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Sökning: AMNE:(MEDICAL AND HEALTH SCIENCES Clinical Medicine Geriatrics) > (2015-2019) > Högskolan i Gävle

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1.
  • 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.
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2.
  • Olsson, Annakarin, 1969-, et al. (författare)
  • Effects of tracking technology on daily life of persons with dementia : three experimental single-case studies
  • 2015
  • Ingår i: American Journal of Alzheimer’s Disease and Other Dementia. - : SAGE Publications. - 1533-3175 .- 1938-2731. ; 30:1, s. 29-40
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives: To investigate the effects of using tracking technology on independent outdoor activities and psychological well-being in 3 persons with dementia (PwDs) and their spouses.Methods: Three experimental single-case studies with an A1B1A2B2 design. The intervention entailed access to a passive positioning alarm and technical support. Continual daily measures of independent outdoor activities among PwDs' and spouses' worries about these activities were made during all phases.Results: Access to a tracking technology consistently increased the independent outdoor activities of 2 PwDs. One of the spouses consistently reported decreased worry during B phases, another's worry decreased only in B2, and the third showed little variability in worrying across all phases.Conclusion: Tracking technology may support PwDs to engage in independent outdoor activities and decrease spouses' worries; however, randomized controlled group studies are needed to investigate whether these results can be replicated on a group level.
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3.
  • Tuvesson, Hanna, et al. (författare)
  • Life weariness and suicidal thoughts in late life : a national study in Sweden
  • 2018
  • Ingår i: Aging & Mental Health. - : Taylor & Francis. - 1360-7863 .- 1364-6915. ; 22:10, s. 1365-1371
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives: This study aimed at investigating the point prevalence of life weariness and suicidal thoughts and their relationship with socio-demographic characteristics in a population of older adults in Sweden. Method: Data from 7913 individuals aged 60 years and older were drawn from the Swedish National Study on Aging and Care, a collaborative study in Sweden. Life weariness and suicidal thoughts were measured by one item derived from the Montgomery–Åsberg Depression Rating Scale. A multinomial regression model was used to investigate the relationships of socio-demographic characteristics with life weariness and suicidal thoughts. Results: Living in urban and semi-urban areas, being of advanced age, being divorced and having lower educational levels were related to life weariness. Living in a residential care facility, being widowed or unmarried, being born in a non-Nordic European country and experiencing financial difficulties were related to both life weariness and suicidal thoughts. Sex was found to be unrelated to either life weariness or suicidal thoughts. Conclusion: This study found that several socio-demographic variables were associated with life weariness and suicidal thoughts among older adults. Specific attention to older individuals with these characteristics may be warranted as they might be more vulnerable to life weariness and suicidal thoughts.
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4.
  • Dahlkvist, Eva, 1952-, et al. (författare)
  • Garden greenery and the health of older people in residential care facilities : a multi-level cross-sectional study
  • 2016
  • Ingår i: Journal of Advanced Nursing. - : Wiley-Blackwell. - 0309-2402 .- 1365-2648. ; 72:9, s. 2065-2076
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims: To test the relationship between greenery in gardens at residential facilities for older people and the self-perceived health of residents, mediated by experiences of being away and fascination when in the garden and the frequency of visitation there. To examine how these indirect effects vary with the number of physical barriers to visiting the garden.Background: Many older people in residential facilities suffer from complex health problems. Access to a green outdoor environment may enable psychological distance, engage effortless attention, encourage more frequent visitation and promote resident health.Design: A multi-level, cross-sectional, correlational design.Methods: Questionnaires were administered June-August, 2011 to convenience samples of residents at 72 facilities for older people with complex healthcare needs. One to 10 eligible residents were sampled during self-motivated garden visits at each facility (n = 290). They reported on their garden experiences and health. Facility staff reported on objective garden characteristics and barriers to access. A serial mediation model was tested with multiple linear regression analysis.Results: The total indirect effect of greenery on self-perceived health was positive and significant. Garden greenery appears to affect health by enhancing a sense of being away, affording possibilities to experience the outdoor environment as interesting and encouraging visitation. Among residents in homes with multiple barriers, only fascination mediated the relationship between greenery and self-perceived health.Conclusion: Ample greenery in outdoor space at residential facilities for older people appears to promote experiences of being away and fascination, more frequent visitation and better health.
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5.
