| 1. |
- Berglund, Helene, 1957, et al.
(författare)
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Effect of a care process programme on frail older people’s life satisfaction
- 2019
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Ingår i: Nursing Open. - : John Wiley & Sons. - 2054-1058. ; 6:3, s. 1097-1104
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Tidskriftsartikel (refereegranskat)abstract
- Aim: The aim of this study was to analyse the effects of a full-scale implementation of a care process programme on life satisfaction among frail older people, as compared with those receiving usual care. Design: The study includes participants from a full-scale care process programme (N = 77) and participants from a historical control group (N = 66). The care process programme establishes a comprehensive continuum of care through components including case management, interprofessional teamwork and care-planning meetings in the older people's own homes. Methods: Questionnaires were used and data were collected at baseline, with follow-ups at three, six and 12 months. Results: The implementation of the full-scale care process programme had a positive effect on life satisfaction among frail older people. From 6-month–12-month follow-ups, a higher proportion of participants in the care process programme had positive life satisfaction outcomes, as compared with the historical control group.
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| 2. |
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| 3. |
- Gustafsson, Susanne, 1963, et al.
(författare)
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A Cross-Cultural Adaptation of the ICECAP-O: Reliability and Validity in Swedish 70-Year-Old Persons
- 2017
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Ingår i: 21st International Association of Gerontology and Geriatrics (IAGG) World Congress, July 23-27, 2017 San Francisco, California. Innovation in Aging, 1 (S1), s. 752. - : Oxford University Press (OUP). - 2399-5300.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Few Quality of Life (QoL) measures tap into the concept of capability, i.e. genuine opportunities to 'do' and 'be' the things that a person deems important in life. The ICECAP-O is one such instrument. This presentation includes test-retest reliability, item relevance, face- and content validity, and accessibility of the ICECAP-O in a Swedish context. Thirty-nine 70-year-olds who took part in a population-based study completed the Swedish version of the ICECAP-O on two occasions, and another 18 partook in cognitive interviews. Test-retest reliability was analyzed for the index and separate items, and participants rated item relevance on a Visual Analogue Scale. A standardized classification scheme was used to quantify any identified response problems, and a thematic analysis was applied to capture participants’ experiences of completing the measure and perceptions of included attributes. Test-retest showed that the index score had good stability, ICC of 0.80 (95 % CI 0.62-0.90). However, Kappa was low for each separate item, and ranged from 0.18 (Control) to 0.41 (Role). Participants gave their highest relevance rating to Attachment and the lowest to Enjoyment. In the cognitive interviews, three participants (18%) had problems completing ICECAP-O, and out of 80 question segments, judged problems occurred for five (6%). Most participants perceived the attributes as understandable even though the meaning of Control brought some uncertainty. ICECAP-O has potential for becoming a valuable addition to the supply of QoL measures in research and health and social care in Sweden. However, we recommend further research on more diverse groups of older person.
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| 4. |
- Gustafsson, Susanne, 1963, et al.
(författare)
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Face and content validity and acceptability of the Swedish ICECAP-O capability measure: Cognitive interviews with 70-year-old persons
- 2018
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Ingår i: Health Psychology Research. - : Open Medical Publishing. - 2420-8124 .- 2281-2075. ; 6:1, s. 1-8
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Tidskriftsartikel (refereegranskat)abstract
- This study is part of a project that aims to culturally adapt the Investigating Choice Experiments for the Preferences of Older People-CAPability Index (ICECAP-O) for use in research and health and social care in Sweden. The objective was to evaluate face and content validity and acceptability. Eighteen 70-year-old community-dwelling persons participated in cognitive interviews. A standardized classification scheme was used to quantify any identified response problems, and a thematic analysis was applied to capture participants' perceptions of included attributes and experiences of completing the measure. The results show that three participants (18%) had problems completing ICECAP-O, and that judged problems occurred for five (6%) of participants responses in the standardized classification scheme. Most participants perceived the attributes as understandable even though the meaning of Control brought some uncertainty. ICECAP-O seems to measure what it is supposed to measure, quality of life (QoL) with a capability approach, and acceptability is satisfactory. ICECAP-O has potential for becoming a valuable addition to the supply of QoL measures in research and health and social care in Sweden. However, we recommend further research on more diverse groups of older persons.
