| 1. |
- Johansson-Pajala, Rose-Marie, et al.
(författare)
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Anxiety and loneliness among older people living in residential care facilities or receiving home care services in Sweden during the COVID-19 pandemic : a national cross-sectional study
- 2022
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Ingår i: BMC Geriatrics. - : Springer Science and Business Media LLC. - 1471-2318. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Older people were subjected to significant restrictions on physical contacts with others during the COVID-19 pandemic. Social distancing impacts older people’s experiences of anxiety and loneliness. Despite a large body of research on the pandemic, there is little research on its effects on older people in residential care facilities (RCF) and in home care services (HCS), who are the frailest of the older population. We aimed to investigate the effect of the first wave of the COVID-19 pandemic in March-May 2020 on experiences of anxiety and loneliness among older people living in RCF or receiving HCS and the impact of the progression of the pandemic on these experiences.Methods: A retrospective cross-sectional design using data from the national user satisfaction survey (March − May 2020) by the Swedish National Board of Health and Welfare. Survey responses were retrieved from 27,872 older people in RCF (mean age 87 years) and 82,834 older people receiving HCS (mean age 84 years). Proportional-odds (cumulative logit) model was used to estimate the degree of association between dependent and independent variables.Results: Loneliness and anxiety were more prevalent among the older persons living in RCF (loneliness: 69%, anxiety: 63%) than those receiving HCS (53% and 47%, respectively). Proportional odds models revealed that among the RCF and HCS respondents, the cumulative odds ratio of experiencing higher degree of anxiety increased by 1.06% and 1.04%, respectively, and loneliness by 1.13% and 1.16%, respectively, for 1% increase in the COVID-19 infection rate. Poor self-rated health was the most influential factor for anxiety in both RCF and HCS. Living alone (with HCS) was the most influential factor affecting loneliness. Experiences of disrespect from staff were more strongly associated with anxiety and loneliness in RCF than in HCS.Conclusion: Older people in RCF or receiving HCS experienced increasing levels of anxiety and loneliness as the first wave of the pandemic progressed. Older people’ mental and social wellbeing should be recognized to a greater extent, such as by providing opportunities for social activities. Better preparedness for future similar events is needed, where restrictions on social interaction are balanced against the public health directives.
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| 2. |
- Johansson-Pajala, Rose-Marie, et al.
(författare)
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Trust and easy access to home care staff are associated with older adults' sense of security : a Swedish longitudinal study
- 2024
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Ingår i: Scandinavian Journal of Public Health. - 1403-4948 .- 1651-1905. ; , s. 36830-
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Tidskriftsartikel (refereegranskat)abstract
- AIM: Older adults are increasingly encouraged to continue living in their own homes with support from home care services. However, few studies have focused on older adults' safety in home care. This study explored associations between the sense of security and factors related to demographic characteristics and home care services.METHODS: The mixed longitudinal design was based on a retrospective national survey. The study population consisted of individuals in Sweden (aged 65+ years) granted home care services at any time between 2016 and 2020 (n=82,834-94,714). Multiple ordinal logistic regression models were fitted using the generalised estimation equation method to assess the strength of relationship between the dependent (sense of security) and independent (demographics, health and care-related factors) variables.RESULTS: The sense of security tended to increase between 2016 and 2020, and was significantly associated with being a woman, living outside big cities, being granted more home care services hours or being diagnosed/treated for depression (cumulative odds ratio 2-9% higher). Anxiety, poor health and living alone were most strongly associated with insecurity (cumulative odds ratio 17-64% lower). Aside from overall satisfaction with home care services, accessibility and confidence in staff influenced the sense of security most.CONCLUSIONS: We stress the need to promote older adults' sense of security for safe ageing in place, as mandated by Swedish law. Home care services profoundly influence older adults' sense of security. Therefore, it is vital to prioritise continuity in care, establish trust and build relationships with older adults. Given the increasing shortage of staff, integrating complementary measures, such as welfare technologies, is crucial to promoting this sense of security.
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| 3. |
- Fritz, Johanna, et al.
