1.
Kirvalidze, Mariam, et al.
(författare)
Effectiveness of integrated person-centered interventions for older people's care: Review of Swedish experiences and experts’ perspective
2024
Ingår i: Journal of Internal Medicine. - : John Wiley & Sons. - 1365-2796 .- 0954-6820. ; 295:6, s. 804-824
Tidskriftsartikel (refereegranskat) abstract
Older adults have multiple medical and social care needs, requiring a shift toward an integrated person-centered model of care. Our objective was to describe and summarize Swedish experiences of integrated person-centered care by reviewing studies published between 2000 and 2023, and to identify the main challenges and scientific gaps through expert discussions. Seventy-three publications were identified by searching MEDLINE and contacting experts. Interventions were categorized using two World Health Organization frameworks: (1) Integrated Care for Older People (ICOPE), and (2) Integrated People-Centered Health Services (IPCHS). The included 73 publications were derived from 31 unique and heterogeneous interventions pertaining mainly to the micro- and meso-levels. Among publications measuring mortality, 15% were effective. Subjective health outcomes showed improvement in 24% of publications, morbidity outcomes in 42%, disability outcomes in 48%, and service utilization outcomes in 58%. Workshop discussions in Stockholm (Sweden), March 2023, were recorded, transcribed, and summarized. Experts emphasized: (1) lack of rigorous evaluation methods, (2) need for participatory designs, (3) scarcity of macro-level interventions, and (4) importance of transitioning from person- to people-centered integrated care. These challenges could explain the unexpected weak beneficial effects of the interventions on health outcomes, whereas service utilization outcomes were more positively impacted. Finally, we derived a list of recommendations, including the need to engage care organizations in interventions from their inception and to leverage researchers’ scientific expertise. Although this review provides a comprehensive snapshot of interventions in the context of Sweden, the findings offer transferable perspectives on the real-world challenges encountered in this field.
2.
Johansson-Pajala, Rose-Marie, et al.
(författare)
Trust and easy access to home care staff are associated with older adults' sense of security : a Swedish longitudinal study
2024
Ingår i: Scandinavian Journal of Public Health. - : SAGE PUBLICATIONS LTD. - 1403-4948 .- 1651-1905. ; , s. 36830-
Tidskriftsartikel (refereegranskat) abstract
AIM: Older adults are increasingly encouraged to continue living in their own homes with support from home care services. However, few studies have focused on older adults' safety in home care. This study explored associations between the sense of security and factors related to demographic characteristics and home care services.METHODS: The mixed longitudinal design was based on a retrospective national survey. The study population consisted of individuals in Sweden (aged 65+ years) granted home care services at any time between 2016 and 2020 (n=82,834-94,714). Multiple ordinal logistic regression models were fitted using the generalised estimation equation method to assess the strength of relationship between the dependent (sense of security) and independent (demographics, health and care-related factors) variables.RESULTS: The sense of security tended to increase between 2016 and 2020, and was significantly associated with being a woman, living outside big cities, being granted more home care services hours or being diagnosed/treated for depression (cumulative odds ratio 2-9% higher). Anxiety, poor health and living alone were most strongly associated with insecurity (cumulative odds ratio 17-64% lower). Aside from overall satisfaction with home care services, accessibility and confidence in staff influenced the sense of security most.CONCLUSIONS: We stress the need to promote older adults' sense of security for safe ageing in place, as mandated by Swedish law. Home care services profoundly influence older adults' sense of security. Therefore, it is vital to prioritise continuity in care, establish trust and build relationships with older adults. Given the increasing shortage of staff, integrating complementary measures, such as welfare technologies, is crucial to promoting this sense of security.
3.
Fondell, Elinor, et al.
