| 1. |
- Gustafsson, Susanne, et al.
(författare)
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Long-term outcome for ADL following the health-promoting RCT-Elderly persons in the risk zone
- 2013
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Ingår i: The Gerontologist. - : Oxford University Press. - 0016-9013 .- 1758-5341. ; 53:4, s. 654-663
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To examine independence in activities of daily living (ADL) at the 1- and 2-year followups of the health-promoting study Elderly Persons in the Risk Zone. Design and Method: A randomized, three-armed, single-blind, and controlled study. A representative sample of 459 independent and community-dwelling older adults, 80 years and older, were included. A preventive home visit was compared with four weekly multiprofessional senior group meetings including a follow-up home visit. Results: Analysis showed a significant difference in favor of the senior meetings in postponing dependence in ADL at the 1-year follow-up (odds ratio [OR] = 1.92, 95% confidence interval [CI] = 1.19-3.10) and also in reducing dependence in three (OR = 0.52, 95% CI = 0.31-0.86) and four or more ADL (OR = 0.40, 95% CI = 0.22-0.72) at the 2-year follow-up. A preventive home visit reduced dependence in two (OR = 0.40, 95% CI = 0.24-0.68) and three or more ADL (OR = 0.37, 95% CI = 0.17-0.80) after 1 year. Implications: A long-term evaluation of Elderly Persons in the Risk Zone showed that both senior meetings and a preventive home visit reduced the extent of dependence in ADL after 1 year. The senior meetings were superior to a preventive home visit since additional significant effects were seen after 2 years. To further enhance the long-term effects of the senior meetings and support the process of self-change in health behavior, it is suggested that booster sessions might be a good way of reinforcing the intervention.
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| 2. |
- Bai, Ge, et al.
(författare)
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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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Ingår i: Age and Ageing. - : Oxford University Press. - 0002-0729 .- 1468-2834. ; 50:6, s. 2174-2182
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Tidskriftsartikel (refereegranskat)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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| 3. |
- Abelsson, Anna, 1971-, et al.
(författare)
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To strengthen self-confidence as a step in improving prehospital youth laymen basic life support
- 2020
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Ingår i: BMC Emergency Medicine. - : NLM (Medline). - 1471-227X. ; 20:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:A rapid emergency care intervention can prevent the cardiac arrest from resulting in death. In order for Cardio Pulmonary Resuscitation (CPR) to have any real significance for the survival of the patient, it requires an educational effort educating the large masses of people of whom the youth is an important part. The aim of this study was to investigate the effect of a two-hour education intervention for youth regarding their self-confidence in performing Adult Basic Life Support (BLS).METHODS:A quantitative approach where data consist of a pre- and post-rating of seven statements by 50 participants during an intervention by means of BLS theoretical and practical education.RESULTS:The two-hour training resulted in a significant improvement in the participants' self-confidence in identifying a cardiac arrest (pre 51, post 90), to perform compressions (pre 65, post 91) and ventilations (pre 64, post 86) and use a defibrillator (pre 61, post 81). In addition, to have the self-confidence to be able to perform, and to actually perform, first aid to a person suffering from a traumatic event was significantly improved (pre 54, post 89).CONCLUSION:By providing youth with short education sessions in CPR, their self-confidence can be improved. This can lead to an increased will and ability to identify a cardiac arrest and to begin compressions and ventilations. This also includes having the confidence using a defibrillator. Short education sessions in first aid can also lead to increased self-confidence, resulting in young people considering themselves able to perform first aid to a person suffering from a traumatic event. This, in turn, results in young people perceiveing themselves as willing to commence an intervention during a traumatic event. In summary, when the youth believe in their own knowledge, they will dare to intervene.
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| 4. |
- Adolfsson, Margareta, 1950-, et al.