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| 5. |
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| 6. |
- Ottenvall Hammar, Isabelle, 1984, et al.
(författare)
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Erfarenheter av självbestämmande hos personer som nyligen utvecklat ett beroende i dagliga aktiviteter
- 2013
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Ingår i: AT-Forum (Arbetsterapeuternas nationella konferens). Stockholm, 24-25 april 2013 (Muntlig presentation).
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Bakgrund: Övergången från att vara oberoende till att utveckla sårbarhet och beroende av annan person i dagliga aktiviteter kan vara fylld med utmaningar. I takt med att en person utvecklar ett beroende, kan möjligheten till självbestämmande i dagliga aktiviteter försämras vilket kan upplevas stressande för den äldre personen. Äldre som är beroende uttrycker ett behov att kunna fortsätta vara delaktiga i beslutsfattande som rör dagliga aktiviteter. För att äldre ska kunna bibehålla god hälsa och välbefinnande är det viktigt att de involveras och tillåts att ta beslut som rör deras dagliga aktiviteter. Hälso- och sjukvårdspersonal är medvetna om vikten av äldres rätt till självbestämmande, dock påvisar studier att professionella efterfrågar mera kunskap om äldres erfarenheter för att kunna stödja de äldre till ökat självbestämmande. Syfte: Att undersöka erfarenheter av självbestämmande vid övergången från oberoende till beroende av annan person i daglig aktivitet hos personer 80 år och äldre. Tillvägagångssätt och analys: En explorativ design baserad på Grounded Theory beskriven av Charmaz används i studien. Semistrukturerade intevjuer kommer att genomföras på ca 15 personer i åldern 80 år och äldre som börjat uppleva svårigheter i dagliga aktiviteter eller som utvecklat ett beroende i minst en Instrumentell Daglig Aktivitet (I-ADL) och/eller minst en Personlig Daglig Aktivitet (P-ADL) enligt ADL-trappan. Insamlad data kommer att analyseras med Grounded Theory. Både intervjuer och analys av data har påbörjats. Resultat/förväntat resultat: Studien förväntas ge en förståelse för hur personer vilka är 80 år och äldre erfar sitt självbestämmande vid övergången från oberoende till beroende av annan person i daglig aktivitet. Slutsatser: Förväntat resultat kommer att leda till ökad kunskap om hur personal inom hälso- och sjukvården kan stödja äldre personer som är i övergången till att utveckla ett beroende i dagliga aktiviteter till ökat självbestämmande.
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| 7. |
- Ottenvall Hammar, Isabelle, 1984, et al.
(författare)
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From Intervention Trial to Full-scale Implementation Research: Positive Tendencies for Frailty and Self-rated Health in Frail Older People.
- 2018
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Ingår i: International Journal of Geriatrics and Gerontology. - 2577-0748. ; 2018:2
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Tidskriftsartikel (refereegranskat)abstract
- A continuum of care for frail older people was created to link the chain between the hospital, and discharge to the person’s home. Despite earlier positive findings, it remains unclear if the benefits are sustainable in a real-life context. The present longitudinal study aimed at evaluate the effects of the implementation of a full-scale process program for frail older people in a real-life context regarding levels of frailty, self-rated health and activities of daily living up to one year later. The sample consisted of a total of 143 frail people aged 75 years and older, divided in the two groups: 77 participants from the full-scale process program and 66 historical controls. The findings showed that at the six months follow-up, the participants partaking in the full-scale process program had a significantly higher odds of displaying decreased frailty (p=0.015), and at twelve months, this sample had a significant lower likelihood of reporting decreased self-rated health (p=0.023). Thus, the findings showed positive results on frailty level and self-rated health when implementing the intervention in real life, indicating that a person-centred, multi-professional team with a case manager is beneficial for frail older people.
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| 8. |
- Ottenvall Hammar, Isabelle, 1984, et al.