(författare)
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Determinants of Implementing an Information and Communication Technology Tool for Social Interaction Among Older People : Qualitative Content Analysis of Social Services Personnel Perspectives
- 2024
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Ingår i: JMIR Aging. - : JMIR Publications Inc.. - 2561-7605. ; 7:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Older people are particularly vulnerable to social isolation and loneliness, which can lead to ill-health, both mentally and physically. Information and communication technology (ICT) can supplement health and social care and improve health among the vulnerable, older adult population. When ICT is used specifically for communication with others, it is associated with reduced loneliness in older populations. Research is sparse on how the implementation of ICT, used specifically for communication among older people in social services, can be performed. It is recommended to consider the determinants of implementation, that is, barriers to and facilitators of implementation. Determinants related to older people using ICT tools are reported in several studies. To the best of our knowledge, studies investigating the determinants related to the social services perspective are lacking. Objective: This study aims to explore the determinants of implementing the Fik@ room, a new, co-designed, and research-based ICT tool for social interaction among older people, from a social services personnel perspective. Methods: This study used an exploratory, qualitative design. An ICT tool called the Fik@ room was tested in an intervention study conducted in 2021 in 2 medium-sized municipalities in Sweden. Informants in this study were municipal social services personnel with experience of implementing this specific ICT tool in social services. We conducted a participatory workshop consisting of 2 parts, with 9 informants divided into 2 groups. We analyzed the data using qualitative content analysis with an inductive approach. Results: The results included 7 categories of determinants for implementing the ICT tool. Being able to introduce the ICT tool in an appropriate manner concerns the personnel’s options for introducing and supporting the ICT tool, including their competencies in using digital equipment. Organizational structure concerns a structure for communication within the organization. Leadership concerns engagement and enthusiasm as driving forces for implementation. The digital maturity of the social services personnel concerns the personnel’s skills and attitudes toward using digital equipment. Resources concern time and money. IT support concerns accessibility, and legal liability concerns possibilities to fulfill legal responsibilities. Conclusions: The results show that implementation involves an entire organization at varying degrees. Regardless of how much each level within the organization comes into direct contact with the ICT tool, all levels need to be involved to create the necessary conditions for successful implementation. The prerequisites for the implementation of an ICT tool will probably change depending on the digital maturity of future generations. As this study only included 9 informants, the results should be handled with care. The study was performed during the COVID-19 pandemic, which has probably affected the results.
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| 4. |
- Gusdal, Annelie K, 1963-, et al.
(författare)
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Older Adults’ Use of a Research-Based Web Platform for Social Interaction
- 2023
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Ingår i: Healthcare. - : MDPI AG. - 2227-9032. ; 11:3
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Tidskriftsartikel (refereegranskat)abstract
- Loneliness and social isolation are triggers for unfavorable changes in older adults’ health and well-being. Information and communication technology (ICT) can be used by older adults to mitigate the negative effects of loneliness and social isolation. However, ICT needs to be customized to the specific needs and conditions of older adults. The aim of this study was to explore older adults’ use of a new, co-designed and research-based web platform for social interaction from the perspectives of older adults, researchers, and social services personnel. The study is an intervention study with a multimethod approach in which 20 older adults used the web platform for social interaction “the Fik@ room” for eight weeks. Quantitative and qualitative data were collected pretest, during the test, and posttest. The Fik@ room met the expectations of those older adults who completed the study. It enabled them to expand their social network and develop new friendships, but their experiences of loneliness were not reduced. The involvement of social services personnel in recruitment and support was important in facilitating older adults’ use of the Fik@ room. Our study contributes knowledge about a new, co-designed and research-based web platform, customized specifically for older adults, which is valuable in guiding the design and delivery of future web platforms for social interaction among older adults.
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| 5. |
- Gusdal, Annelie K, 1963-, et al.
(författare)
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Prerequisites for a healthy and independent life among older people : a Delphi study
- 2021
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Ingår i: Ageing & Society. - : Cambridge University Press. - 0144-686X .- 1469-1779. ; 41:9, s. 2171-2187
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Tidskriftsartikel (refereegranskat)abstract
- The number of older people (aged 65+) will more than double by 2050 in Sweden. The ageing population is an increasing concern due to rising health-care costs and a shortage of health professionals. Older people generally prefer ageing in place, as long as they feel confident and comfortable. However, preventive and supportive measures are needed to maintain older people's independence and active participation in society. The aim of this study is to explore the prerequisites for a healthy and independent life among older people in Sweden. A Delphi study was conducted in three rounds. In round 1, seven focus group interviews were performed with older persons aged 65-79, older persons aged >= 80, next of kin of older persons, health professionals in primary and home health care, assistant nurses in home care, care managers and local politicians. The data were analysed using thematic analysis, resulting in 35 statements of the prerequisites needed for a healthy and independent life. These statements were sent to the participants from round 1, who were asked to evaluate the degree to which they agreed with each statement in round 2, and again in round 3. There was an agreement of at least 80 per cent for 31 of the 35 statements. When asked to identify the three prerequisites of most importance for a healthy and independent life, most participants stated: to have a social life, to have freedom of choice and power over one's own situation, and to have the possibility to choose independently one's type of housing. There was an overall high group agreement on the prerequisites needed for a healthy and independent life among older people. The main areas of importance were to have a social life, several dimensions of feeling safe and to retain one's personal control.
