1.
Religa, D., et al.
(författare)
SveDem, the Swedish Dementia Registry - A tool for improving the quality of diagnostics, treatment and care of dementia patients in clinical practice
2015
Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 10:2
Tidskriftsartikel (refereegranskat) abstract
Background: The Swedish Dementia Registry (SveDem) was developed with the aim to improve the quality of diagnostic work-up, treatment and care of patients with dementia disorders in Sweden. Methods: SveDem is an internet based quality registry where several indicators can be followed over time. It includes information about the diagnostic work-up, medical treatment and community support (www.svedem.se). The patients are diagnosed and followed-up yearly in specialist units, primary care centres or in nursing homes. Results: The database was initiated in May 2007 and covers almost all of Sweden. There were 28 722 patients registered with a mean age of 79.3 years during 2007-2012. Each participating unit obtains continuous online statistics from its own registrations and they can be compared with regional and national data. A report from SveDem is published yearly to inform medical and care professionals as well as political and administrative decision-makers about the current quality of diagnostics, treatment and care of patients with dementia disorders in Sweden. Conclusion: SveDem provides knowledge about current dementia care in Sweden and serves as a framework for ensuring the quality of diagnostics, treatment and care across the country. It also reflects changes in quality dementia care over time. Data from SveDem can be used to further develop the national guidelines for dementia and to generate new research hypotheses.
2.
3.
Barbabella, Francesco, 1984-, et al.
(författare)
A multilingual web platform supporting informal carers in 27 EU member states
2015
Ingår i: Broader, bigger, better: AAL solutions for Europe. Proceedings of the 6<sup>th</sup> AAL Forum 2014. - Bucharest : UEFISCDI. - 9789730201192 ; , s. 169-172
Konferensbidrag (refereegranskat) abstract
Informal care is a hot topic in research and policy agendas at European and national level, since it greatly contributes to the sustainability and efficiency of national health care systems. A specific intervention – part of the wider INNOVAGE project funded by FP7 – was planned for developing and testing a new multilingual web platform for informal carers of dependent older people in the EU-27. Preliminary results of the pilot study, conducted in Italy, Germany and Sweden will be discussed. The final platform will be accessible in all official languages of the EU-27 and publicly available in spring 2015.
4.
Johansson, Karin, et al.
(författare)
Patients' experiences of support for learning to live with diabetes to promote health and well-being : A lifeworld phenomenological study
2016
Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Taylor & Francis. - 1748-2623 .- 1748-2631. ; 11:1
Tidskriftsartikel (refereegranskat) abstract
Learning to live with diabetes in such a way that the new conditions will be a normal and natural part of life imposes requirements on the person living with diabetes. Previous studies have shown that there is no clear picture of what and how the learning that would allow persons to incorporate the illness into their everyday life will be supported. The aim of this study is to describe the phenomenon of support for learning to live with diabetes to promote health and well-being, from the patient's perspective. Data were collected by interviews with patients living with type 1 or type 2 diabetes. The interviews were analysed using a reflective lifeworld approach. The results show that reflection plays a central role for patients with diabetes in achieving a new understanding of the health process, and awareness of their own responsibility was found to be the key factor for such a reflection. The constituents are responsibility creating curiosity and willpower, openness enabling support, technology verifying bodily feelings, a permissive climate providing for participation and exchanging experiences with others. The study concludes that the challenge for caregivers is to create interactions in an open learning climate that initiates and supports reflection to promote health and well-being.
5.
6.
Mosallanezhad, Z., et al.
