1. |
- Olaison, Anna, 1974-, et al.
(author)
-
‘Do you have a future when you are 93?’ Frail older person’s perceptions about the future and end of life – a qualitative interview study in primary care
- 2022
-
In: Scandinavian Journal of Primary Health Care. - : Taylor & Francis Group. - 0281-3432 .- 1502-7724. ; 40:4, s. 417-425
-
Journal article (peer-reviewed)abstract
- Objective: To explore frail older persons’ perceptions of the future and the end of life.Design: Qualitative content analysis of individual semi-structured interviews.Setting: Nine primary health care centres in both small and middle-sized municipalities in Sweden that participated in the intervention project Proactive healthcare for frail elderly persons.Subjects/Patients: The study includes 20 older persons (eight women and 12 men, aged 76–93 years).Main outcome measures: Frail older persons’ perceptions of the future and end of life.Results: The analysis uncovered two main categories: Dealing with the future and Approaching the end of life. Dealing with the future includes two subcategories: Plans and reflections and Distrust and delay. Approaching the end of life includes three subcategories: Practical issues, Worries and realism, and Keeping it away.Conclusion: This study highlights the diverse ways older people perceive future and the end of life. The results make it possible to further understand the complex phenomenon of frail older persons’ perceptions on the future and the end of life.
|
|
2. |
- Olaison, Anna, 1974-, et al.
(author)
-
Maneuvering the care puzzle: Experiences of participation in care by frail older persons with significant care needs living at home
- 2021
-
In: International Journal of Qualitative Studies on Health and Well-being. - : Informa UK Limited. - 1748-2623 .- 1748-2631. ; 16:1
-
Journal article (peer-reviewed)abstract
- Purpose: Despite evidence that older persons want to be involved in care, little is known about how frail older people with significant care needs living at home experience participation in care provided by different stakeholders. This study investigates the experiences of participation in care by older people following their involvement in an intervention of a health care model called Focused Primary care (FPC). Methods: Individual semi-structured interviews were conducted with 20 older persons in five municipalities in Sweden. Results: The results show that older persons highlighted opportunities and limitations fo rparticipation on a personal level i.e., conditions for being involved in direct care and in relation to independence. Experiences of participation on organizational levels were reported to a lesser degree. This included being able to understand the organizational system underpinning care. The relational dimensions of caregiving were emphasized by the older persons as the most central aspects of caregiving in relation to participation. Conclusions: Primary care should involve older persons more directly in planning and execution of care on all levels. An ongoing connection with one specialized elderly teamand a coordinating person in Primary care who safeguards relationships is important for providing participation in care for frail older persons with significant care needs living at home
|
|
3. |
- Areskoug Josefsson, Kristina, 1973-, et al.
(author)
-
Co-creation of a working model to improve sexual health for persons living with rheumatological diseases
- 2020
-
In: Open Journal of Rheumatology and Autoimmune Diseases. - : Scientific Research Publishing. - 2163-9914 .- 2164-005X. ; 10:3, s. 109-124
-
Journal article (peer-reviewed)abstract
- Background: Sexual health needs are insufficiently met for persons living with rheumatological diseases and it is necessary to create better ways to meet these needs. Objective: To co-create a working model to improve sexual health for persons living with rheumatological diseases, that can be used by rheumatological teams in regular rheumatology practice. Design: This study applied a co-creation design with three key features: 1) it took a systems perspective with emergent multiple interactive entities; 2) the research process was viewed as a creative endeavour with strong links to design, while human imagination and the individual experience of patient and staff were at the core of the creative design effort; 3) the process of the co-creative efforts was as important as the generated product. Results: A model defining the role of the patient, the professionals, and the team in optimizing sexual health for persons living with rheumatological diseases was co-created. The model can be seen as a practice guideline, which includes the support needed from and to each participant in the process of promoting sexual health, while being within the professional scope of the professionals’ knowledge and capacity, and in line with the needs of the persons living with rheumatological diseases. Discussion and Conclusions: The co-creative work process identified crucial factors in promoting sexual health, resulting in a useful model for patients, professionals and teams. Co-creation was experienced to be a useful research design to improve rheumatological care, through valuing and using the competence of all research members equally.
|
|
4. |
- Bergström, Maria, 1983-, et al.
