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| 2. |
- Borglin, Gunilla, 1959-, et al.
(författare)
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Older people in Sweden with various degrees of present quality of life : their health, social support, everyday activities and sense of coherence
- 2006
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Ingår i: Health & Social Care in the Community. - : Blackwell Publishing. - 0966-0410 .- 1365-2524. ; 14:2, s. 136-146
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Tidskriftsartikel (refereegranskat)abstract
- Public health policies in most European countries are concerned with how to keep older people living independently with a qualitatively good life in the community as long as possible. However, knowledge about what may characterise those seemingly 'healthy' older people is sparse. The aim of the study was to investigate the characteristics of a sample of people (75+) reporting various degrees of Quality of Life (QoL) with respect to QoL in different areas, as well as self-rated health, health problems, social support, everyday activities and sense of coherence. A postal questionnaire was sent out in spring 2001 to a randomly selected population-based sample (n= 600) in the southern parts of Sweden. A two-step cluster analysis was performed (n= 385, mean age 84.6, SD = 5.7) with 'present QoL' as clustering attribute. Three groups were disclosed, classified as high, intermediate and low present QoL, of which 33.8% could be regarded being at risk of low QoL. Those with low present QoL (18.4%) were the oldest and most vulnerable, a majority were women with 'poor or bad' self-rated health, high frequencies of health problems, low total QoL, low social support and sense of coherence and less physically active. Those with high present QoL (47.8%) reported more 'excellent or good' self-rated health, physical activity, satisfactory social support and higher sense of coherence and total QoL than the other two groups. Those with intermediate present QoL (33.8%) had more of 'poor or bad' self-rated health, more health problems were less physically active, had lower total QoL and sense of coherence, and less social support than those with high present QoL. The sample seemed to reflect the ageing process in that the respondents were at different stages of ageing. However, the fact that the level of social support, sense of coherence and self-rated health followed the same curve as QoL may indicate that some are more vulnerable to low present QoL given the same health and these should be targeted in preventive programmes since they report low QoL.
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| 3. |
- Eklund, Kajsa, et al.
(författare)
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Outcomes of coordinated and integrated interventions targeting frail elderly people: a systematic review of randomised controlled trials
- 2009
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Ingår i: Health & Social Care in the Community. - : Hindawi Limited. - 0966-0410 .- 1365-2524. ; 17:5, s. 447-458
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to review randomised controlled trials on integrated and coordinated interventions targeting frail elderly people living in the community, their outcome measurements and their effects on the client, the caregiver and healthcare utilisation. A literature search of PubMed, AgeLine, Cinahl and AMED was carried out with the following inclusion criteria: original article; integrated intervention including case management or equivalent coordinated organisation; frail elderly people living in the community; randomised controlled trials; in the English language, and published in refereed journals between 1997 and July 2007. The final review included nine articles, each describing one original integrated intervention study. Of these, one was from Italy, three from the USA and five from Canada. Seven studies reported at least one outcome measurement significantly in favour of the intervention, one reported no difference and one was in favour of the control. Five of the studies reported at least one outcome on client level in favour of the intervention. Only two studies reported caregiver outcomes, both in favour of the intervention for caregiver satisfaction, but with no effect on caregiver burden. Outcomes focusing on healthcare utilisation were significantly in favour of the intervention in five of the studies. Five of the studies used outcome measurements with unclear psychometric properties and four used disease-specific measurements. This review provides some evidence that integrated and coordinated care is beneficial for the population of frail elderly people and reduces health care utilisation. There is a lack of knowledge about how integrated and coordinated care affects the caregiver. This review pinpoints the importance of using valid outcome measurements and describing both the content and implementation of the intervention.
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| 4. |
- Haraldsson, K, et al.
(författare)
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The self-reported health condition of women after their participation in a stress management programme: a pilot study
- 2005
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Ingår i: Health & Social Care in the Community. - : Hindawi Limited. - 0966-0410 .- 1365-2524. ; 13:3, s. 224-230
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Tidskriftsartikel (refereegranskat)abstract
- From a public health perspective, it is important to develop effective measures to deal with stress which are based on the individual's participation, such as stress management provided in group sessions. Therefore, the aim of the present study was to compare and evaluate the self-reported health condition of women in terms of their general symptoms, stress and sense of coherence (SOC) after participation in a stress management programme. The intervention, which had a modified crossover design and involved 40 women divided into two groups (G1 and G2), comprised eight meetings, the content of which was both theoretical and practical, and included information about stress, stress management, massage and mental training. A questionnaire was filled in on three occasions: before and after the intervention (8 weeks later), and after another 8 weeks (16 weeks later). The questionnaire contained 60 items comprising background factors, general symptoms, stress and SOC. No significant differences existed between the groups at baseline. In favour of the intervention, significant differences were found between the groups with regard to fewer general symptoms (P = 0.035) as well as a tendency to stress reduction (P = 0.060). A comparison within groups showed that both groups had a significant reduction in symptoms after the intervention (G1, P = 0.002; and G2, P = 0.003) and in reduced stress (both P = 0.001). After a further 8 weeks, both groups still showed significantly fewer general symptoms and reduced stress, as well as significant improvements with regard to SOC (G1, P = 0.012; and G2, P = 0.026). These findings indicate that the combination of mental training and massage in this stress management programme had a positive influence on the women's health condition. The pilot study design could be used in a full-scale study with randomised groups.
