 1518) were selected. RESULTS: Mean age at death was 85.9 ± 7.3 (range 65.1-109.0). Among the 1518 participants (women n = 888, 58.5%), of which 741 (49%) were living in assisted living facilities and 1061 (69.9%) had at least one hospitalization during last year of life. The most common causes of death were cardiovascular disease (43.8%) and tumors (15.3%). A multivariable logistic regression revealed that living in ordinary housing, younger age and higher numbers of NQR's increased the likelihood of hospitalization. CONCLUSIONS: Persons in their last year of life consumed high amount of health- and social care although 12% did not receive any home care. Married persons received less home care than never married. Persons living in ordinary housing had higher numbers of hospitalizations compared to participants in assisted living facilities. Older persons and persons registered in fewer NQR's were less hospitalized.
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| 29. |
- Hallgren, Jenny, 1978-, et al.
(författare)
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Implementing a person centred collaborative health care model : A qualitative study on patient experiences
- 2021
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Ingår i: International Emergency Nursing. - : Elsevier. - 1755-599X .- 1878-013X. ; 59
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Tidskriftsartikel (refereegranskat)abstract
- Background: Collaborative Health Care (CHC) is a unique model in which ambulance services, home health care, hospital care and the national telephone helpline for healthcare in Sweden – Swedish health care direct (SHD1177) collaborate to provide the fastest possible health care for inhabitants living in eleven municipalities in western region of Sweden. Aim: To explore how patients experience and perceive health care received in the CHC. Method: Qualitative descriptive study using open-ended individual telephone interviews with fifteen community dwelling persons with experiences of care throughthe model CHC were conducted. Results: Two main categories and six subcategories were identified. The category “Thoughts of time in regard to acute health care” include “CHC leads to shorter waiting time for health care”, “Knowledge about the staff working hours” and “To alert or not alert”. The category “Thoughts on unplanned health care from CHC” involved “Receiving health care in my home”, ”Coordination from SHD1177 surprises” and “Accessibility of health care values higher than continuity”. Conclusion: Integrated health care models such as CHC are time saving and highly appreciated by community dwelling persons. The benefits of provision of coherent health care like in CHC, addresses the need to implement innovative integrated healthcare models in today's health care.
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| 30. |
- Hallman, Elsie-Britt, et al.
(författare)
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Avancerad specialistsjuksköterska : från idé till verklighet
- 2005
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Ingår i: Vård i Norden. - : Sykepleiernes Samarbeid i Norden (SSN). - 0107-4083 .- 1890-4238. ; 25:3, s. 76-78
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Tidskriftsartikel (refereegranskat)abstract
- The role of the Nurse Practitioner has successfully been developed internationally within different areas of health care. To satisfy the needs of health care of the population in Sweden, an optimal utilization of the available resources is demanded and treatment of health care problems at an appropriate level of care is required to be able to give health care with good availability, high quality and safety. A collaboration started between the Primary Health Care in the county of Skaraborg and the University of Skövde to develop the role of the district nurses in primary health care toward a more specialized function with the competence to independently make decisions and solve health care problems. The plans of this new role in the health care system gained approval at the National Board of Health and Welfare and other public authorities. St Martin´s College, Great Britain and University of Rhode Island, USA have also been partners of collaboration. The result of the work became a curriculum of a new education in Sweden – Advanced Nursing Practice in Primary Health Care.
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| 31. |
- Hedén, Lena E, et al.