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| 6. |
- Gusdal, Annelie K, 1963-, et al.
(författare)
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Preventing Falls and Malnutrition among Older Adults in Municipal Residential Care in Sweden : A Registry Study
- 2021
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Ingår i: Sage Open Nursing. - : SAGE Publications Inc.. - 2377-9608. ; 7
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Older adults in municipal residential care are among the most vulnerable and in need of most care. The prevalence of negative events, such as falls and malnutrition, is increased among these older adults. The need for strategies to prevent falls and malnutrition is emphasized in guidelines and systematic, individualized risk assessments are prerequisites for adequate interventions. Objectives: The overall purpose of this study was to investigate the assessed risks of, and risk factors for, falling and malnutrition and the correlations between these assessed risks among older women and men in residential care. Further, the purpose was to investigate the consistency between planned and performed interventions among women and men assessed as at risk. Methods: A cross-sectional registry study based on risk assessment data in the Swedish national quality registry, Senior Alert. Altogether, 5,919 older adults ≥65 in nursing homes and dementia care units in 19 municipalities in Sweden were included. Results: Of the older adults, 77% were at risk of falls, and 59% were at risk of malnutrition. The most prevalent risk factors for falls were previous falls and not being cognitively oriented; and for malnutrition were having mild or severe dementia or depression. A significant positive correlation between the risk of falling and the risk of malnutrition was found. Less than half of the planned interventions for falls and malnutrition were performed. Care staff’s least common interventions to prevent falls were balance, muscular function, and strength training, which contrasts with the recommendations; interventions to prevent malnutrition were only partially adhering to recommendations. Conclusions: This cross-sectional registry study points towards the importance of using an evidence-based approach, based on adherence to recommended guidelines, in the prevention of falling and malnutrition. Further, the implementation of clinical practice guidelines is needed, which requires educational training for care staff and supportive leadership.
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| 7. |
- Hjort-Telhede, Eva, 1968-
(författare)
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Health intervention with weighted blankets for frail older people with insomnia in nursing homes
- 2024
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Insomnia is a common health problem among frail older people in nursing homes. An alternative method of dealing with insomnia has been developed through weighted blankets. The overall aim was to explore and describe how older people with insomnia living in nursing homes are affected in terms of sleep, quality of life, ADL ability, nutritional status and medication after an intervention using a weighted blanket. The study uses a qualitative and quantitative approach to explore the experiences and outcomes of using the weighted blankets. It increases the opportunity to integrate different perspectives and methods to understand the weighted blanket sufficiently. Study I aimed to explore how frail older people insomnia living in nursing homes experience the use of a weighted blanket. Study II aimed to explore nursing staff’s experiences of how a weighted blanket-based intervention influenced nursing home residents’ self-rated health. Study III investigated the effects of weighted blankets on the health of older people nursing home residents in terms of QoL, sleep, nutrition, cognition, ADL, and medication needs. Study IV examined how weighted blankets affect the sleep patterns of frail older people living in nursing homes. The studies suggest that weighted blankets improve the sleep of frail older people living in nursing homes by reducing the number of times they wake during the night. They can also improve overall well-being, emotional state, cognitive function, nutritional status, and daytime activity levels. However, it is essential to consider individual differences, as some users may find the blankets uncomfortable. Study IV revealed that weighted blankets can improve the sleep and quality of life of older people nursing home residents. Their use constitutes a safe and non-pharmacological intervention, but more research is needed to explore the long-term effects.
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| 8. |
- Hoppe, Julia A., et al.
