| 1. |
- Andersson, Stefan, et al.
(författare)
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Valued and received forms of support among Swedish working carers of older people : a descriptive study with focus on ICT-mediated support
- 2019
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Ingår i: Technology and Disability. - : IOS Press. - 1055-4181 .- 1878-643X. ; 31:4, s. 189-202
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Working family carers are an important resource for the care of older people but can experience negativepressures without support.OBJECTIVE: This study examined the perceived value of forms of support and the level of receipt of valued forms of supportamong Swedish working carers, with a focus on information and communication technology (ICT)-mediated support.METHODS: A convenience sample (N = 129) of working carers caring for an older (> 65 years) relative completed a webbasedquestionnaire that addressed: caring characteristics; work-care conflict; and valued and received forms of support.RESULTS: Overall non-ICT forms of support were the most highly valued, while receipt of valued support was low: on averageonly 16.9% of participants who valued ICT-mediated forms of support received such support, while the figure was only slightlyhigher (23.4%) for non-ICT forms of support. Higher levels of work-care conflict were associated with higher perceived value ofsupport for 13 out of fourteen forms of support.CONCLUSIONS: The findings suggest that ICT-mediated and non-ICT forms of support should be regarded as complementary,while the low level of receipt of valued forms of support could indicate high levels of unmet need in working carers. Implicationsfor further research and policy on working carers are considered.
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| 2. |
- Ekman, Björn, et al.
(författare)
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Cost analysis of informal care : estimates from a national cross-sectional survey in Sweden
- 2021
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Ingår i: BMC Health Services Research. - : BioMed Central. - 1472-6963. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundOver the past decades, informal care has increased in most OECD-countries. Informal care is costly to caregivers and to society in the form of lost income and direct costs of providing care. Existing evidence suggests that providing informal care affects caregivers' overall health. However, estimates of the social costs of informal care based on national data on individuals are currently scarce.ObjectiveThis study contributes to the existing evidence on the costs of informal care by estimating the direct and indirect costs to caregivers using a purposive national household survey from Sweden.MethodsAdopting a bottom-up, prevalence approach, the direct and indirect costs are estimated using the survey data and the value of working time and leisure time from existing sources.ResultsThe results suggest that around 15% of the adult population of Sweden provide informal care and that such care costs around SEK 152 billion per year (around 3% of GDP; USD 16,3 billion; EUR 14,5 billion), or SEK 128000 per caregiver. Around 55% of costs are in the form of income loss to caregivers. The largest cost items are reduced work hours and direct costs of providing informal care. Replacing informal caregivers with professional care providers would be costly at around SEK 193,6 billion per year.ConclusionsFindings indicate that, even in a country with a relatively generous welfare system, significant resources are allocated toward providing informal care. The costing analysis suggests that effective support initiatives to ease the burden of informal caregivers may be cost-effective.
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| 3. |
- Falk Johansson, Marcus, et al.
(författare)
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A comparison of spouse and non-spouse carers of people with dementia : a descriptive analysis of Swedish national survey data
- 2021
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Ingår i: BMC Geriatrics. - : BioMed Central. - 1471-2318. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundBeing an informal carer of a person with dementia (PwD) can have a negative effect on the carer's health and quality of life, and spouse carers have been found to be especially vulnerable. Yet relatively little is known about the care provided and support received by spouse carers. This study compares spouse carers to other informal carers of PwDs regarding their care provision, the support received and the psychosocial impact of care.MethodsThe study was a cross-sectional questionnaire-based survey of a stratified random sample of the Swedish population aged 18 or over. The questionnaire explored how much care the respondent provided, the support received, and the psychosocial impact of providing care. Of 30,009 people sampled, 11,168 (37.7%) responded, of whom 330 (2.95%) were informal carers of a PwD.ResultsIn comparison to non-spouse carers, spouse carers provided more care more frequently, did so with less support from family or the local authority, while more frequently experiencing negative impacts on their social life and psychological and physical health. Spouse carers also received more carer support and more frequently experienced a closeness in their relationship with the care-recipient.ConclusionsSpouse carers of PwD differed from non-spouse carers on virtually all aspects of their care situation. Policy and practice must be more sensitive to how the carer-care-recipient relationship shapes the experience of care, so that support is based on an understanding of the individual carer's actual needs and preferences rather than on preconceptions drawn from a generalised support model.
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| 4. |
- Vicente, Joana, et al.
(författare)
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Informal care provision among male and female working carers : Findings from a Swedish national survey
- 2022
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Ingår i: PLOS ONE. - : Public Library of Science. - 1932-6203. ; 17:3
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Tidskriftsartikel (refereegranskat)abstract
- IntroductionInformal carers in paid employment–working carers (WKCs)—have complex support needs. However, little is known about WKCs’ pattern of informal care provision, the support they receive, the impact providing care has on their employment, and how these vary between male and female WKCs. This study describes the pattern of informal care provision and received support among Swedish WKCs.Research method/DesignThe study was a cross-sectional questionnaire-based survey of a stratified random sample of the Swedish population aged 18 or over. The questionnaire addressed the type and extent of informal care provided, support received and the impact of care provision on employment. Of the 30,009 people who received the questionnaire, 11,168 (37.3%) responded, providing an analytic sample of 818 (7.32% of respondents) employed or self-employed informal carers.FindingsA typical Swedish WKC was a middle-aged female, providing weekly or daily care to a non-cohabitant parent, who experiences care as sometimes demanding and receives no formal support as a carer. Female WKCs were more likely than males to care alone and with higher intensity, to report a need for help in meeting their care-recipient’s needs, and to experience care as demanding. Approximately 17% of WKCs reported their employment had been affected due to caring, 40% their ability to work, and 31% their career development opportunities. Female WKCs’ ability to work was affected more than males’, and they were more commonly prevented from applying for work.ConclusionSwedish female WKCs compared to males provide more hours of informal care, across more care domains, more often alone. This places them in a challenging situation when combining paid work and care. Greater recognition of the challenges faced by WKCs is required in Sweden and other countries, as are policies to reduce gender inequalities in informal care provision in this group.
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| 5. |
- Carstensen, Gunilla, 1964-, et al.
(författare)
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Before evening falls : Perspectives of a good old age and healthy ageing among oldest-old Swedish men
- 2019
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Ingår i: Archives of gerontology and geriatrics (Print). - : ELSEVIER IRELAND LTD. - 0167-4943 .- 1872-6976. ; 82, s. 35-44
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Tidskriftsartikel (refereegranskat)abstract
- The late life experiences of men in the oldest-old age group have been under-researched, and their perspectives on ageing successfully neglected. This study explored the perspectives of oldest-old Swedish men on what a 'good old age' and ageing successfully meant to them. A purposive sample of 17 men, aged 85-90 years, was drawn from the Uppsala Longitudinal Study of Adult Men. An interview guide explored participants' perspectives on their ageing experiences and how they viewed ageing successfully. Participants were interviewed twice, with 1-2 weeks between interviews, and both interviews were recorded and transcribed. Content analysis identified four themes: i) Adaptation, concerning the ability to adapt to growing old with increasing limitations; ii) Sustaining Independence, related to financial resources and good health as the foundation for independence; iii) Belongingness, representing close relationships, established friendships, and the significance of the spouse; and iv) Perspectives of Time, also a common thread in all themes, in which past life experiences create an existential link between the past, the present and the future, establishing continuity of the self and enhancing life satisfaction. The participants presented themselves as active agents involved in maintaining meaning and achieving life satisfaction; a process related to the ability to manage changes in life. Our findings have resonance with models of healthy or successful ageing, but also diverge in important ways, since such models do not consider the significance of an individual's life history for their present well-being, and primarily conceptualise health as an outcome, rather than as a resource.
