| 11. |
- Grundberg, Åke, et al.
(author)
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District nurses' perspectives on detecting mental health problems and promoting mental health among community-dwelling seniors with multimorbidity
- 2016
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In: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 25:17-18, s. 2590-2599
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Journal article (peer-reviewed)abstract
- AIMS AND OBJECTIVES:To describe district nurses' perspectives on detecting mental health problems and promoting mental health among homebound older people with multimorbidity.BACKGROUND:Mental health problems among older people with multiple chronic conditions, that is, multimorbidity, are challenging issues. These patients' homes often serve as arenas in which district nurses can promote health. Mental health promotion must be studied in greater depth within primary care because older people with multimorbidity are particularly prone to developing poor mental health, which can go undetected and untreated.DESIGN:A descriptive, qualitative study using semi-structured interviews and content analysis.METHODS:Twenty-five district nurses completed individual or focus group interviews. Data were analysed using qualitative content analysis.RESULTS:Most district nurses stated that detecting mental health problems and promoting mental health were important tasks but that they typically focused on more practical home health care tasks. The findings revealed that district nurses focused on assessment, collaboration and social support as means of detecting mental health problems and promoting mental health.CONCLUSIONS:The district nurses described various factors and actions that appeared to be important prerequisites for their involvement in primary mental health care. Nevertheless, there were no established goals for mental health promotion, and district nurses often seemed to depend on their collaboration with other actors. Our findings indicated that district nurses cannot bear the primary responsibility for the early detection of mental health problems and early interventions to promote mental health within this population.RELEVANCE TO CLINICAL PRACTICE:The findings of this study indicated that workforce training and collaboration between different care providers are important elements in the future development of this field. Early detection and early treatment of mental health-related issues should also be stated as explicit objectives in the provision of care to community-dwelling older people with multimorbidity.
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| 12. |
- Grundberg, Åke, et al.
(author)
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Home care assistants' perspectives on detecting mental health problems and promoting mental health among community-dwelling seniors with multimorbidity
- 2016
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In: Journal of Multidisciplinary Healthcare. - 1178-2390. ; 9, s. 83-95
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Journal article (peer-reviewed)abstract
- Introduction: Elderly people with multiple chronic conditions, or multimorbidity, are at risk of developing poor mental health. These seniors often remain in their homes with support from home care assistants (HCAs). Mental health promotion by HCAs needs to be studied further because they may be among the first to observe changes in clients’ mental health status. Aim: To describe HCAs’ perspectives on detecting mental health problems and promoting mental health among homebound seniors with multimorbidity. Methods: We applied a descriptive qualitative study design using semi-structured interviews. Content analyses were performed on five focus group interviews conducted in 2014 with 26 HCAs. Results: Most HCAs stated that they were experienced in caring for clients with mental health problems such as anxiety, depression, sleep problems, and high alcohol consumption. The HCAs mentioned as causes, or risk factors, multiple chronic conditions, feelings of loneliness, and social isolation. The findings reveal that continuity of care and seniors’ own thoughts and perceptions were essential to detecting mental health problems. Observation, collaboration, and social support emerged as important means of detecting mental health problems and promoting mental health. Conclusion: The HCAs had knowledge of risk factors, but they seemed insecure about which health professionals had the primary responsibility for mental health. They also seemed to have detected early signs of mental health problems, even though good personal knowledge of the client and continuity in home visits were crucial to do so. When it came to mental health promotion, the suggestions related to the aim of ending social isolation, decreasing feelings of loneliness, and increasing physical activity. The results indicate that the HCAs seemed dependent on supervision by district nurses and on care managers’ decisions to support the needed care, to schedule assignments related to the detection of mental health problems, and to promote mental health.