(författare)
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Effects of the Intervention "reflective STRENGTH-Giving Dialogues" for Older Adults Living with Long-Term Pain : A Pilot Study
- 2020
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Ingår i: Journal of Aging Research. - : Hindawi Publishing Corporation. - 2090-2204 .- 2090-2212. ; 2020
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Tidskriftsartikel (refereegranskat)abstract
- Background. Long-term musculoskeletal pain is a major, often undertreated, disabling health problem among an increasing number of older adults. Reflective STRENGTH-giving dialogues (STRENGTH) may be a tool to support older adults living with long-term pain. The main aim of this pilot study was to investigate the immediate and longitudinal effect of the intervention STRENGTH on levels of pain, wellbeing, occurrence of depression symptoms, and sense of coherence (SOC) among community-dwelling older adults suffering from musculoskeletal pain compared to a control group. Methods. The study was semiexperimental with an intervention group and a control group. The effect of a single STRENGTH intervention was reported on the Numeric Rating Scale (NRS) regarding pain and wellbeing. To evaluate the longitudinal effect of STRENGTH, using the Brief Pain Inventory-Short Form (BPI-SF), the Geriatric Depression Scale-20 (GDS-20), SOC-13 at baseline (T1), and six months after the intervention/no intervention (T2), a total of 30 older adults, aged 72 to 97 years (Mdn 86 years), were included consecutively and fulfilled the intervention series (n = 18) or untreated controls (n = 12). Results. The intervention with STRENGTH decreases pain (NRS 6 Mdn versus NRS 4 Mdn, p<0.001) and increases wellbeing (NRS 7 Mdn versus NRS 8 Mdn, p<0.001). After a six-month study period with STRENGTH, no longitudinal effect difference was found compared to baseline. Compared to the control group, there was an increasing trend between decreased pain level and increased SOC level for STRENGTH intervention. Conclusions. This pilot study supports STRENGTH's effect as a pain-alleviating model that provides a decrease in pain levels and an increase of wellbeing in older adults with long-term pain. STRENGTH dialogues could be a useful intervention to provide individually holistic care in older adults living with long-term pain.
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| 32. |
- Hovlin, Lina, et al.
(författare)
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Mutual trust is a prerequisite for nurses’ sense of safety and work satisfaction – Mobile Integrated Care Model : A qualitative interview study
- 2023
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Ingår i: Nordic journal of nursing research. - : Sage Publications. - 2057-1585 .- 2057-1593. ; 43:1, s. 1-8
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Tidskriftsartikel (refereegranskat)abstract
- An increasing number of older persons have complex health care needs. This, along with the organizational principle of remaining at home, emphasizes the need to develop collaborations among organizations caring for older persons. A health care model developed in Sweden, the Mobile Integrated Care Model aims to promote work in teams across organizations. The aim of the study was to describe nurses’ experiences in working and providing health care in the Mobile Integrated Care Model in the home with home health care physicians. Semi-structured interviews were conducted with 18 nurses and analyzed through qualitative content analysis. The method was compliant with the COREQ checklist. A mutually trusting collaboration with physicians, which formed person-centered care, created work satisfaction for the nurses. Working within the Mobile Integrated Care Model was negatively impacted by being employed by different organizations, lack of time to provide health care, and physicians’ person-centered work abilities.
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| 33. |
- Hovlin, Lina, et al.
(författare)
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The role of the home health care physician in mobile integrated care : a qualitative phenomenograpic study
- 2022
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Ingår i: BMC Geriatrics. - : BioMed Central (BMC). - 1471-2318. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: An increasing older population, along with the organizational principle of remaining at home, has moved health care from institutions into the older person’s home, where several health care providers facilitate care. The Mobile Integrated Care Model strives to provide cost-efficient, coherent, person-centered health care in the home. In the integrated care team, where the home health care physician is the medical authority, several health care professions work across organizational borders. Therefore, the aim of this study was to describe Home Health Care Physicians perceptions of working and providing health care in the Mobile Integrated Care Model, as well as perceptions of participating in and forming health care.Methods: A phenomenographic qualitative study design, with semi-structured interviews using an interview guide.Results: Working within Mobile Integrated Care Model was a different way of working as a physician. The physicians’ role was to support the patient by making safe medical decisions. Physicians described themselves as a piece in the team puzzle, where the professional knowledge of others was crucial to give quality health care. Being in the patients’ homes was expressed as adding a unique dimension in the provision of health care, and the physicians learned more about the patients by meeting them in their homes than at an institution. This aided the physicians in respecting patient autonomy in medical decision making, even though the physicians sometimes disregarded patient autonomy in favor of their own medical experience. There was a divided view on next of kin participation among the home health care physicians, ranging from always including to total absence of involving next of kin in decision making.Conclusions: The home health care physicians described the Mobile Integrated Care Model as the best way to work, but there was still a need for additional resources and structure when working in different organizations. The need for full-time employment, additional time or hours, more equipment, access to each other’s medical records, and additional collaboration with other health care providers were expressed, which could contribute to increased work satisfaction and facilitate further development of person-centered care in the Mobile Integrated Care Model.
