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Träfflista för sökning "AMNE:(MEDICAL AND HEALTH SCIENCES Clinical Medicine Geriatrics) srt2:(2010-2014)"

Sökning: AMNE:(MEDICAL AND HEALTH SCIENCES Clinical Medicine Geriatrics) > (2010-2014)

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  • Westius, Anders, et al. (författare)
  • Views of life and sense of identity in people with Alzheimer's disease
  • 2010
  • Ingår i: Ageing & Society. - Cambridge, United Kingdom : Cambridge university press. - 0144-686X .- 1469-1779. ; 30:7, s. 1257-1278
  • Tidskriftsartikel (refereegranskat)abstract
    • Making it possible for people with Alzheimer's disease to retain a sense of identity during the process of the disease poses a great challenge to care-givers, professionals and family carers. The aim of this study is to elucidate the role of the view of life of people with Alzheimer's in framing their sense of identity. Is their view of life a vital aspect of their sense of identity? ‘View of life’ was interpreted as a vital aspect of sense of identity, understood as the individual's beliefs about their life history and about the attributes that characterised them. Twenty-one people with mild to moderate stages of Alzheimer's disease were interviewed about their life story. The narratives were interpreted using a phenomenological hermeneutic method. By telling their life story, the participants also narrated their view of life, i.e. their conception of reality, their central system of values and their basic emotional attitudes. By their own accounts, the origins of the narrators' central values and basic emotional attitudes were established in early life. They also expressed a sense of meaningfulness and continuity when looking back on their lives. The findings suggest that for a care-giver or confidant, having knowledge of a person with dementia's view of life is valuable when seeking to confirm that person's sense of identity.
  • Magnusson, Lennart, et al. (författare)
  • Extended safety and support systems for people with dementia living at home
  • 2014
  • Ingår i: Journal of Assistive Technologies. - : Emerald Group Publishing Limited. - 1754-9450 .- 2042-8723. ; 8:4, s. 188-206
  • Tidskriftsartikel (refereegranskat)abstract
    • Abstract Purpose – The purpose of this paper is to highlight the complexity surrounding the implementation of advanced electronic tracking, communication and emergency response technologies, namely, an extended safety and support (ESS) system for people with dementia (pwd) living at home. Results are presented from a Swedish demonstration study (2011-2012) conducted in 24 municipalities. Design/methodology/approach – It is a descriptive intervention study with a pre-post test design. Questionnaires were administered to pwd, carers and professionals at the outset and eight months later. ESS logging data were analyzed. Findings – ESS usage rates varied widely. A total of 650 alerts were triggered, mainly when the pwd was outdoors. Activities were reduced amongst pwd, most likely due to a progression of their disease. Carers noted that pwd were more independent than previously on those occasions when they engaged in outdoor activities. Staff considered that nearly half of pwd could remain living at home due to the ESS, compared with a third amongst carers. In total, 50 per cent of carers felt it was justified to equip their relative with an ESS without their explicit consent, compared to one in eight staff. Research limitations/implications – A limitation is the amount of missing data and high drop- out rates. Researchers should recruit pwd earlier in their illness trajectory. A mixed-methods approach to data collection is advisable. Practical implications – Carers played a crucial role in the adoption of ESS. Staff training/supervision about assistive devices and services is recommended. Social implications – Overall, use of ESS for pwd living at home was not an ethical problem. Originality/value – The study included key stakeholder groups and a detailed ethical analysis was conducted.
  • Lagergren, Mårten, et al. (författare)
  • Horizontal and vertical target efficiency - a comparison between users and non-users of public long-term care in Sweden
  • 2014
  • Ingår i: Ageing & Society. - : Cambridge University Press. - 0144-686X .- 1469-1779. ; 34:4, s. 700-719
  • Tidskriftsartikel (refereegranskat)abstract
    • The extent to which a system of services is in tune with the needs of the population can be expressed in terms of target efficiency, which includes horizontal target efficiency - the extent to which those deemed to need a service receive it - and vertical target efficiency - the corresponding extent to which those who receive a service actually need it. Vertical efficiency can be measured by looking only at those receiving services. To measure horizontal target efficiency in a population, one must have access to population surveys. Data were taken from the baseline survey of the Swedish National Study on Ageing and Care (SNAC study). The results show that more than 80 per cent of those dependent in personal activities of daily living in the studied geographic areas were users of public long-term care (LTC). Dependency in instrumental activities of daily living was identified as the most important predictor of using LTC. Vertical target efficiency was 83-95 per cent depending on age, gender and type of household, if need was defined as dependency in instrumental activities of daily living. It was considerably lower, 35-61 per cent when defined as dependency in personal daily activities. Overall, long-term target efficiency in Sweden must be regarded as high. Few persons who need public LTC services fail to receive them.