(författare)
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Pain management for children with cerebral palsy in school settings in two cultures: action and reaction approaches
- 2018
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Ingår i: Disability and Rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 40:18, s. 2152-2162
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Forskningsöversikt (refereegranskat)abstract
- © 2017 Informa UK Limited, trading as Taylor & Francis Group Background: Children with cerebral palsy (CP) face particular challenges, e.g. daily pain that threaten their participation in school activities. This study focuses on how teachers, personal assistants, and clinicians in two countries with different cultural prerequisites, Sweden and South Africa, manage the pain of children in school settings. Method: Participants’ statements collected in focus groups were analysed using a directed qualitative content analysis framed by a Frequency of attendance-Intensity of involvement model, which was modified into a Knowing-Doing model. Results: Findings indicated that pain management focused more on children’s attendance in the classroom than on their involvement, and a difference between countries in terms of action-versus-reaction approaches. Swedish participants reported action strategies to prevent pain whereas South African participants primarily discussed interventions when observing a child in pain. Conclusion: Differences might be due to school- and healthcare systems. To provide effective support when children with CP are in pain in school settings, an action-and-reaction approach would be optimal and the use of alternative and augmentative communication strategies would help to communicate children’s pain. As prevention of pain is desired, structured surveillance and treatment programs are recommended along with trustful collaboration with parents and access to “hands-on” pain management when needed.Implications for rehabilitation•When providing support, hands-on interventions should be supplemented by structured preventive programs and routines for parent collaboration (action-and-reaction approach).•When regulating support, Sweden and South Africa can learn from each other;○In Sweden, the implementation of a prevention program has been successful.○In South Africa, the possibilities giving support directly when pain in children is observed have been beneficial.
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| 5. |
- Al Ansari, A., et al.
(författare)
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Analysis of psychometric properties of the modified SETQ tool in undergraduate medical education
- 2017
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Ingår i: BMC Medical Education. - : BioMed Central. - 1472-6920. ; 17:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: Effective clinical teaching is crucially important for the future of patient care. Robust clinical training therefore is essential to produce physicians capable of delivering high quality health care. Tools used to evaluate medical faculty teaching qualities should be reliable and valid. This study investigates the psychometric properties of modification of the System for Evaluation of Teaching Qualities (SETQ) instrument in the clinical years of undergraduate medical education.Methods: This cross-sectional multicenter study was conducted in four teaching hospitals in the Kingdom of Bahrain. Two-hundred ninety-eight medical students were invited to evaluate 105 clinical teachers using the SETQ instrument between January 2015 and March 2015. Questionnaire feasibility was analyzed using average time required to complete the form and the number of raters required to produce reliable results. Instrument reliability (stability) was assessed by calculating the Cronbach’s alpha coefficient for the total scale and for each sub-scale (factor). To provide evidence of construct validity, an exploratory factor analysis was conducted to identify which items on the survey belonged together, which were then grouped as factors.Results: One-hundred twenty-five medical students completed 1161 evaluations of 105 clinical teachers. The response rates were 42% for student evaluations and 57% for clinical teacher self-evaluations. The factor analysis showed that the questionnaire was composed of six factors, explaining 76.7% of the total variance. Cronbach’s alpha was 0.94 or higher for the six factors in the student survey; for the clinical teacher survey, Cronbach’s alpha was 0.88. In both instruments, the item-total correlation was above 0.40 for all items within their respective scales.Conclusion: Our modified SETQ questionnaire was found to be both reliable and valid, and was implemented successfully across various departments and specialties in different hospitals in the Kingdom of Bahrain.
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| 6. |
- Ameryoun, Ahmad, et al.
(författare)
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Effectiveness of an In-Service Education Program to Improve Patient Safety Directed at Surgical Residents : A Randomized Controlled Trial
- 2019
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Ingår i: Journal of Surgical Education. - ;HHJ : Elsevier. - 1931-7204 .- 1878-7452. ; 76:5, s. 1309-1318
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Tidskriftsartikel (refereegranskat)abstract
- Background: Patient safety is a critical issue in healthcare services particularly in surgical units and operation rooms because of the high prevalence and risk of medical errors in such settings. This study was conducted to determine whether a 1-day educational intervention can change the attitude and behavior of surgical residents regarding patient safety.Methods: A total of 90 surgical residents were recruited from 6 university hospitals located in Tehran and Qazvin, Iran, and were randomized to either the intervention or a control group. Those in the intervention group participated in a 1-day workshop on patient safety, whereas the control group received no intervention. Both groups were followed for 3 months after the intervention was completed. The Safety Attitude Questionnaire and Oxford Non-Technical Skills scale were administered at 3 points in time (baseline, 1 month after the intervention, and 3 month later). The data were analyzed using repeated measures analysis of variance.Results: Total score on the Safety Attitude Questionnaire improved from 54.5 (SD = 14.4) at baseline to 58.3 (SD = 13.8) 3 months after the intervention in the intervention group; all dimensions, with the exception of working condition, showed significant changes. In addition, the Oxford Non-Technical Skills scale – as assessed by attending surgeons – improved significantly in all domains (p < 0.05). More than 60% of participants in the intervention group scored in the positive range for items assessing safety and teamwork climate.Conclusions: A 1-day interactive educational workshop may be effective in changing the attitude and practice of surgical residents regarding patient safety. Further assessment of this intervention in other healthcare settings involving health professionals from various specialties and use of an objective measure such as number of reported medical errors are needed to corroborate these findings.