(författare)
A structural equation model of the relation between socioeconomic status, physical activity level, independence and health status in older Iranian people
2017
Ingår i: Archives of Gerontology and Geriatrics. - : Elsevier BV. - 0167-4943 .- 1872-6976. ; 70, s. 123-129
Tidskriftsartikel (refereegranskat) abstract
Background and aim: Health status is an independent predictor of mortality, morbidity and functioning in older people. The present study was designed to evaluate the link between socioeconomic status (SES), physical activity (PA), independence (I) and the health status (HS) of older people in Iran, using structural equation modelling. Methods: Using computerized randomly selection, a representative sample of 851 75-year-olds living in Tehran (2007-2008), Iran, was included. Participants answered questions regarding indicators of HS, SES and also PA and I through interviews. Both measurement and conceptual models of our hypotheses were tested using Mplus 5. Maximum-likelihood estimation with robust standard errors (MLR estimator), chisquare tests, the goodness of fit index (and degrees of freedom), as well as the Comparative Fit Index (CFI), and the Root Mean Square Error of Approximation (RSMEA) were used to evaluate the model fit. Results: The measurement model yielded a reasonable fit to the data, chi(2) = 110.93, df = 38; CFI = 0.97; RMSEA = 0.047, with 90% C.I. = 0.037-0.058. The model fit for the conceptual model was acceptable; chi(2) = 271.64, df = 39; CFI = 0.91; RMSEA = 0.084, with 90% C.I. = 0.074-0.093. SES itself was not a direct predictor of HS (beta = 0.13, p = 0.059) but it was a predictor of HS either through affecting PA (beta = 0.31, p < 0.001) or I (beta = 0.57, p < 0.001). Conclusion: Socioeconomic status appeared to influence health status, not directly but through mediating some behavioral and self-confidence aspects including physical activity and independence in ADL. (C) 2017 Elsevier B.V. All rights reserved.
7.
Smedback, Jonas, et al.
(författare)
Palliative care during the final week of life of older people in nursing homes : A register-based study
2017
Ingår i: Palliative & Supportive Care. - : Cambridge University Press. - 1478-9515 .- 1478-9523. ; 15:4, s. 417-424
Tidskriftsartikel (refereegranskat) abstract
Objective: Our aim was to explore the presence of symptoms, symptom relief, and other key aspects of palliative care during the final week of life among older people residing in nursing homes. Method: Our study employed data from the Swedish Palliative Care Register on all registered individuals aged 60 and older who had died in nursing homes during the years 2011 and 2012. Variables pertaining to monitoring and treatment of symptoms, end-of-life discussions, circumstances around the death, and the individual characteristics of deceased individuals were explored using descriptive statistics. Results: The most common underlying causes of death among the 49,172 deceased nursing home residents were circulatory diseases (42.2%) and dementia (22.7%). The most prevalent symptom was pain (58.7%), followed by rattles (42.4%), anxiety (33.0%), confusion (21.8%), shortness of breath (14.0%), and nausea (11.1%). Pain was the symptom with the highest degree of total relief (46.3%), whereas shortness of breath and confusion were totally relieved in 6.1 and 4.3% of all individuals, respectively. The use of valid instruments for symptom assessment was reported for pain in 12.3% and for other symptoms in 7.8% of subjects. The most prevalent individual prescriptions for injection PRN (pro re nata, according to circumstances) were for pain treatment (79.5%) and rattles (72.8%). End-of-life discussions were performed with 27.3% of all the deceased individuals and with 53.9% of their relatives. Of all individuals, 82.1% had someone present at death, and 15.8% died alone. Of all the nursing home resident deaths recorded, 45.3% died in their preferred place. Significance of results: There were large variations in degree of relief from different symptoms during the final week of life. Pain was the most prevalent symptom, and it was also the symptom with the highest proportion of total/partial relief. Other symptoms were less prevalent but also less well-relieved. Our results indicate a need for improvement of palliative care in nursing home settings, focusing on management of distressing symptoms and promotion of end-of-life discussions.
8.
Barbabella, Francesco, 1984-, et al.
(författare)
Launching an interdisciplinary “International Summer School on Ageing” (ISSA) : Aims, methodology and outcomes
2016
Ingår i: Educational gerontology. - : Informa UK Limited. - 0360-1277 .- 1521-0472. ; 42:4, s. 253-264
Tidskriftsartikel (refereegranskat) abstract
Despite the increasing availability of gerontological training programmes, knowledge of theircontents, characteristics, methods and outcomes remains limited. However, the transitionfrom multidisciplinarity to interdisciplinary orientations is now fundamental to such training,providing participants from diverse academic orientations and professional backgrounds withopportunities to interact ‘across boundaries’. In response to recommendations of the EUFuturage Road Map for European Ageing Research (2011) concerning training and careerdevelopmentneeds of future cohorts of practitioners and scholars in aging, an InternationalSummer School on Ageing (ISSA) was developed in 2012. Its aim was to initiate the practicalimplementation of some of the capacity building goals identified by Futurage. The design andstructure of the ISSA was informed by the experience of Canada’s Summer Programme inAgeing - run by the Institute of Aging of the Canadian Institutes of Health Research – and bythe cross-border academic training activities organized by Lund University (Sweden) inScandinavian countries. As Italy has lacked a tradition of comprehensive, interdisciplinarytraining programmes in gerontology, the Italian National Institute of Health and Science onAgeing undertook to launch the inaugural ISSA. In this article, the core aims andmethodology of the ISSA are presented, together with an analysis of its main outcomes, asmeasured by participant evaluations. These are discussed in the context of internationaldebate on this topic.