  • Lindgren, Helena, et al. (författare)
  • Sociotechnical integration of decision support in the dementia domain
  • 2010
  • Ingår i: Information Technology in Health Care. - : IOS Press. - 9781607505686 - 9781607505693 ; , s. 79-84
  • Bokkapitel (refereegranskat)abstract
    • The need for improving dementia care has driven the development of the clinical decision support system DMSS (Dementia Management and Support System). A sociotechnical approach to design and development has been applied, with an activity-centered methodology and user participation throughout the process. Prototypes have been developed based on the characteristics of clinical practice and domain knowledge, while clinical practice has been subjected to different efforts for development such as education and organizational change. This paper addresses the lessons learned and role and impact DMSS has had, and is expected to have on the clinical assessment of dementia in different clinics in Sweden, South Korea and Japan. Furthermore, it will be described in what way the development of DMSS and the development of dementia care in these three areas are interlinked. Results indicate that the most important contribution of DMSS at the point of care, is the educational support that DMSS provides, part from the tailored explanatory support related to a patient case. This effect was partly manifested in a change of routines in the encounter with patients.
  • Kalpouzos, Gregoria, et al. (författare)
  • Local brain atrophy accounts for functional activity differences in normal aging
  • 2012
  • Ingår i: Neurobiology of Aging. - : Elsevier. - 0197-4580 .- 1558-1497. ; 33:3, s. 623.e1-
  • Tidskriftsartikel (refereegranskat)abstract
    • Functional brain imaging studies of normal aging typically show age-related under-and overactivations during episodic memory tasks. Older individuals also undergo nonuniform gray matter volume (GMv) loss. Thus, age differences in functional brain activity could at least in part result from local atrophy. We conducted a series of voxel-based blood oxygen level-dependent (BOLD)-GMv analyses to highlight whether age-related under-and overrecruitment was accounted for by GMv changes. Occipital GMv loss accounted for underrecruitment at encoding. Efficiency reduction of sensory-perceptual mechanisms underpinned by these areas may partly be due to local atrophy. At retrieval, local GMv loss accounted for age-related overactivation of left dorsolateral prefrontal cortex, but not of left dorsomedial prefrontal cortex. Local atrophy also accounted for age-related overactivation in left lateral parietal cortex. Activity in these frontoparietal regions correlated with performance in the older group. Atrophy in the overrecruited regions was modest in comparison with other regions as shown by a between-group voxel-based morphometry comparison. Collectively, these findings link age-related structural differences to age-related functional under-as well as overrecruitment.
  • Wikgren, Mikael, et al. (författare)
  • Shorter telomere length is linked to brain atrophy and white matter hyperintensities
  • 2014
  • Ingår i: Age and Ageing. - : Oxford University Press (OUP). - 0002-0729 .- 1468-2834. ; 43:2, s. 212-217
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: leukocyte telomere length (TL) is considered a marker of biological aging. Several studies have investigated the link between leukocyte TL and aging-associated functional attributes of the brain, but no prior study has investigated whether TL can be linked to brain atrophy and white matter hyperintensities (WMHs); two prominent structural manifestations of brain aging. Methods: we investigated whether leukocyte TL was related to brain atrophy and WMHs in a sample of 102 non-demented individuals aged 64-75 years. Results: shorter TL was related to greater degree of subcortical atrophy (beta = -0.217, P = 0.034), but not to cortical atrophy. Furthermore, TL was 371 bp shorter (P = 0.041) in participants exhibiting subcortical WMHs, and 552 bp shorter (P = 0.009) in older participants exhibiting periventricular WMHs. Conclusion: this study provides the first evidence of leukocyte TL being associated with cerebral subcortical atrophy and WMHs, lending further support to the concept of TL as a marker of biological aging, and in particular that of the aging brain.