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| 6. |
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| 7. |
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| 8. |
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| 9. |
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| 10. |
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| 11. |
- Dahlberg, Lena, 1970-, et al.
(författare)
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A social exclusion perspective on loneliness in older adults in the Nordic countries
- 2022
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Ingår i: European Journal of Ageing. - : Springer Science and Business Media LLC. - 1613-9372 .- 1613-9380. ; 19:2, s. 175-188
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Tidskriftsartikel (refereegranskat)abstract
- Several factors associated with loneliness are also considered indicators of social exclusion. While loneliness has been proposed as an outcome of social exclusion, there is limited empirical evidence of a link. This study examines the associations between social exclusion indicators and loneliness in older adults (60+ years) in four Nordic countries. Data from four waves of the European Social Survey were pooled, providing a total of 7755 respondents (Denmark n = 1647; Finland n = 2501, Norway n = 1540; Sweden n = 2067). Measures of loneliness, demographic characteristics, health, and eight indicators of social exclusion were selected from the survey for analysis. Country-specific and total sample hierarchical logistic regression models of loneliness were developed. Significant model improvement occurred for all models after social exclusion indicators were added to models containing only demographic and health variables. Country models explained between 15.1 (Finland) and 21.5% (Sweden) of the variance in loneliness. Lower frequency of social contacts and living alone compared to in a two-person household was associated with a higher probability of loneliness in all countries, while other indicators were associated with loneliness in specific countries: lower neighbourhood safety (Sweden and Denmark); income concern (Sweden and Finland); and no emotional support (Denmark, Finland, and Sweden). A robust relationship was apparent between indicators of social exclusion and loneliness with the direction of associations being highly consistent across countries, even if their strength and statistical significance varied. Social exclusion has considerable potential for understanding and addressing risk factors for loneliness.
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| 12. |
- Dahlberg, Lena, 1970-, et al.
(författare)
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A systematic review of longitudinal risk factors for loneliness in older adults
- 2021
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Ingår i: Aging & Mental Health. - : Informa UK Limited. - 1360-7863 .- 1364-6915. ; 26:2, s. 225-249
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To effectively reduce loneliness in older adults, interventions should be based on firm evidence regarding risk factors for loneliness in that population. This systematic review aimed to identify, appraise and synthesise longitudinal studies of risk factors for loneliness in older adults.METHODS: Searches were performed in June 2018 in PsycINFO, Scopus, Sociology Collection and Web of Science. Inclusion criteria were: population of older adults (M = 60+ years at outcome); longitudinal design; study conducted in an OECD country; article published in English in a peer-review journal. Article relevance and quality assessments were made by at least two independent reviewers.RESULTS: The search found 967 unique articles, of which 34 met relevance and quality criteria. The Netherlands and the United States together contributed 19 articles; 17 analysed national samples while 7 studies provided the data for 19 articles. One of two validated scales was used to measure loneliness in 24 articles, although 10 used a single item. A total of 120 unique risk factors for loneliness were examined. Risk factors with relatively consistent associations with loneliness were: not being married/partnered and partner loss; a limited social network; a low level of social activity; poor self-perceived health; and depression/depressed mood and an increase in depression.CONCLUSION: Despite the range of factors examined in the reviewed articles, strong evidence for a longitudinal association with loneliness was found for relatively few, while there were surprising omissions from the factors investigated. Future research should explore longitudinal risk factors for emotional and social loneliness.
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| 13. |
- Dahlberg, Lena, 1970-, et al.
(författare)
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Correlates of social and emotional loneliness in older people : evidence from an English community study
- 2014
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Ingår i: Aging & Mental Health. - : Taylor & Francis. - 1360-7863 .- 1364-6915. ; 18:4, s. 504-514
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Loneliness is an important influence on quality of life in old age, and has been conceptualised as consisting of two dimensions, social and emotional. This paper describes analyses that sought to produce models of social and emotional loneliness in older people, using demographic, psychological and health, and social variables.Method: Older people (aged 65+, N=1255) from the Barnsley metropolitan area of the United Kingdom were recruited randomly from within a stratified sampling frame, and received a questionnaire-based interview (response rate: 68.1%). The questionnaire contained items and scales on demographic, psychological and health and social characteristics, and a validated measure of loneliness that assesses both social and emotional loneliness.Results: Of the respondents, 7.7% were found to be severely or very severely lonely, while another 38.3% were moderately lonely. Social and Emotional Loneliness shared 19.36% variance. Being male, being widowed, low well-being, low self-esteem, low income comfort, low contact with family, low contact with friends, low Activity, low Perceived Community Integration, and receipt of community care were significant predictors of Social Loneliness (R=.50, R2=.25, F(18, 979)=18.17, p<.001). Being widowed, low well-being, low self-esteem, high activity restriction, low income comfort, and non-receipt of informal care were significant predictors of Emotional Loneliness (R=.55, R2=.30, F(18, 973)=23.00, p<.001).Conclusion: This study provides further empirical support for the conceptual separation of emotional and social loneliness. Consequently, policy on loneliness in older people should be directed to developing a range of divergent intervention strategies if both emotional and social loneliness are to be reduced.
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| 14. |
- Dahlberg, Lena, 1970-, et al.
(författare)
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Ensamhet bland äldre personer i Norden
- 2020
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Rapporten presenterar översikter av tidigare forskning och analyser av känslan av ensamhet bland äldre personer. Överlag finns det kunskap om ensamhetens konsekvenser för ohälsa, men det behövs ytterligare forskning där starkare slutsatser kan dras om sambandens riktning, och ett tydligare fokus på ensamhet i gruppen äldre personer. En systematisk översikt visar att det finns god kunskap om en del faktorer som ökar risken för ensamhet, men mer forskning behövs om andra potentiella riskfaktorer. Analyserna visar en relativt låg och stabil förekomst av ensamhet bland äldre personer i Norden, samt att ohälsa och olika indikatorer för social exkludering (t.ex. bristande sociala relationer, otillräcklig inkomst, samt otrygghet i närområdet) har samband med ensamhet. Slutligen konstateras att forskningen om nordiska interventioner för att minska ensamhet bland äldre personer är begränsad.
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| 15. |
- Dahlberg, Lena, 1970-, et al.