9.
Barbabella, Francesco, 1984-, et al.
(författare)
La bussola di NNA : lo stato dell'arte basato sui dati
2015
Ingår i: L'assistenza agli anziani non autosufficienti in Italia. - Rimini : Maggioli Editore. - 8891614068 - 9788891614063 ; , s. 15-33
Bokkapitel (refereegranskat)
10.
11.
Gori, Cristiano, et al.
(författare)
How different countries allocate long-term care resources to older users : changes over time
2016
Ingår i: Long-term care reforms in OECD countries. - Bristol : Policy Press. - 978 144731 071 6 ; , s. 77-116
Bokkapitel (refereegranskat) abstract
A key policy debate in long-term care (LTC) policies across OECD countriestoday can be summarised by the following question: what measures and strategiescan be adopted to optimise resources? New policies are required for balancingfinances and access to care, with different options on the table and waiting forgovernments’ decisions.This chapter looks at changes over time in public resource allocation amongLTC users in the same OECD countries considered in the previous chapter (exceptfor Australia). As in Chapter Four, this chapter focuses exclusively on publiccare inputs, defined as those inputs that are (at least partially) publicly funded,and looks at users aged 65 and over. Chapter Four led the way to reconsideringhow public resources are allocated in different LTC systems through an in-depthanalysis of current spending. To complement that analysis, this chapter adopts along-term perspective, investigating the changes that have occurred over the last20–25 years in three crucial dimensions of resource allocation: the mix of LTCservices for older people, their intensity, and their coverage.The countries considered are representative of the OECD environment withrespect to both the overall welfare models and the models of LTC policies.Concerning the former, as Campbell et al have noted in Chapter Four, ‘wehave Sweden in social-democratic Northern Europe, Italy in familial SouthernEurope, Germany in corporatist mid-continent, Australia, the US and Englandas quite different versions of the Anglo-Saxon “residual” model, and Japan as therelatively new entry that shares aspects of all the other models.’ From the pointof view of LTC policies, the sample of countries selected represents the differentmodels in the OECD context:• Universal coverage within a single programme: this model guarantees people access toformal services without taking into account users’ income or assets as eligibilitycriteria. It is also organised as a single system, separated or integrated with theoverall health system (Germany, Japan and Sweden).• Mixed systems: in this case, LTC is provided through a mix of different universalprogrammes and benefits operating alongside, or a mix of universal and meanstestedLTC entitlements (England and Italy).• Means-tested systems: under this type of scheme, LTC coverage is providedthrough safety-net programmes. In countries using this system, income and/or asset tests are used to define thresholds for eligibility to publicly fundedcare. Only those falling below a set threshold are entitled to publicly fundedservices or benefits (the US) (Colombo et al, 2011).This chapter is organised as follows. First, it addresses the issue of resourceallocation, providing a definition of the topic and the methodology used. Themain policies implemented in each of the six countries are then examined. Finally,a comparative discussion on the trends emerging across our sample is presented,followed by a final paragraph looking ahead.
12.
Berner, Jessica, et al.
(författare)
Factors influencing Internet usage in older adults (65 years and above) living in rural and urban Sweden
2015
Ingår i: Health Informatics Journal. - : Sage Publications. - 1460-4582 .- 1741-2811. ; 21:3, s. 237-249
Tidskriftsartikel (refereegranskat) abstract
Older adults living in rural and urban areas have shown to distinguish themselves in technology adoption; a clearer profile of their Internet use is important in order to provide better technological and health-care solutions. Older adults' Internet use was investigated across large to midsize cities and rural Sweden. The sample consisted of 7181 older adults ranging from 59 to 100 years old. Internet use was investigated with age, education, gender, household economy, cognition, living alone/or with someone and rural/urban living. Logistic regression was used. Those living in rural areas used the Internet less than their urban counterparts. Being younger and higher educated influenced Internet use; for older urban adults, these factors as well as living with someone and having good cognitive functioning were influential. Solutions are needed to avoid the exclusion of some older adults by a society that is today being shaped by the Internet.