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| 34. |
- Johansson, Yvonne A., 1956-
(författare)
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Delirium hos äldre patienter som vårdas på sjukhus : identifiering av symtom, tecken och riskfaktorer samt journalförda vårdåtgärder
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- I samband med sjukhusvård kan äldre patienter riskera försämrad hälsa, inklusive delirium. Delirium, som är vanligt hos äldre patienter på sjukhus, är ett akut och allvarligt tillstånd med svåra konsekvenser för såväl patienten som för närstående, vårdpersonal och hälso- och sjukvård. Det är viktigt att delirium förebyggs, identifieras och behandlas. Forskning visar dock på brister i vården, vilket kan påverka patienternas hälsa och välbefinnande negativt. Det övergripande syftet med avhandlingen var att identifiera och beskriva symtom, tecken, riskfaktorer och vårdåtgärder vid delirium hos äldre patienter som vårdas på sjukhus samt att utvärdera tillämpbarheten av ett bedömningsinstrument för att identifiera delirium. Alla deltagande patienter var 65 år och äldre och rekryterades från ett länssjukhus (I-IV) och ett universitetssjukhus (III, IV). Dessutom ingick de bedömare som bedömt delirium med bedömningsinstrumentet 4AT i delarbete IV. Delarbetena bestod av en kvantitativ subgruppsanalys (n=25) av en punktprevalensstudie (n=210), en retrospektiv journalgranskning (n=78) med kvalitativ analys och två tvärsnittsstudier baserade på samma urval (n=200) med kvantitativa (III, IV) och kvalitativa analyser (IV). Data samlades in genom strukturerade intervjuer, validerade instrument, patientjournaler, frågeformulär och en öppen intervjufråga.Patienterna rapporterade svåra och besvärande symtom vilka hade journalförts i begränsad omfattning (14%). Även kognitiv funktionsnedsättning och patienternas beskrivningar av sitt välbefinnande hade journalförts i liten utsträckning. Patienternas tecken på delirium ledde till nedsatt förmåga att såväl delta i sin egen vård som att undvika skada. Vårdpersonalen svarade delvis på patienternas tecken på delirium då åtgärderna kunde vara både anpassade, bristfälliga och utöver vanlig vård. Skörhet var den starkaste riskfaktorn för delirium. Andelen patienter med delirium ökade med svårighetsgraden av skörhet. Den svenska versionen av bedömningsinstrumentet 4AT för att identifiera delirium hade diagnostisk precision och klinisk användbarhet med hög interbedömarreliabilitet. Bedömningsinstrumentet 4AT tolererades väl av patienterna, var lätt att använda och tog några minuter att genomföra. Detta innebär att det nu finns ett enkelt bedömningsinstrument för delirium på svenska som kan användas för att bedöma delirium hos äldre patienter som vårdas på sjukhus.Endast en mindre del av den studerade vården kan ses som personcentrerad och patientsäker. Struktur, systematik och ett helhetsperspektiv tycktes saknas, liksom ett personcentrerat förhållnings- och arbetssätt. För att minska incidensen av delirium, lidande och kostnader behöver vården förbättras. Det finns behov av att öka kunskapen om delirium och att se delirium som en vårdskada inom all vård. Vidare finns behov av att utveckla vården genom att tydligt integrera ett personcentrerat och patientsäkert förhållnings- och arbetssätt för att nå en helhetssyn på patienten. Målet är att främja hälsa och välbefinnande genom att förebygga delirium. För att möjliggöra identifiering av individuella vårdbehov är det en förutsättning att etablera en tillitsfull vårdrelation med den äldre patienten, där patientens perspektiv tillvaratas. Individuella vårdbehov behöver identifieras strukturerat och systematiskt genom bedömning med bedömningsinstrument av symtom, tecken, välbefinnande, delirium och riskfaktorer för delirium innefattande skörhet samt kognitiv funktionsnedsättning. Detta möjliggör individuellt anpassade vårdåtgärder.Ett individuellt anpassat omhändertagande som överensstämmer med ett integrerat personcentrerat och patientsäkert förhållnings- och arbetssätt skulle kunna bidra till att minska incidensen av delirium vilket kan skapa positiva effekter för såväl patienter som för vårdpersonal och hälso- och sjukvård.