(författare)
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Assistive robots in care : Expectations and pereceptions of older people
- 2020
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Ingår i: Aging between Participation and Simulation. - : De Gruyter Open. ; , s. 139-156
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Bokkapitel (refereegranskat)abstract
- This chapter analyzes older people’s expectations and perceptions about welfare technology and in particular about robots in elderly care. Assistive robots may serve as a means to prolonged autonomy in old age as well as support for nursing staff. Justified by a rapid change in the health care sector, the need to focus on user driven and not technology driven development of assistive robots must be emphasized to ensure an adequate and sustainable orientation process toward assistive robots. This study presents an inventory of the expectations and perceptions of older people regarding assistive robots, by conducting a qualitative approach with focus group discussions. Our findings reveal that seven themes in particular need to be addressed in order to improve older people’s perceptions of robot technology: (1) independence and safety, (2) physical and mental assistance, (3) communication and socialization, (4) relief to nursing staff, (5) individual’s right to decide, (6) data protection, and (7) liability. Additionally, the focus group interviews stress that dissemination of information on how robots can provide assistance may change older people’s attitudes towards technology
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| 9. |
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| 10. |
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| 11. |
- Hoppe, J. A., et al.
(författare)
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When do individuals choose care robots over a human caregiver? : Insights from a laboratory experiment on choices under uncertainty
- 2023
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Ingår i: Computers in Human Behavior Reports. - : Elsevier B.V.. - 2451-9588. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- Demographic changes and a predicted shortage of nursing staff are progressively putting pressure on the healthcare system. Care robots may represent one part of a possible solution to this problem as they can assist care work. However, large parts of the population are reportedly skeptical about robotics in care, and field studies are difficult to conduct due to the low prevalence of real robotics in the field. Therefore, we follow an experimental approach pertaining to the question of individual decision-making. In this regard, we analyze the aspects that influence the individual's choice between a care robot and a human caregiver for assistance in their daily life. Our economic experiment is conducted in a virtual laboratory to examine specifically how quality uncertainty of care affects individual's decisions for and against robotic care. In the experiment, 162 participants fully completed the experiment in which they were asked to repeatedly choose between a human caregiver and a care robot. Our results reveal that, overall, the care robot is chosen more often than a human caregiver. At the same time, the quality uncertainty of care linked to a human caregiver barely affected the choice of participants. On the other hand, a participant's health status and their attitude toward direct interactions with care robots did partially affect their choice. Additionally, we explored causes for indecisiveness and its effect on the choice. Here, we found indecisive participants tending to choose a human caregiver more often.
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| 12. |
- Johansson-Pajala, Rose-Marie, et al.
(författare)
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A codesigned web platform for reducing social isolation and loneliness in older people : a feasibility study
- 2024
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Ingår i: Informatics for Health and Social Care. - : Informa UK Limited. - 1753-8157 .- 1753-8165.
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Tidskriftsartikel (refereegranskat)abstract
- Social isolation and loneliness are associated with negative health outcomes, physical as well as cognitive. Information and communication technology (ICT) can be effective tools for preventing and tackling social isolation and loneliness among older people. Our objective was to evaluate the feasibility of the Fik@ room, a web platform for social interaction designed for older people. A mixed methods design was applied, where both quantitative and qualitative data were collected during a 12-week period (n = 28, Md age 74). Experiences of loneliness were reduced using the Fik@ room. The results highlight the feasibility issues surrounding the recruitment process, adoption, pattern of use, usability, support service, and technical infrastructure. In particular, the importance of offering ICT solutions with few technical issues, and to provide easily accessible and appropriate support. The Fik@ room is a feasible tool for older people to develop new friendships, reduce loneliness, and grow their social networks. However, it is not a communication option that fits all. The results offer a compilation of feasibility issues that can serve as an inspirational guide in the design and implementation of similar technologies.
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| 13. |
- Johansson-Pajala, Rose-Marie, et al.
(författare)
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Care Robot Orientation : What, Who and How? Potential Users' Perceptions
- 2020
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Ingår i: International Journal of Social Robotics. - : Springer. - 1875-4791 .- 1875-4805. ; 12:5, s. 1103-1117
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Tidskriftsartikel (refereegranskat)abstract
- Exploring the specific field of care robot orientation generates many questions regarding the meaning, content and how it should be conducted. The issue is important due to the general digitalisation and implementation of welfare technology and care robots. The aim of the study was to explore perceptions of care robot orientation from the potential users' perspective. Data were collected by focus group interviews in Finland, Germany and Sweden. In all three countries, potential user groups were represented: older adults, relatives, professional caregivers and care service managers. A qualitative descriptive method was used for analysing data. The data revealed three aspects of care robot orientation: (1) What care robot orientation is, (2) Who needs it and by Whom it should be given and (3) How it should be performed. The need for care robot orientation is general in society. In the absence of knowledge about care robots, it is nearly impossible to know what to ask for or actually seek information about. Therefore, care robot orientation must be founded on agile implementation planning for care robots, with a firm basis in trustworthy knowledge and information and respecting individuals' wishes. This also gives rise to an ethical challenge when care robots are offered to people having reduced decision-making ability (dementia, cognitive impairment), along with the issue of who then should make the decision. The mapping of the What, Who/Whom and How aspects of care robot orientation offers a foundation for the creation of orientation models, which might facilitate structured and goal-oriented care robot orientation strategies.