13.
Sjölund, Britt-Marie, et al.
(författare)
Incidence of ADL Disability in Older Persons, Physical Activities as a Protective Factor and the Need for Informal and Formal Care : Results from the SNAC-N Project
2015
Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 10:9
Tidskriftsartikel (refereegranskat) abstract
BACKGROUND: The aim of the study was to examine 1) the incidence of disability in Activities of Daily Living (ADL), in persons 78 years and older 2) explore whether being physical active earlier is a significant predictor of being disability free at follow-up and 3) describe the amount of informal and formal care in relation to ADL-disability.METHODS: Data were used from a longitudinal community-based study in Nordanstig (SNAC-N), a part of the Swedish National Study on Aging and Care (SNAC). To study objectives 1) and 2) all ADL-independent participants at baseline (N = 307) were included; for objective 3) all participants 78 years and older were included (N = 316). Data were collected at baseline and at 3- and 6-year follow-ups. ADL-disability was defined as a need for assistance in one or more activities. Informal and formal care were measured using the Resource utilization in Dementia (RUD)-instrument.RESULTS: The incidence rates for men were similar in the age groups 78-81and 84 years and older, 42.3 vs. 42.5/1000 person-years. For women the incidence rate for ADL-disability increased significantly from the age group 78-81 to the age group 84 years and older, 20.8 vs.118.3/1000 person-years. In the age group 78-81 years, being physically active earlier (aOR 6.2) and during the past 12 month (aOR 2.9) were both significant preventive factors for ADL-disability. Both informal and formal care increased with ADL-disability and the amount of informal care was greater than formal care. The incidence rate for ADL-disability increases with age for women and being physically active is a protective factor for ADL-disability.CONCLUSION: The incidence rate for ADL-disability increases with age for women, and being physical active is a protective factor for ADL-disability.
14.
Almberg, Maria, et al.
(författare)
Experiences of facilitators or barriers in driving education from learner and novice drivers with ADHD or ASD and their driving instructors
2017
Ingår i: Developmental Neurorehabilitation. - : Taylor & Francis. - 1751-8423 .- 1751-8431. ; 20:2, s. 59-67
Tidskriftsartikel (refereegranskat) abstract
Background: Little is known about whether individuals with autism spectrum disorder (ASD) or attention deficit hyperactive disorder (ADHD) experience any specific facilitators or barriers to driving education.Objective: To explore the facilitators or barriers to driving education experienced by individuals with ASD or ADHD who obtained a learner’s permit, from the perspective of the learner drivers and their driving instructors.Methods: Data were collected from 33 participants with ASD or ADHD, and nine of their driving instructors.Results: Participants with ASD required twice as many driving lessons and more on-road tests than those with ADHD. Participants with ADHD repeated the written tests more than those with ASD. Driving license theory was more challenging for individuals with ADHD, whilst individuals with ASD found translating theory into practice and adjusting to “unfamiliar” driving situations to be the greatest challenges.Conclusion: Obtaining a driving license was associated with stressful training experience.
15.
Karlsson, Staffan, 1959-, et al.
(författare)
Trends in treatment with antipsychotic medication in relation to national directives, in people with dementia : a review of the Swedish context
2017
Ingår i: BMC Psychiatry. - London : BioMed Central. - 1471-244X. ; 17, s. 1-9
Forskningsöversikt (refereegranskat) abstract
Background: The aim of this study was to explore trends in treatment with antipsychotic medication in Swedish dementia care in nursing homes as reported in the most recent empirical studies on the topic, and to relate these trends to directives from the national authorities. Methods: The study included two scoping review studies based on searches of electronic databases as well as the Swedish directives in the field. Results: During the past decade, directives have been developed for antipsychotic medication in Sweden. These directives were generic at first, but have become increasingly specific and restrictive with time. The scoping review showed that treatment with antipsychotic drugs varied between 6% and 38%, and was higher in younger older persons and in those with moderate cognitive impairment and living in nursing homes for people with dementia. A decreasing trend in antipsychotic use has been seen over the last 15 years. Conclusions: Directives from the authorities in Sweden may have had an impact on treatment with antipsychotic medication for people with dementia. Treatment with antipsychotic medication has decreased, while treatment with combinations of psychotropic medications is common. National directives may possibly be even more effective, if applied in combination with systematic follow-ups.