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| 13. |
- Grundberg, Åke
(author)
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Mental health promotion among community-dwelling seniors with multimorbidity : perspectives of seniors, district nurses and home care assistants
- 2015
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Doctoral thesis (other academic/artistic)abstract
- The prevalence of mental illness is increasing among the older population in Sweden. One of the most vulnerable groups for mental health problems is older persons with multimorbidity, i.e. seniors with multiple chronic conditions. Many of them remain in their own homes with a comprehensive and complex need of support and healthcare, mainly provided by home care assistants (HCAs) and district nurses (DNs). However, the detection of mental health problems for adequate treatment or to promote mental health among community-dwelling seniors with multimorbidity, calls for skills and competences in this area.This thesis aimed to gain a deeper understanding of how mental health may be promoted among community-dwelling seniors with multiple chronic conditions. Four studies have been included in this thesis (I-IV). All studies had a qualitative descriptive design with either a phenomenographic approach or latent and manifest qualitative content analysis technique. The aim of study I was to describe the variations in how community-dwelling seniors with multimorbidity perceived the concept of mental health and what may influence it. The findings showed the participants conceptualised mental health as having both positive and negative facets. The participants further conceived that social contact, physical activity and optimism may improve mental health, while social isolation, ageing, and chronic pain may worsen it. Study II aimed to describe the experience of health-promoting dialogues from the perspective of community-dwelling seniors with multimorbidity, and what these seniors believed to be important for achieving a dialogue that may promote their mental health. The main finding was the necessity of being seen as a unique individual by an accessible and competent person. Further, the participants missed having friends and relatives to talk to and they especially lacked healthcare or social service providers for health-promoting dialogues that may promote mental health. The aim of study III was to describe DNs’ perspectives on detecting mental health problems and promoting mental health among community-dwelling seniors with multimorbidity. Findings revealed that the DNs’ focus was on assessment, collaboration and social support as a way of detecting mental health problems and promoting mental health. Study IV described HCAs’ perspectives on detecting mental health problems and promoting mental health among the seniors in focus. The findings revealed that continuity of care and the seniors’ own thoughts and perceptions were regarded as essential for the detection of mental health problems. Further, observation, collaboration, and social support emerged as important means of detecting mental health problems and promoting mental health.Conclusions: The results of this thesis are based on interviews and show that: 1) Seniors with multimorbidity should have an opportunity to describe how multiple chronic conditions may affect their life situation; 2) An optimal level of care can be achieved through continuity, involvement, and by providing a health-promoting dialogue based on the person’s wishes and needs; 3) Even if DNs seemed engaged in primary mental healthcare, there were no expressed goals set in the improvement of mental health, and it seemed that these DNs could not bear the primary responsibility for early detection of mental health problems and early interventions to improve mental health; 4) HCAs had knowledge about risk factors for mental health problems and it appears that they were dependent on care managers’ decision-making in granted support, as well as supervision from DNs in the detection of mental health problems and to promote mental health.In summary, the finding in the present thesis demonstrates that managing mental health problems is still an ongoing challenge for those organisations providing continuity in home care and home healthcare for homebound elderly persons with complex chronic conditions. The finding in the thesis also shows that DNs and HCAs seem to be dependent on each other in this area. Mental health promotion was expressed as an important assignment among DNs and HCAs, even though they describe different prerequisites and factors which could be seen as barriers in the detection of common mental health problems such as depression, anxiety and sleep problems. These personnel further described difficulties in collaboration and transmission of information between care- and healthcare providers from the community and primary care context. Social and physical interventions - as well as social contacts and social support to break social isolation - seemed important according to all the informants, with their different perspectives of how mental health may be promoted.
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| 14. |
- Göransson, Carina, 1967-
(author)
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Developing and evaluating an interactive app to support self-care among older persons receiving home care
- 2019
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Doctoral thesis (other academic/artistic)abstract
- The proportion of older persons worldwide is growing. With older age, complex health problems may occur and the need for home care increases. To support older persons to maintain health and self-care, innovative ways need to be developed. The aim of the project was to develop and evaluate an interactive app among older persons receiving home care. The project had several phases: i) to define and understand the problem ii) develop the intervention iii) develop and optimise evaluation. Qualitative and quantitative methods were employed. Data were collected through a scoping review, interviews with healthcare experts, older persons and nursing assistants (study I); interviews with older persons (studies II, III); focus groups with homecare nurses (study II). Questionnaires at baseline, end of intervention and 6-month follow-up; with instruments to assess aspects of health, health literacy, self-care, and a study specific question regarding sense of security were used (studies III-IV). Logged data from reported health concerns, alerts, and notes were collected (study IV). Data were analysed using qualitative content analysis (study I), thematic analysis (study II), qualitative content analysis with directed approach (study III) and descriptive and inferential statistics (studies III, IV). Results: Important aspects for health and self-care from the older persons’ perspectives were described as: frame of mind, having relationships and social activities, physical ability and concerns, and maintaining self-care (I). These results were included in the app as questions with self-care advice, graphs and alerts to homecare nurses. The app use was described as an enabler for learning (II). The older persons showed improved communicative and critical health literacy at the 6- month follow-up (IV). They described an increased sense of security (II and III), which decreased at the 6-month follow-up (III). They expressed increased self-confidence (II) and support in self-care, but reported a decrease in self-care ability at the 6-month follow-up (III). App usage was high, with the health concern pain triggering the most alerts (IV). Their aspects of health were unchanged at the three assessments points (IV). In this context using an app may increase older persons’ participation in their care. The results show that for some older persons, an app can be implemented as a tool for support in conventional home care.