  • Hägglund, Karin M., et al. (författare)
  • Assistant nurses working in care of older people : associations with sustainable work ability
  • 2011
  • Ingår i: Scandinavian Journal of Caring Sciences. - 0283-9318 .- 1471-6712. ; 25:2, s. 325-332
  • Tidskriftsartikel (refereegranskat)abstract
    • Indicators of health have shown improvements in the Swedish working population during the past decades, but with the exception of low-skilled women. Earlier research has shown that assistant nurses belong to an occupational group, which has the lowest share of individuals with long-term health in the total Swedish workforce. Sick leave research has mostly focused on determining risk factors for the development of diseases and dysfunctions. In the process of acquiring knowledge about mechanisms for sick leave, it has become obvious that there is also a need to focus on what contributes to work ability. The aim in this study was to explore what promotes sustainable work ability in female assistant nurses working in care of older people. Associations between factors related to work, health, lifestyle and sustainable work ability were investigated in a cross-sectional nested case-control study in a cohort of 366 female assistant nurses. Data were collected in self-reports in a questionnaire. Odds ratios were calculated, and a multiple logistic regression analysis was performed with sustainable work ability as the dependent variable. Sustainable work ability was associated with good self-rated health, a BMI < 30, ability to sleep well, recuperation, low stress level, support from family and friends, being over 25 years of age at birth of the first child, and control over one's own life in the >= 50 age group. In the logistic regression analysis, the significant associations were good self-rated health, being over 25 years of age at the birth of the first child and recuperation. In conclusion, the study showed that self-rated health and factors in private life are important for assistant nurse's sustainable work ability over time. The results from this study could be applied in health promotion work for employees in the care sector to strengthen and enhance sustainable work ability.
  • Bouillon, Kim, et al. (författare)
  • Measures of frailty in population-based studies: An overview
  • 2013
  • Ingår i: BMC Geriatrics. - 1471-2318 .- 1471-2318. ; 13:64
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Although research productivity in the field of frailty has risen exponentially in recent years, there remains a lack of consensus regarding the measurement of this syndrome. This overview offers three services: first, we provide a comprehensive catalogue of current frailty measures; second, we evaluate their reliability and validity; third, we report on their popularity of use.Methods: In order to identify relevant publications, we searched MEDLINE (from its inception in 1948 to May 2011); scrutinized the reference sections of the retrieved articles; and consulted our own files. An indicator of the frequency of use of each frailty instrument was based on the number of times it had been utilized by investigators other than the originators.Results: Of the initially retrieved 2,166 papers, 27 original articles described separate frailty scales. The number (range: 1 to 38) and type of items (range of domains: physical functioning, disability, disease, sensory impairment, cognition, nutrition, mood, and social support) included in the frailty instruments varied widely. Reliability and validity had been examined in only 26% (7/27) of the instruments. The predictive validity of these scales for mortality varied: for instance, hazard ratios/odds ratios (95% confidence interval) for mortality risk for frail relative to non-frail people ranged from 1.21 (0.78; 1.87) to 6.03 (3.00; 12.08) for the Phenotype of Frailty and 1.57 (1.41; 1.74) to 10.53 (7.06; 15.70) for the Frailty Index. Among the 150 papers which we found to have used at least one of the 27 frailty instruments, 69% (n = 104) reported on the Phenotype of Frailty, 12% (n = 18) on the Frailty Index, and 19% (n = 28) on one of the remaining 25 instruments.Conclusions: Although there are numerous frailty scales currently in use, reliability and validity have rarely been examined. The most evaluated and frequently used measure is the Phenotype of Frailty.
  • Eriksson, Irene, et al. (författare)
  • Older women's experiences of suffering from urinary tract infections
  • 2014
  • Ingår i: Journal of Clinical Nursing. - : John Wiley & Sons. - 0962-1067 .- 1365-2702. - 9789174591644 ; 23:9-10, s. 1385-1394
  • Tidskriftsartikel (refereegranskat)abstract
    • Aims and objectives: To describe and explore older women's experiences of having had repeated urinary tract infections (UTIs). Background: UTIs are one of the most common bacterial infections among older women. Approximately one-third of very old women suffer from at least one UTI each year. Despite the high incidence of UTI, little is known about the impact of UTI on health and daily life in older women. Design: A qualitative descriptive design. Methods: A qualitative study using semi-structured interviews was conducted with 20 Swedish women aged 67-96 years who suffered from repeated UTIs the preceding year. The data were analysed using qualitative content analysis. Results: Two main themes were identified: being in a state of manageable suffering and depending on alleviation. Being in a state of manageable suffering was described in terms of experiencing physical and psychological health problems, struggling to deal with the illness and being restricted in daily life. Depending on alleviation was illustrated in terms of having access to relief but also receiving inadequate care. Conclusions: This study demonstrated that UTIs are a serious health problem among older women that not only affects both physical and mental health but also has serious social consequences. The women in this study described the physical and psychological health problems, struggling to deal with the illness, being restricted in daily life, depending on access to relief and receiving inadequate care. Relevance to clinical practice: It is important to improve the knowledge about how UTI affects the health of older women. This knowledge may help nurses develop strategies to support these women. One important part in the supportive strategies is that nurses can educate these women in self-care. © 2013 John Wiley & Sons Ltd.
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