(författare)
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Living on the edge : Social exclusion and the receipt of informal care in older people
- 2016
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Ingår i: Journal of Aging Research. - : Hindawi Limited. - 2090-2204 .- 2090-2212. ; , s. 1-10
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Tidskriftsartikel (refereegranskat)abstract
- Older people have been identified as being at risk of social exclusion. However, despite the fact that care is commonly required in later life and the majority of that care provided by informal carers, a connection between social exclusion and informal care-receipt has rarely been considered. The aim of this study was to examine how informal care-receipt is related to social exclusion.A face-to-face questionnaire survey on social exclusion and informal care-receipt was carried out among older people (n=1255) living in Barnsley, United Kingdom. Multivariable analyses examined the association between social exclusion and categories of informal care-receipt: care receiver; assurance receiver; non-receiver with no need; non-receiver with need.Compared to being a non-receiver with no need participants were more likely to be a care receiver or assurance receiver if they had higher levels of social exclusion. The highest level of social exclusion, however, was found in non-receivers with need. Despite a lack of informal care and support, formal practical support and personal care was also low in this latter group. Findings are discussed in relation to the conceptualisation of care-receipt and how contact with medical services could be an opportunity for identification and appropriate referral of non-receivers with need.
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| 16. |
- Dahlberg, Lena, 1970-, et al.
(författare)
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Predictors of loneliness among older women and men in Sweden : A national longitudinal study
- 2014
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Objectives: To examine the extent to which older women and men (70+) report feelings of loneliness with a focus on: a) changes in reported loneliness as people age, and b) which factors predict loneliness.Methods: Data from the 2004 and 2011 waves of SWEOLD, a longitudinal national survey study, was used. The prediction of loneliness in 2011 by data collected in 2004 was examined in three logistic regression models for the total sample (n=587), for women and for men.Results: Older people moved in and out of frequent loneliness over time, but there was a general increase in loneliness as they aged. Recent widowhood and depression increment were associated with loneliness in both women and men. Loneliness, widowhood, depression and mobility problems measured in 2004 predicted loneliness uniquely in women in 2011; whereas low level of education and social contact reduction predicted loneliness uniquely in men.Discussion: Loneliness is not always a stable condition, demonstrating the importance of longitudinal research. Gender differences in incidence and predictors make it important to look at women and men separately both when researching loneliness and when targeting interventions to prevent or reduce loneliness in older people.
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| 17. |
- Dahlberg, Lena, 1970-, et al.
(författare)
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Predictors of loneliness among older women and men in Sweden : A national longitudinal study
- 2015
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Ingår i: Aging & Mental Health. - : Routledge. - 1360-7863 .- 1364-6915. ; 19:5, s. 409-417
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Longitudinal research on loneliness in old age has rarely considered loneliness separately for men and women, despite gender differences in life experiences. The objective of this study was to examine the extent to which older women and men (70+) report feelings of loneliness with a focus on: (a) changes in reported loneliness as people age, and (b) which factors predict loneliness.Method: Data from the 2004 and 2011 waves of SWEOLD, a longitudinal national survey, was used (n = 587). The prediction of loneliness in 2011 by variables measured in 2004 and 2004–2011 variable change scores was examined in three logistic regression models: total sample, women and men. Variables in the models included: gender, age, education, mobility problems, depression, widowhood and social contacts.Results: Older people moved into and out of frequent loneliness over time, although there was a general increase in loneliness with age. Loneliness at baseline, depression increment and recent widowhood were significant predictors of loneliness in all three multivariable models. Widowhood, depression, mobility problems and mobility reduction predicted loneliness uniquely in the model for women; while low level of social contacts and social contact reduction predicted loneliness uniquely in the model for men.Conclusion: This study challenges the notion that feelings of loneliness in old age are stable. It also identifies important gender differences in prevalence and predictors of loneliness. Knowledge about such differences is crucial for the development of effective policy and interventions to combat loneliness in later life.
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| 18. |
- Dahlberg, Lena, 1970-, et al.
(författare)
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Psychological, health and social predictors of emotional and social loneliness in older people
- 2013
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Ingår i: Proceedings of the 20th IAGG World Congress of Gerontology and Geriatrics, Seoul, Korea.
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Konferensbidrag (refereegranskat)abstract
- Background: Loneliness in old age has been shown to have negative outcomes such as mortality, physical and mental health problems, and reduced activity levels. To reduce loneliness in older people, factors associated with loneliness and open to intervention must be identified.Methods: Older people (aged 65+, N=1255) from the United Kingdom received a questionnaire-based interview (response rate: 66.0%). The questionnaire covered items on demographic, psychological, health and social characteristics. It also contained the de Jong-Gierveld Loneliness Scale (de Jong-Gierveld & Kamphuis, 1985), measuring Emotional and Social Loneliness.Findings: Eight percent of the respondents were found to be severely or very severely lonely, while another 38% were moderately lonely. Being female, widowed, low well-being, low self-esteem, high activity restriction, and high concern about personal finances were significant predictors of Emotional Loneliness (F(17, 976)=25.59, R2=.31, p<.001). Being female, widowed, low well-being, low self-esteem, high concern about personal finances, low contact with family, low contact with friends, low engagement, and low perceived community integration were significant predictors of Social Loneliness (F(17, 982)=19.63, R2=.25, p<.001).Discussion: This study provides empirical evidence for conceptual separation of emotional and social loneliness. Consequently, different targets for intervention are required in order to reduce emotional and social loneliness respectively, although psychological intervention has the potential to reduce both. Background: Loneliness in old age has been shown to have negative outcomes such as mortality, physical and mental health problems, and reduced activity levels. To reduce loneliness in older people, factors associated with loneliness and open to intervention must be identified.Methods: Older people (aged 65+, N=1255) from the United Kingdom received a questionnaire-based interview (response rate: 66.0%). The questionnaire covered items on demographic, psychological, health and social characteristics. It also contained the de Jong-Gierveld Loneliness Scale (de Jong-Gierveld & Kamphuis, 1985), measuring Emotional and Social Loneliness.Findings: Eight percent of the respondents were found to be severely or very severely lonely, while another 38% were moderately lonely. Being female, widowed, low well-being, low self-esteem, high activity restriction, and high concern about personal finances were significant predictors of Emotional Loneliness (F(17, 976)=25.59, R2=.31, p<.001). Being female, widowed, low well-being, low self-esteem, high concern about personal finances, low contact with family, low contact with friends, low engagement, and low perceived community integration were significant predictors of Social Loneliness (F(17, 982)=19.63, R2=.25, p<.001).Discussion: This study provides empirical evidence for conceptual separation of emotional and social loneliness. Consequently, different targets for intervention are required in order to reduce emotional and social loneliness respectively, although psychological intervention has the potential to reduce both.
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| 19. |
- Dahlberg, Lena, 1970-, et al.
(författare)
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Social exclusion and well-being among older adults in rural and urban areas
- 2018
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Ingår i: Archives of gerontology and geriatrics (Print). - : Elsevier BV. - 0167-4943 .- 1872-6976. ; 79, s. 176-184
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Tidskriftsartikel (refereegranskat)abstract
- Background: Social exclusion (SE) is a process that limits participation in society across life domains, and is associated with poor quality of life. Neighbourhood exclusion has been identified as particularly important for older adults. This paper examines the association between SE and well-being in older adults from urban and rural areas, focusing on neighbourhood exclusion. Methods: Using a cross-sectional survey design with a stratified sampling frame, participants (aged 65+) from rural (n = 628) and urban (n = 627) areas of Barnsley, United Kingdom, completed a questionnaire containing indicators of five SE domains: civic activity, material resources, social relationships, services and neighbourhood. Sequential multiple regression models were developed for 1) total sample; 2) rural areas; and 3) urban areas, with well-being regressed on SE indicators after controlling for self-reported health. Results: SE indicators explained 13.4% of the variance in well-being in the total sample (of which neighbourhood exclusion explained 1.2%); corresponding figures for the rural model were 13.8% (3.8%) and for the urban model 18.0% (1.7%); the addition of neighbourhood exclusion significantly improved all three models. Five SE indicators were significant in the rural model, compared with seven in the urban model, with four common to both. Discussion: Neighbourhood exclusion explained more variance in well-being in rural than urban areas, whereas exclusion from services explained more variance in urban than rural areas. Area characteristics and the role of neighbourhood should be considered in policy initiatives to reduce SE and promote well-being.
