| 1. |
- Lagergren, Mårten, et al.
(författare)
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Horizontal and vertical targeting : a population-based comparison of public eldercare services in urban and rural areas of Sweden
- 2016
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Ingår i: Aging Clinical and Experimental Research. - : Springer Science and Business Media LLC. - 1594-0667 .- 1720-8319. ; 28:1, s. 147-158
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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.
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| 2. |
- Fagerström, Cecilia, Docent, 1973-, et al.
(författare)
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Factorial validity and invariance of the Life Satisfaction Index in older people across groups and time: Addressing the heterogeneity of age, functional ability, and depression.
- 2012
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Ingår i: Archives of gerontology and geriatrics (Print). - : Elsevier BV. - 0167-4943 .- 1872-6976. ; 55:2, s. 349-356
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Tidskriftsartikel (refereegranskat)abstract
- In the last decades, extensive research efforts have been directed at exploring life satisfaction in old age, and the Life Satisfaction Index A scale (LSIA), developed by Neugarten et al. in the 1960s, is one of the most commonly used instruments. However, studies have focused on predicting and comparing changes in people’s life satisfaction without testing if the LSIA instrument is equally valid for different subgroups of people. The present study investigated the underlying dimensions of the LSIA in a Swedish population (n=1402) of people 60−96 years of age. The study also examined factorial invariance across age, gender, functional ability and depression during a six-year period. The results showed that while a five-factor solution of the LSIA did not exhibit an acceptable fit to the data, a three-factor solution did show a close fit. The two three-factor models that demonstrated the best fit showed invariance across gender and across time, but noninvariance across groups with different levels of reduced functional ability, depressive symptoms and age. These findings suggest that the psychometric properties of life satisfaction instruments like the LSIA need to be taken into consideration before drawing conclusions about life satisfaction when comparing older people of different ages and with different depression and function levels.
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| 3. |
- Hofflander, Malin, et al.
(författare)
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Discharge planning : narrated by nursing staff in primary healthcare and their concerns about using video conferencing in the planning session - an interview study
- 2013
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Ingår i: Journal of Nursing Education and Practice. - : Sciedu Press. - 1925-4040 .- 1925-4059. ; 3:1, s. 88-98
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Tidskriftsartikel (refereegranskat)abstract
- Background/Objective: This paper sets out to describe experience-based reflections on discharge planning as narrated by nursing staff in primary healthcare, along with their concerns about how the introduction of video conferencing might influence the discharge planning situation.Methods: Interviews were conducted with nursing staff working at a primary healthcare centre in South East Sweden. Each interview took place was conducted on a one-to-one basis in dialogue form, using open questions and supported by an interview guide. It was then analysed using a phenomenological hermeneutic method. Participants were eligible for the study if they had given their informed consent and if they worked with discharge planning and home-based healthcare provision. In total, 10 of the 30 persons working at the primary healthcare centre participated in the study.Results: It was found that nursing staff in primary healthcare regarded the planning session as stressful, time-consuming and characterised by a lack of respect between nursing staff at the hospital and nursing staff in primary healthcare. They also described uncertainty and hesitation about using video conferences where patients might probably be the losers and nursing staff the winners.Conclusions: It is suggested that there is a need for improvement in communication and understanding between nursing staff at the hospital and nursing staff in primary healthcare in order to develop discharge planning. There is also a need for the nursing staff in primary healthcare to obtain more information about how Information Technology (IT) solutions could support their work and help them to find ways to collaborate.
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| 4. |
- Nilsson, Lina, 1977-, et al.
(författare)
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The importance of Interaction in the implementation of information technology in health care : A symbolic interactionism study on the meaning of accessibility
- 2012
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Ingår i: Informatics for Health and Social Care. - : Informa Healthcare. - 1753-8157 .- 1753-8165. ; 37:4, s. 277-290
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Tidskriftsartikel (refereegranskat)abstract
- A challenge when groups from different disciplines work together in implementing health information technology (HIT) in a health-care context is that words often have different meanings depending upon work practices, and definition of situations. Accessibility is a word commonly associated with HIT implementation. This study aimed to investigate different meanings of accessibility when implementing HIT in everyday work practice in a health-care context. It focused on the perspective of nurses to highlight another view of the complex relationship between HIT and information in a health-care context. This is a qualitative study influenced by institutional ethnographic. District nurses and student nurses were interviewed. The results indicate that when implementing HIT accessibility depends on working routines, social structures and patient relationship. The findings of the study suggest that interaction needs to take on a more important role when implementing HIT because people act upon words from the interpreted meaning of them. Symbolic interactionism is proposed as a way to set a mutual stage to facilitate an overall understanding of the importance of the meaning of words. There is a need for making place and space for negotiation of the meaning of words when implementing HIT in everyday work practice.