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| 7. |
- Andersson, Ann-Christine, 1968-
(författare)
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Förbättringskunskap och förbättringsforskning : Kunskapsöversikt om förbättringsarbetes framväxt inom hälso- och välfärdssektorn i Sverige, samt implikationer för projektet Barnens Bästa Gäller! i Kronoberg
- 2022
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Rapport (övrigt vetenskapligt/konstnärligt)abstract
- Syftet med denna kunskapsöversikt är att belysa hur förbättringskunskapen utvecklats i den svenska hälsovård- och välfärdssektorn, och vilka implikationer förbättringskunskap kan ha för projektet ”Barnens Bästa Gäller! i Kronoberg” (BBGiK). Rapporten avslutas med en diskussion om de möjligheter och utmaningar som påverkar projektet. Förbättringskunskap är nära besläktat med kvalitetsutveckling, och är numer vanligt förekommande i hälso- vård- och välfärdsorganisationer. De lagar och regelverk som styr innefattar skyldigheter att bedriva kvalitetsutveckling, och Ledningssystem för systematiskt kvalitetsarbete (SOSFS 2011:9) gäller för både vård- och omsorgsorganisationer.Rapporten lyfter fram förbättringskunskapens ursprung, dess forskningsanknytning och evidens och utveckling och övergång till vård- och välfärdsorganisationer. När förbättringskunskap fått fäste i den kunskapsintensiva evidensbaserade vårdsektorn och förbättringsarbeten började bli mera vanligt, uppstod frågor om hur förbättringsmetoder fungerar. Flera av de tidiga aktörerna inom förbättringskunskap var läkare och sjuksköterskor, och därför blev det angeläget att även arbetet med förbättringar kunde betraktas utifrån evidenskrav. Runt sekelskiftet 2000 började de första forskningspublikationerna dyka upp. En av förbättringsforskningens stora utmaningar är att utveckla vetenskaplig robust kunskap, och en vanlig kritik har varit att en svag vetenskaplig och teoretisk grund.I rapporten har befintlig litteratur producerad i Sverige, i form av böcker och bokkapitel, avhandlingar och artiklar, sammanställts och analyserats avseende publikationsfrekvens över tid och innehåll (tema). Sammanställningen lyfter fram studier som har extra relevans för projektet, såsom samverkansprojekt och olika ansatser att överföra och anpassa förbättringskunskap till den sociala sektorn. Mellan åren 2007–2020 utkom 30 böcker, bokkapitel och enklare skrifter. De flesta är läroböcker i form av antologier skrivna för vårdens professioner och handlar ofta om grundläggande förbättringskunskap. 32 avhandlingar från nio svenska lärosäten identifierades, den första från 2003. Flera avhandlingar intar organisationsperspektiv, men även ledarskap, patientsäkerhet och patientinvolvering/delaktighet förekommer. Totalt 210 artiklar identifierades publicerade mellan 1992 och 2020, med flest antal (n=166) efter 2011. Tematiseringen resulterade i sex olika teman: 1) Systematiskt och värdeskapande förbättringsarbete; 2) Samverkan mellan organisationer och vårdgivare; 3) Användning av förbättringsmetoder och (teoretiska) modeller; 4) Ledarskap och lärande; 5) Mätningar, kvalitetsregister och uppföljning; samt 6) Personinvolvering och patientsäkerhet.Delaktighet och samskapade är en tydligt ökande trend inom vården. Samtidigt har det inom sociala verksamheter länge ansetts viktigt att beakta personers rättigheter och möjligheter till inflytande. Sammanställningen pekar mot en utveckling där samverkan mellan organisationer och samskapande med dem vård och omsorg är till för blir en allt viktigare faktor. Detta är en viktig aspekt för projektet BBGiK, som spänner över flera olika verksamheter och organisationer. Det är alltid en utmaning när olika verksamheter tillsammans ska hitta fungerande lösningar. Denna utmaning blir inte mindre av att de kommer ifrån olika kunskapstraditioner, men i projektet finns förutsättningar för gemensamt lärande runt en gemensam modell. En förutsättning för att lyckas med förbättringsarbete är ett aktivt ledarskap, och strävan mot samma gemensamma mål: ”att skapa en trygg och säker uppväxt för VARJE barn genom främjande, tidiga och samordnade insatser”.