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| 20. |
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| 21. |
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| 22. |
- Dahlberg, Lena, 1970-, et al.
(författare)
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Trends and gender associations in social exclusion in older adults in Sweden over two decades
- 2020
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Ingår i: Archives of gerontology and geriatrics (Print). - : Elsevier BV. - 0167-4943 .- 1872-6976. ; 89
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Tidskriftsartikel (refereegranskat)abstract
- Background: Social exclusion in older adults is associated with lower well-being and poorer health. To date there has been little research on whether the level of social exclusion in older adults changes over time, and its association with gender.Aim: To examine trends and gender associations in social exclusion indicators in older adults for the years 1992, 2002 and 2011.Methods: Three waves of data from the Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD), a national survey of adults aged 77 years or older, were analysed: 1992 (n = 537), 2002 (n = 621), and 2011 (n = 904). Summative scales were created for four domains of social exclusion: material resources, social relations and leisure activities, civic participation, and services. Associations between gender and social exclusion within waves were examined as were trends in social exclusion across years.Results: The analyses of trends found significant reductions in exclusion in the domains of material resources and services. Higher levels of exclusion from material resources and civic participation were found in women than men. Within domains, significant trends and gender associations in exclusion were found on several indicators, with indicators showing opposing trends.Conclusion: Although levels of social exclusion have reduced in certain domains during the years examined, our results reflect the persistence of social exclusion in the population of older adults. This underlines the continuing importance of a well-developed welfare and social security system to ensure the social inclusion of vulnerable groups such as older adults.
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| 23. |
- Dahlberg, Lena, 1970-, et al.
(författare)
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Trends in social exclusion among older women and men in Sweden
- 2018
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Konferensbidrag (refereegranskat)abstract
- Background: Social exclusion is a framework for understanding the complexity of disadvantage across various domains of life such as material resources, social relations, civic activities and services. Reviews have identified a lack of gender perspective in social exclusion research. This paper will introduce the framework of social exclusion, and examine trends over time in the levels of social exclusion across different life domains for older women and men in Sweden.Methods: Data on indicators of social exclusion were analysed from respondents aged 76+ years who participated in the 1992, 2002 and 2011 waves of the nationally representative Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD).Results: There was evidence of a gender different in exclusion from material resources and civic activities, from which women were more often excluded than men. Regardless of gender there were improvements in access to material resources, such as owning a house/apartment. Social contacts (visiting or being visited by friends) decreased over time, while engagement in cultural activities and going to restaurants increased.Conclusions: Trends in social exclusion in older adults over the last 20 years are dependent on the domain considered. Over a range of indicators, older women were more vulnerable to exclusion than men, which needs to be taken into account in policy to combat exclusion.
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| 24. |
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| 25. |
- Elf, Marie, 1962, et al.
(författare)
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A systematic review of the psychometric properties of instruments for assessing the quality of the physical environment in healthcare
- 2017
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Ingår i: Journal of Advanced Nursing. - : Wiley. - 0309-2402 .- 1365-2648. ; 73:12, s. 2796-2816
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Tidskriftsartikel (refereegranskat)abstract
- Aim. To identify instruments measuring the quality of the physical healthcare environment, describe their psychometric properties. Background. The physical healthcare environment is regarded as a quality factor for health care. To facilitate evidence-based design there is a need for valid and usable instruments that can evaluate the design of the healthcare environment. Data sources. A systematic literature search in Medline, CINAHL, Psychinfo, Avery index and reference lists of eligible papers (1990-2016). Review method. Consensus based standards for selection of health measurement instruments guidelines were used to evaluate psychometric data reported. Results. Twenty-three instruments were included. Most of the instruments are intended for healthcare environments related to the care of older people. Many of the instruments were old, lacked strong, contemporary theoretical foundations, varied in the extent to which they had been used in empirical studies and in the degree to which their validity and reliability had been evaluated. Conclusions. Although we found many instruments for measuring the quality of the physical healthcare environment, none met all of our criteria for robustness. Of the instruments, The Multiphasic environmental assessment procedure, The Professional environment assessment protocol and The therapeutic environment screening have been used and tested most frequently. The Perceived hospital quality indicators are user centred and combine aspects of the physical and social environment. The Sheffield care environment assessment matrix has potential as it is comprehensive developed using a theoretical framework that has the needs of older people at the centre. However, further psychometric and user-evaluation of the instrument is required.
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| 26. |
- Elf, Marie, et al.
(författare)
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Development of an instrument measuring the quality of residential care facilities for older people
- 2016
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Ingår i: The 23rd Nordic Congress of Gerontology, 19-22 June 2016, in Tampere, Finland.
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Konferensbidrag (refereegranskat)abstract
- Aims. To validate the Swedish version of the Sheffield Care Environment Assessment Matrix (S-SCEAM). The instrument’s items measure environmental elements important for supporting the needs of older people, and conceptualized within eight domains.Methods. Item relevance was assessed by a group of experts and measured using content validity index (CVI). Test-retest and inter-rater reliability tests were performed. The domain structure was assessed by the inter-rater agreement of a second group of experts, and measured using Fleiss kappa.Results. All items attained a CVI above 0.78, the suggested criteria for excellent content validity. Test-retest reliability showed high stability (96% and 95% for two independent raters respectively), and inter-rater reliability demonstrated high levels of agreement (95% and 94% on two separate rating occasions). Kappa values were very good for test-retest (κ = 0.903 and 0.869) and inter-rater reliability (κ = 0.851 and 0.832). Domain structure was good, Fleiss’ kappa was 0.63 (range 0.45 to 0.75). Conclusion. The S-SCEAM of 210 items and eight domains showed good content validity and construct validity. The instrument is suggested for use in measuring of the quality of the physical environment in residential care facilities for older persons.
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| 27. |
- Fagerberg, Johan, 1992-, et al.
(författare)
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The unreflective practitioner : A pilot study on functional stupidity and social work
- 2020
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Ingår i: European Journal of Social Work. - : Informa UK Limited. - 1369-1457 .- 1468-2664. ; , s. 1-13
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Tidskriftsartikel (refereegranskat)abstract
- This study’s aim was to operationalise and test a model of functional stupidity, a form of unreflective compliance, and explore its appropriateness for understanding how social workers comply with and motivate performing morally or professionally problematic tasks. A sample of 120 social workers from six municipalities in Sweden self-completed a questionnaire containing 20 Likert-type items denoting 10 ‘stupidity rationales’ within three reflective modes of compliance, and a measure of work satisfaction. Most functional stupidity items performed well, with social workers endorsing several rationales for being unreflective at work. Associations among items supported most elements of the model. Both being older and having more work experience were associated with endorsing the fun rationale, while being older was also associated with endorsing rationales within the despair mode. Endorsing cynical mode rationales was associated with lower work satisfaction, while endorsing the fun rationale was associated with higher work satisfaction. This is the first study to operationalise and empirically test the concept of functional stupidity using a quantitative approach. The results indicate that the model has value for understanding how social workers’ reflexivity about professional hardships can facilitate periods of unreflective performance that, for good and bad, helps them through the working day.