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| 35. |
- Johansson, Yvonne A, 1956-, et al.
(författare)
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Diagnostic accuracy and clinical applicability of the Swedish version of the 4AT assessment test for delirium detection, in a mixed patient population and setting
- 2021
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Ingår i: BMC Geriatrics. - : Springer Science and Business Media LLC. - 1471-2318. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Delirium is common in older hospitalized patients. It has serious consequences e.g., poor health outcomes, mortality and increased costs. Despite that, many cases are undetected. Early detection of delirium is important in improving outcomes and use of assessment tools improves detection rates. The 4AT is a brief screening tool for delirium detection, which has not previously been translated into Swedish. The study aim was to evaluate diagnostic accuracy and clinical applicability of a Swedish version of the screening tool 4AT for delirium detection. Method This diagnostic test accuracy study used a quantitative and a qualitative approach and evaluated the patients' and the health care professionals' experiences of the tool. Study included 200 patients >= 65 years from a university hospital and a county hospital in two Swedish regions. Medical specialties were geriatric stroke/neurology, geriatric multimorbidity, severe cognitive impairment, orthopaedic, and urology. The translated 4AT was tested against the reference standard DSM-IV-TR criteria, based on the Organic Brain Syndrome scale and patient records. The 4AT was assessed simultaneously and independently by two assessors. Additionally, data was collected through patient record reviews, and questions about applicability to the patients (n = 200) and the assessors (n = 37). Statistical analyses, and qualitative content analyses were conducted. Results By reference standard 18% had delirium, and by 4AT 19%. The overall percent agreement was 88%, AUROC 0.808, sensitivity 0.70 (95% CI 0.51-0.84) and specificity 0.92 (95% CI 0.87-0.96). In the ward for severe cognitive impairment (n = 63) the 4AT was less sensitive and less specific. In the other wards (n = 132) sensitivity was 0.77 (95% CI 0.50-0.93), specificity 0.93 (95% CI 0.87-0.97), and AUROC 0.848. Interrater reliability (Kappa) was 0.918, p = < 0.001 (n = 144). The 4AT was well tolerated by patients, easy to use for health care professionals, and took a few minutes to conduct. Conclusion The Swedish version of 4AT is an accurate and applicable tool to use in clinical practice for detecting delirium in hospitalized patients across different medical specialities, and to use by different professionals and levels of seniority. To improve patient outcomes, we recommend the 4AT to be incorporated in clinical practice in health care settings in Sweden.
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| 36. |
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| 37. |
- Johansson, Yvonne A, 1956-, et al.
