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| 2. |
- Ekstam, Lisa, et al.
(författare)
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A research-based strategy for managing housing adaptations: study protocol for a quasi-experimental trial
- 2014
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Ingår i: BMC Health Services Research. - : Springer Science and Business Media LLC. - 1472-6963. ; 14
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Tidskriftsartikel (refereegranskat)abstract
- Background: The primary aim of this paper is to describe the design of a project evaluating the effects of using a research-based strategy for managing housing adaptations (HAs). The evaluation targets clients' perspectives in terms of activity, participation, usability, fear of falling, fall incidence, use of mobility devices, and health-related quality of life, and determines the societal effects of HAs in terms of costs. Additional aims of the project are to explore and describe this strategy in relation to experiences and expectations (a) among clients and cohabitants and (b) occupational therapists in ordinary practice. Methods/design: This study is a quasi-experimental trial applying a multiphase design, combining quantitative and qualitative data. At the experimental sites, the occupational therapists (OTs) apply the intervention, i.e. a standardized research-based strategy for HA case management. At the control site, the occupational therapists are following their regular routine in relation to HA. Three municipalities in south Sweden will be included based on their population, their geographical dispersion, and their similar organizational structures for HA administration. Identical data on outcomes is being collected at all the sites at the same four time points: before the HA and then 3, 6, and 12 months after the HA. The data-collection methods are semi-structured qualitative interviews, observations, clinical assessments, and certificates related to each client's HA. Primary outcomes are the usability of the home and the client's independence in daily activities (ADL). Cross-sectional and longitudinal data analyses will be conducted as well as statistical analyses, health-economic analyses, and qualitative analyses. Qualitative and quantitative data will be sequentially analyzed, and case studies will be developed. Discussion: The intervention in this study has been developed and tested through many years of research and in collaboration with practitioners. This process includes methodological development and testing research aimed at identifying the most important outcomes and research targeting current HA case-management procedures in Swedish municipalities. When the study is completed, the results will be used for further optimization of the practice strategy for HA, in close collaboration with the data-collecting OTs.
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| 5. |
- Haak, Maria, et al.
(författare)
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The importance of successful place integration for perceived health in very old age: a qualitative meta-synthesis
- 2011
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Ingår i: International Journal of Public Health. - : Springer Science and Business Media LLC. - 1661-8556 .- 1661-8564. ; 56:6, s. 589-595
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to increase our understanding of the multifaceted phenomenon of home and health, by exploring processes underlying these dynamics when living at home in very old age. A qualitative meta-synthesis was used on four complementary qualitative studies, based on data from the Swedish ENABLE-AGE In-depth Study, focusing on very old, single-living people's experiences of home in relation to participation, independence and health (N = 40). Over time, very old people manage increased frailty by means of three intertwined processes concerning changes in everyday life: The turning points, The struggle and The negotiations. The findings show that these processes take place through the context of the Homelike functional home and a state of mind labelled, The awareness of frailty. The results can be useful in constructing and implementing guidelines for more holistic approaches to housing provision for senior citizens. Further, the study delivers a deeper understanding about how very old people live their lives, useful for practitioners as well as it contributes to theory development within the context of ageing and environments.
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| 6. |
- Iwarsson, Susanne, et al.
(författare)
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The Housing Enabler Screening Tool: Feasibility and Interrater Agreement in a Real Estate Company Practice Context
- 2012
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Ingår i: Journal of Applied Gerontology. - : SAGE Publications. - 1552-4523 .- 0733-4648. ; 31:5, s. 641-660
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Tidskriftsartikel (refereegranskat)abstract
- The ambition underlying this study is to provide a valid and efficient screening tool targeting accessibility problems in the ordinary housing stock. The study aims to test the feasibility and interrater agreement of a screening-tool version of the Housing Enabler in a real estate company practice context. Two rater pairs administer the screening in 35 apartments in a Swedish municipality. The overall agreement for the rater pairs was 83% and 78%. For 29 of the 61 items of the tool, the agreement was > 80% for both rater pairs; for 8 items, it was < 80%. The findings show that the tool is feasible for use in a real estate practice context but that there is a need for more rater training and an instrument manual. This study contributes to the development of research-based strategies for the identification of accessibility problems in ordinary housing, with the long-term aim to increase accessibility in the housing stock, ultimately supporting activity and participation among senior citizens.