(author)
-
A dyadic exploration of support in everyday life of persons with RA and their significant others
- 2023
-
In: Scandinavian Journal of Occupational Therapy. - : Taylor & Francis Ltd. - 1103-8128 .- 1651-2014. ; 30:5, s. 616-627
-
Journal article (peer-reviewed)abstract
- Background Support from significant others is important for participation in everyday life for persons with rheumatoid arthritis (RA). Meanwhile, significant others also experience limitations. Aims To explore how support is expressed by persons with RA and significant others, and how support relates to participation in everyday life of persons with RA. Material and methods Sixteen persons with RA and their significant others participated in individual semi-structured interviews. The material was analyzed using dyadic analysis. Results Persons with RA and significant others reported that RA and support had become natural parts of everyday life, especially emotional support. The reciprocal dynamics of support were also expressed as imperative. Also, support from people outside of the dyads and well-functioning communication facilitated everyday life. Conclusions Significant others and the support they give are prominent factors and facilitators in everyday life of persons with RA. Concurrently, the support persons with RA provide is important, along with support from outside of the dyads. Significance The results indicate that the interaction between persons with RA and the social environment is central to gain insight into how support should be provided for optimal participation in everyday life. Significant others can preferably be more involved in the rehabilitation process.
|
|
5. |
|
|
6. |
- Björk, Mathilda, et al.
(author)
-
Inflammatory Arthritis and the Effect of Physical Activity on Quality of Life and Self-reported Function : A Systematic Review and Meta-analysis
- 2022
-
In: Arthritis care & research. - : John Wiley & Sons. - 2151-464X .- 2151-4658. ; 74:1, s. 31-43
-
Research review (peer-reviewed)abstract
- OBJECTIVE: Although physical activity (PA) is an evidence-based intervention that reduces disease-related symptoms and comorbidity in rheumatoid arthritis (RA), PA's effect on self-reported function and Quality of Life (QoL) has not been analyzed. This study synthesizes the evidence for the effectiveness of PA on QoL and self-reported function in adults with RA, spondyloarthritis (SpA), and psoriatic arthritis (PsA).METHODS: The databases PubMed, Embase, CINAHL, and Cochrane Central Register of Controlled Trials (CENTRAL) were searched to identify relevant randomized controlled trials (RCTs). Screening, risk of bias assessment (using RoB 2.0 tool), and data extraction were independently performed by two or more of the authors. The meta-analyses were conducted with a random-effects model.RESULTS: The systematic review included 55 RCTs and the meta-analysis included 37 RCTs. In 55 studies included, 76% investigated RA, 20% investigated SpA, and 4% investigated PsA. In RA effects were found on QoL and function compared to inactive controls, effects not sustained in comparison to active controls. In SpA the effects of PA on QoL were in favor of the control group. Effects on function were found compared to inactive controls and sustained in fatigue and pain when compared to active controls. In PsA no effects on QoL were found but on function compared to inactive controls. The effect size was below 0.30 in the majority of the comparisons.CONCLUSION: PA may improve QoL and self-reported function in RA, SpA, and PsA. However, larger trials are needed, especially in SpA and PsA.
|
|
7. |
|
|
8. |
- Cedersund, Elisabet, 1950-, et al.
(author)
-
Finding the right care path: Experiences of participation in care by older persons with complex health problems : A Focused Primary Care Intervention
- 2021
-
Conference paper (peer-reviewed)abstract
- Introduction: Despite evidence that older persons want to be involved in care, little is known about how older people with complex health problems living at home experience participation in care provided by different stakeholders. This study investigates the experiences of participation in care by older people, following their involvement in a proactive intervention based on a new health care model called Focused Primary Care. Material and methods: Individual semi-structured interviews were conducted with 20 older persons in five municipalities in Sweden. All the interviewees had participated in the intervention. Results: The older persons highlighted opportunities and limitations for participation on a personal level i.e. conditions for being involved in direct care and in relation to independence. Experiences of participation on an organisational level were reported to a lesser degree. In order to keep care contacts together and improve participation, a coordinating person (called “the spider in the net”) was requested who could safeguard the staff’s relationship with the older person. Conclusions: Primary care should to a greater extent involve older persons more directly in the planning and execution of care. There is considerable potential for developing the health and primary care sector to better target the needs of older persons with complex health problems, and to enhance their participation and independence. Interventions, like the one followed in this project, can play a critical role in realising the needs of older persons, where providing participation in care is recognised as a significant goal to assist them in navigating the care system.
|
|
9. |
- Dale, Richard Allan, 1965, et al.