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| 28. |
- Falk Johansson, Marcus, et al.
(författare)
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Negative Impact and Positive Value of Caregiving in Spouse Carers of Persons With Dementia in Sweden
- 2021
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Ingår i: Family Caregiving and Persons with Dementia. - : Oxford University Press (OUP). ; , s. 154-
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Konferensbidrag (refereegranskat)abstract
- As welfare providers struggle to meet the care needs of persons with dementia (PwDs), most of their needs are being met by a family carers, most often a spouse. The situation for spouse carers is unique, e.g., with grief, loneliness and loss of intimacy combining with stress and poor health. Research is needed to develop adequate support for spouse carers based on evidence of what influences negative and positive outcomes of care. The present study investigated psychosocial correlates of spouse carers’ (i) negative impact and (ii) positive value of caring. Data from a cross-sectional survey of 165 spouse carers community-resident in Sweden was analysed in two hierarchical regression models to predict negative impact and positive value of caring. Results found that negative impact and positive value were explained by different variables, significant predictors for negative impact included carer stress, health, and emotional loneliness, and change in intimacy with the care-recipient, while positive value was predicted by mutuality, change in closeness to the care-recipient and quality of support. Negative impact and positive value shared variance of only 17.2%. Thus, negative impact and positive value represent different aspects of the carer situation. Consequently, support needs to target several aspects in carers’ life, aiming to; facilitate for spouses to manage PwD’s impairment, increase emotional support while also strengthening the relationship between carer and PwD to reduce negative impact while increasing positive value.
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| 29. |
- Falk Johansson, Marcus, et al.
(författare)
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Negative Impact and Positive Value of Caregiving in Spouse Carers of Persons with Dementia in Sweden
- 2022
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 19:3
-
Tidskriftsartikel (refereegranskat)abstract
- (1) Background: Spouse carers of persons with dementia (PwD) are particularly vulnerable to negative outcomes of care, yet research rarely focuses on their caregiving situation. This study explores factors associated with the positive value and negative impact of caregiving in spouse car-ers of PwD in Sweden. (2) Methods: The study was a cross-sectional questionnaire-based survey, with a convenience sample of spouse carers of PwD (n = 163). The questionnaire addressed: care situation, carer stress, health and social well-being, relationship quality and quality of support, and contained measures of positive value and negative impact of caregiving. (3) Results: Hierarchical regression models explained 63.4% variance in positive value and 63.2% variance in negative impact of caregiving. Three variables were significant in the model of positive value: mutuality, change in emotional closeness following dementia and quality of support. Six variables were significant in the model of negative impact: years in relationship, years as carer, behavioural stress, self-rated health, emotional loneliness and change in physical intimacy following dementia. (4) Conclusions: Support to spouse carers of PwD should address the carer–care-recipient relationship quality, although different aspects of the relationship should be addressed if both the positive value of caregiving is to be enhanced and the negative impact reduced.
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| 30. |
- Falk Johansson, Marcus, et al.
(författare)
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Spouse’s supported and unsupported care of persons with dementia : Home care and the informal caregiver’s perspective
- 2021
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Konferensbidrag (refereegranskat)abstract
- Introduction. Caring for a person with dementia (PWD) can negatively affect the quality of life of informal carers, and research suggests spouse carers, often being older, are particularly vulnerable and requiring of support. Yet the formal support offered is rarely tailored to meet the needs of spouse carers of PWDs. The aim of the present study was to compare spouse carers to other carers of PWDs on a range of factors, as a foundation for a better understanding of their support needs. Material and methods. Cross-sectional survey. In late 2018 a random stratified sample was taken of the Swedish population aged 18 and older. Of 30,009 people contacted, 11,168 completed and returned a questionnaire or completed a web-based version, a response rate of 37.3%. The questionnaire contained questions on whether the respondent was an informal carer for another person, the extent of care provided, contact with and support received from formal services, and impacts of care.Results. Of the respondents, 378 (3.38%) were carers of PWDs, of whom 107 (28.3%) were spouse carers. Spouse carers compared to other carers of PWD provide care more intenselyand are more informed on their right to support from local authorities. While more often being offered formal support in their carer role, they are less supported in providing care and report a higher negative impact (for all p<.05). Conclusions. Formal support is offered to spouse carers in their carer role, but might not be tailored to their specific needs of support.
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| 31. |
- Lüdecke, Daniel, et al.
(författare)
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For better or worse : Factors predicting outcomes of family care of older people over a one-year period. A six-country European study
- 2018
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 13:4
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Demographic change has led to an increase of older people in need of long-term care in nearly all European countries. Informal carers primarily provide the care and support needed by dependent people. The supply and willingness of individuals to act as carers are critical to sustain informal care resources as part of the home health care provision. This paper describes a longitudinal study of informal care in six European countries and reports analyses that determine those factors predicting the outcomes of family care over a one-year period.METHODS: Analyses are based on data from the EUROFAMCARE project, a longitudinal survey study of family carers of older people with baseline data collection in 2004 and follow-up data collection a year later in six European countries (Germany, Greece, Italy, Poland, Sweden, and the United Kingdom), N = 3,348. Descriptive statistics of the sample characteristics are reported. Binary logistic random-intercept regressions were computed, predicting the outcome of change of the care dyad's status at follow-up.RESULTS: Where care is provided by a more distant family member or by a friend or neighbour, the care-recipient is significantly more likely to be cared for by someone else (OR 1.62) or to be in residential care (OR 3.37) after one year. The same holds true if the care-recipient has memory problems with a dementia diagnosis (OR 1.79/OR 1.84). Higher dependency (OR 1.22) and behavioural problems (OR 1.76) in the care-recipient also lead to a change of care dyad status. Country of residence explained a relatively small amount of variance (8%) in whether a care-recipient was cared for by someone else after one year, but explained a substantial amount of variance (52%) in whether a care-recipient was in residential care. Particularly in Sweden, care-recipients are much more likely to be cared for by another family or professional carer or to be in residential care, whereas in Greece the status of the care dyad is much less likely to change.DISCUSSION: The majority of family carers continued to provide care to their respective older relatives over a one-year period, despite often high levels of functional, cognitive and behavioural problems in the care-recipient. Those family carers could benefit most from appropriate support. The carer/care-recipient relationship plays an important role in whether or not a family care dyad remains intact over a one-year period. The support of health and social care services should be particularly targeted toward those care dyads where there is no partner or spouse acting as carer, or no extended family network that might absorb the caring role when required. Distant relatives, friends or acquaintances who are acting as carers might need substantial intervention if their caregiving role is to be maintained.
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| 32. |
- Marmstål Hammar, Lena, 1979-, et al.