(författare)
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Symptoms and Well-Being in Older Hospitalized Patients with Cognitive Impairment, As Self-Reported and Reported in Patient Records: A Quantitative Exploratory Subgroup Analysis
- 2021
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Ingår i: Dementia and Geriatric Cognitive Disorders Extra. - : S. Karger AG. - 1664-5464. ; 11:2, s. 71-77
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Given the aging population and the high prevalence of cognitive impairment in older hospitalized patients, it is essential to provide good fundamental care to these vulnerable patients, who easily might be affected by poor outcomes as delirium. Risk factors for delirium are, for example, cognitive impairment, old age, pain, and sleep deprivation. Different symptoms are often unidentified in hospitals, and associated with poor well-being, but this is rarely studied in older patients with cognitive impairment. The study aim was to examine symptoms and sense of well-being in older hospitalized patients with cognitive impairment, as self-reported and reported in patient records. Methods: Exploratory quantitative subgroup (n = 25) analysis of a point-prevalence study (n = 210). Inclusion criteria were age >= 65, and cognitive impairment. Data were collected through structured interviews, validated instruments, and patient records. Associations between well-being and symptoms, and concordance between the occurrence of self-reported symptoms and symptoms reported in patient records were analyzed. Results: The patients reported severe and distressing symptoms that were sparsely reported (14%) in their records. As well were cognitive impairment, and the patients' own descriptions of their well-being. Some symptoms and the total symptom burden were associated with poor well-being. Discussion/Conclusion: To our knowledge, this hypothesis-generating study is one of few studies that describe both symptoms and well-being as self-reported and reported in patient records, in vulnerable patients due to old age, cognitive impairment, and hospitalization. Despite the limited sample size, the results indicate that symptoms were more insufficient alleviated in these patients compared to patients with normal cognitive function in other studies. To our knowledge, this has not been shown previously. Additionally, patients' own experiences were sparsely reported in their records. A larger sample size and longitudinal design has the potential to determine if symptom alleviation differs between patients with and without cognitive impairment, and if a total symptom burden increases the risk of poor outcomes as delirium in vulnerable patients.
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| 38. |
- Leonardsen, Ann-Chatrin Linqvist, et al.
(författare)
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Nursing students’ attitudes towards the use of digital technology in the healthcare of older adults- a cross-sectional study in Norway and Sweden
- 2023
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Ingår i: BMC Nursing. - : BioMed Central (BMC). - 1472-6955. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Implementation of digital technology has been suggested as a potential solution to future healthcare challenges. Healthcare personnel’s attitudes are important in the acceptance and implementation of digital technologies. Aim: The aims of this study were to (1) translate and validate two different questionnaires to Norwegian and Swedish respectively, and then (2) use these to examine nursing students’ attitudes towards digital technology in healthcare, as well as their attitudes towards older adults’ abilities to use digital technology. Design: Cross-sectional. Methods: A web-based questionnaire was distributed in first year nursing students in a Norwegian and a Swedish university college, respectively. The questionnaire consisted of the short form of the ‘Information Technology Attitude Scales for Health (ITASH)’ and the ‘Attitudes Towards Older Adults Using Digital technology (ATOAUT-11)’ questionnaire. The questionnaires were translated and validated in both countries. Frequencies, Student’s t-test, and one-way ANOVA were used to analyze the data. Results: In total 236 students responded to the questionnaire in the period September 2022 to April 2023. Students mainly reported positive attitudes towards digital technology use in general. They most agreed with the items ‘Using digital technology devices makes my communication with other health professionals faster’, ‘The sort of information I can get from the digital technology devices helps me give better care to patient’, and ‘Digital technology skills are becoming more and more necessary for healthcare professionals’. However, they reported more negative attitudes towards older adults using digital technology. They most agreed with the items ‘One needs a lot of patience to explain to an older adult how to use digital technologies’, ‘It’s hard to explain to older adults how to use digital technology’, ‘Using digital technology is harder for most older adults’, and ‘Most older adults fear using digital technology because they fear of being scammed or cheated’. Conclusion: The ITASH and the ATOAUT-11 is appropriate for use in a Norwegian and Swedish setting. Even if nursing students are positive to digital technology in healthcare in general, they are sceptical to older adults using digital technology. This may impact on their attitudes to using digital technology in the healthcare of older adults. These aspects need emphasis when revising nursing education curricula focusing on developing technological competencies in nursing, and gaining knowledge regarding older adults’ use of digital technology.
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| 39. |
- Lindblad, Emma, et al.