(författare)
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Governing or being governed: Older persons' experiences of self-determination
- 2014
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Ingår i: Age Well - 22nd Nordic Congress of Gerontology, 25-28 maj, Göteborg, Sverige.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: In Sweden it is a legal right for older persons to exercise self-determination. Exercising self-determination is also important for older persons’ health and well-being. Health professionals are in general aware of the importance, but research shows that older persons’ self-determination is not fully respected within the health care sector. Research on self-determination from the perspective of older persons who are in the beginning to develop dependence in daily activities is limited. In order to deepen the knowledge of older persons own experiences in this process, further studies are needed. Aim: The aim of this study was to explore experiences of self-determination when developing dependence in daily activities among community-dwelling persons 80 years and older. Method: Qualitative interviews with 11 persons aged 84-95 years who were in the beginning to experience difficulties in daily activities were performed in accordance with the constructivist grounded theory method. Results: The core category, shifting between governing oneself or being governed by others, illustrates the complexity and the shifting of the experiences during the development of dependence. The categories struggling against the aging body, guarding one’s own independence and transferring the performance highlights different ways of governing in one’s life, whereas exercising self-determination is in the hands of others is a result of the increasing dependence. Conclusions: For community-dwelling older persons, the social context and the ageing body may influence the possibilities to exercise self-determination in daily life. Professionals and health care providers should enable and encourage older persons to exercise self-determination related their own healthcare.
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| 9. |
- Ottenvall Hammar, Isabelle, 1984, et al.
(författare)
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Impact on Participation and Autonomy – test of validity and reliability for older persons
- 2014
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Ingår i: Health Psychology Research. - : Open Medical Publishing. - 2420-8124. ; 2:3, s. 68-73
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Tidskriftsartikel (refereegranskat)abstract
- In research and health care it is important to measure older person’s self-determination in order to improve their possibilities to decide for themselves in daily life. The questionnaire Impact on Participation and Autonomy (IPA) assesses self-determination, but is not constructed for older persons. The aim of this study was to examine the validity and reliability of the IPA-S questionnaire for persons aged 70 years and older. The study was performed in two steps; first a validity test of the Swedish version of the questionnaire, IPA-S, followed by a reliability test-retest of an adjusted version. The validity was tested with focus groups and individual interviews on persons aged 77-88 years, and the reliability on persons aged 70-99 years. The validity test result showed that IPA-S is valid for older persons but it was too extensive and the phrasing of the items needed adjustments. The reliability test-retest on the adjusted questionnaire, IPA-for Older persons (IPA-O), showed that 15 of 22 items had high agreement. IPA-O can be used to measure older persons’ right to self-determination in their care and rehabilitation.
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| 10. |
- Ottenvall Hammar, Isabelle, 1984
(författare)
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Navigating towards a self-determined daily life in old age. Experiences, instrument evaluation and explanatory factors.
- 2015
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Aim: The overall aim of this thesis was to explore self-determination in the context of community-dwelling older persons with different degrees of dependence in daily activities. Methods: Using a qualitative, grounded design, study I explored how people 80 years and older experienced their self-determination when developing dependence in daily activities. Study II employed a qualitative and quantitative design where the validity of the questionnaire Impact on Participation and Autonomy (IPA-S) was tested using focus group discussions and individual interviews. The participants were aged 70 years and older. The focus groups were followed by a reliability test-retest of the adjusted version (IPA-O) on persons in the same age. Study III and IV applied an exploratory, cross-sectional design where two sets of data were combined, resulting in a sample of persons aged 80 years and older. Perceived self-determination in daily life was explored in relation to degree of dependence in daily activities (study III) and in relation to a set of explanatory factors (study IV). Results: The results showed that self-determination was experienced as constantly shifting between self-governing and being governed by the ageing body or by other persons. This shift gave rise to a struggle against the ageing body and a need to constantly guard one’s own independence. The relationship had an impact on the person’s possibilities to make decisions; that is, decision-making was relational (study I). The validity test showed that the items within the IPA-S were important and relevant, but the questionnaire was too extensive and focused on the executional part of the activities. The IPA-S was adjusted to a version entitled IPA-O (-Older persons) consisting of fewer items with emphasises on the decisional part. The reliability test-retest step showed that 15 of the 22 items within the IPA-O had high agreement and six items had moderate agreement. One item showed low agreement between the test and retest (study II). People dependent in activities of daily living (ADL) showed a general pattern of perceiving reduced self-determination in daily life. Perceptions of reduced self-determination were most pronounced among people dependent in personal activities of daily living (P-ADL) (study III). However, the association between dependence in ADL and reduced self-determination was not statistically significant. The final regression model showed that the explanatory factors of high education, frailty, poor self-rated health, unsatisfaction with physical health, and receiving help from public home care service were significantly associated with perceiving reduced self-determination (study IV). Conclusions: Being dependent in daily activities occasionally meant being governed by the ageing body or by others. Reduced perceptions of self-determination in daily life were associated with both internal and external factors. Exercising self-determination in old age was directly related to the relationship between the persons receiving help and the persons providing help. Therefore, healthcare professionals should enable trough navigate towards a more self-determined daily life in old age. A first step in this direction could be to conduct a conversation about self-determination based on the IPA-O, a psychometrically tested and adjusted instrument designed specifically for older people. Acknowledging human capabilities and creating relationships based on partnership could enhance the older person’s self-determination.