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| 5. |
- Janlöv, Ann-Christin, et al.
(författare)
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Older persons' experience of being assessed for and receiving public home help: do they have any influence over it?
- 2006
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Ingår i: Health & Social Care in the Community. - : Hindawi Limited. - 0966-0410 .- 1365-2524. ; 14:1, s. 26-36
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this qualitative study was to explore older persons' experience of participation in and influence on decisions about public home help/care when undergoing needs assessment and receiving public home help. A purposive sample of 28 home help recipients over the age of 75 were selected. Data were collected by means of in-depth interviews. A content analysis revealed one overarching category: 'Having to be satisfied, adjust, and walk a fine line when balancing between needs and available help'; and three principal categories: Balancing the comfort and guilt – receiving help from the family at the limits of their capacity; 'A necessary evil'– balancing feelings and resources against having no choice but to accept; Incorporating the home help into daily life to gain a sense of continuity. The findings indicate that older persons have difficulties coping and adapting to their new life situation and have no actual influence over the decisions about their home help. The officer told them what was available. This implies a need to pay attention to the frail persons' mental state in the needs assessment and to ensure adequate understanding of information. Further, it suggests that the needs assessment and the home help officer should to a larger extent focus on individual needs as a whole, involve and encourage the older person to strengthen his or her sense of being in control.
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| 6. |
- Rennemark, Mikael, 1951-, et al.
(författare)
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Factors related to frequent usage of the primary healthcare services in old age: findings from the Swedish National study on Aging and Care
- 2009
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Ingår i: Health & Social Care in the Community. - United Kingdom : Blackwell Publishing Ltd. - 0966-0410 .- 1365-2524. ; 17:3, s. 304-311
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Tidskriftsartikel (refereegranskat)abstract
- People aged 60 or more are the most frequent users of healthcare services.In this age range, however, both frequent and infrequent users can be found.Frequent users have high rates of illnesses. Previous research has found thatthe frequency may be influenced also by psychological and social factors.The aim of this study was to investigate to what degree such factors add tothe explanation of differences in number of visits to a physician. A crosssectionalstudy was conducted with a random sample consisting of 1017individuals, aged 60 to 78 years, from the Blekinge part of the SwedishNational Study on Aging and Care database. The data were collected during2001 to 2003. Hierarchical logistic regression analyses were used withfrequent (three visits or more during a year) and infrequent use as adichotomous dependent variable. The final statistical analyses included643 individuals (63% of the sample). Independent variables were sense ofcoherence (SOC), internal locus of control, education level and socialanchorage. Control variables were age, gender, functional ability andcomorbidity. The results showed that comorbidity was most strongly relatedto frequent use [adjusted odds ratio (OR) = 8.17, 95% confidence interval (CI)5.54–12.04]. In addition, SOC and internal locus of control had small, butsignificant effects on the odds of being a frequent user (adjusted OR = 1.03,95% CI 1.00–1.06 and adjusted OR = 1.14, 95% CI 1.02–1.27, respectively).The lower the SOC and the internal locus of control were, the higher were theodds of frequent use. Education level and social anchorage were unrelatedto frequency of use. The results indicate that frequent healthcare servicesusers are more ill than infrequent users. Psychological factors influence theuse only marginally, and social factors as well as age and gender are not bythemselves reason for frequent healthcare services use.
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| 7. |
- Tops, Dolf, et al.
(författare)
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Staff experience and understanding of working with abused women suffering from mental illness
- 2009
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Ingår i: Health & Social Care in the Community. - : Hindawi Limited. - 0966-0410 .- 1365-2524. ; 17:5, s. 459-465
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Tidskriftsartikel (refereegranskat)abstract
- The phenomenon of abused women with mental illness is often unrecognised by staff working within welfare services. This may be explained by staff members' attitudes, insecurity or lack of awareness. Today, there are shortcomings in the knowledge of staff members' experiences and interpretations of abuse against women suffering from mental illness. The aim of this qualitative study was to describe how staff members experience and understand their work with abused women suffering from mental illness. Thematic interviews were conducted with 13 staff members from various welfare services. Data were subject to content analysis. The findings showed that working with abused women was experienced as ambiguous and painful and made the staff act pragmatically. Feelings of ambiguity were mainly related to the lack of theoretical frameworks for interpreting why women with mental illness are exposed to abuse. Painful experiences involved intertwined feelings of distress, frustration, worthlessness, ambivalence and powerlessness. These were all feelings that emerged in the direct encounters with the abused women. In response to the abused women's comprehensive needs, staff members acted pragmatically, implying networking without any sanction from the leaders of the organisation, compliance with routines and taking action in here-and-now situations. By acting pragmatically, staff members could achieve concrete results through their interventions. It is concluded that staff members, working with abused women with mental illness, are in a vulnerable situation and in need of formally accepted and implemented support and legitimacy as well as theoretical knowledge regarding causes and consequences of abuse in this particular group of women.