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| 5. |
- Wimo, Anders, et al.
(författare)
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Formal and informal care of community-living older people : A population-based study from the swedish national study on aging and care
- 2017
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Ingår i: The Journal of Nutrition, Health & Aging. - : SPRINGER FRANCE. - 1279-7707 .- 1760-4788. ; 21:1, s. 17-24
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Study formal and informal care of community-living older people in the Swedish National study of Aging and Care (SNAC). Design: Cross-sectional, population based cohort. Setting: Three areas in Sweden: Municipality of Nordanstig, Stockholm and Skane County. Participants: 3,338 persons >= 72 years. Measurements: Patterns and amounts of informal and formal care by cognition and area of residence. Results: 73% received no care; 14% formal care; and 17% informal care (7% received both). In the whole study population, including those who used no care, individuals in small municipalities received 9.6 hours of informal care/month; in mid-size municipalities, 6.6; and in urban areas, 5.6. Users of informal care received 33.1 hours of informal care/month in small municipalities, 54.6 in mid-size municipalities and 36.1 in urban areas. Individuals with cognitive impairment received 14.1 hours of informal care/month, 2.7 times more than people with no/slight impairment. In the whole study population, individuals in small municipalities received an average of 3.2 hours of formal care/month; in mid-size municipalities 1.4; and in urban areas, 2.6. Corresponding figures for formal care users were 29.4 hours in small municipalities, 13.6 in mid-size municipalities and 16.7 in urban areas. Formal care users received 7.1 hours, and informal care users, 5.9 hours for each hour/month received by people in the study population as a whole. Conclusions: More informal than formal care was provided. Informal care is more frequent in small municipalities than urban areas and for those with than without cognitive impairment. The relationship between data on the whole population and the data on users or care indicates that population-based data are needed to avoid overestimates of care.
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| 6. |
- Eriksen, Sara, et al.
(författare)
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Health in Hand: Putting mHealth Design in Context
- 2014
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Ingår i: 2014 IEEE 2nd International Workshop on Usability and Accessibility Focused Requirements Engineering (USARE). - : IEEE conference proceedings. - 2334-3109. ; , s. 36-39, s. 36-39
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Konferensbidrag (refereegranskat)abstract
- Wireless technologies, cloud computing and connectivity have enabled mobile services that extend the coverage of health services, resulting in a branch of eHealth now commonly referred to as mHealth. However, at least in Sweden, where the healthcare sector is heavily institutionalized and regulated, mHealth has so far mainly evolved in the form of applications for support of healthy life-style and self-management of chronic diseases, implemented outside of the firewalls of traditional healthcare delivery environments. In this paper we present an on-going Indo-Swedish research and development project in which we are putting mHealth design into context both from a patient's perspective and from the perspective of a healthcare team working within a professional healthcare organization. Our research approach is inspired by the Scandinavian tradition of Participatory Design of ICT and informed by studies of how to measure usability, user experience and impact of mHealth interventions. The involved research teams are multi-disciplinary, including researchers from engineering, computing and health sciences. The project includes, on the Swedish side, a partner from the public healthcare sector, three SME:s and an industrial partner who is currently providing Electronic Patient Record and other healthcare information system solutions and who is interested in developing mobile solutions for healthcare professionals. We are currently in the process of collaborative articulation and specification of problems, goals and requirements within the framework of the first Swedish case study of the project, focused on mobile support for patients with diabetes type 2 and their healthcare teams.
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| 7. |
- Wickström, Hanna Linnea, et al.
(författare)
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Antibiotic prescription using a digital decision support system : a register-based study of patients with hard-to-heal ulcers in Sweden
- 2022
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Ingår i: BMJ Open. - : BMJ Publishing Group Ltd. - 2044-6055. ; 12:10
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: To investigate differences in antibiotic prescription for patients with hard-to-heal ulcers assessed using a digital decision support system (DDSS) compared with those assessed without using a DDSS. A further aim was to examine predictors for antibiotic prescription. DESIGN: Register-based study. SETTING: In 2018-2019, healthcare staff in primary, community and specialist care in Sweden tested a DDSS that offers a mobile application for data and photograph transfer to a platform for multidisciplinary consultation and automatic transmission of data to the Registry of Ulcer Treatment (RUT). Register-based data from patients assessed and diagnosed using the DDSS combined with the RUT was compared with register-based data from patients whose assessments were merely registered in the RUT. PARTICIPANTS: A total of 117 patients assessed using the DDSS combined with the RUT (the study group) were compared with 1784 patients whose assessments were registered in the RUT without using the DDSS (the control group). PRIMARY AND SECONDARY OUTCOME MEASURES: The differences in antibiotic prescription were analysed using the Pearson's χ2 test. A logistic regression analysis was used to check for influencing factors on antibiotic prescription. RESULTS: Patients assessed using a DDSS in combination with the RUT had significantly lower antibiotic prescription than patients entered in the RUT without using the DDSS (8% vs 26%) (p=0.002) (only healed ulcers included). Predictors for antibiotic prescription were diabetes; long healing time; having an arterial, neuropathic or malignant ulcer. CONCLUSIONS: A DDSS with data and photograph transfer that enables multidisciplinary communication appears to be a suitable tool to reduce antibiotic prescription for patients with hard-to-heal ulcers.