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| 15. |
- Hansson, Anna, et al.
(author)
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Impact of changes in life circumstances on subjective well-being in an adult population over a 3-year period
- 2008
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In: Public Health. - : Elsevier BV. - 0033-3506 .- 1476-5616. ; 122:12, s. 1392-1398
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Journal article (peer-reviewed)abstract
- OBJECTIVES:Mental health problems are a major issue worldwide, and there is a need to further explore factors that may increase or decrease people's subjective well-being (SWB). The main aim of the present study was to extend knowledge concerning changes in cohabitation, social support or financial situation and their influence on SWB, after controlling for personality (i.e. neuroticism), in a 3-year follow-up of an adult population-based sample. The change in overall well-being was also studied during the 3- year interval.STUDY DESIGN:Longitudinal design.METHODS:A random sample of Swedish citizens, aged 20-64 years, residing in Stockholm County received a questionnaire by post, comprising items pertaining to demographics, personality, social support and SWB. All the respondents received a second questionnaire 3 years later. In total, 8324 subjects were included in the present study.RESULTS:The overall well-being of the study sample was relatively stable. Separate analyses of the three life circumstances indicated that, after controlling for personality, positive and negative changes in each sphere of life still affected SWB.CONCLUSIONS:Despite personality and the stability of SWB, these results indicate that changes in financial situation, social support and cohabitation influence SWB. It is important for society and the healthcare services to be aware that a negative change in any of these life circumstances may lead to decreased well-being for a period of at least 3 years.
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| 16. |
- Hansson, Anna
(author)
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Subjective Well-being in an Adult Swedish Population : Findings from a Population-based Study
- 2009
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Doctoral thesis (other academic/artistic)abstract
- This doctoral thesis examines various factors associated with subjective well-being (SWB) in an adult Swedish population, aged 20-64 years, using cross-sectional and longitudinal data. The thesis includes four studies based on the PART study, a current population-based study on mental health, work, and relations in Stockholm County, Sweden. Research has shown that there is a relationship between mental health problems such as depression and low well-being. It is therefore of great interest to investigate various factors associated with SWB in order to promote or increase mental health. We also examined if the well-being scale used in all studies could be used as a screening instrument for depression.The specific aim of Study I was to examine if age, gender, foreign background (i.e. not born in Sweden), cohabitation, education, financial strain, social support, childhood conditions and negative life events and their associations with SWB could be replicated in our data. In Study II we investigated strategies people chose to employ in order to improve or maintain their well-being and whether these were associated with SWB. Study III examined if changes in cohabiting, social support or the financial situation influenced SWB, after controlling for neuroticism at a 3-year follow-up. The change in the study sample’s SWB was also studied during the same time period. In Study IV the aim was to investigate whether the well-being scale, the (WHO) Ten Well-being index, could be used as a screening instrument for depression.Results from Study I showed that men had higher SWB than women, and that positive childhood conditions, cohabiting, greater age, sound financial situation, absence of negative life events, and support from friends were all positively associated with SWB. Social support had the strongest relationship. Together, these factors explained 20 % of the variance in SWB and the findings replicated earlier research. The strategies reported in Study II were physical exercise, physical health,engaging in pleasurable activities, relaxation, plan/set limits, social support, professional contacts, positive thinking, and work. Of these, social support, relaxation, physical exercise and physical health were associated with higher SWB. Social support showed the strongest association. In Study III changes in financial situation, social support, or cohabiting influenced SWB after controlling for neuroticism. The results also suggested that SWB was relatively stable over a period of three years. Preliminary findings from Study IV indicate that the (WHO) Ten Well-being index can work as a screening instrument for depression in populationbased samples.In summary, the findings suggest that demographics and psychosocial factors explain only a small part of the variance in SWB, replicating previous data. Certain self-care strategies are positively associated with SWB. In addition, changes in life circumstances influence SWB, even after controlling for neuroticism over a period of three years despite the stability of SWB. Furthermore, the preliminary findings indicate that the well-being scale can work as a screening instrument for depression in a population-based sample. The overall conclusion from the results of this thesis suggests that it is important for the health care services to be aware that negative life events/circumstances may affect people’s SWB over several years. Furthermore, selfhelp interventions might be important in order to maintain or increase SWB.
