| 1. |
- Kristensson Ekwall, Anna, et al.
(author)
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Compensating, Controlling, Resigning and Accepting-Older Person's Perception of Physical Decline.
- 2012
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In: Current Aging Science. - : Bentham Science Publishers Ltd.. - 1874-6128 .- 1874-6098. ; 5:1, s. 13-18
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Journal article (peer-reviewed)abstract
- It is important to know about how frail older people experience their physical decline and how they adapt to their bodily changes so that the health system can design preventive interventions targeting this group early on in the disability process. The aim of this study was to explore how older people perceive their physical decline. The study is qualitative in design and based on interviews with older persons, who were in an acute care process. Fourteen people, five men and nine women, aged 74 - 92 years (mean 81 years) were included in the study. Content analysis was used. The main finding was that physical decline was marked as occurring in two dimensions. One dimension was the physical decline and its impact on the individual's physical body (labelled individual body). The other dimension was the impact on the body in its environmental context such as the home or the society (labelled contextual body). The strategies for adapting constituted the two sub-themes, which were labeled compensating/controlling and accepting/resignation. The strategies were executed both on an intellectual level and practical level. For healthcare workers striving to increase physical activity, knowledge about how closely related self-image and physical ability are is useful when helping the frail older people. Increasing coping strategies for handling the general life situation may be a useful way of increasing physical activity and making it feel meaningful, despite the person's frail health situation with limited physical and sometimes psychological resources.
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| 2. |
- Kristensson, Jimmie, et al.
(author)
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Case managers for frail older people: a randomised controlled pilot study.
- 2010
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In: Scandinavian Journal of Caring Sciences. - : Wiley. - 1471-6712 .- 0283-9318. ; May 4, s. 755-763
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Journal article (peer-reviewed)abstract
- Scand J Caring Sci; 2010 Case managers for frail older people; a randomised controlled pilot study Aim: The aim was to test sampling and explore sample characteristics in a pilot study using a case management intervention for older people with functional dependency and repeated contact with the healthcare services as well as to investigate the effects of the intervention on perceived health and depressed mood after 3 months. The aim was also to explore internal consistency in the life satisfaction index Z, activities of daily living-staircase and Geriatric Depression Scale-20. Method: This pilot study was carried out in a randomised controlled design with repeated follow-ups. In all, 46 people were consecutively and randomly assigned to either an intervention (n = 23) or a control (n = 23) group. Two nurses worked as case managers and carried out the intervention, which consisted of four parts. Result: No differences were found between the groups at baseline. The results showed the participants had low life satisfaction (median 14 vs. 12), several health complaints (median 11) and a high score on the Geriatric Depression Scale (median 6) at baseline, indicating the risk of depression. No significant effects were observed regarding depressed mood or perceived health between or within groups at follow-up after 3 months. Cronbach's alpha showed satisfactory internal consistency for group comparisons. Conclusions: The sampling procedure led to similar groups. The life satisfaction, functional dependency and symptoms of depression measures were reliable to use. No changes in perceived health and symptoms of depression were found after 3 months, indicating that it may be too early to expect effects. The low depression score is noteworthy and requires further research.
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| 3. |
- Kristensson, Jimmie, et al.
(author)
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Frail Older Adults' Experiences of Receiving Health Care and Social Services
- 2010
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In: Journal of Gerontological Nursing. - : SLACK, Inc.. - 0098-9134 .- 1938-243X. ; 36:10, s. 20-28
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Journal article (peer-reviewed)abstract
- This study explored frail older adults' overall experience of receiving health care and/or social services. Frail older adults with unstable health are dependent on the health care system because of the frequency of their contacts with it. More knowledge is needed about how they experience the health care and social services they receive. Interviews with 14 older adults (mean age = 81) revealed one main category, Having Power or Being Powerless, that incorporated three categories: Autonomous or Without Control in Relation to the Health Care and/or Social Services System, Being Confirmed or Violated in Relation to Caregivers, and Paradoxes in Health Care or Social Services. Each category comprised subcategories reflecting aspects of having power or being powerless. The findings indicate it is important for health care and social services to ensure a high level of interpersonal continuity to empower frail older adults. This may contribute to more relationship-based care and help older adults remain in control of their life situations.