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| 11. |
- Ottenvall Hammar, Isabelle, 1984, et al.
(författare)
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People dependent of support in daily activities perceives reduced self-determination – a cross-sectional study with community-dwelling older people
- 2015
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Ingår i: Quality in Ageing and Older Adults. - 1471-7794. ; 16:4, s. 208-221
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Tidskriftsartikel (refereegranskat)abstract
- Purpose – The purpose of this paper is to explore the relationship of self-determination with degree of dependence in daily activities among community-dwelling persons aged 80 years and older. Design/methodology/approach – This cross-sectional study focused on community-dwelling people 80 years or older with varied degree of dependence in daily activities. Self-determination in daily life was assessed with the statements from the Impact on Participation and Autonomy-Older persons (IPA-O), and degree of dependence in daily activities was assessed with the activities of daily living (ADL) staircase. Data were analysed using Fisher’s exact test, and the relative risk with a 95 per cent confidence interval was used to explore the risk of perceiving reduced self-determination in daily life. Findings – Compared to the independent persons, the perceived self-determination was significantly lower among persons dependent in instrumental activities of daily living (I-ADL), and persons dependent in personal activities of daily living (P-ADL). Reduced self-determination was most pronounced in persons requiring help with P-ADL. Practical implications – Following key features could be applied to strengthen the community-dwelling older people’s self-determination; incorporating a dialogue where self-determined questions are raised; adopting a person-centred approach between the persons involved; acknowledging older people’s capabilities – what they are able to do and to be, and what they value. Originality/value – This study highlights the need of integrating a self-determined dialogue into healthcare where the older person and the professional focus on self-determined questions.
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| 12. |
- Ottenvall Hammar, Isabelle, 1984, et al.
(författare)
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Risk for depression affects older people's possibilities to exercise self-determination in using time, social relationships and living life as one wants : A cross-sectional study with frail older people
- 2018
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Ingår i: Health Psychology Research. - : Pagepress Publications. - 2420-8124 .- 2281-2075. ; 6:1
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Tidskriftsartikel (refereegranskat)abstract
- Exercising self-determination in daily life is highly valued by older people. However, being in the hands of other people may challenge the older people's possibilities to exercise self-determination in their daily life. Among frail older people living in Sweden, risk for depression is highly predominant. There is a knowledge gap regarding if, and how having a risk of depression affects older people's self-determination. The objective was, therefore, to explore if, and in that case how, frail older people's self-determination is affected by the risk of depression. In this cross-sectional, secondary data analysis, with 161 communitydwelling frail older people, simple logistic regression models were performed to explore the association between self-determination, the risk of depression and demographic variables. The findings showed that risk for depression and reduced self-determination were significantly associated in the dimensions: use of time (P=0.020), social relationship (P=0.003), help and support others (P=0.033), and the overall self-determination item (P=0.000). Risk for depression significantly affected self-determination in use of time (OR=3.04, P=0.014), social relationship (OR=2.53, P=0.011), and overall self-determination (OR=6.17, P=0.000). This point out an increased need of strengthening healthcare professionals' perspectives, and attitudes towards a self-determined, friendly, and person-centred dialogue.