  • Wimo, Anders, et al. (författare)
  • Cohort Effects in the Prevalence and Survival of People with Dementia in a Rural Area in Northern Sweden
  • 2016
  • Ingår i: Journal of Alzheimer's Disease. - 1387-2877 .- 1875-8908. ; 50:2, s. 387-396
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Recent studies suggest that trends in cardiovascular risk may result in a decrease in age-specific prevalence of dementia. Studies in rural areas are rare.Objectives: To study cohort effects in dementia prevalence and survival of people with dementia in a Swedish rural area.Methods: Participants were from the 1995-1998 Nordanstig Project (NP) (n = 303) and the 2001-2003 Swedish National study on Aging and Care in Nordanstig (SNAC-N) (n = 384). Overall 6-year dementia prevalence and mortality in NP and SNAC-N were compared for people 78 years and older. Logistic regression analyses were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for dementia occurrence using the NP study population as the reference group. Cox regression models were used to analyze time to death.Results: The crude prevalence of dementia was 21.8% in NP and 17.4% in SNAC-N. When the NP cohort was used as the reference group, the age- and gender-adjusted OR of dementia was 0.71 (95% CI 0.48-1.04) in SNAC-N; the OR was 0.47 (0.24-0.90) for men and 0.88 (0.54-1.44) for women. In the extended model, the OR of dementia was significantly lower in SNAC-N than in the NP cohort as a whole (0.63; 0.39-0.99) and in men (0.34; 0.15-0.79), but not in women (0.81; 0.46-1.44). The Cox regression models indicated that the hazard ratio of dying was lower in the SNAC-N than NP population.Conclusions: Trends toward a lower prevalence of dementia in high-income countries seem to be evident in this Swedish rural area, at least in men.
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6.
  • Mamhidir, Anna-Greta, 1952-, et al. (författare)
  • Systematic pain assessment in nursing homes: a cluster-randomized trial using mixed-methods approach
  • 2017
  • Ingår i: BMC Geriatrics. - : Springer Science and Business Media LLC. - 1471-2318. ; 17
  • Tidskriftsartikel (refereegranskat)abstract
    • BackgroundChronic pain affects nursing home residents’ daily life. Pain assessment is central to adequate pain management. The overall aim was to investigate effects of a pain management intervention on nursing homes residents and to describe staffs’ experiences of the intervention.MethodsA cluster-randomized trial and a mixed-methods approach. Randomized nursing home assignment to intervention or comparison group. The intervention group after theoretical and practical training sessions, performed systematic pain assessments using predominately observational scales with external and internal facilitators supporting the implementation. No measures were taken in the comparison group; pain management continued as before, but after the study corresponding training was provided. Resident data were collected baseline and at two follow-ups using validated scales and record reviews. Nurse group interviews were carried out twice. Primary outcome measures were wellbeing and proxy-measured pain. Secondary outcome measures were ADL-dependency and pain documentation.ResultsUsing both non-parametric statistics on residential level and generalized estimating equation (GEE) models to take clustering effects into account, the results revealed non-significant interaction effects for the primary outcome measures, while for ADL-dependency using Katz-ADL there was a significant interaction effect. Comparison group (n = 66 residents) Katz-ADL values showed increased dependency over time, while the intervention group demonstrated no significant change over time (n = 98). In the intervention group, 13/44 residents showed decreased pain scores over the period, 14/44 had no pain score changes ≥ 30% in either direction measured with Doloplus-2. Furthermore, 17/44 residents showed increased pain scores ≥ 30% over time, indicating pain/risk for pain; 8 identified at the first assessment and 9 were new, i.e. developed pain over time. No significant changes in the use of drugs was found in any of the groups. Nursing pain related documentation was sparse. In general, nurses from the outset were positive regarding pain assessments. Persisting positive attitudes seemed strengthened by continued assessment experiences and perceptions of improved pain management.ConclusionThe implementation of a systematic work approach to pain issues in nursing homes indicates that an increased awareness, collaboration across and shared understanding among the team members of the pain assessment results can improve pain management and lead to decreased physical deterioration or the maintenance of physical and functional abilities among NH residents. However, pain (proxy-measured) and wellbeing level did not reveal any interaction effects between the groups over time.Trial registrationThe study was registered in ISRCTN71142240 in September 2012, retrospectively registered.
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7.
  • Marques, Maria J., et al. (författare)
  • Relationship quality and sense of coherence in dementia : results of a European cohort study
  • 2019
  • Ingår i: International Journal of Geriatric Psychiatry. - : John Wiley & Sons. - 0885-6230 .- 1099-1166. ; 34:5, s. 745-755
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: Quality of life of people with dementia and their family carers is strongly influenced by interpersonal issues and personal resources. In this context, relationship quality (RQ) and sense of coherence (SOC) potentially protect and promote health. We aimed to identify what influences RQ in dyads of people with dementia and their carers and to examine differences in their perspectives.Methods: Cross-sectional data from the Actifcare cohort study of 451 community-dwelling people with dementia and their primary carers in eight European countries. Comprehensive assessments included the Positive Affect Index (RQ) and the Orientation to Life Questionnaire (SOC).Results: Regression analyses revealed that RQ as perceived by people with dementia was associated with carer education, stress and spouse caregiving. RQ as perceived by carers was associated with carer stress, depression, being a spouse, social support, reported neuropsychiatric symptoms of dementia and carer SOC. Neuropsychiatric symptoms and carer stress contributed to discrepancies in RQ ratings within the dyad. The only factor associated with both individual RQ ratings and with discrepancies was carer stress (negative feelings sub-score). No significant differences in the overall perception of RQ were evident between spouses and adult children carers, but RQ determinants differed between the two.Conclusions: In this European sample, carer SOC was associated with carer-reported RQ. RQ determinants differed according to the perspective considered (person with dementia or carer) and carer subgroup. A deeper understanding of RQ and its determinants will help to tailor interventions that address these distinct perspectives and potentially improve dementia outcomes.