(författare)
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Being ‘alone’ striving for belonging and adaption in a new reality : The experiences of spouse carers of persons with dementia
- 2021
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Ingår i: Dementia. - : Sage Publications. - 1471-3012 .- 1741-2684. ; 20:1, s. 273-290
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Tidskriftsartikel (refereegranskat)abstract
- Background and aimSpouse carers of a person with dementia report feeling lonely and trapped in their role, lacking support and having no time to take care of their own health. In Sweden, the support available for family carers is not specialised to meet the needs of spouse carers of people with dementia. The aim of the study described in this paper was to explore spouse carers’ experiences of caring for a partner with dementia, their everyday life as a couple and their support needs.MethodsNine spouse carers of a partner with dementia living at home were recruited through a memory clinic and a dementia organisation. Semi-structured interviews were conducted with the participants, focusing on their experiences of providing care, their support needs in relation to their caring situation, their personal well-being and their marital relationship. The interviews were transcribed and underwent qualitative content analysis.ResultsThe analysis resulted in one overall theme Being ‘alone’ striving for belonging and adaption in a new reality, synthesized from four sub-themes: (1) Being in an unknown country; (2) Longing for a place for me and us; (3) Being a carer first and a person second; and (4) Being alone in a relationship.ConclusionsThe training of care professionals regarding the unique needs of spouse carers of people with dementia needs improvement, with education, in particular, focusing on their need to be considered as a person separate from being a carer and on the significance of the couple’s relationship for their mutual well-being.
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| 33. |
- Marmstål Hammar, Lena, 1979-, et al.
(författare)
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Exhausted and trapped in isolation. Caring for a spouse with dementia during the Covid-19 pandemic
- 2021
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Ingår i: Family Caregiving (HS Poster). - : Oxford University Press (OUP). ; , s. 800-801
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Konferensbidrag (refereegranskat)abstract
- Even before the Covid-19 pandemic, spouse carers of persons with dementia (PwDs) found their care responsibilities overwhelming and had little time to focus on their own lives. To minimize the risk of being infected with Covid-19, older persons are recommended to self-isolate in their homes, while formal support such as respite care and day care centers are withdrawn. This study involved semi-structured interviews with 24 spouse carers of community-living PwDs, with the aim of describing their situation during the pandemic. The interviews were analyzed with qualitative content analysis. Results revealed that they commonly declined help because of the perceived risk of their spouse being infected with Covid-19 and thus also possibly causing their death. They described feelings of being trapped in their situation, as they experienced having no choice than take all responsibility for the care of their partner themselves, with cost of being unable to take necessary breaks. This was described as making an already strained situation almost unbearable, which led to conflicts with their partner. However, the spouses also described positive aspects due to strategic changes in health and social care provision to prevent the spread of the virus, such as greater staff continuity in home care services, and patient transportation service. These made the PwD less stressed and influenced their everyday life positively. It could be concluded that the extent burden during the Covid-19 pandemic calls for extensive development of tailored support to better tackle the rapid changes that can occur in a society.
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| 34. |
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| 35. |
- Mauritzson, Elin, et al.
(författare)
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Older Adults' Experiences, Worries and Preventive Measures Regarding Home Hazards : A Survey on Home Safety in Sweden
- 2023
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 20:2
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Tidskriftsartikel (refereegranskat)abstract
- Home safety is important for preventing injuries and accidents among older adults living at home. Feeling safe at home is also essential for older adults' well-being. Thus, this study aimed to explore older adults' perceptions of safety in their homes by examining their experiences, worries and preventive measures in relation to a range of potential home-based health and safety hazards. The study was a national cross-sectional telephone survey of 400 randomly selected adults over 70 years of age living at home in ordinary housing in Sweden. Participants were asked for their experience of, worry about, and preventive measures taken regarding fifteen home hazards. Data were also collected on background variables including age, health, and cohabitation status. Falls and stab/cut injuries were the most experienced hazards and worry was highest for burglary and falls, while preventive measures were most common for fire and burglary. While older adults' experience and worry regarding home hazards were associated with preventive measures, these associations were not strong and other factors were associated with preventive behaviour. Further identification of the main determinants of older adults' preventive behaviour can contribute to policy for effectively reducing home accidents.
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| 36. |
- Mauritzson, Elin, et al.
(författare)
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Perceptions and experiences of safety at home : a survey among older adults in Sweden
- 2022
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Ingår i: 26th Nordic Congress of Gerontology. Abstracts. ; , s. 277-277
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Konferensbidrag (refereegranskat)abstract
- IntroductionHome safety is important to prevent injuries and accidents in older adults living at home. Feeling safe at home is also essential for frail older adults’ well-being. "Ageing in place" is a term focusing on enabling older adults to stay in their ordinary homes, rather than in special housing. But when older adults continue living at home, more injuries and accidents can occur. The aim of this study was to explore older adults’ experiences, preventive measures, and feelings of safety in their home in relation to a range of potential home-based health and safety hazards.Methods and MaterialsThe study had a cross-sectional design and was based on a national telephone survey among 400 adults over 70 years of age, living at home in ordinary housing in Sweden. Descriptive and comparative statistics were used to analyse the data.ResultsThe participants rated the importance of feeling safe at home as high, and seldom felt unsafe. Higher age, greater frequency of feeling unsafe at home or in the neighbourhood, access to support, better health, importance of safety and living alone were associated with level of worry or for having taken preventive measures against some but not all hazards in the home.ConclusionsTaking preventive measures is not always is not always associated with experiences or level of worry. Age, feelings of safety, access to support, health and living alone or not, are all factors that can influence level of worry or for taking preventive measures or not against specific hazards in the home.
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| 37. |
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| 38. |
- McKee, Kevin, 1961-, et al.
(författare)
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Developmentand initial validation of the Staff Perception Of Residential care Environments (SPORE) instrument
- 2019
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Konferensbidrag (refereegranskat)abstract
- Staff perceptions of the health care environment influence the delivery of person-centred care. Little research has examined staff perceptions of health care environments, in part because of a lack of validated instruments. This study reports the development and initial validation of the Staff Perception Of Residential care Environments (SPORE) instrument for use in residential care facilities for older people (RCFs).Items developed in a British project on the design of care environments were translated and adapted for the Swedish care context as SPORE (24 items, 5 sub-scales). In a study of the physical environment and quality of care, 200 staff recruited from 20 RCFs sampled from across Sweden completed a questionnaire containing SPORE, the Person-centred Care Assessment Tool (PCAT), the Person-centred Climate Questionnaire – staff version (PCQ-S), and the Sheffield Care Environment Assessment Matrix –Sweden (SCEAM-S).All SPORE sub-scales were normally distributed with good internal consistency reliability (Cronbach αs=.85-.88). Correlations between SPORE and PCAT sub-scales ranged from .301-.503, and between SPORE and PCQ-S sub-scales from .353-.557. RCF-level analyses (N=20) indicated that scores on SCEAM overall environment quality correlated significantly with all SPORE sub-scales (range=.496-.700). The SCEAM Comfort sub-scale was correlated with all SPORE sub-scales (range=.509-.721), while the SCEAM Privacy sub-scale was correlated (r=.428) with the SPORE Staff Facilities sub-scale. The SPORE Working and Caring for Residents sub-scale was correlated with SCEAM cognitive support (r=.502) and physical support (r=.566) sub-scales.The SPORE instrument demonstrated good psychometric properties and its sub-scales an excellent range of associations with staff perceptions of person-centred care and with objective assessments of the physical environment. Further validation is required, but the SPORE instrument has potential for understanding how staff perceptions of the RCF environment relate to the delivery of person-centred care.