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| 13. |
- Ottenvall Hammar, Isabelle, 1984, et al.
(författare)
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Self-determination among community-dwelling older persons: explanatory factors
- 2016
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Ingår i: Scandinavian Journal of Occupational Therapy. - : Informa UK Limited. - 1103-8128 .- 1651-2014. ; 23:3, s. 198-206
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Tidskriftsartikel (refereegranskat)abstract
- Background Although it is acknowledged that exercising self-determination in daily activities affects older people’s health and well-being, few studies have focused on the explanatory factors for self-determination in daily life. Objective To investigate explanatory factors for self-determination in the context of community-dwelling older persons. Method: This cross-sectional study combined two sets of data that included community-dwelling persons 80 years and older (n=456). A bivariate logistic regression was performed to analyse the association of self-determination and a set of explanatory factors. Results The final bivariate logistic regression model revealed five explanatory factors that were significantly associated with perceiving reduced self-determination: high education (OR=2.83), frailty (OR=2.70), poor self-rated health (OR=2.54), dissatisfaction with physical health (OR=6.50), and receiving help from public homecare service (OR=2.46). Conclusion Several explanatory factors related to the ageing body and environmental aspects were associated with reduced self-determination. To help older people maintain self-determination, healthcare professionals should consider using a person-centred and capability approach to care.
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| 14. |
- Ottenvall Hammar, Isabelle, 1984, et al.
(författare)
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Shifting between self-governing and being governed: a qualitative study of older persons’ self-determination
- 2014
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Ingår i: BMC Geriatrics. - : Springer Science and Business Media LLC. - 1471-2318. ; 14
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Tidskriftsartikel (refereegranskat)abstract
- Background: Older persons’ right to exercise self-determination in daily life is supported by several laws. Research shows that older persons’ self-determination is not fully respected within the healthcare sector. In order to enable and enhance older persons’ self-determination, extensive knowledge of older persons’ self-determination is needed. Aim: To explore experiences of self-determination when developing dependence in daily activities among community-dwelling persons 80 years and older. Methods: Qualitative interviews were performed in accordance with a grounded theory method, with 11 persons aged 84–95 years who were beginning to develop dependence in daily activities. Results: The data analysis revealed the core category, “Self-determination - shifting between self-governing and being governed”. The core category comprised three categories: “Struggling against the aging body”, “Decision-making is relational”, and “Guarding one’s own independence”. Self-determination in daily activities was related to a shifting, which was two-fold, and varied between self-governing and being governed by the aging body, or by others. Conclusions: The findings imply a need to adopt a person-centered approach where the older persons’ own preferences and needs are in focus, in order to enhance their possibilities to exercise self-determination.
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| 15. |
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| 16. |
- Ottenvall Hammar, Isabelle, 1984, et al.
(författare)
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Validitet och reliabilitet av frågeformuläret Inverkan på Delaktighet och Autonomi för äldre personer
- 2013
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Ingår i: Posterpresentation AT-Forum Stockholmsmässan 24-25/4-2013.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Bakgrund: Frågeformuläret Inverkan på Delaktighet och Autonomi (IPA) har konstruerats för att mäta en persons upplevda delaktighet och självbestämmande/beslutande autonomi. Eftersom validiteten och reliabiliteten av IPA är testade på personer under 75 års ålder, behövs ytterligare studier riktade mot äldre. Syfte: Att undersöka validiteten och reliabiliteten av frågeformuläret IPA för personer i åldern 70 år och äldre. Metod: Studien utfördes i två steg som figuren visar; först ett validitetstest av den svenska versionen av IPA och därefter ett test-retest reliabilitetstest av det reviderade frågeformuläret. I test-retesten användes Svenssons program, ett statistiskt program som är lämpligt vid analys av ordinaldata. Resultat: Deltagarna ansåg att frågorna var viktiga men omfattande. När de besvarade frågorna framkom att de fokuserade på enbart utförandet av aktiviteterna. Revideringen resulterade i 22 frågor om upplevd delaktighet och självbestämmande. Test-retesten visade att den procentuella överensstämmelsen varierade, 15 frågor hade hög reliabilitet (70 % eller över). Slutsatser: IPA-Ä är valit och reliabelt för den äldre populationen. IPA-Ä kan användas som ett utvärderingsinstrument för att säkerställa äldre personers rätt till självbestämmande och delaktighet. IPA-Ä rekommenderas som ett utvärderingsinstrument vid geriatrisk rehabilitering.