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| 8. |
- Dahlberg, Lena, 1970-, et al.
(författare)
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Age and gender of informal carers : a population-based study in the UK
- 2007
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Ingår i: Health & Social Care in the Community. - : Hindawi Limited. - 0966-0410 .- 1365-2524. ; 15:5, s. 439-45
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Tidskriftsartikel (refereegranskat)abstract
- This paper identifies variations in the age and gender characteristics of informal carers in the UK. The paper is based on the Individual Sample of Anonymous Records, a 3% random sample of the 2001 UK Census. The sample size was 1 825 595. Of this sample, 10% were reported to be carers. The analysis shows that informal caregiving is systematically linked with both age and gender. Caregiving increased with age until reaching a peak in the 45-59 age group, in which almost 20% were carers. Similarly, the amount of time spent caregiving increased with age, with the highest levels of caregiving commitment in people aged 80-89 years. Regarding gender, 11.3% of women were carers compared to 8.6% of men and overall women committed more time to caregiving than men. However, this pattern was reversed in later life (70+), where there was a higher proportion of carers and greater time commitment to caregiving amongst men. While the predominance of women as informal carers has been well reported, the importance of men as informal carers in old age is much less commented upon. This study thus suggests that informal caregiving is most prevalent in groups of the population that, according to previous research, may experience most strain from doing so: elderly people who may be frail and often are in a spousal relationship with the care-recipient, and middle-aged women with multiple roles. Therefore, it is of great importance that their particular needs and circumstances are fully taken into account both in the development of formal support and when information about available support is targeted.
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| 9. |
- Dahlberg, Lena, 1970-
(författare)
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The complementarity norm : service provision by the welfare state and voluntary organisations in Sweden.
- 2006
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Ingår i: Health & Social Care in the Community. - : Hindawi Limited. - 0966-0410 .- 1365-2524. ; 14:4, s. 302-10
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Tidskriftsartikel (refereegranskat)abstract
- Previous research has shown that different providers of social welfare tend to provide complementary services at a local level, but that there is no complete task specialisation. This means that elements of complementarity theory are challenged, especially the so-called 'principle of matching', i.e. that actors only undertake tasks which match their characteristics. The aim of the present study was to explore complementarity between Swedish local authorities and voluntary organisations in their support for relatives of older people. Interviews were carried out with 55 politicians, civil servants and representatives of voluntary organisations drawn from four municipalities. These municipalities were selected from a sampling frame that ensured representation of different combinations of high and low levels of voluntary and statutory services. Qualitative analysis of interview transcripts showed that, while local authorities are seen as responsible for the support for relatives, voluntary organisations are expected to be complementary, offering 'the icing on the cake', i.e. social support and activities which are regarded as less demanding. Overall, substantial support for a norm of complementarity was found. It is argued that, if those who are active in social policy and voluntary work at a local level agree with the ideal of complementarity, this will influence their wish to arrange activities and services. Therefore, the complementarity norm - rather than the principle of matching - influences the outcome in terms of service provision.
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| 10. |
- Hultberg, Eva-Lisa, 1952, et al.
(författare)
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Using pooled budgets to integrate health and welfare services: a comparison of experiments in England and Sweden.
- 2005
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Ingår i: Health & social care in the community. - : Hindawi Limited. - 0966-0410 .- 1365-2524. ; 13:6, s. 531-41
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Tidskriftsartikel (refereegranskat)abstract
- The lack of collaboration between health, social and other welfare services is believed to impair efficiency and reduce effectiveness in addressing the complex problems of patients. Differences in funding streams, political accountabilities, organisational structures and professional cultures are all alleged to contribute to barriers between services. Drawing on their respective evaluations, this paper describes experiments in England and Sweden that use pooled budgets between services to improve interagency and interprofessional collaboration and presents evidence on their impact. Despite differences in the funding and organisation of health and welfare services in each country, some similar conclusions are reached. Among senior managers and politicians, budget pooling broadened their awareness of interdependencies with other agencies and professionals in promoting patients' welfare. However, these broadened perspectives were not immediately shared by professionals working at the front line, with whom patients had immediate contact. Moreover, neither experiment yielded unequivocal evidence of improved cost-effectiveness or of the benefits of budget pooling on the outcomes for service users. These experiments also raise questions about the equity and accountability of welfare services because in both countries only a limited range of services has been integrated under the umbrella of the pooled budgets.
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