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| 4. |
- Kristensson, Jimmie, et al.
(author)
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Psychometric properties of the consumer emergency care satisfaction scale: tested on persons accompanying patients in emergency department.
- 2008
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In: Journal of Nursing Care Quality. - 1550-5065. ; 23:3, s. 277-282
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Journal article (peer-reviewed)abstract
- The aim of this study was to investigate construct validity and internal consistency of a modified version of the Consumer Emergency Care Satisfaction Scale used on persons accompanying emergency department patients. The sample comprised 128 persons. The results showed satisfactory reliability, and an exploratory factor analysis revealed 3 factors: caring, teaching, and clinical competence. The modified version of this scale seems feasible and may be a useful tool for measuring satisfaction in persons accompanying patients in the emergency department.
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| 5. |
- Modig, Sara, et al.
(author)
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Frail elderly patients in primary care-their medication knowledge and beliefs about prescribed medicines.
- 2009
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In: European Journal of Clinical Pharmacology. - : Springer Science and Business Media LLC. - 1432-1041 .- 0031-6970. ; 65, s. 151-155
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Journal article (peer-reviewed)abstract
- PURPOSE: The aim of this study was to describe elderly patients' knowledge about and attitudes towards their medicines in Swedish primary care. METHODS: Thirty-four patients aged 65 years and above with multiple illnesses were included. Medication knowledge was assessed with a questionnaire measuring knowledge about indication and possible adverse effects for each medicine. Attitudes were investigated with the Beliefs about Medicines Questionnaire. RESULTS: The indication of at least 75% of their medicines was known to 71% of the patients. Patients with polypharmacy and multi-dose drug distribution respectively had significantly less knowledge. Eighty-four percent had no knowledge about possible adverse effects. For 93% of the patients, the benefits of the medication outweighed the costs (concerns). No correlation was found between attitudes and knowledge. CONCLUSIONS: The knowledge about indication was higher than previously seen, but the knowledge about possible adverse effects was poor. The patients had strong beliefs in the benefits of their medication.
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| 6. |
- Ahlström, Gerd, et al.
(author)
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Collaboration and guidelines for the coordination of health care for frail older persons with intellectual disability : A national survey of nurses working in municipal care
- 2021
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In: Nursing Open. - : Wiley. - 2054-1058. ; 8:3, s. 1369-1379
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Journal article (peer-reviewed)abstract
- Aims: To describe and compare perceptions of collaboration between care providers on the part of three groups of Registered Nurses working in municipal care and having particular responsibility concerning the care of frail older people with intellectual disability (ID); and, furthermore, to investigate the presence of and compliance with guidelines for the coordination of care. Design: National survey study with cross-sectional design. Methods: Nurses (N = 110) with key positions concerning people with ID answered a national questionnaire about collaboration, guidelines and coordinated individual plans. Descriptive and comparative statistical analyses were applied. Results: The meetings on cooperation and coordination of interventions were attended most frequently by nurses, and least frequently by social workers. The nurses were overall satisfied with the collaboration but perceived shortcomings in the case of inpatient and outpatient psychiatric care. Only in about half of the meetings for making care plans participated the people with intellectual disability and next of kin.
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| 7. |
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| 8. |
- Axmon, Anna, et al.
(author)
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Use of antipsychotics, benzodiazepine derivatives, and dementia medication among older people with intellectual disability and/or autism spectrum disorder and dementia
- 2017
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In: Research in Developmental Disabilities. - : Elsevier. - 0891-4222 .- 1873-3379. ; 62, s. 50-57
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Journal article (peer-reviewed)abstract
- Background Although people with intellectual disability (ID) and people with dementia have high drug prescription rates, there is a lack of studies investigating drug use among those with concurrent diagnoses of ID and dementia. Aim To investigate the use of antipsychotics, benzodiazepine derivatives, and drugs recommended for dementia treatment (anticholinesterases [AChEIs] and memantine) among people with ID and dementia. Methods and procedures Having received support available for people with ID and/or autism spectrum disorder (ASD) was used as a proxy for ID. The ID cohort consisted of 7936 individuals, aged at least 55 years in 2012, and the referent cohort of age- and sex-matched people from the general population (gPop). People with a specialists’ diagnosis of dementia during 2002–2012 were identified (ID, n = 180; gPop, n = 67), and data on prescription of the investigated drugs during the period 2006–2012 were collected. Outcome and results People with ID/ASD and dementia were more likely than people with ID/ASD but without dementia to be prescribed antipsychotics (50% vs 39% over the study period; odds ratio (OR) 1.85, 95% confidence interval 1.13–30.3) and benzodiazepine derivatives (55% vs 36%; OR 2.42, 1.48–3.98). They were also more likely than people with dementia from the general population to be prescribed antipsychotics (50% vs 25%; OR 3.18, 1.59–6.34), but less likely to be prescribed AChEIs (28% vs 45%; OR 0.32, 0.16–0.64).
