| 1. |
- Borglin, Gunilla, 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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| 2. |
- Franzén, Kristofer, et al.
(författare)
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Impact of chronic heart failure on elderly persons' daily life : a validation study
- 2006
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Ingår i: European Journal of Cardiovascular Nursing. - : Sage Publications. - 1474-5151 .- 1873-1953. ; 5:2, s. 137-145
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Knowledge about how elderly persons perceive the impact of chronic heart failure (CHF) on daily life is important when planning nursing care. For this purpose, disease specific instruments are needed. However, few instruments have been developed or tested specifically on elderly persons. AIM: To validate a Swedish version of the Minnesota Living with Heart Failure Questionnaire (LHFQ) on elderly persons with CHF, and use it to describe the impact of CHF on daily life in the same population. METHODS: The sample comprised of 357 persons, aged between 65 and 99, diagnosed with CHF. A questionnaire including background data, the LHFQ and the SF-12 was used. RESULTS: A factor analysis resulted in four dimensions: physical, emotional, treatment and pleasure. LHFQ showed convergent validity and ability to discriminate between known groups. Cronbach's alpha for the total scale was 0.94. Impairments in the physical dimension were most common, especially fatigue (88%) and shortness of breath (87%). CONCLUSIONS: The LHFQ showed satisfying psychometric properties in an elderly Swedish population with CHF and can, with minor alterations, be recommended for research and clinical use. The impact of chronic heart failure on daily life was mostly physical, but other impairments were also common.
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| 3. |
- Franzén, Kristofer, et al.
(författare)
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Predictors for health related quality of life in persons 65 years or older with chronic heart failure
- 2007
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Ingår i: European Journal of Cardiovascular Nursing. - : Oxford University Press. - 1474-5151 .- 1873-1953. ; 6:2, s. 112-120
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundA main goal in nursing care of persons with chronic heart failure (HF) is to strengthen their health related quality of life (HRQoL). This presupposes knowledge about the relation between heart failure and HRQoL. Existing studies have shown incongruent results about whether HRQoL is affected differently depending on age or sex of elderly persons with chronic HF.AimThis study aimed to investigate if age, sex, disease severity, comorbidity and living conditions predict health related quality of life among persons 65 years or older with chronic HF.MethodsThe study included a sample of 357 persons. HRQoL was measured by the Minnesota Living with Heart Failure Questionnaire and the Short Form-12 Health Survey Questionnaire. Multiple regression analyses were performed to analyse the relation between the predictors and HRQoL.ResultsThe main finding was that self-rated disease severity was strongly associated with HRQoL, but also age, sex, diabetes and respiratory diseases was associated with some of the dimensions of HRQoL.ConclusionsInterventions aimed at delaying the progress of the disease, assist persons' to cope with the disease and maintain the domains of HRQoL that are still feasible could be important to improve HRQoL in elderly persons with chronic HF.
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| 4. |
- Sandman, Lars, et al.
(författare)
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Ethical considerations of refusing nutrition after stroke
- 2008
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Ingår i: Nursing Ethics. - : Sage Publications Ltd.. - 0969-7330 .- 1477-0989. ; 15:2, s. 147-59
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this article is to analyse and discuss the ethically problematic conflict raised by patients with stroke who refuse nutritional treatment. In analysing this conflict, the focus is on four different aspects: (1) Is nutritional treatment biologically necessary? (2) If necessary, is the reason for refusal a functional disability, lack of appetite or motivation, misunderstanding of the situation or a genuine conflict of values? (3) If the latter, what values are involved in the conflict? (4) How should we deal with the different kinds of refusal of nutritional treatment? We argue that patients' autonomy should be respected as far as possible, while also considering that those who have suffered a stroke might re-evaluate their life as a result of a beneficial prognosis. However, if patients persist with their refusal, health care professionals should force nutritional treatment only when it is clear that the patients will re-evaluate their future life.