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| 14. |
- Johansson-Pajala, Rose-Marie
(författare)
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Conditions for the Successful Implementation of Computer-Aided Drug Monitoring from Registered Nurses' Perspective : A Case Site Analysis
- 2019
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Ingår i: Computers, Informatics, Nursing. - : Lippincott Williams and Wilkins. - 1538-2931 .- 1538-9774. ; 37:4, s. 196-202
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Tidskriftsartikel (refereegranskat)abstract
- This research addressed the introduction of a computerized decision support system for drug monitoring to be used by registered nurses in nursing homes. The system was introduced, and its effects were evaluated over the period of 1 year; however, at the end of 1 year, the implementation was not successful in all the participating settings. The aim of this study was to identify the conditions needed for the successful implementation of a computerized decision support system from the registered nurses' perspective. Two case sites were purposively selected based on the implementation's success in one nursing home, but not in the other. Focus group discussions were performed, one in each setting, with eight registered nurses. An inductive thematic analysis was conducted. The findings revealed six themes illustrating the registered nurses' views about the conditions needed: need to see benefits, have the time and take the time, curb administrative hassle, collaboration at all levels, stated responsibility, and requirements set from managerial positions. The most outstanding findings, when compared with the previous implementations of nursing informatics, involved collaboration and the view of drug monitoring responsibility in relation to themselves and the physicians.
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| 15. |
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| 16. |
- Johansson-Pajala, Rose-Marie, et al.
(författare)
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Improved Knowledge Changes the Mindset : Older Adults’ Perceptions of Care Robots
- 2019
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Ingår i: Lecture Notes in Computer Science, vol. 11592. - Cham : Springer Verlag. - 9783030220112 ; , s. 212-227
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Konferensbidrag (refereegranskat)abstract
- This paper explores Finnish, German and Swedish older adults’ perceptions of a future welfare service with increased use of welfare technologies, specifically care robots. The issues are the rapid digitalization and development of health and welfare technology, which presently is mainly technology driven (not need or user driven), and the demographic challenge. The aim of the study was to explore older adults’ perception of the future use of welfare technology or care robots. A qualitative approach with focus group discussions was employed, followed by thematic analysis. The results are presented in four overall themes: the impact on daily life for older adults and professional caregivers, codes of practice and terms of use, dissemination of information and knowledge, and conditions for successful implementation. There were significant differences in the informants’ attitudes toward and knowledge about care robots. However, the informants’ attitudes appeared to change during the focus groups and in general, became more positive. Authentic needs, which care robots could support, refer to independence, safety and security, and the ability to manage or ease daily life or working life. The results suggest that older adults, after receiving relevant information, were open to the idea of being supported by care robots in their daily lives.
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| 17. |
- Johansson-Pajala, Rose-Marie, et al.
(författare)
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No thank you to humanized robots : attitudes to care robots in elder care services.
- 2022
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Ingår i: Home Health Care Services Quarterly. - : Informa UK Limited. - 0162-1424 .- 1545-0856. ; 41:1, s. 40-53
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Tidskriftsartikel (refereegranskat)abstract
- The growing older population will increase the demands on the health and welfare systems, including elder care services. One way of meeting these growing service needs is to shift from traditional care services to technologically oriented services. Robotic innovations are gradually being introduced to elder care services. The aim was to explore attitudes toward the use of care robots in elder care services - specifically focusing on situations and interaction, influence, and emotions in interaction with care robots. Data were obtained from visitors at a welfare technology fair (n = 124). The results show that the most negative attitudes concerned if the care robots were humanized and had emotions. The attitudes toward interacting with care robots in general were predominately positive. In conclusion, concrete usage scenarios in elder care services need to be detected, based both on users' needs, digital literacy and on the maturity of the technology itself.