(författare)
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Experiences of the new role of advanced practice nurses in Swedish primary health care - A qualitative study
- 2010
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Ingår i: International Journal of Nursing Practice. - : Blackwell Publishing Asia Pty Ltd. - 1322-7114 .- 1440-172X. ; 16:1, s. 69-74
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to investigate and describe the experiences of the first advanced practice nurses (APNs), a new profession for Swedish health care, and of their supervising general practitioners (GPs), regarding the new role and scope of practice of APNs in primary health care. Individual interviews were conducted with the four first APNs and one focus group interview was conducted with five supervising physicians. The material was transcribed verbatim and analysed using latent content analysis. The respondents expressed confidence and trust in the new role of APNs. Some opposition to this new role from the GPs and other colleagues was observed, but was nonetheless overcome. The experiences of the APN role indicate that the new role is clearly demarcated from the role of physicians. The APNs were considered an extra resource for both the GPs and other nurses, which contributed to an increased availability of care for patients. The APN role requires an explicit definition and demarcation in relation to responsibility and roles among colleagues. Further development of the APN role presupposes the right to prescribe medication and order treatments, as well as an evaluation of patient, organizational and inter-professional perspectives on the matter. © 2010 Blackwell Publishing Asia Pty Ltd.
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| 40. |
- Nässén, Kristina, et al.
(författare)
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Health care professionals' experiences of possibilities and constraints in caring for older adults living with long-term pain in community home care
- 2023
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Ingår i: Journal of Aging Studies. - : Elsevier. - 0890-4065 .- 1879-193X. ; 65
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Tidskriftsartikel (refereegranskat)abstract
- Caring for a growing population of older adults with complex health problems in their homes is part of every-day work for many health care professionals in the world. This qualitative interview study explores the way health care professionals perceive possibilities and constraints when caring for older adults living with long-term pain in community home care in Sweden. The study aims to understand the relationship between health care professionals' subjective experiences and social structures such as the organization of care and shared norms and values in regard to their perceived space of action. Findings provide insight into how institutional structures such as organization and time, conflate with cultural notions, norms, and ideals, and how these enable and constrain health care professionals in their daily work but also create dilemmas. Findings suggest centering the meaning of structuring aspects in social organizations as a tool for reflection on priorities, improvement, and development in care settings.
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| 41. |
- Palmér, Lina, 1979-, et al.
(författare)
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The intertwining of reconciliation and displacement : a lifeworld hermeneutic study of older adults’ perceptions of the finality of life
- 2020
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Taylor & Francis. - 1748-2623 .- 1748-2631. ; 15:1
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: This study aimed to explain and understand the existential meaning of the finality of life from the perspective of healthy older adults. Method: Participants were recruited from a major project on older adults’ life situations. They were interviewed about their thoughts on the end of life, and their responses were interpreted using a lifeworld hermeneutic approach. Results: The findings showed that thinking about the inevitable finality of life involves feelings of liberation, frightening thoughts, a comforting promise of something beyond death, acceptance of the concept of death as a companion in life and a desire to live. Philosopher Simone de Beauvoir’s existential ideas about ageing and death were then used to further explain and understand the meaning of the finality of life and to support a comprehensive understanding. de Beauvoir suggests that when the temporal horizon of existence shrinks, one lives closer to the finality of life. For a comprehensive understanding, attributing meaning to the finality of life required the intertwining of reconciliation and displacement. The interpretations were further discussed using ideas from the fields of existential philosophy and caring science in order to develop a basis for caring practice. Conclusions: The conclusions suggested that professional health care for older adults would benefit from a lifeworld-led caring science approach that includes readiness for a caring dialogue that focuses on existential issues.
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| 42. |
- Palmér, Lina, 1979-, et al.