(författare)
Adherence to the Nordic Nutrition Recommendations as a measure of a healthy diet and upper respiratory tract infection
2011
Ingår i: Public Health Nutrition. - : CAMBRIDGE UNIV PRESS. - 1368-9800 .- 1475-2727. ; 14:5, s. 860-869
Tidskriftsartikel (refereegranskat) abstract
Objective: The Nordic countries have published joint dietary recommendations, the Nordic Nutrition Recommendations (NNR), since 1980. We evaluated adherence to the NNR as a measure of a healthy diet and its potential association with self-reported upper respiratory tract infection (URTI). Design: A prospective, population-based study with a follow-up period of 4 months. Dietary intake was assessed using a semi-quantitative FFQ with ninety-six items, along with other lifestyle factors, at baseline. URTI was assessed every three weeks. A Poisson regression model was used to control for age, sex and other confounding factors. Setting: A middle-sized county in northern Sweden. Subjects: Swedish men and women (n 1509) aged 20-60 years. Results: The NNR include recommendations on macronutrient proportions, physical activity and intake of micronutrients, sodium, fibre and alcohol. We found that overall adherence to the NNR was moderately good. In addition, we found that high adherence to the NNR (>5.5 adherence points) was not associated with a lower risk of URTI (incidence rate ratio (IRR) 0.89, 95% CI 0.73, 1.08) compared with low adherence (<4.5 adherence points). When investigating individual components of the NNR, only high physical activity was associated with lower URTI risk (IRR=0.82, 95% CI 0.69, 0.97) whereas none of the dietary components were associated with risk of URTI. Conclusions: Overall adherence to the NNR was moderately good. Overall adherence to the NNR was not associated with URTI risk in our study. However, when investigating individual components of the NNR, we found that high physical activity was associated with lower URTI risk.
4.
Platts, Loretta G., et al.
(författare)
The nature of paid work in the retirement years
2023
Ingår i: Ageing & Society. - Bimingham : Cambridge University Press. - 0144-686X .- 1469-1779. ; 43:6, s. 1310-1332
Tidskriftsartikel (refereegranskat) abstract
Ever more people are in paid work following the age of state pension availability, and yet the experience of working in this phase of the late career has been little studied. We interviewed a purposive sample of 25 Swedish people in their mid- to late sixties and early seventies, many of whom were or had recently been working while claiming an old-age pension. The data were analysed with constant comparative analysis in which we described and refined categories through the writing of analytic memos and diagramming. We observed that paid work took place within a particular material, normative and emotional landscape: a stable and secure pension income decommodifying these workers from the labour market, a social norm of a retired lifestyle and a looming sense of contraction of the future. This landscape made paid work in these years distinctive: characterised by immediate intrinsic rewards and processes of containing and reaffirming commitments to jobs. The oldest workers were able to craft assertively the temporal flexibility of their jobs in order to protect the autonomy and freedom that retirement represented and retain favoured job characteristics. Employed on short-term (hourly) contracts or self-employed, participants continually reassessed their decision to work. Participation in paid work in the retirement years is a distinctive second stage in the late career which blends the second and third ages.
5.
Marmstål Hammar, Lena, 1979-, et al.
(författare)
Being Treated With Respect and Dignity? : Perceptions of Home Care Service Among Persons With Dementia
2021
Ingår i: Journal of the American Medical Directors Association. - New York : Elsevier. - 1525-8610 .- 1538-9375. ; 22:3, s. 656-662
Tidskriftsartikel (refereegranskat) abstract
Objective: Studies on the quality of home care services (HCS) offered to persons with dementia (PwDs) reveal the prevalence of unmet needs and dissatisfaction related to encounters and a lack of relationships with staff. The objective of this study was to enhance knowledge of the perceptions of PwDs regarding their treatment with dignity and respect in HCS over time.Design: A mixed longitudinal cohort study was designed to study trends in the period between 2016 and 2018 and compare the results between PwDs (cases) and persons without dementia (controls) living at home with HCS.Setting and Participants: Persons aged 65 years and older with HCS in Sweden.Methods: Data from an existing yearly HCS survey by the Swedish National Board of Health and Welfare (NBHW) was used. The focus was on questions concerning dignity and respect. NBHW data sets on diagnoses, medications, HCS hours, and demographic information were also used. We applied GEE logistic and cumulative logit regression models to estimate effects and trends of interest after controlling for the effects of age, gender, self-rated health, and number of HCS hours.Results: Over the study period, 271,915 (PwDs¼8.1%) respondents completed the survey. The results showed that PwDs were significantly less likely (3%-10% lower odds and cumulative odds) than controls to indicate that they were satisfied in response to questions related to dignity and respect. Both groups experienced a decrease in satisfaction from 2016 to 2018. Females, individuals with poor self-rated health, and individuals granted more HCS hours were found to be more dissatisfied.Conclusions and Implications: The HCS organization needs to shift from a task-oriented system to a person-centered approach, where dignity and respect are of the utmost importance. The HCS organizations need to be developed to focus on competence in person-centered care, and leadership to support staff.