16.
Frennert, Susanne, PhD, et al.
(författare)
How Do Older People Think and Feel About Robots in Health- and Elderly Care?
2019
Ingår i: Inclusive Robotics for a Better Society. - Cham : Springer International Publishing. - 9783030240745 - 9783030240738 ; , s. 167-174
Konferensbidrag (refereegranskat) abstract
This extended abstract is a report on older people’s perception of interactive robots in health- and elderly care. A series of focus groups was conducted. In total 31 older people participated. The majority of the participants viewed interactive robots in health- and elderly care as an asset but they also voiced concerns regarding reliability, practical handling, costs and fear of mechanical care.
17.
Eklund, Mona, et al.
(författare)
Wellbeing, activity and housing satisfaction - comparing residents with psychiatric disabilities in supported housing and ordinary housing with support
2017
Ingår i: BMC Psychiatry. - : BioMed Central. - 1471-244X. ; 17
Tidskriftsartikel (refereegranskat) abstract
Background: The home is imperative for the possibilities for meaningful everyday activities among people with psychiatric disabilities. Knowledge of whether such possibilities vary with type of housing and housing support might reveal areas for improved support. We aimed to compare people with psychiatric disabilities living in supported housing (SH) and ordinary housing with support (OHS) regarding perceived well-being, engaging and satisfying everyday activities, and perceived meaning of activity in one's accommodation. The importance of these factors and socio-demographics for satisfaction with housing was also explored. Methods: This naturalistic cross-sectional study was conducted in municipalities and city districts (n = 21) in Sweden, and 155 SH residents and 111 OHS residents participated in an interview that included both self-reports and interviewer ratings. T-test and linear regression analysis were used. Results: The SH group expressed more psychological problems, but better health, quality of life and personal recovery compared to the OHS residents. The latter were rated as having less symptom severity, and higher levels of functioning and activity engagement. Both groups rated themselves as under-occupied in the domains of work, leisure, home management and self-care, but the SH residents less so regarding home management and self-care chores. Although the groups reported similar levels of activity, the SH group were more satisfied with everyday activities and rated their housing higher on possibilities for social interaction and personal development. The groups did not differ on access to activity in their homes. The participants generally reported sufficient access to activity, social interaction and personal development, but those who wanted more personal development in the OHS group outnumbered those who stated they received enough. Higher scores on satisfaction with daily occupations, access to organization and information, wanting more social interaction, and personal recovery predicted high satisfaction with housing in the regression model. Conclusion: The fact that health, quality of life and recovery were rated higher by the SH group, despite lower interviewer-ratings on symptoms and level of functioning, might partly be explained by better access to social interaction and personal development in the SH context. This should be acknowledged when planning the support to people who receive OHS.
18.
Roos, John Magnus
(författare)
Personality and E-shopping : Insights from a Nationally Representative Study
2019
Ingår i: Digital Transformation and Global Society. - Cham : Springer. - 9783030378578 - 9783030378585 ; 1038 CCIS, s. 257-267
Bokkapitel (refereegranskat) abstract
According to previous research, a high degree of Openness and Neuroticism, and a low degree of Agreeableness are personality determinants of e-shopping. This study aims to explore the relationship between the Five-factor model of personality (i.e. Openness, Conscientiousness, Extraversion, Agreeableness, and Neuroticism) and e-shopping in a Swedish context. In a nationally representative sample, a questionnaire was distributed to 3400 citizens. The response rate was 53 percentage (N = 1812). The questionnaire included measures of the Five-factor model of personality (BFI-ten) and e-shopping. Multiple regression analyses were conducted to test if the Five-factor model of personality predicted e-shopping. The dependent variable was self-reported frequencies of e-shopping during the last 12 months. The first analysis showed that Openness is predicting e-shopping. However, this effect disappeared, when age, educational attainment and income were controlled for. Our conclusion is that the Five-factor model of personality is a poor predictor of e-shopping and that e-shopping frequencies are unrelated to the personality of internet users. Methodological limitations are discussed, for instance the use of a single-item for measuring e-shopping and a short-scale for measuring personality. There are difficulties comparing our findings with previous findings, since the concepts personality and e-shopping have not been defined uniformly. The analyses revealed significant variation in definitions, measurements and methodologies. Caution should also be taken in generalizing the present results to other countries and other time periods. © 2019, Springer Nature Switzerland AG.