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| 18. |
- Johansson-Pajala, Rose-Marie, et al.
(författare)
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Nurses in municipal care of the elderly act as pharmacovigilant intermediaries : a qualitative study of medication management
- 2016
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Ingår i: Scandinavian Journal of Primary Health Care. - : Informa UK Limited. - 0281-3432 .- 1502-7724. ; 34:1, s. 37-45
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To explore registered nurses' experience of medication management in municipal care of the elderly in Sweden, with a focus on their pharmacovigilant activities. Design: A qualitative approach using focus-group discussions was chosen in order to provide in-depth information. Data were analysed by qualitative content analysis. Setting: Five focus groups in five different long-term care settings in two regions in Sweden. Subject: A total of 21 registered nurses (RNs), four men and 17 women, aged 27-65 years, with 4-34 years of nursing experience. Results: The findings reveal that RNs in municipal long-term care settings can be regarded as vigilant intermediaries in the patients' drug treatments. They continuously control the work of staff and physicians and mediate between them, and also compensate for existing shortcomings, both organizational and in the work of health care professionals. RNs depend on other health care professionals to be able to monitor drug treatments and ensure medication safety. They assume expanded responsibilities, sometimes exceeding their formal competence, and try to cover for deficiencies in competence, experience, accessibility, and responsibility-taking. Conclusion: The RNs play a central but also complex role as vigilant intermediaries in the medication monitoring process, including the issue of responsibility. Improving RNs' possibility to monitor their patients' drug treatments would enable them to prevent adverse drug events in their daily practice. New strategies are justified to facilitate RNs' pharmacovigilant activities.
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| 19. |
- Johansson-Pajala, Rose-Marie, et al.
(författare)
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Nurses' use of computerised decision support systems affects drug monitoring in nursing homes
- 2017
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Ingår i: Journal of Nursing Management. - : Hindawi Limited. - 0966-0429 .- 1365-2834. ; 25:1, s. 56-64
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Tidskriftsartikel (refereegranskat)abstract
- AimTo describe variations in nurses' perceptions of using a computerised decision support system (CDSS) in drug monitoring. BackgroundThere is an increasing focus on incorporating informatics into registered nurses' (RNs) clinical practice. Insight into RNs' perceptions of using a CDSS in drug monitoring can provide a basis for further development of safer practices in drug management. MethodA qualitative interview study of 16 RNs. Data were analysed using a phenomenographic approach. ResultsThe RNs perceived a variety of aspects of using a CDSS in drug monitoring. Aspects of time' were evident, as was giving a standardisation' to the clinical work. There were perceptions of effects of obtained knowledge and evidence' and the division of responsibilities' between RNs and physicians of using the CDSS. ConclusionThe RNs perceived a CDSS as supportive in drug monitoring, in terms of promoting standardised routines, team-collaboration and providing possibilities for evidence-based clinical practice. ImplicationsImplementing a CDSS seems to be one feasible strategy to improve RNs' preconditions for safe drug management. Nurse managers' engagement and support in this process are vital for a successful result.
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| 20. |
- Johansson-Pajala, Rose-Marie
(författare)
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Pharmacovigilance in municipal elderly care : From a nursing perspective
- 2017
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Medication management constitutes a large part of registered nurses' (RNs) daily work in municipal elderly care. They are responsible for monitoring multimorbid older persons with extensive treatments, and they often work alone, without daily access to physicians. RNs’ drug monitoring is, in this thesis, based on the concept of pharmacovigilance. Pharmacovigilance is about the science and the activities that aim to improve patient care and safety in drug use, that is, to detect, assess, understand and prevent drug-related problems.The overall aim was to explore conditions for pharmacovigilance from a nursing perspective, focusing on implications of RNs’ competence and use of a computerized decision support system (CDSS). Both quantitative and qualitative research methods were used, including a questionnaire (I), focus group discussions (II), individual interviews (III) and an intervention study (IV). In total 216 RNs and 54 older persons participated from 13 special accommodations, located in three different regions.RNs who had completed further training in pharmacovigilance rated their medication competence higher than those who had not. However, there was no difference between groups in the number of pharmacovigilant activities they performed in clinical practice (I). The RNs appeared to act as “vigilant intermediaries” in drug treatment. They depended on the nursing staff's observations of drug-related problems. The RNs continuously controlled the work of staff and physicians, and attempted to compensate for shortcomings in competence, accessibility and continuity (II). RNs’ use of a CDSS was found to affect drug monitoring, including aspects of time, responsibility, standardization of the work, as well as access to knowledge and opportunities for evidence-based care (III). The CDSS detected significantly more drug-related problems when conducting medication reviews, than the RNs did. Nevertheless, this did not result in any significant improvement in the quality of drug use in the follow up, three and six months later (IV).This thesis contributes to the recognition of pharmacovigilance from a nursing perspective. Increased medication competence seems to be insufficient to generate pharmacovigilant activities. RNs depend on other health care professionals and organizational conditions in order to perform their work. A CDSS has the potential to support RNs, both in structured medication reviews and in daily clinical practice. Inter-professional collaboration is crucial, with or without a CDSS, and the entire team needs to be aware of and take responsibility. Other important conditions is the existence of well-functioning communication channels, competence across the team, and established procedures based on current guidelines.