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| 39. |
- McKee, Kevin, 1961-, et al.
(författare)
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Five Years From Now : Correlates of Older People's Expectation of Future Quality of Life
- 2015
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Ingår i: Research on Aging. - : SAGE Publications. - 0164-0275 .- 1552-7573. ; 37:1, s. 18-40
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Tidskriftsartikel (refereegranskat)abstract
- Few studies have explored older people's expected future quality of life (QoL), despite evidence that perceptions of one's future influence healthy aging. Research on this topic should embrace a range of potential influences, including perceptions of one's neighborhood and region. This study examined expected QoL in a random sample of the population of Dalarna, a Swedish region. A self-completion questionnaire assessed demographic characteristics, current neighborhood and regional evaluations, self-evaluations, expectations for the future, and current and expected QoL. In total, 786 people aged 65 years participated. A sequential multiple regression model explained 44% of the variance in older people's expected QoL, with self-reported health (sr(2) = .03), Expected Regional Opportunity (sr(2) = .03), and Perceived Regional Status (sr(2) = .02) having the strongest associations with expected QoL. Research on the importance of one's neighborhood to QoL in older people should encompass people's perceptions of their region, to better inform social policy for healthy aging.
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| 40. |
- McKee, Kevin, 1961-, et al.
(författare)
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Five years from now : Correlates of older people’s expectation of future quality of life
- 2014
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Ingår i: Age Well - Challenges for Individuals and Society.
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Konferensbidrag (refereegranskat)abstract
- Few studies have explored older people’s expected future quality of life (QoL), despite evidence that perceptions of one’s future influence healthy ageing. Research on this topic should embrace a range of potential influences, including perceptions of one’s neighbourhood and region. This study examined expected QoL in a random sample of the population of Dalarna, a Swedish region. A self-completion questionnaire assessed demographic characteristics, current neighbourhood and regional evaluations, self-evaluations, expectations for the future, and current and expected QoL. In total, 786 people aged ≥ 65 years participated. Current QoL was favourably evaluated, and while expected QoL also received a positive assessment, the mean value for expected QoL was notably lower than that for current QoL (t(755)=24.06, p<.05). Indeed, only 3.6% (n=27) of participants rated their expected QoL higher than their current QoL. A sequential multiple regression model explained 44% of the variance in older people’s expected QoL. Nine IVs were significant (p<.05) in the final model of expected QoL: current QoL (1% unique variance explained), age (1%), education level (1%), Regional Development Beliefs (1%), Perceived Regional Status (2%), self-reported health (3%), social influence (1%), Expected Regional Opportunity (3%) and expected change in housing need (1%). Our findings establish the significance of an older person’s perception of their locality for their expected future QoL. Policies that focus only on individual and relational factors for the promotion of healthy ageing are overlooking the potential contribution of an older person’s connection to their neighbourhood and region.
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| 41. |
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| 42. |
- McKee, Kevin, 1961-, et al.
(författare)
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Psychosocial factors in healthy ageing
- 2015
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Ingår i: Psychology and Health. - : Informa UK Limited. - 0887-0446 .- 1476-8321. ; 30:6, s. 607-626
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Tidskriftsartikel (refereegranskat)
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| 43. |
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| 44. |
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| 45. |
- Mocumbi, Sibone, et al.
(författare)
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Ready to deliver maternal and newborn care? Health providers' perceptions of their work context in rural Mozambique
- 2018
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Ingår i: Global Health Action. - : Informa UK Limited. - 1654-9880 .- 1654-9716. ; 11:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Deficiencies in the provision of evidence-based obstetric care are common in low-income countries, including Mozambique. Constraints relate to lack of human and financial resources and weak health systems, however limited resources alone do not explain the variance. Understanding the healthcare context ahead of implementing new interventions can inform the choice of strategies to achieve a successful implementation. The Context Assessment for Community Health (COACH) tool was developed to assess modifiable aspects of the healthcare context that theoretically influence the implementation of evidence. Objectives: To investigate the comprehensibility and the internal reliability of COACH and its use to describe the healthcare context as perceived by health providers involved in maternal care in Mozambique. Methods: A response process evaluation was completed with six purposively selected health providers to uncover difficulties in understanding the tool. Internal reliability was tested using Cronbach's a. Subsequently, a cross-sectional survey using COACH, which contains 49 items assessing eight dimensions, was administered to 175 health providers in 38 health facilities within six districts in Mozambique. Results: The content of COACH was clear and most items were understood. All dimensions were near to or exceeded the commonly accepted standard for satisfactory internal reliability (0.70). Analysis of the survey data indicated that items on all dimensions were rated highly, revealing positive perception of context. Significant differences between districts were found for the Work culture, Leadership, and Informal payment dimensions. Responses to many items had low variance and were left-skewed. Conclusions: COACH was comprehensible and demonstrated good reliability, although biases may have influenced participants' responses. The study suggests that COACH has the potential to evaluate the healthcare context to identify shortcomings and enable the tailoring of strategies ahead of implementation. Supplementing the tool with qualitative approaches will provide an in-depth understanding of the healthcare context.
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| 46. |
- Naseer, Mahwish, et al.
(författare)
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Individual and contextual predictors of emergency department visits among community-living older adults : a register-based prospective cohort study
- 2022
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 12:2
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To examine the extent to which contextual factors explain emergency department (ED) visits and ED revisits, additional to that explained by individual factors.DESIGN: A register-based prospective cohort study.SETTING: Swedish region of Dalarna.PARTICIPANTS: Participants were 16 543 community-living adults aged 80 or older who were residents of the Dalarna region of Sweden, excluding older adults who moved out of Dalarna or into residential care during the study period.OUTCOME MEASURES: Dependent variables were initial ED visit, and at least one ED revisit within 30 days of an initial ED visit.RESULTS: Approximately 36% of the participants visited the ED during the study period with 18.9% returning to the ED within 30 days. For both initial ED visits and ED revisits, the addition of contextual factors to models containing individual factors significantly improved model fit (p<0.001; p<0.022) and the amount of variance explained in the outcome. In the final models, initial ED visit was significantly associated with older age, number of chronic diseases, receipt of home help, number of primary care visits, proportion of 80+ in the population and shorter distance to the ED; while an ED revisit was significantly associated with greater use of social care, number of hospital admissions and disposition (discharged; admitted to hospital) at initial ED visit.CONCLUSION: Contextual factors explain variance in initial ED visit, additional to that explained by individual factors alone, which indicates inequitable access to ED care. These findings suggest considering local variations in contextual factors in order to improve health-related outcomes among older adults.
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| 47. |
- Nilsen, Charlotta, et al.