19.
Hallgren, Jenny, 1978-, et al.
(författare)
In Hospital We Trust : Experiences of older peoples' decision to seek hospital care
2015
Ingår i: Geriatric Nursing. - : Elsevier. - 0197-4572 .- 1528-3984. ; 36:4, s. 306-311
Tidskriftsartikel (refereegranskat) abstract
The purpose of this study was to explore how older people experience and perceive decisions to seek hospital care while receiving home health care. Twenty-two Swedish older persons were interviewed about their experiences of decision to seek hospital while receiving home health care. The interviews were analyzed using qualitative content analysis. The findings consist of one interpretative theme describing an overall confidence in hospital staff to deliver both medical and psychosocial health care, In Hospital We Trust, with three underlying categories: Superior Health Care, People's Worries, and Biomedical Needs. Findings indicate a need for establishing confidence and ensuring sufficient qualifications, both medical and psychological, in home health care staff to meet the needs of older people. Understanding older peoples' arguments for seeking hospital care may have implications for how home care staff address individuals' perceived needs. Fulfillment of perceived health needs may reduce avoidable hospitalizations and consequently improve quality of life.
20.
21.
Kylén, Maya, et al.
(författare)
The importance of the built environment in person-centred rehabilitation at home : study protocol
2019
Ingår i: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 16:13
Tidskriftsartikel (refereegranskat) abstract
Health services will change dramatically as the prevalence of home healthcare increases. Only technologically advanced acute care will be performed in hospitals. This-along with the increased healthcare needs of people with long-term conditions such as stroke and the rising demand for services to be more person-centred-will place pressure on healthcare to consider quality across the continuum of care. Research indicates that planned discharge tailored to individual needs can reduce adverse events and promote competence in self-management. However, the environmental factors that may play a role in a patient's recovery process remain unexplored. This paper presents a protocol with the purpose to explore factors in the built environment that can facilitate/hinder a person-centred rehabilitation process in the home. The project uses a convergent parallel mixed-methods design, with ICF (International Classification of Functioning, Disability and Health) and person-environment theories as conceptual frameworks. Data will be collected during home visits 3 months after stroke onset. Medical records, questionnaires, interviews and observations will be used. Workshops will be held to identify what experts and users (patients, significant others, staff) consider important in the built environment. Data will be used to synthesise the contexts, mechanisms and outcomes that are important to support the rehabilitation process at home.
22.
Manasatchakun, Pornpun, 1983-, et al.
(författare)
Community nurses’ experiences regarding the meaning and promotion of healthy aging in northeastern Thailand
2018
Ingår i: Journal of Holistic Nursing. - Thousand Oaks, CA : Sage Publications. - 0898-0101 .- 1552-5724. ; 36:1, s. 54-67
Tidskriftsartikel (refereegranskat) abstract
Purpose: Describe community nurses’ experiences regarding the meaning and promotion of healthy aging in northeastern Thailand.Method: Data were collected through five focus group interviews with 36 community nurses in northeastern Thailand. Latent content analysis was conducted to analyze the data.Findings: Healthy aging was characterized by the interconnection of older persons, older persons’ family members and the community. Healthy aging was associated with two themes: “being strong” and “being a supporter and feeling supported”. The nurses’ experiences in promoting healthy aging were described using the themes “providing health assessment”, “sharing knowledge” and “having limited resources”.Conclusions: The findings of this study provide a deeper understanding of the meaning of healthy aging from a holistic viewpoint. Community nurses must pay attention to older persons and their surroundings when planning how to promote healthy aging. Person-centredness should be applied in practice to promote healthy aging. The current findings contribute useful information that should help policy makers develop healthy aging strategies in Thailand.
23.
Nordin, Susanna, et al.