(författare)
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The meaning of growing old : A lifeworld hermeneutic study on existential matters during the third age of life
- 2019
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Ingår i: Healthy Aging Research. - : Wolters Kluwer. - 2261-7434. ; 8:2, s. 1-7
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Tidskriftsartikel (refereegranskat)abstract
- This study investigates existential matters in the third age of life, which encompasses the years after retirement and ends when extensive support needs emerge in the fourth age. As the theoretical starting point in a lifeworld hermeneutic approach, 18 healthy older adults were interviewed about what it means for them to grow old. The interviews were interpreted according to Gadamer's principles of openness and Ricoeur's proposal to provide suggestions on how meaning can be explained. The findings are presented in three interpreted themes: Feeling free, Becoming vulnerable, and Existing in closeness to death. The themes are further interpreted, and a comprehensive understanding is reached with theoretical support from Jean-Paul Sartre's idea of factuality and project. The meaning of growing old is discussed in terms of positive factors, such as healthy aging, transition and gerotranscendence, but also in respect to concerns over future suffering in relation to illness and dependence. It is concluded that the freedom of the third age is greatly appreciated for a healthy life, but also threatened by increased risks of ill health. It is not morbidity in itself that worries most, but the risk of being dependent on care and support from others. This is important to consider when planning and performing care in order to promote a healthy aging.
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| 43. |
- Rosenburg, Marcus, 1983-
(författare)
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Living with a venous leg ulcer : Lived experiences and the presence of self-care in daily life
- 2024
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Aim: The overall aim of this thesis was to describe the lived experiences of patients with hard-to-heal venous leg ulcers before and after healing, as well as the understanding of the role and presence of self-care activities in ulcer management.Methods: The thesis is based on four studies, with differing designs. In Studies I and II, a phenomenological approach was used. To describe lived experiences of undergoing ulcer management, 16 persons were interviewed (I), and to describe lived experiences of daily life after healing,15 persons were interviewed (II). Study III was a registry-based, quantitative study. In total, data from 699 patients with venous leg ulcers(VLUs) were analyzed. Logistic regressions were performed to describe associations between advice given on self-care and its impact on ulcer healing. Study IV, which focused on patient experiences of the feasibility of an intervention for self-care, was based on eleven interviews with six patients with VLUs. The data from the interviews underwent qualitative content analysis.Results: Ulcer management aims at ulcer healing. In the protracted process, patients often experience hopelessness. When healing is slow, patients doubt the professionals’ knowledge. A patient’s trust in professionals and the entire healthcare system may erode if treatment and information vary between different professionals (Study I). Study II revealed that daily life after healing was still strongly affected by the ulcer. Memories from a lost period in life were ever-present. Life after healing was changed – for some, life was not very eventful. The patients’ own knowledge was often limited, and there was a struggle to do what was best for the own body to prevent a new ulcer. Study III revealed that advice on nutrition and physical activity had no impact on healing time. Only 44% of the sample were advised on both nutrition and physical activity. It was common to have an ulcer for a long time before seeking help; about half of the sample had an ulcer for >84 days before registration. Other findings were that the median age among the 699 patients was 77 years, the majority were female, and comorbidity was common. The intervention tested in Study IV offered welcomed information. However, even among those experiencing some sense of recognition, the link to their own situation and life was unclear. The technical solution with videos on a flash drive was difficult for most people to use. The importance of close cooperation with professionals was highlighted.Conclusion: Venous leg ulcers have a profound impact on patients and their life situations. Ulcer management can, in different ways, impose suffering on patients. Not being listened to or seen as a person is anexperience that leaves its marks on a patient. When healing is slow, and someone has to be blamed, relationships with professionals are damaged. The role of self-care is unclear for most patients, which makes self-care harder. Those who tried a video-based intervention for self-care showed difficulties in relating it to their own life. Enabling a caring relationship can enhance patients’ understanding of information and advice. Patients must be invited to share their own experiences, to create a foundation for self-care. The provision of advice alone is not the solution to the issues related to self-care.
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| 44. |
- Tarvis, Maria, 1963-, et al.