(författare)
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Long-term risk factors for old-age social exclusion in Sweden : a 30-year longitudinal study
- 2022
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Ingår i: Archives of gerontology and geriatrics (Print). - : Elsevier BV. - 0167-4943 .- 1872-6976. ; 103
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Tidskriftsartikel (refereegranskat)abstract
- Purpose of the research: Social exclusion threatens quality of life in older age. However, there is a lack of research on social exclusion from life-course and gender perspectives. We investigated early-and midlife risk factors for old-age social exclusion among women and men.Materials and methods: Two individually linked studies of Swedish nationally representative samples provided longitudinal data over a 30-year period on 1,819 people at baseline. Indicators of economic exclusion, leisure/ social exclusion, and civic exclusion were assessed at early late life (M=70 years) and late life (M=81). Educational attainment, non-employment, psychological health problems and mobility problems were measured as risk factors at midlife (M=54) and late midlife (M=61). Path analysis derived a model of old-age social exclusion.Results: Exclusion on a domain in early late life led to exclusion on the same domain in late life, except for the economic domain. Leisure/social exclusion in early late life also led to civic exclusion in late life. Midlife risk factors influenced late-life exclusion almost exclusively through early late-life exclusion. While model fit could not be significantly improved by allowing coefficients to vary freely by gender, there was a stronger effect of non -employment on exclusion in women and a stronger effect of psychological health problems on exclusion in men.Conclusions: This study confirms that old-age exclusion is persistent and dynamic, and influenced by risk factors experienced earlier in life. A holistic approach with integrated efforts across different policy areas is needed to efficiently reduce old-age social exclusion.
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| 48. |
- Nordin, Susanna, et al.
(författare)
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Assessing the physical environment of older people’s residential care facilities: development of the Swedish version of the Sheffield Care Environment Assessment Matrix (S-SCEAM)
- 2015
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Ingår i: BMC Geriatrics. - : Springer Science and Business Media LLC. - 1471-2318. ; 15:3, s. 1-11
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundThere is emerging evidence that the physical environment is important for health, quality of life and care, but there is a lack of valid instruments to assess health care environments. The Sheffield Care Environment Assessment Matrix (SCEAM), developed in the United Kingdom, provides a comprehensive assessment of the physical environment of residential care facilities for older people. This paper reports on the translation and adaptation of SCEAM for use in Swedish residential care facilities for older people, including information on its validity and reliability.MethodsSCEAM was translated into Swedish and back-translated into English, and assessed for its relevance by experts using content validity index (CVI) together with qualitative data. After modification, the validity assessments were repeated and followed by test-retest and inter-rater reliability tests in six units within a Swedish residential care facility that varied in terms of their environmental characteristics.Results Translation and back translation identified linguistic and semantic related issues. The results of the first content validity analysis showed that more than one third of the items had item-CVI (I-CVI) values less than the critical value of 0.78. After modifying the instrument, the second content validation analysis resulted in I-CVI scores above 0.78, the suggested criteria for excellent content validity. Test-retest reliability showed high stability (96% and 95% for two independent raters respectively), and inter-rater reliability demonstrated high levels of agreement (95% and 94% on two separate rating occasions). Kappa values were very good for test-retest (κ= 0.903 and 0.869) and inter-rater reliability (κ= 0.851 and 0.832).ConclusionsAdapting an instrument to a domestic context is a complex and time-consuming process, requiring an understanding of the culture where the instrument was developed and where it is to be used. A team, including the instrument’s developers, translators, and researchers is necessary to ensure a valid translation and adaption. This study showed preliminary validity and reliability evidence for the Swedish version (S-SCEAM) when used in a Swedish context. Further, we believe that the S-SCEAM has improved compared to the original instrument and suggest that it can be used as a foundation for future developments of the SCEAM model.
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| 49. |
- Nordin, Susanna, et al.
(författare)
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Development and initial validation of the staff perception of residential care environments (SPORE) instrument
- 2024
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Ingår i: International Journal of Older People Nursing. - 1748-3735 .- 1748-3743. ; 19:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The impact of the physical environment on healthcare staff well-being and work performance is well recognised, yet there is a lack of instruments assessing environmental features from the perspective of staff working in residential care facilities (RCFs) for older people.OBJECTIVES: To develop and provide initial validation of the instrument Staff Perceptions Of Residential care facility Environments (SPORE).DESIGN: An instrument development and psychometric evaluation study.METHODS: Based on material from a British project, items were translated and adapted for Swedish residential care facilities as SPORE. Care staff (N = 200), recruited from 20 Swedish RCFs, completed a questionnaire-based survey containing the SPORE instrument and two other instruments selected as suitable for use in the validation. In addition, an environmental assessment instrument was used for further validation. Analyses were performed at individual (staff) level and home (RCF) level.RESULTS: The SPORE subscales demonstrated good internal consistency reliability and were moderately to strongly correlated at the individual level with the subscales of measures of person-centred care, and strongly correlated with the same measures at the home level. The SPORE subscales were also highly correlated with the total score of the instrument used to assess the quality of the physical environment.CONCLUSION: The initial validation indicates that the SPORE instrument is promising for measuring care staff perceptions of environmental features in care facilities for older people. SPORE can be a valuable instrument for use in research and in practice to evaluate the environment as part of working towards high-quality care.IMPLICATIONS FOR PRACTICE: The design of the physical environment within RCFs can affect the staff's health and work performance. The instrument is useful for evaluating the environment and informing decisions about design solutions that support staff in their important work.
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| 50. |
- Nordin, Susanna, et al.
(författare)
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Digital homecare twin expectations among Swedish social service professionals – a qualitative study
- 2024
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Konferensbidrag (refereegranskat)abstract
- Digital homecare twin expectations among Swedish social service professionals – a qualitative studyBackground and purposeDesigning care and support interventions that are tailored to the persons’ needs is essential to high-quality care and is increasingly recognised as associated with positive effects on the health and well-being of older adults and caregivers. In line with demographic trends observed in many countries, Sweden is confronted with a double demographic challenge where the proportion of older adults is increasing while the proportion of people of working age is decreasing. This will lead to a significant shortage of personnel within the sector of health and social care services by the year 2030 with the risk of deteriorations in the quality of care. This pressing situation underscores an urgent need for novel and innovative solutions in municipal homecare. Therefore, the purpose of this study was to identify expectations of social service professionals in Sweden concerning a digital homecare twin intended to support person-centeredness and enhance the working environment in homecare. A digital twin serves as a digital representation of assets, processes, and systems, which in the context of homecare includes older adults and their homes, as well as homecare services and personnel. This study constitutes an integral part of a broader research project aimed at the co-development and evaluation of a digital twin for homecare, which is based on Industry 4.0 technology. MethodsThe present study adopted a qualitative design with four focus groups involving thirty participants working in municipal homecare in urban and rural locations. They represented a diverse spectrum of social service roles: homecare workers, planners, IT specialists, and managers across various levels of responsibility. During the two-hour focus group sessions, the participants discussed three topics: valuable aspects of homecare; knowledge needs for effective homecare delivery; and anticipations related to a digital twin. The focus group sessions were recorded, transcribed verbatim and analysed thematically. FindingsThe analysis will be completed by the end of 2023 and the preliminary results will be presented at ECSWR 2024.Conclusions and implicationsThe present study can contribute to valuable knowledge on how a digital twin can be used in homecare, and the results are expected to support person-centered homecare and increase job satisfaction for homecare workers. The main outcomes and their implications for practice and further research will be presented at ECSWR 2024.
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