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| 17. |
- Ottenvall Hammar, Isabelle, 1984
(författare)
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Validity and Reliability of the questionnaire Impact on Participation and Autonomy for older people
- 2012
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Ingår i: Poster Nordic Congress of Gerontology 10/6-13/6 2012.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- Introduction: According to the Swedish Law of Health and Care (1982:763), health care should be built on the respect for self-determination and integrity. Recent studies of older persons indicate that self-determination is not fully respected within the health care sector. Restrictions in older person’s self-determination can influence their mental health. The questionnaire Impact on Participation and Autonomy (IPA) was constructed to measure a person’s perceived impact of every day life on participation and decisional autonomy (self-determination). Since the IPA based its psychometric properties on persons under the age of 75, further studies of higher ages are needed. Purpose: The purpose was to examine the validity and reliability of the IPA for people 70 years and older. Method: The study was performed in two steps: validity was tested with focus groups and individual interviews with persons aged 77-88 years, and reliability with persons aged 70-99 years, all from the Gothenburg region. In the test-retest reliability step data were analyzed in accordance with Svensson's method. Results: Face- and content validity test of IPA-S: The participants emphasized the relevance of the questionnaire. When answering the questions, their way of answering revealed that they focused on the executional part of the activity, and not on the decisional part. The participants valued that their voice could be heard about their possibility of deciding for themselves in daily activities. A removal of items was recommended. Revision phase: All items were revised in order to clarify the decisional part of self-determination in the questionnaire. The IPA-S with its 31 items resulted in 22 items about perceived participation called IPA-O (-for older persons). Test-retest reliability of IPA-O: The range of PA between the test and retest assessments of all 22 items differed from 54 % to 100 %. The test-retest showed that 15 of 22 items had high agreement, one item had low agreement (PA of < 59 %). Discussion and conclusion: The result showed that IPA-O is a valid and reliable questionnaire for the older population. The findings showed that the participants emphasized the importance of receiving questions about making their own decisions in daily activities. IPA-O can be used for older persons both as an evaluation tool and in client work to ensure older persons right to self-determination in the planning of their care and rehabilitation. The questionnaire is appropriate in the scientific research area when the purpose is to examine and investigate older populations’ perceptions of their self-determination. Take home message • IPA-O is a valid and reliable questionnaire when targeting self-determination among older persons in research. • IPA-O is recommended to be used in client work within health care, social care and rehabilitation.
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| 18. |
- Santos Tavares Silva, Iolanda, et al.
(författare)
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The extent of using mobility assistive devices can partly explain fatigue among persons with late effects of polio - a retrospective registry study in Sweden
- 2016
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Ingår i: Bmc Neurology. - : Springer Science and Business Media LLC. - 1471-2377. ; 16
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Tidskriftsartikel (refereegranskat)abstract
- Background: Fatigue is reported as one of the most disabling symptoms and is common among persons living with late effects of polio. Although fatigue has been studied in the context of people living with late effects of polio, there is a lack of knowledge concerning the association of fatigue and variables of importance for participation in daily life. Therefore, the aim of this study was to explore possible factors associated with fatigue among persons with late effects of polio in Sweden. Methods: This retrospective registry study consisted of 89 persons with late effects of polio living in Sweden. Fatigue was measured with the Multidimensional Fatigue Inventory (MFI-20) scale, Swedish version. Pearson's correlation coefficient was used to analyse the correlation between the factors and fatigue, and a multiple linear regression was carried out to explore factors for fatigue. Results: Fatigue statistically significantly correlated with age (r = 0.234, p < 0.05) and the use of mobility assistive devices (r = 0.255, p < 0.05). The multiple linear regression model showed that the factors age (beta = 0.304, p < 0.019) and mobility assistive devices (beta = 0.262, p < 0.017) were associated with fatigue among persons living with late effects of polio, and the model partly explained 14% of the variation of fatigue. Conclusions: Fatigue could partly be explained by the extent of using mobility assistive devices and age. Healthcare professionals should provide and demonstrate the importance of assistive devices to ensure management of fatigue in persons living with late effects of polio.