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| 17. |
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| 18. |
- Hansson, Anna, et al.
(author)
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Well-being in an adult Swedish population
- 2005
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In: Social Indicators Research. - : Springer Science and Business Media LLC. - 0303-8300 .- 1573-0921. ; 74:2, s. 313-25
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Journal article (peer-reviewed)abstract
- Objectives: The aim of this study was to see if earlier findings about factors associated with well-being could be replicated in a large population-based sample in Sweden. To the best of our knowledge, no research on well-being has been conducted on such a large population in a country, which by most standards is regarded as one of the most fortunate in the world. With its economic wealth and highly developed social welfare and health care system, Sweden is a country where the conditions for a high level of well-being would appear to be met. Methods: 10,441 randomly selected Swedish citizens, aged between 20 and 64 years, living in Stockholm County, completed a questionnaire covering issues such as demographics, social network and psychological well-being. The data were collected during the years 1998-2000. Results: Male gender, greater age, cohabiting, good childhood conditions, support from friends, sound financial situation and absence of negative life events were positively associated with well-being and explained 20% of the variance. Conclusion: The findings replicated earlier studies. Factors associated with well-being seem to remain the same, and are still explaining only a small part of the total variance, despite different measurements, time, sample sizes or country of origin. Therefore, research on well-being needs to take a new turn, by placing less focus on external factors and more focus on the internal factors, such as a person's personality and coping strategies
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| 19. |
- Hansson, Anna, et al.
(author)
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What kind of self-care strategies do people report using and is there an association with well-being?
- 2005
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In: Social Indicators Research. - : Springer Science and Business Media LLC. - 0303-8300 .- 1573-0921. ; 73:1, s. 133-39
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Journal article (peer-reviewed)abstract
- Objectives: The aim of this study was to describe what kind of self-care strategies people report using to improve or maintain their well-being. Furthermore, we also wanted to investigate whether reports of using self-care strategies were associated with well-being. Methods: A selected sample (n = 871), aged between 20 and 64 years, living in Stockholm County, answered an open-ended question about self-care strategies. Well-being was assessed using the WHO (Ten) well-being index. Results: Ten different categories were found. The most commonly reported self-care strategy was physical exercise, followed by social support and engaging in pleasurable activities. Physical exercise, social support, relaxation, and physical health were associated with a better well-being, social support being strongest correlated. Conclusion: The results suggest that reports of using certain self-care strategies are associated with a better well-being
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| 20. |
- Hedman, Ragnhild, 1962-, et al.
(author)
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Living in uncertainty while a spouse is undergoing a cognitive assessment : Voices of women care partners
- 2022
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In: Dementia. - : SAGE Publications. - 1471-3012 .- 1741-2684. ; 21:8, s. 2631-2646
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Journal article (peer-reviewed)abstract
- INTRODUCTION: Women often support partners with cognitive symptoms during the assessment process and when they are receiving a cognitive diagnosis. Living with a partner with cognitive symptoms can be stressful; however, there is limited insights into the specific experiences of older women during the assessment process. Previous research indicates that there are gender differences in the experiences of spousal caregiving; however, further research is needed in regard to the experiences of men and women as care partners. Therefore, the aim of the present study was to describe women's experiences of living with a partner undergoing a cognitive assessment.METHODS: Semi-structured interviews were conducted with seven women when their male partners commenced a cognitive assessment and after the assessment had been completed. The interviews were analysed with abductive content analysis.FINDINGS: Uncertainty permeated the women's experiences. Antecedents, attributes and strategies to manage the uncertainty were described.CONCLUSION: The participants expressed informational and existential uncertainty when their partner underwent a cognitive assessment. A lack of knowledge regarding the assessment process and cognitive diagnoses, especially mild cognitive impairment, was identified. Further, there was a need to process existential uncertainty evoked by the situation.
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