| 51. |
- Nilsson, Maria H, et al.
(author)
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Fatigue in Parkinson's Disease: Measurement Properties of a Generic and a Condition-specific Rating Scale.
- 2013
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In: Journal of Pain and Symptom Management. - : Elsevier BV. - 1873-6513 .- 0885-3924. ; 46:5, s. 737-746
-
Journal article (peer-reviewed)abstract
- CONTEXT: High-quality fatigue rating scales are needed to advance the understanding of fatigue and determine the efficacy of interventions. Several fatigue scales are used in Parkinson's disease, but few have been tested using modern psychometric methodology (Rasch analysis). OBJECTIVES: To examine the measurement properties of the generic Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) scale and the condition-specific 16-item Parkinson Fatigue Scale (PFS-16) using Rasch analysis. METHODS: Postal survey data (n=150; 47% women; mean age 70 years) were Rasch analyzed. The PFS-16 scores were tested according to both the original polytomous and the suggested alternative dichotomized scoring methods. RESULTS: The PFS-16 showed overall Rasch model fit, whereas the FACIT-F showed signs of misfit, which probably was the result of a sleepiness-related item and mixing of positively/negatively worded items. There was no differential item functioning by disease duration but by fatigue status (greater likelihood of needing to sleep or rest during the day among people classified as nonfatigued) in the PFS-16 and FACIT-F. However, this did not impact total score-based estimated person measures. Targeting and reliability (≥0.86) were good, but the dichotomized PFS-16 showed compromised measurement precision. Polytomous and dichotomized PFS-16 and FACIT-F scores identified six, three, and four statistically distinct sample strata, respectively. CONCLUSION: We found general support for the measurement properties of both scales. However, polytomous PFS-16 scores exhibited advantages compared with dichotomous PFS-16 and FACIT-F scores. Dichotomization of item responses compromises measurement precision and the ability to separate people, and should be avoided.
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| 52. |
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| 53. |
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| 54. |
- Ottenvall Hammar, Isabelle, 1984, et al.
(author)
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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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In: International Journal of Geriatrics and Gerontology. - 2577-0748. ; 2018:2
-
Journal article (peer-reviewed)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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| 55. |
- Religa, D., et al.
(author)
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SveDem, the Swedish Dementia Registry - A tool for improving the quality of diagnostics, treatment and care of dementia patients in clinical practice
- 2015
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In: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 10:2
-
Journal article (peer-reviewed)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.
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| 56. |
- Roos, John Magnus
(author)
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Personality and E-shopping : Insights from a Nationally Representative Study
- 2019
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In: Digital Transformation and Global Society. - Cham : Springer. - 9783030378578 - 9783030378585 ; 1038 CCIS, s. 257-267
-
Book chapter (peer-reviewed)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.
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| 57. |
- Smedback, Jonas, et al.
(author)
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Palliative care during the final week of life of older people in nursing homes : A register-based study
- 2017
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In: Palliative & Supportive Care. - : Cambridge University Press. - 1478-9515 .- 1478-9523. ; 15:4, s. 417-424
-
Journal article (peer-reviewed)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.
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| 58. |
- Almborg, Ann-Helene, et al.