6.
Eklund, Caroline, 1983-, et al.
(författare)
The Meaning of Sedentary Behavior as Experienced by People in the Transition From Working Life to Retirement : An Empirical Phenomenological Study
2021
Ingår i: Physical Therapy. - : Oxford University Press (OUP). - 0031-9023 .- 1538-6724. ; 101:8
Tidskriftsartikel (refereegranskat) abstract
ObjectiveSedentary behavior (SB) is defined as a mean of >6 hours of daytime sitting or lying down. SB has been shown to increase with older age and is a risk factor for disease. During the transition from working life to retirement, changes in daily life activities occur, risking increased SB. The aim of the present study was to gain a deeper understanding of SB in relation to the transition from working life to retirement as experienced by persons in retirement.MethodsThe study was grounded in a phenomenological life-world perspective. Fourteen semi-structured interviews were conducted with participants aged 64–75. Data were analyzed using the empirical phenomenological psychological method.ResultsThe participants described that voluntary sedentary time was positively related to general health and well-being, while involuntary sedentary time was negatively related to health. Increased sedentary time was described as natural when aging. Retirement was expressed as a time for rest after hard work and the ability to choose a slower pace in life. Internal and external demands and daily routines interrupted SB, whereas loneliness was perceived to increase SB. Participants strived to find a balance between physical activity and sedentary time. The variations in the participants’ descriptions formed three typologies: in light of meaningful sedentary behavior, in the shadow of involuntary sedentary behavior, and a dual process – postponing sedentary behavior with physical activity.ConclusionsIncreased SB was perceived as natural when aging, but something that may be postponed by conscious choices. SB was perceived as associated with health, rest and recovery but also with the risk of deteriorating health.ImpactThis knowledge of the experienced meaning of SB could guide the design of health promotion interventions and may be helpful in targeting those in need of support and individualizing interventions to decrease SB in retirement.Lay SummaryThis study reveals how persons in retirement describe sedentary behavior as something healthy but also as unhealthy and that sedentary behavior is natural in aging and can be postponed by physical activity.
7.
Lostelius, Petra, et al.
(författare)
Identification of health-related problems in youth : a mixed methods feasibility study evaluating the Youth Health Report System
2024
Ingår i: BMC Medical Informatics and Decision Making. - : BioMed Central Ltd. - 1472-6947. ; 24:1
Tidskriftsartikel (refereegranskat) abstract
Background: Because poor health in youth risk affecting their entry in adulthood, improved methods for their early identification are needed. Health and welfare technology is widely accepted by youth populations, presenting a potential method for identifying their health problems. However, healthcare technology must be evidence-based. Specifically, feasibility studies contribute valuable information prior to more complex effects-based research. The current study assessed the process, resource, management, and scientific feasibility of the Youth Health Report System prototype, developed within a youth health clinic context in advance of an intervention study. Methods: This mixed-methods feasibility study was conducted in a clinical setting. The process, resource, management, and scientific feasibility of the Youth Health Report System were investigated, as recommended in the literature. Participants were youth aged 16–23 years old, attending a youth health clinic, and healthcare professionals from three clinics. The youth participants used their smart phones to respond to Youth Health Report System health questions and healthcare professionals used their computer to access the results and for registration system entries. Qualitative data were collected from interviews with healthcare professionals, which were described with thematic analysis. Youth participants’ quantitative Youth Health Report System data were analyzed for descriptive statistics. Results: Feasibility analysis of qualitative data from interviews with 11 healthcare professionals resulted in three themes: We expected it could be hard; Information and routines helped but time was an issue; and The electronic case report form was valuable in the health assessment. Qualitative data were collected from the Youth Health Report System. A total of 54 youth participants completed the evaluation questionnaire, and healthcare professionals retrieved information from, and made post-appointment system entries. Quantitative results revealed few missing items and acceptable data variability. An assessment template of merged qualitative and quantitative data guided a consensus discussion among the researchers, resulting in acceptable feasibility. Conclusions: The process-, resource-, management-, and scientific feasibility aspects were acceptable, with some modifications, strengthening the potential for a successful Youth Health Report System intervention study.