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| 19. |
- Westgård, Theresa, et al.
(författare)
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Comprehensive geriatric assessment pilot of a randomized control study in a Swedish acute hospital : a feasibility study
- 2018
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Ingår i: Pilot and Feasibility Studies. - : Springer Science and Business Media LLC. - 2055-5784. ; 4
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Tidskriftsartikel (refereegranskat)abstract
- Background: Comprehensive geriatric assessment (CGA) represent an important component of geriatric acute hospital care for frail older people, secured by a multidisciplinary team who addresses the multiple needs of physical health, functional ability, psychological state, cognition and social status. The primary objective of the pilot study was to determine feasibility for recruitment and retention rates. Secondary objectives were to establish proof of principle that CGA has the potential to increase patient safety.Methods: The CGA pilot took place at a University hospital in Western Sweden, from March to November 2016, with data analyses in March 2017. Participants were frail people aged 75 and older, who required an acute admission to hospital. Participants were recruited and randomized in the emergency room. The intervention group received CGA, a person-centered multidisciplinary team addressing health, participation, and safety. The control group received usual care. The main objective measured the recruitment procedure and retention rates. Secondary objectives were also collected regarding services received on the ward including discharge plan, care plan meeting and hospital risk assessments including risk for falls, nutrition, decubitus ulcers, and activities of daily living status.Result: Participants were recruited from the emergency department, over 32 weeks. Thirty participants were approached and 100% (30/30) were included and randomized, and 100% (30/30) met the inclusion criteria. Sixteen participants were included in the intervention and 14 participants were included in the control. At baseline, 100% (16/16) intervention and 100% (14/14) control completed the data collection. A positive propensity towards the secondary objectives for the intervention was also evidenced, as this group received more care assessments. There was an average difference between the intervention and control in occupational therapy assessment - 0.80 [95% CI 1.06, - 0.57], occupational therapy assistive devices - 0.73 [95% CI 1.00, - 0.47], discharge planning -0.21 [95% CI 0.43, 0.00] and care planning meeting 0.36 [95% CI-1.70, -0.02]. Controlling for documented risk assessments, the intervention had for falls - 0.94 [95% CI 1.08, - 0.08], nutrition - 0.87 [95% CI 1.06, - 0.67], decubitus ulcers - 0.94 [95% CI 1.08, - 0.80], and ADL status - 0.80 [95% CI 1.04, - 0.57].Conclusion: The CGA pilot was feasible and proof that the intervention increased safety justifies carrying forward to a large-scale study.Trial registration: Clinical Trials ID: NCT02773914. Registered 16 May 2016.
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| 20. |
- Westgård, Theresa, 1969, et al.
(författare)
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Feeling respected as a person: a qualitative analysis of frail older people's experiences on an acute geriatric ward practicing a Comprehensive Geriatric Assessment
- 2019
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Ingår i: Geriatrics. - : MDPI AG. - 0016-867X .- 2308-3417. ; 4:1
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Tidskriftsartikel (refereegranskat)abstract
- Comprehensive geriatric assessment (CGA) practices multidimensional, interdisciplinary, and diagnostic processes as a means to identify care needs, plan care, and improve outcomes of frail older people. Conventional content analysis was used to analyze frail older people’s experiences of receiving CGA. Through a secondary analysis, interviews and transcripts were revisited in an attempt to discover the meaning behind the participants’ implied, ambiguous, and verbalized thoughts that were not illuminated in the primary study. Feeling “respected as a person” is the phenomenon participants described on a CGA acute geriatric ward, achieved by having a reciprocal relationship with the ward staff, enabling their participation in decisions when engaged in communication and understanding. However, when a person was too ill to participate, then care was person-supportive care. CGA, when delivered by staff practicing person-centered care, can keep the frail older person in focus despite them being a patient. If a person-centered care approach does not work because the person is too ill, then person-supportive care is delivered. However, when staff and/or organizational practices do not implement a person-centered care approach, this can hinder patients feeling “respected as a person”.
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