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| 21. |
- Johansson-Pajala, Rose-Marie, et al.
(författare)
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Registered nurses’ use of computerised decision support in medication reviews : Implications in Swedish nursing homes
- 2018
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Ingår i: International Journal of Health Care Quality Assurance. - : Emerald Group Publishing Ltd.. - 0952-6862 .- 1758-6542. ; 31:6, s. 531-544
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The purpose of this paper is to explore the implications of registered nurses’ (RNs) use of a computerized decision support system (CDSS) in medication reviews. Design/methodology/approach: The paper employs a quasi-experimental, one-group pre-test/post-test design with three- and six-month follow-ups subsequent to the introduction of a CDSS. In total, 11 RNs initiated and prepared a total of 54 medication reviews. The outcome measures were the number of drug-related problems (DRPs) as reported by the CDSS and the RNs, respectively, the RNs’ views on the CDSS, and changes in the quality of drug treatment. Findings: The CDSS significantly indicated more DRPs than the RNs did, such as potential adverse drug reactions (ADRs). The RNs detected additional problems, outside the scope of the CDSS, such as lack of adherence. They considered the CDSS beneficial and wanted to continue using it. Only minor changes were found in the quality of drug treatments, with no significant changes in the drug-specific quality indicators (e.g. inappropriate drugs). However, the use of renally excreted drugs in reduced renal function decreased. Practical implications: The RNs’ use of a CDSS in medication reviews is of value in detecting potential ADRs and interactions. Yet, in order to have an impact on outcomes in the quality of drug treatment, further measures are needed. These may involve development of inter-professional collaboration, such as established procedures for the implementation of medication reviews, including the use of CDSS. Originality/value: This is, to the best of the authors’ knowledge, the first study to explore the implications of medication reviews, initiated and prepared by RNs who use a CDSS. The paper adds further insight into the RNs’ role in relation to quality of drug treatments.
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| 22. |
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| 23. |
- Martin, Lene, 1953-, et al.
(författare)
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Nurses' self-reported medication competence in relation to their pharmacovigilant activities in clinical practice
- 2015
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Ingår i: Journal of Evaluation In Clinical Practice. - : Wiley. - 1356-1294 .- 1365-2753. ; 21:1, s. 145-152
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Tidskriftsartikel (refereegranskat)abstract
- Rationale, aims and objectivesAdverse drug reactions (ADRs) represent a major health problem and previous studies show that nurses can have an active role in promoting medication safety. The aim of this study was to describe and evaluate nurses' self-reported competence and pharmacovigilant activities in clinical practice and also to explore the impact of age, education, workplace and nursing experience on these matters.MethodsThis cross-sectional study was based on a questionnaire covering areas related to nurses' medication competence, including knowledge, assessment and information retrieval, and pharmacovigilant activities within these areas, for example, the detection and assessment of ADRs. A 45-item questionnaire was 2013 sent out to 296 nurses in different settings and counties in Sweden. They were selected on the basis of having applied to a university course including pharmacovigilance during 2008–2011. One hundred twenty-four had participated in the courses (exposed) and 172 had applied to the courses but not participated (unexposed).ResultsCompleted questionnaires were obtained from 75 exposed (60%) and 93 unexposed (54%) nurses. Overall nurses rated themselves high in medication competence but low in pharmacovigilant activities. Significant (P ≤ 0.001) differences between groups were observed regarding medication competence. The exposure of completed dedicated courses in pharmacovigilance was the strongest factor for self-reported medication competence when adjusted for age, other education, workplace and experience. No significant differences between the groups were found regarding the number of pharmacovigilant activities during the 6 months prior to answering the questionnaire.ConclusionDedicated university courses improved nurses' self-reported competence in pharmacovigilance but did not increase the number of related activities. Education per se seems to be not sufficient to generate pharmacovigilant activities among nurses.