(författare)
The importance of the physical environment to support individualised care
2018
Ingår i: Individualized Care: Theory, Measurement, Research and Practice. - Cham : Springer International Publishing. - 9783319898995 - 9783319898988 ; , s. 207-215
Bokkapitel (övrigt vetenskapligt/konstnärligt) abstract
The physical environment is an important part of individualised care. Creating care environments tailored towards the individual person’s needs is essential for high-quality care and is increasingly recognised as being associated with improved health and well-being among older people. Today, care should be holistic and view the person behind the disease, taking that person’s perspective and treating the patient as a unique individual. Despite the emerging focus on individualised care approaches, the physical environment is still not considered as an integral part of care, and relatively little attention has been paid to environmental aspects. However, the physical environment has a great potential to facilitate or restrict care processes in a broad range of care settings, not least in residential care facilities for older people. The present chapter focuses on ways to support the individual in terms of the physical environment.
24.
Hedna, Khedidja, 1978, et al.
(författare)
Clinical relevance of alerts from a decision support system, PHARAO, for drug safety assessment in the older adults
2019
Ingår i: BMC Geriatrics. - : Springer Science and Business Media LLC. - 1471-2318. ; 19:1, s. 164-
Tidskriftsartikel (refereegranskat) abstract
BackgroundPHARAO is a decision support system developed to evaluate the risk for a set of either common or serious side-effects resulting from a combination of pharmacodynamic effects from a patient's medications. The objective of this study was to investigate the validity of the risk scores for the common side-effects generated by PHARAO in older patients.MethodsSide-effects included were sedation, constipation, orthostatic symptoms, anticholinergic and serotonergic effects. The alerts generated by PHARAO were tested in 745 persons 65years old. Dispensed prescriptions retrieved from the Swedish prescribed drug register were used to generate the pharmacological risk scores of patients' medications. Symptoms possibly related to side-effects were extracted from medical records data.ResultsThe PHARAO system generated 776 alerts, most often for the risk of anticholinergic symptoms. The total specificity estimates of the PHARAO system were 0.95, 0.89 and 0.78 for high, intermediate and low risk alerts, respectively. The corresponding sensitivity estimates were between 0.12 and 0.37. The negative predictive value was 0.90 and the positive predictive value ranged between 0.20-0.25.ConclusionsThe PHARAO system had a high specificity and negative predictive value to detect symptoms possibly associated with the of patients' medications, while the sensitivity and positive predictive value were low. The PHARAO system has the potential to minimise the risk of over-alerts in combination with a drug-drug interaction alert system, but should be used in connection with a medical evaluation of the patient.
25.
Lagergren, Mårten, et al.
(författare)
Horizontal and vertical targeting : a population-based comparison of public eldercare services in urban and rural areas of Sweden
2016
Ingår i: Aging Clinical and Experimental Research. - : Springer Science and Business Media LLC. - 1594-0667 .- 1720-8319. ; 28:1, s. 147-158
Tidskriftsartikel (refereegranskat) abstract
The concepts of target efficiency can be used to assess the extent to which service provision is in line with the needs of the population. Horizontal target efficiency denotes the extent to which those deemed to need a service receive it and vertical target efficiency is the corresponding extent to which those who receive services actually need them. The aim of this study was to assess the target efficiency of the Swedish eldercare system and to establish whether target efficiencies differ in different geographical areas such as large urban, midsize urban and rural areas. Vertical efficiency was measured by studying those people who received eldercare services and was expressed as a percentage of those who received services who were functionally dependent. To measure horizontal target efficiency, data collected at baseline in the longitudinal population study SNAC (Swedish National study on Aging and Care) during the years 2001-2004 were used. The horizontal efficiency was calculated as the percentage of functionally dependent persons who received services. Functional dependency was measured as having difficulty with instrumental activities of daily living (IADL) and/or personal activities of daily living (PADL). Services included long-term municipal eldercare services (LTC). Horizontal target efficiency for the public LTC system was reasonably high in all three geographical areas, when using dependency in PADL as the measure of need (70-90 %), but efficiency was lower when the less restrictive measure of IADL dependency was used (40-50 %). In both cases, the target efficiency was markedly higher in the large urban and the rural areas than in the midsize urban areas. Vertical target efficiency showed the same pattern-it was almost 100 % in all areas for IADL dependency, but only 50-60 % for PADL dependency. Household composition differed in the areas studied as did the way public long-term care was provided to people living alone as compared to those co-habiting.