(författare)
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From chaos to a new normal—the COVID-19 pandemic as experienced by municipal health and social care providers in Sweden : A qualitative study
- 2023
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Ingår i: Nordic journal of nursing research. - London : Sage Publications. - 2057-1585 .- 2057-1593. ; 43:1, s. 1-9
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Tidskriftsartikel (refereegranskat)abstract
- When the COVID-19 pandemic began to spread around the world, Swedish municipalities were unprepared. Different guidelines on how to act in relation to the disease varied and protective equipment was lacking. This study aims to describe the experiences of health and social care providers of working at municipality level during the COVID-19 pandemic. A total of 12 assistant nurses, 13 registered nurses, and three physicians were interviewed, individually or in groups, between fall 2020 and spring 2021. The interviews were semi-structured and were analyzed using thematic analysis, utilizing a design following the COREQ-checklist. Three main themes were identified as follows: ‘Initial chaotic situation and uncertainty regarding how to deal with the pandemic’; ‘Continuous changes in organization and work routines’, and ‘Management of the pandemic has become the new normal’. Though health and social care workers eventually managed to embed dealing with COVID-19 as a routine feature of their daily work, municipalities must prepare for future crises.
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| 45. |
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| 46. |
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| 47. |
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| 48. |
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| 49. |
- Åberg, Cecilia, 1976-, et al.
(författare)
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"It is like living in a diminishing world" : older persons' experiences of living with long-term health problems - prior to the STRENGTH intervention
- 2020
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Taylor & Francis. - 1748-2623 .- 1748-2631. ; 15:1, s. 1-12
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Ageing is often associated with multiple long-term health problems influencing older persons' well-being in daily living. It is not unusual that the point of interest in research is often on the management of the actual health problem instead of being holistic and person-centred.Purpose: To describe the phenomenon of living with long-term health problems that influence daily living, from the older persons' perspective.Methods: Qualitative individual interviews were conducted with 34 older persons living with long-term health problems. The data were analysed using a Reflected Lifeworld Research (RLR) approach, grounded in phenomenology. Results: Life with long-term health problems entails living in a diminishing world. It entails living in uncertainty, not being able to trust one's own ability. The freedom to make decisions of your own is deprived by relatives and health-care providers. Living with long-term health problems entails being dependent on support in daily life and a strive to maintain meaningfulness in daily living.Conclusions: The results address a need for extended individual and holistic guidance and support in living with long-term health problems to increase the older person's sense of well-being and meaning in life.
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| 50. |
- Åberg, Cecilia, 1976-, et al.
(författare)
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Older persons’ experiences of Reflective STRENGTH-Giving Dialogues – ‘It's a push to move forward’
- 2021
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Ingår i: Scandinavian Journal of Caring Sciences. - : John Wiley & Sons. - 0283-9318 .- 1471-6712. ; 35:3, s. 779-787
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Tidskriftsartikel (refereegranskat)abstract
- Rationale: Experiences of the innovative method Reflective STRENGTH-Giving Dialogue (STRENGTH), which is grounded in a lifeworld perspective and developed to improve quality of care, is described in this study. Innovative thinking in developing health and social care, which may include digital solutions, is required to ensure a meaningful and dignified life in old age. Aim: The aim of this study was to describe experiences of the intervention Reflective STRENGTH-Giving Dialogue from the perspective of older persons living with long-term health problems. Method: Individual qualitative interviews were conducted with 27 older persons who participated in the intervention. The older persons wrote notes from each dialogue in booklets, and the booklets became part of the study data, analysed with a Reflective Lifeworld Research approach. Results: STRENGTH is experienced as an opportunity to reflect upon life and identify small and large life projects. Dialogues that lead to change in thoughts and actions influence the older persons' well-being, sense of balance, joy and meaning in life. There is an experience of STRENGTH as a starting point and a push to move forward in an effort to experience joy and meaning in life when living with long-term health problems. Conclusions: STRENGTH has the potential to contribute to quality improvement in person-centred care and enhance meaning in life for older persons living with long-term health problems. However, the use of a digital tool in this particular context poses challenges that must be considered.
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