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| 8. |
- Nilsson, Lina, et al.
(författare)
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Social Challenges When Implementing Information Systems in Everyday Work in a Nursing Context
- 2014
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Ingår i: Computers, Informatics, Nursing. - : Lippincott Williams & Wilkins. - 1538-2931 .- 1538-9774. ; 32:9, s. 442-450
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Tidskriftsartikel (refereegranskat)abstract
- Implementation of information systems in healthcare has become a lengthy process where healthcare staff (eg, nurses) are expected to put information into systems without getting the overall picture of the potential usefulness for their own work. The aim of this study was to explore social challenges when implementing information systems in everyday work in a nursing context. Moreover, this study aimed at putting perceived social challenges in a theoretical framework to address them more constructively when implementing information systems in healthcare. Influenced by institutional ethnography, the findings are based on interviews, observations, and written reflections. Power (changing the existing hierarchy, alienation), professional identity (calling on hold, expert becomes novice, changed routines), and encounter (ignorant introductions, preconceived notions) were categories (subcategories) presented in the findings. Social Cognitive Theory, Diffusion of Innovations, organizational culture, and dramaturgical analysis are proposed to set up a theoretical framework. If social challenges are not considered and addressed in the implementation process, it will be affected by nurses’ solidarity to existing power structures and their own professional identity. Thus, implementation of information systems affects more aspects in the organization than might have been intended. These aspects need to be taken in to account in the implementation process.
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| 9. |
- Enlöf, Per, et al.
(författare)
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Smart Glasses for Anesthesia Care : Initial Focus Group Interviews with Specialized Health Care Professionals
- 2021
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Ingår i: Journal of Perianesthesia Nursing. - : ELSEVIER SCIENCE INC. - 1089-9472 .- 1532-8473. ; 36:1, s. 47-53
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: Smart glasses are a kind of wearable technology that gives users sustained, hands-free access to data and can transmit and receive information wirelessly. Earlier studies have suggested that smart glasses have the potential to improve patient safety in anesthesia care. Research regarding health care professionals' views of the potential use of smart glasses in anesthesia care is limited. The purpose of this study was to describe anesthesia health care professionals' views of smart glasses before clinical use. Design: A qualitative descriptive study. Methods: Data were collected from focus group interviews and analyzed using thematic content analysis. Findings: Three categories of participants' views of smart glasses were created during the analysis: views of integrating smart glasses in clinical setting; views of customized functionality of smart glasses; and views of being a user of smart glasses. One theme, striving for situational control, was identified in the analysis. Conclusions: Smart glasses were seen as a tool that can impact and improve access to patient-related information, and aid health care professionals in their struggle to gain situational control during anesthesia care. These are factors related to increased patient safety. (c) 2020 American Society of PeriAnesthesia Nurses. Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
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| 10. |
- Bohman, Doris, et al.
(författare)
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Primary healthcare nurses' experiences of physical activity referrals : an interview study
- 2015
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Ingår i: Primary Health Care Research and Development. - : Cambridge University Press. - 1463-4236 .- 1477-1128. ; 16:3, s. 270-280
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Tidskriftsartikel (refereegranskat)abstract
- CONCLUSION: Our findings suggest that viewing the PAR as a complex intervention, with all that this entails, might be one approach to increasing the number of PARs being issued. Simpler systems, more time and the potential for testing the effectiveness of follow-ups could be possible ways of achieving this. AIM: The aim of this study is to illuminate primary health care (PHC) nurses' experiences of physical activity referrals (PARs). BACKGROUND: Despite extensive knowledge about the substantial health effects physical activities can produce, fewer and fewer people in our modern society regularly engage in physical activity. Within health care and, particularly, within the PHC arena, nurses meet people on a daily basis who need help to engage in a healthier lifestyle. The possibility of issuing written prescriptions for physical activities, often referred to as PARs, has been introduced as a tool to support such lifestyles. However, even though PHC nurses can prescribe physical activities, studies investigating their experience in this type of nursing intervention are rare. METHODS: For this study, 12 semi-structured interviews were conducted with PHC nurses, and the transcribed texts were analysed using a qualitative content analysis. FINDINGS: Two categories--PARs, an important nursing intervention, and PARs, the necessity of organisational support--reflected the nurses' experiences in using PARs.
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