(author)
-
YOUNG ADULTS' EXPERIENCES WITH NEAR-INJURY SITUATIONS: A CRITICAL INCIDENT STUDY IN SWEDEN
- 2017
-
In: International Journal of Child Youth & Family Studies. - : University of Victoria Libraries. - 1920-7298. ; 8:1, s. 97-111
-
Journal article (peer-reviewed)abstract
- As injuries are the main health threat for young adults (18-29 years) in industrial countries, a better understanding of injury risk is needed for this population. Using the Critical Incident Technique, this study explores how young people experience situations that have the potential to cause physical injury (i.e., near-injury situations). Clearly, understanding how and why near-injury situations arise can be used to develop strategies to help prevent severe injury. Content analysis was used to categorize the characteristics of the experiences into unexpected risk in ordinary tasks, duty first, and price for learning. Young adults' exposures to new or unusual environmental conditions, especially in unexpected risk in ordinary tasks, should be considered when planning injury prevention strategies. A combination of individual, social, and contextual demands and expectations was identified in both work-and sports-related experiences with near-injury situations. The price for learning, which arises from the added risk involved in learning situations, is another condition that was identified and requires further attention. The Critical Incident Technique proved to be a useful method for identifying near-injury situations that might otherwise have been difficult to recall. Young adults' efforts to display their ability to handle difficult situations at work and in their everyday lives was identified as a major contributor to near-injury situations.
|
|
10. |
- Eldh, Ann Catrine, Docent, 1965-, et al.
(author)
-
Health Care Professionals' Experience of a Digital Tool for Patient Exchange, Anamnesis, and Triage in Primary Care : Qualitative Study.
- 2020
-
In: JMIR Human Factors. - Toronto, Canada : JMIR Publications. - 2292-9495. ; 7:4
-
Journal article (peer-reviewed)abstract
- BACKGROUND: Despite a growing body of knowledge about eHealth innovations, there is still limited understanding of the implementation of such tools in everyday primary care.OBJECTIVE: The objective of our study was to describe health care staff's experience with a digital communication system intended for patient-staff encounters via a digital route in primary care.METHODS: In this qualitative study we conducted 21 individual interviews with staff at 5 primary care centers in Sweden that had used a digital communication system for 6 months. The interviews were guided by narrative queries, transcribed verbatim, and subjected to content analysis.RESULTS: While the digital communication system was easy to grasp, it was nevertheless complex to use, affecting both staffing and routines for communicating with patients, and documenting contacts. Templates strengthened equivalent procedures for patients but dictated a certain level of health and digital literacy for accuracy. Although patients expected a chat to be synchronous, asynchronous communication was extended over time. The system for digital communication benefited assessments and enabled more efficient use of resources, such as staff. On the other hand, telephone contact was faster and better for certain purposes, especially when the patient's voice itself provided data. However, many primary care patients, particularly younger ones, expected digital routes for contact. To match preferences for communicating to a place and time that suited patients was significant; staff were willing to accept some nuisance from a suboptimal service-at least for a while-if it procured patient satisfaction. A team effort, including engaged managers, scaffolded the implementation process, whereas being subjected to a trial without likely success erected barriers.CONCLUSIONS: A digital communication system introduced in regular primary care involved complexity beyond merely learning how to manage the tool. Rather, it affected routines and required that both the team and the context were addressed. Further knowledge is needed about what factors facilitate implementation, and how. This study suggested including ethical perspectives on eHealth tools, providing an important but novel aspect of implementation.
|
|