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| 5. |
- Abrahamsson, Agneta, 1951-
(författare)
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"Det var inte så lätt som vi trodde" : tvärsektoriell samverkan på en familjecentral
- 2007
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Ingår i: Socialmedicinsk Tidskrift. - 0037-833X. ; 84:6, s. 529-540
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Tidskriftsartikel (refereegranskat)abstract
- Samarbete och samverkan tas ofta för givet som något gott. Men trots höga förväntningar på positiva effekter är det svårare än vad många förväntar sig. Familjecentralen som den här artikeln handlar om är ett exempel på hur tvärsektoriell samverkan kan se ut i praktiken. Personalen har tillsammans med en forskare studerat samarbetets grundvalar och i artikeln diskuteras det spänningsfält som personalen på grund av samlokalisering befinner sig i och som innebär såväl hinder som möjligheter för samarbete. För att skapa gynnsamma förutsättningar för tvärsektoriellt samarbete i en samlokaliserad verksamhet behöver följande aspekter diskuteras och övervägas. - Moderorganisationernas ledning behöver se över ekonomiska och administrativa rutiner för familjecentralen och skapa yttre förutsättningar i form av handledning och tid för lärande och utveckling inom gruppen. - Personalen behöver tänka över betydelsen av sin egen och professionens utveckling samt aspekter av den organisationskultur som de representerar och bär upp. Olikheter kan bli bränsle för lärande och utveckling i gruppen, som i sin tur kan leda till en utveckling och nytänkande i verksamheten och man kan undvika att olikheter blir grogrund för samarbetsproblem.
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| 6. |
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| 7. |
- Almborg, Ann-Helene, et al.
(författare)
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Discharge planning of stroke patients : the relatives' perceptions of participation
- 2009
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Ingår i: Journal of Clinical Nursing. - 0962-1067 .- 1365-2702. - 0962-1067 ; 18:6, s. 857-865
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Tidskriftsartikel (refereegranskat)abstract
- To describe relatives' perceived participation in discharge planning for patients with stroke and identify correlates to perceived participation. Stroke affects both patients and their relatives and previous research shows that relatives were often dissatisfied with their perceived involvement in discharge planning and the information they get. Prospective cross-sectional study. The study comprised 152 consecutively enrolled relatives (mean age = 60.8 years) of acute stroke patients admitted to a stroke unit in southern Sweden during 2003-2005. Data were collected through interviews 2-3 weeks after discharge using 'Relative's Questionnaire about Participation in Discharge planning'. This instrument measures perceived participation in three subscales: R-Information-Illness, R-Information-Care/support, and R-Goals and Needs. The Overall Rating of Relative's Perceived Participation in Discharge Planning was measured by a visual analogue scale (VAS) (1-10 score). Among the relatives, 56-68% reported positively according to R-Information-Illness, but 46-53% perceived that they did not receive any information about care/medication/rehabilitation/support. About 80% perceived no participation at all in goals and needs. The mean value of the VAS was 3.89 (SD 3.40) score. Regression analyses revealed that longer stay at hospital, patients with higher education, and relatives of female patients and female relatives were associated with relatives' perceptions of higher participation in discharge planning. Relatives perceived that they needed more information and knowledge about stroke and care/medication/rehabilitation/support. They also needed to be more involved in goal-setting and in identifying patient needs. Professionals should take into consideration these associated variables to improve relatives' perceived participation. Clinicians should give more attention to the altered situation of stroke patients' relatives when planning for continuing care and when setting postdischarge goals for the patients. The professionals need to develop strategies to involve relatives in sharing information, goal-setting and needs assessment in discharge planning.
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| 8. |
- Almborg, Ann-Helene, et al.