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| 25. |
- Pekkarinen, Satu, et al.
(författare)
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Embedding care robots into society and practice : Socio-technical considerations
- 2020
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Ingår i: Futures. - : Elsevier. - 0016-3287 .- 1873-6378. ; 122
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Tidskriftsartikel (refereegranskat)abstract
- Robots are not yet typical in daily use in elder care services, but recent studies suggest that they will soon be mainstream. In this study, we focus on the future of elder care, affected by the emergence of care robotics. We tackle the socio-technical transition—a multi-level change with a re-configuration of social and technological elements of the system—of elder care. The transition in the elder care system and the conditions of the embedding the robots in welfare services and society in three European countries, Germany, Sweden and Finland, are examined. Our qualitative study focuses on current situation in the use of robots in elder care as well as advancing and hindering elements in embedding robots into society and elder care practices. According to the results, there is a shift towards using robots in care, but remarkable inertia exists in both technological development and socio-institutional adaptation. Advancing and hindering elements in transition are both technical and social – and increasingly interrelated, which needs to be considered in management and policy measures to promote successful future transition pathways. The change of attitudes and embedding robots into society is promoted, for instance, by raising relevant knowledge on robots at different levels.
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| 26. |
- Tuisku, Outi, et al.
(författare)
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Assistant nurses and orientation to care robot use in three European countries
- 2022
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Ingår i: Behavior and Information Technology. - : Informa UK Limited. - 0144-929X .- 1362-3001.
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Tidskriftsartikel (refereegranskat)abstract
- This study investigates assistant nurses’ views on and needs for orientation to care robot use in three European countries. The use of care robots is gradually being incorporated into welfare services. Orientation to care robot use (in short, introduction to the use of the care robot technology) has thus become a key issue for care services. A survey was sent to assistant nurses in Finland, Germany, and Sweden, to which 302 participants responded (Finland n = 117; Germany n = 73; Sweden n = 112). Only 11.3% of assistant nurses had experience of giving orientation to care robot use to older adults or colleagues, but over 50% were willing to do so. Those with experience of using care robots should take part in orientation. Orientation to care robot use should be seen as part of care management and an issue that may affect the whole organisation. Management should, firstly, allow assistant nurses to get to know care robots by offering information, and secondly, consider with the assistant nurses the ways care robots can change their work and the implications of this change. Emphasising the social factors and practical orientation to care robot use extends the previous theories and perspectives of technology acceptance, adoption and diffusion.
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| 27. |
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| 28. |
- Zander, Viktoria, et al.
(författare)
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Methods to evaluate perspectives of safety, independence, activity, and participation in older persons using welfare technology. A systematic review
- 2019
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Ingår i: Disability and Rehabilitation. - : Informa UK Limited. - 1748-3107 .- 1748-3115. ; 15:4, s. 373-393
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To conduct a systematic review of existing methods to evaluate the individual aspects of welfare technology from the perspectives of independence, safety, activity, and participation. Furthermore, the study aimed to describe outcomes that have been the focus of previous research to evaluate individual aspects of welfare technology in older persons living in ordinary housing. Materials and methods: A systematic literature review in PubMed, CINAHL Plus, PsycINFO, Scopus, and Web of Science. Studies selected were those that explored the use of assistive and welfare technology devices from older persons’ perspectives, and which considered the concepts of independence, safety, activity and participation, and quality of life. Results: A broad spectrum of instruments was applied in the studies. For independence, three questionnaires were used in the identified studies. For safety, one instrument was used in two versions. To study activity and participation as well as quality of life, several scales were used. Additionally, several studies included qualitative approaches for evaluation, such as interviews, or posed one or more questions regarding the effects of welfare technology. Conclusions: The integration of digital assistive and welfare technology should be based on the needs of older persons, and those needs must be assessed using reliable and relevant instruments. The heterogeneity of the target group, i.e., older persons, together with the fact that assessments must give consideration to identifying goals, obstacles, and risks as well as users’ preferences, implies a person-centred approach.
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