8.
Manasatchakun, Pornpun, 1983-, et al.
(författare)
Healthy Ageing in Isan-Thai culture – A phenomenographic study based on older persons' lived experiences
2016
Ingår i: International Journal of Qualitative Studies on Health and Well-being. - Järfälla : Co-Action Publishing. - 1748-2623 .- 1748-2631. ; 11
Tidskriftsartikel (refereegranskat) abstract
Healthy ageing is a concept that concerns older persons’ quality of life and is a key factor in promoting wellbeing. The older population in Thailand is growing. Isan (a region of north-eastern Thailand) has been reported as having one of the most rapidly increasing older populations in the country. In order to care for and promote the health of older people, healthcare providers should understand how healthy ageing is perceived by this target group. Although healthy ageing has been studied in different contexts as well as perspectives,no studies have previously focused on older persons’ experiences of healthy ageing from a life world perspective in Isan-Thai. Therefore, the aim of this study is to describe older persons’ qualitatively different conceptions of healthy ageing in Isan-Thai culture. A phenomenographic approach with an epistemological base in lifeworld theory was used to disclose the various ways to conceptualize healthy ageing. Individual, qualitative interviews were conducted with 17 older people aged 60 and above who live in Isan-Thai. The findings of this study revealed three categories of descriptions: “being independent in dependence”, “being at peace”, and “being a valuable person”. This study also found family members, friends, healthcare providers, and religion important to healthy ageing in the Isan-Thai culture. Understanding how older people conceptualize healthy aging is valuable for healthcare providers. They can apply these findings regarding healthy ageing in their fieldwork when caring for older people. © 2016 P. Manasatchakun et al.
9.
Bidgoli, Hassan Haghparast, et al.
(författare)
Pre-hospital trauma care resources for road traffic injuries in a middle-income country-A province based study on need and access in Iran.
2011
Ingår i: Injury. - : Elsevier BV. - 0020-1383 .- 1879-0267. ; 42:9, s. 879-884
Tidskriftsartikel (refereegranskat) abstract
BACKGROUND: Access to pre-hospital trauma care can help minimize many of traffic related mortality and morbidity in low- and middle-income countries with high rate of traffic deaths such as Iran. The aim of this study was to assess if the distribution of pre-hospital trauma care facilities reflect the burden of road traffic injury and mortality in different provinces in Iran. METHODS: This national cross-sectional study is based on ecological data on road traffic mortality (RTM), road traffic injuries (RTIs) and pre-hospital trauma facilities for all 30 provinces in Iran in 2006. Lorenz curves and Gini coefficients were used to describe the distributions of RTM/RTIs and pre-hospital trauma care facilities across provinces. Spearman rank-order correlation was performed to assess the relationship between RTM/RTI and pre-hospital trauma care facilities. RESULTS: RTM and RTIs as well as pre-hospital trauma care facilities were distributed unequally between different provinces. There was no significant association between the rate of RTM and RTIs and the number of pre-hospital trauma care facilities across the country. CONCLUSIONS: The distribution of pre-hospital trauma care facilities does not reflect the needs in terms of RTM and RTIs for different provinces. These results suggest that traffic related mortality and morbidity could be reduced if the needs in terms of RTM and RTIs were taken into consideration when distributing pre-hospital trauma care facilities between the provinces.
10.