(författare)
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Patients' perceptions of their participation in discharge planning after acute stroke
- 2009
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Ingår i: Journal of Clinical Nursing. - : Wiley-Blackwell. - 0962-1067 .- 1365-2702. ; 18:2, s. 199-209
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Tidskriftsartikel (refereegranskat)abstract
- Aims and objectives. To describe stroke patients' perceptions of their participation in the discharge planning process and identify correlates of perceived participation. Background. Patients have the right to participate in discharge planning, but earlier research has shown that they are often dissatisfied with the information they receive and their involvement in goal-setting during discharge planning. Design. Cross-sectional study. Methods. The sample consisted of 188 persons (mean age 74 years, SD 11·2) with acute stroke who were admitted to a stroke unit at a hospital in southern Sweden during 2003–2005. Data was collected by face-to-face interviews 2–3 weeks after discharge using the 'Patients' Questionnaire on Participation in Discharge Planning'. This instrument measures perceived participation in discharge planning in three subscales: P-Information, P-Medical Treatment, P-Goals and Needs. Results. The percentage of patients who perceived that they had participated in discharge planning was as follows: 72–90% according to P-Information, 29–38% according to P-Medical Treatment and 15–47% according to P-Goals and Needs. Age, education and performance of activities of daily living were significantly related to perceived participation as measured by different subscales. Conclusions. Most of the patients perceived that they received information, but fewer perceived participation in the planning of medical treatment and needs of care/service/rehabilitation and goal-setting. Professionals need to pay more attention to patients in different subgroups to facilitate their participation in discharge planning. Relevance to clinical practice. To facilitate and increase patients' participation in discharge planning, methods should be implemented for goal-setting and identifying patients' needs. Methods that foster patient participation may improve goal-orientated care, services and rehabilitation after discharge.
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| 9. |
- Andersson, Bodil T., et al.
(författare)
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Radiographers' areas of professional competence related to good nursing care
- 2008
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Ingår i: Scandinavian Journal of Caring Sciences. - : Blackwell Munksgaard. - 0283-9318 .- 1471-6712. ; 22:3, s. 401-409
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Tidskriftsartikel (refereegranskat)abstract
- Background: Radiographers’ ability and competence is a matter of vital importance for patients. Nursing care is an integral part of the radiographer’s work. The demand for high competence in clinical activities has increased in diagnostic radiology and has had an impact on the development of the profession.Aim: The aim was to describe the radiographer’s areas of professional competence in relation to good nursing care based on critical incidents that occur in the course of radiological examinations and interventions.Method: A descriptive design with a qualitative approach, using the Critical Incident Technique was employed. Interviews were conducted with a strategic sample of registered radiographers (n = 14), based at different hospitals in Sweden.Ethical issues: The appropriate ethical principles were followed. All the participants provided informed consent, and formal approval for conducting the research was obtained according to national and local directives.Results: The data analysis resulted in two main areas; direct and indirect patient-related areas of competence, which describe the radiographers’ skills that either facilitate or hinder good nursing care. In the direct patient-related area of competence, four categories emerged, which illustrate good nursing care in the patient’s immediate surroundings. In the indirect patient-related area of competence, four categories illuminated good nursing care that is provided without direct contact with the patient.Conclusions: The study highlights the different areas of the radiographer’s unique professional competence. The findings provide insight into the radiographer’s profession, on one hand as a carer and on the other as a medical technologist as well as highlighting the importance of each role. The radiographer’s work encompasses a variety of components – from caring for the patient to handling and checking the technical equipment.
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| 10. |
- Andersson, Magdalena, et al.
(författare)
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Health care consumption and place of death among old people with public home care or in special accommodation in their last year of life
- 2007
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Ingår i: Aging Clinical and Experimental Research. - 1594-0667 .- 1720-8319. ; 19:3, s. 228-239
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND AIMS:Developing care for older people in the last phase of life requires knowledge about the type and extent of care and factors associated with the place of death. The aim of this study was to examine age, living conditions, dependency, care and service among old people during their last year of life, but also their place of death and factors predicting it.METHODS:The sample (n=1198) was drawn from the care and services part of the Swedish National Study on Ageing and Care (SNAC). Criteria for inclusion were being 75+ years, dying in 2001-2004, and having public care and services at home or in special accommodation.RESULTS:In the last year of life, 82% of persons living at home and 51% living in special accommodation were hospitalized; median stays were 10 and 6.7 days respectively. Those living at home were younger and less dependent in ADL than those living in special accommodation. Those living at home and those having several hospital stays more often died in hospital. In the total sample, more visits to physicians in outpatient care predicted dying in hospital, whereas living in special accommodation and PADL dependency predicted dying outside hospital.CONCLUSIONS: Old people in their last year of life consumed a considerable amount of both municipal care and outpatient and in-hospital medical care, especially those living at home, which in several cases ended with death in hospital.
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