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| 9. |
- Bartosch, Patrik, et al.
(author)
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A “snap-shot” visual estimation of health and objectively measured frailty : capturing general health in aging older women
- 2022
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In: Aging clinical and experimental research. - : Springer Science and Business Media LLC. - 1594-0667 .- 1720-8319. ; 34:7, s. 1663-1671
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Journal article (peer-reviewed)abstract
- Background: In clinic, a subjective visual estimation of a patient’s general health often guides interventions, yet little is known of how this assessment relates to objectively measured frailty. Aims: To characterize the relationship between these two assessments and explore the implication of discordance. Methods: The study was performed in the OPRA cohort of 75-year old community-dwelling women (n = 1044). Visual perception of health (VPH) was estimated within 15 s from first sight and stratified into tertiles (poor/intermediate/good health). Frailty was measured using a frailty index (FI) (scored 0.0–1.0) and stratified into tertiles: ‘frail’ (≥ 0.22), ‘pre-frail’ (0.13–0-21) and ‘non-frail’ (≤ 0.12). Association between VPH and FI and with 10-year mortality was evaluated using Kaplan Meier curves and Cox proportional hazard models. Results: VPH and FI correlated, but was strongest in those perceived to be in poor health (rs = 0.424, p < 0.001). Approximately half of these women were also objectively frail (53.7%). Similarly, 50.7% perceived to be in good health were also objectively non-frail. However, for one in ten, perceived health was discordant with measured frailty. Subjective and objective measures were associated with mortality, but VPH lacked discrimination in healthier looking women (p = 0.372) compared to FI (p = 0.002). Discussion: Detecting pre-frailty is important to prevent or slow the transition into a frail state. The frailest can be identified with a visual estimation, but only objective frailty assessments can reliably identity pre-frailty. Conclusions: A visual estimation of health provides valuable complementary information on health, whereas objective assessment of frailty has a broader applicability for health in aging.
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| 10. |
- Bartosch, Patrik S., et al.
(author)
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Frailty and prediction of recurrent falls over 10 years in a community cohort of 75-year-old women
- 2020
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In: Aging clinical and experimental research. - : Springer Science and Business Media LLC. - 1594-0667 .- 1720-8319. ; 32:11, s. 2241-2250
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Journal article (peer-reviewed)abstract
- Background: Frailty captures the age-related declines in health leading to increased vulnerability, including falls which are commonplace in older women. The relationship between frailty and falls is complex, with one leading to the other in a vicious cycle. Aims: This study addresses the gap in understanding how patterns of frailty and falls propensity interact, particularly in those who have not yet entered the falls-frailty cycle. Methods: The Osteoporosis Risk Assessment cohort consists of 1044 community-dwelling women aged 75, with 10 years of follow-up. Investigations were performed and a frailty index constructed at baseline, 5 and 10 years. Falls were self-reported for each previous 12 months. Analysis was two-directional, firstly based on frailty status and second, based on falls status. Recurrent falls was the primary outcome. Results: Baseline frailty was a significant predictor of recurrent falls after 5 and 10 years [(OR 2.55 (1.62–3.99); 3.04 (1.63–5.67)]. Among women who had no history of falls at age 75, frailty was a stronger predictor of falls at 5 years [OR 3.06 (1.59–5.89)] than among women who had previously fallen. Discussion: Frailty is significantly associated with recurrent falls and most pronounced in those who are frail but have not yet fallen. Conclusions: This suggests that frailty should be an integral part of falls-risk assessment to improve identification of those at risk of becoming fallers.
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