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| 8. |
- Arvidsson, Patrik, et al.
(författare)
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The Relationship Between Intelligence Quotient and Aspects of Everyday Functioning and Participation for People Who Have Mild and Borderline Intellectual Disabilities
- 2018
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Ingår i: JARID. - : John Wiley & Sons. - 1360-2322 .- 1468-3148. ; 31:1, s. e68-e78
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundThis study explored the relationship between intelligence quotient (IQ) and aspects of everyday functioning/participation in individuals (age 16–40) who have a mild/borderline intellectual disability (IQ 55–85).MethodCorrelations were examined between IQ and (i) self-rated (n = 72) ability, participation as performance (how often an activity is performed), important participation restriction (not/seldom performing an activity perceived as important) and general well-being and (ii) proxy-rated (n = 41) ability and participation as performance.ResultsNo significant correlations between IQ and any of the explored measures were found. However, the effect sizes of the correlations between IQ and ability were considered as small but not negligible.ConclusionsThe results support the notion that IQ is a poor predictor of general aspects of everyday functioning in persons with mild/borderline intellectual disability. The result indicates that self-ratings partly generate other information than proxy ratings which may be important for assessments of supportive requirements and diagnosis.
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| 9. |
- Axelsson, Anna Karin, et al.
(författare)
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A Swedish cultural adaptation of the participation questionnaire Functional Scale of the Disability Evaluation System - Child version
- 2022
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Ingår i: Disability and Rehabilitation. - : TAYLOR & FRANCIS LTD. - 0963-8288 .- 1464-5165. ; 44:9, s. 1720-1727
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: The aim was to culturally validate a questionnaire about children's/youth's participation to be used in a Swedish context. Methods: FUNDES-Child, based on the well-established CASP, was chosen. Questions about engagement and hindering factors were added to the existing questions about frequency and independence in 20 activity areas. Using a qualitative, explorative design, 16 interviews with children/youths/caregivers were made to explore opinions about the questionnaire. Follow-up interviews confirmed the result of the revised questionnaire. Qualitative content analysis was performed. Results: The interviews provided support for the questionnaire's relevance by being a tool to assess important aspects of participation, to gain insights into one's own/the child's participation, and to promote ideas about what causes the degree of participation. To achieve comprehensiveness, no activity area was found to be missing nor superfluous. However, some examples were needed to be modified where "parades" are unusual in Sweden and therefore removed, while "singing in choir" was added. In search for comprehensibility, opinions about the layout of the first version were raised and a varying degree of understanding of wording and concepts were found and thus taken into account. Conclusions: The questionnaire can be used for establishing meaningful goals and to potentially increase children's participation.
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| 10. |
- Carlander (Goliath), Ida, 1968-, et al.
(författare)
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Being Me and Being Us in a Family Living Close to Death at Home
- 2011
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Ingår i: Qualitative Health Research. - : Sage Publications Inc. - 1049-7323 .- 1552-7557. ; 21:5, s. 683-695
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Tidskriftsartikel (refereegranskat)abstract
- We used interpretive description to describe how everyday life close to death was experienced and dealt with in families with one member who had a life-threatening illness. We performed 28 individual, couple, and group interviews with five families. We found two patterns, namely, “being me in a family living close to death” and “being us in a family living close to death.” “Being me” meant that every individual in the family had to deal with the impending death, regardless of whether or not he or she was the person with the life-threatening illness. This was linked to ways of promoting the individual’s self-image, or “me-ness.” This pattern was present at the same time as the pattern of “being us,” or in other words, being a family, and dealing with impending death and a new “we-ness” as a group. “Striving for the optimal way of living close to death” was the core theme.
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