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| 9. |
- Malmgren Fänge, Agneta, et al.
(författare)
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Housing adaptations from the perspectives of Swedish occupational therapists.
- 2013
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Ingår i: Scandinavian Journal of Occupational Therapy. - : Informa UK Limited. - 1651-2014 .- 1103-8128. ; 20:3, s. 228-240
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Tidskriftsartikel (refereegranskat)abstract
- Abstract Aim: The aim of this study was to investigate how occupational therapists in Sweden administer housing adaptation cases, how they perceive the housing adaptation process, and which improvements they consider necessary. Methods: A total of 1 679 occupational therapists employed by the county councils or the local authorities (and involved in housing adaptations) participated in a web-based survey. The survey targeted issues related to referral and needs identification, assessment, certification, case progress feedback, and evaluation. Results: Less than half of the occupational therapists systematized the assessment prior to intervention and very few conducted any evaluation afterwards. Feedback from workmen or grant managers to the occupational therapists on each case's adaptation progress was often asked for but rarely given. The majority of the participants were satisfied with the housing adaptation process in general, while at the same time they indicated a need for further improvements in the process. Differences between occupational therapists related to employer and year of graduation were found on the majority of the targeted issues. Conclusions: To conclude, to a very large extent housing adaptations seem to be based on non-standardized procedures for assessment, and only a few of them are evaluated systematically.
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| 13. |
- Pettersson, Cecilia, 1963-, et al.
(författare)
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Clients' experiences of housing adaptations : a longitudinal mixed-methods study
- 2012
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Ingår i: Disability and Rehabilitation. - : Informa Healthcare. - 0963-8288 .- 1464-5165. ; 34:20, s. 1706-1715
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To explore clients' experience of the housing adaptations (HAs) over time in relation to housing and health.METHOD: A multiple longitudinal case study, employing an embedded mixed-method design was used. Four participants were included and data from semi-structured interviews were combined with data from structured survey assessments.RESULTS: HA made it possible to maintain valuable roles and activities, to continue to live in the participants' own homes and to take part in the society. The participants strived for autonomy and control, and in order to do so they needed different kinds of support, in terms of HA and mobility devices as well as support from professionals. HA also challenged the participants' routines and habits, as well as their perception about how an appealing HA aesthetically. Thus, the decision to apply for a HA was not always straightforward. Instead, the participants were constantly engaged in negotiations with themselves, concerning benefits and drawbacks of different decisions.CONCLUSIONS: HAs involve complex person-environment-activity (P-E-A) transactions, and enhance clients' activity and independence in spite of functional decline. The knowledge generated is important in order to improve individual HA, as well as improving the efficiency and effectiveness of the intervention.
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| 14. |
- Sixsmith, Judith, et al.
(författare)
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Healthy Ageing and Home: the Perspectives of Very Old People in Five European Countries
- 2014
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Ingår i: Social Science and Medicine. - : Elsevier BV. - 0277-9536 .- 1873-5347. ; 106, s. 1-9
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Tidskriftsartikel (refereegranskat)abstract
- This paper reports on in-depth research, using a grounded theory approach, to examine the ways in which very old people perceive healthy ageing in the context of living alone at home within urban settings in five European countries. This qualitative study was part of a cross-national project entitled ENABLE-AGE which examined the relationship between home and healthy ageing. Interviews explored the notion of healthy ageing, the meaning and importance of home, conceptualisations of independence and autonomy and links between healthy ageing and home. Data analysis identified five ways in which older people constructed healthy ageing: home and keeping active; managing lifestyles, health and illness; balancing social life; and balancing material and financial circumstances. Older people reflected on their everyday lives at home in terms of being engaged in purposeful, meaningful action and evaluated healthy ageing in relation to the symbolic and practical affordances of the home, contextualised within constructions of their national context. The research suggests that older people perceive healthy ageing as an active achievement, created through individual, personal effort and supported through social ties despite the health, financial and social decline associated with growing older. The physicality and spatiality of home provided the context for establishing and evaluating the notion of healthy ageing, whilst the experienced relationship between home, life history and identity created a meaningful space within which healthy ageing was negotiated.
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