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8.
  • Voraroon, Supraon, et al. (författare)
  • Older People’s Lived Experiences with Participation in Shareholding Networks for the Care of Older People in Rural Areas of Thailand : A Phenomenological Hermeneutic Study
  • 2017
  • Ingår i: Open Journal of Nursing. - : Scientific Research Publishing, Inc.. - 2162-5336 .- 2162-5344. ; 7:7, s. 875-892
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Older people participating in shareholding networks are exposed to diverse situations, which may be associated with dignity. Aims: This study aimed to illuminate the meaning of lived experiences when participating in shareholding networks for the care of older people in rural areas. Methods: This qualitative study is based on individual interviews. Ten older Thai persons with at least 12 months of lived experiences participating in shareholding networks for older people in rural areas were interviewed. A phenomenological-hermeneutic approach, inspired by Ricoeur, was used to understand the meaning of the narrated text. Findings: The structural analysis resulted in four themes: 1) being satisfied with activities, 2) being valued as important, 3) being frustrated and feeling sad, and 4) being bored and feeling disinterest. The meaning of participation in a shareholding network for the elderly can be understood as a pathway to feelings of confidence and presence of others. Confidence and allowing the presence of others mean facing humanity and sensing vulnerability, because in a trusting relationship the person who gives confidence is susceptible to the other’s betrayal. Conclusion: An individual’s dignity should be a high priority in health and social care strategies. Therefore, it is important for healthcare professionals to initiate a dialogue with the shareholding participants for support and information. The narrations in this study can be used as a basis for developing cooperating care with older people in shareholding network focusing on their needs and dignity.
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9.
  • Öberg, Peter, et al. (författare)
  • Partner-age in late life unions - ideals vs realities
  • 2016
  • Ingår i: The Gerontologist. - : Oxford University Press (OUP). - 0016-9013 .- 1758-5341. ; 56:3, s. 732-732, s. 732-732
  • Tidskriftsartikel (refereegranskat)abstract
    • Age homo/heterogamy in romantic unions is given little attention in current gerontological research. Still partner age-differences are important for men’s and women’s relationship opportunities. This paper studies actual partner-age (age-difference) in cross-gendered unions, and ideal partner-age both for singles and respondents in unions. The study was carried out by a survey to 60–90 year old Swedes, currently either singles or in a cross-gender relationship (married, cohabiting, LAT) (n=1225). Unions follow a traditionally gendered age structure: 56% of men, but only 16% of women have a younger partner. This pattern is more pronounced: in first unions (p<.001) and unions initiated before 1970 (p<.01). For respondents in unions actual partner-age showed no significant correlation with union form or urbanity (modernity-hypothesis), and not with education or income (power-hypothesis). For respondents in unions Ideal Partner-Age correlates strongly (p<.001; R2=0,76) with actual partner-age (ideal slightly younger). Among single respondents, almost all (92%) single men and half of the single women (47%) prefer a younger partner (8,9 years younger on average for men; 2,2 for women). The proportion preferring a younger partner increases by age, leading to increasingly incompatible age ideals. Results will be discussed in relation to life-course theory; gender and power; the deinstitutionalization hypothesis.
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10.
  • Öberg, Peter, et al. (författare)
  • Initiation and development of new intimate relationships in later life
  • 2016
  • Ingår i: The Gerontologist. - : Oxford University Press (OUP). - 0016-9013 .- 1758-5341. ; 56:Suppl. 3, s. 17-18, s. 17-18
  • Tidskriftsartikel (refereegranskat)abstract
    • According to contemporary family theory late modern relationships are guided less be external norms and more by internal negotiation between relatively equal partners. The purpose of this paper is to study initiation and development of new intimate relationships in later life, with a focus on negotiation and change, based on relationship histories with older Swedes (n=28), who are currently in new late in life cross-gender relationships initiated 60+, or currently dating singles. The results show a paradox: relationship ideals often seem unchangeable in prospect, but actual relationship arrangements appear open and changeable, when described in retrospect. LATs recall having been determined not to initiate any new relationships, cohabitants to retain their own home, remarried informants never to marry again. The analysis focuses the negotiations leading to relationship change. We discuss and question prevailing implicit assumptions about older people’s relationships as non-negotiated and unchangeable.
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