(author)
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Discharged after stroke - important factors for health-related quality of life
- 2010
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In: Journal of Clinical Nursing. - 0962-1067 .- 1365-2702. ; 19:15-16, s. 2196-2206
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Journal article (peer-reviewed)abstract
- Aims. This study examines different correlates to health-related quality (HRQoL) of life after discharge in patients with stroke. Background. HRQoL is an important aspect of life after suffering a stroke. Previous research has revealed several variables associated with poststroke quality of life, including age, gender, depression, fatigue, length of hospital stay, functional status and amount of social participation. However, the time span after stroke varies greatly in the different studies. Although the multiple factors that contribute to short-term postdischarge HRQoL have potential importance for discharge planning, to our knowledge, these factors have not been systematically investigated during the earlier days following discharge. Design. Cross-sectional study. Methods. The sample consisted of 188 consecutively included individuals (mean age 74 years, 56% men) from a stroke unit in southern Sweden. The interviews were performed two to three weeks after discharge and included use of the SF-36, the Center for Epidemiological Studies Depression Scale, the Barthel Index, the Frenchay Activities Index, performance of interests and survey of patients' perceived participation in discharge planning. Multiple linear regression analysis was conducted to identify variables associated with HRQoL. Results. Multiple regression analyses with the eight scales of SF-36 as dependent variables revealed eight models, one for each scale, which were statistically significant. Depressive symptoms were associated with lower HRQoL. Ability to perform personal and social activities, interests, younger age, education (elementary school) and shorter hospital stay were related to higher HRQoL. Patients' perceived participation in discharge planning was both positively and negatively associated with HRQoL. Conclusions. Several variables were related to good HRQoL two to three weeks post-discharge, particularly fewer depressive symptoms, participation in social activities such as outdoor activities and performance of interests. Relevance to clinical practice. These results can be used to design needs assessment forms of discharge planning to promote adaptation and recovery after stroke.
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| 59. |
- Bai, Ge, et al.
(author)
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Frailty trajectories in three longitudinal studies of aging : Is the level or the rate of change more predictive of mortality?
- 2021
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In: Age and Ageing. - : Oxford University Press. - 0002-0729 .- 1468-2834. ; 50:6, s. 2174-2182
-
Journal article (peer-reviewed)abstract
- BACKGROUND: frailty shows an upward trajectory with age, and higher levels increase the risk of mortality. However, it is less known whether the shape of frailty trajectories differs by age at death or whether the rate of change in frailty is associated with mortality.OBJECTIVES: to assess population frailty trajectories by age at death and to analyse whether the current level of the frailty index (FI) i.e. the most recent measurement or the person-specific rate of change is more predictive of mortality.METHODS: 3,689 individuals from three population-based cohorts with up to 15 repeated measurements of the Rockwood frailty index were analysed. The FI trajectories were assessed by stratifying the sample into four age-at-death groups: <70, 70-80, 80-90 and >90 years. Generalised survival models were used in the survival analysis.RESULTS: the FI trajectories by age at death showed that those who died at <70 years had a steadily increasing trajectory throughout the 40 years before death, whereas those who died at the oldest ages only accrued deficits from age ~75 onwards. Higher level of FI was independently associated with increased risk of mortality (hazard ratio 1.68, 95% confidence interval 1.47-1.91), whereas the rate of change was no longer significant after accounting for the current FI level. The effect of the FI level did not weaken with time elapsed since the last measurement.CONCLUSIONS: Frailty trajectories differ as a function of age-at-death category. The current level of FI is a stronger marker for risk stratification than the rate of change.
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| 60. |
- Beck, Ingela, 1965-, et al.
(author)
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Applying a palliative care approach in residential care : effects on nurse assistants' work situation
- 2015
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In: Palliative & Supportive Care. - : Cambridge University Press. - 1478-9515 .- 1478-9523. ; 13:3, s. 543-553
-
Journal article (peer-reviewed)abstract
- Objectives: The aim was to investigate the effects of an intervention that applies a palliative care approach in residential care upon nurse assistants' level of strain, job satisfaction, and view of leadership.Method: A quasi-experimental, pretest and posttest design was used. Study circles with workshops involving nurse assistants (n = 75) and their superiors (n = 9) focusing on emotional and existential issues in palliative care were evaluated using a questionnaire answered by the nurse assistants at baseline (November 2009), post-intervention (May 2010), and six-month follow-up (November 2010) in comparison with controls (n = 110).Results: Directly after the intervention, the job satisfaction of the nurse assistants decreased and they perceived the leadership more negatively than before the intervention. Six months later, strain as a result of criticism from residents and their superiors and having difficulty in balancing emotional involvement had decreased.Significance of results: The intervention initially seemed to decrease the well-being of the nurse assistants, which could be the result of their increased awareness of the residents' and relatives' needs, in combination with limited support. More emphasis should be placed on the role of leadership when implementing changes in practice.
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