| 1. |
- Andersson Hammar, Isabelle, et al.
(author)
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Frail older people with decreased cognition can perceive reduced self-determination in self-care and social relationships.
- 2024
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In: BMC geriatrics. - 1471-2318. ; 24:1
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Journal article (peer-reviewed)abstract
- Self-determination in old age is essential for people's experiences of good subjective health and quality of life. The knowledge concerning how frail older people with decreased cognition perceive their ability to be self-determined in the different dimension in daily life is, however, limited. The aim of this study was therefore to explore the relationship of self-determination and cognition in frail older people.This study was a cross-sectional secondary data analysis using baseline data with 119 frail people 75≥from a larger randomized control trial. Self-determination was measured with the statements from the Impact on Participation and Autonomy-Older persons (IPA-O). Cognition was measured using the Mini Mental State Examination (MMSE), where decreased cognition was broadly defined as a score below 25 points. Fisher's exact test was used to test differences in proportions of perceiving self-determination in relation to cognition. The Relative Risk (RR) with a 95% Confidence Interval (CI) was used to explore the risk of perceiving reduced self-determination in relation to cognitive functioning.Nearly the entire study population, regardless of cognitive functioning, perceived self-determination in Financial situation. For people with decreased cognition, the relative risk for perceiving reduced self-determination was statistically significant higher in activities related to Self-care and in Social relationships when comparing with the participants with intact cognition.Perceiving self-determination when being old, frail and having decreased cognition is possible but is dependent upon which activities that are involved. Organizing healthcare needs according to the older people's wants and wishes is crucial regardless of people having a cognitive decline or not when the effort is to enable the people to be as self-determined as they want. The frail older people with decreased cognition should be treated as being experts in their own lives, and healthcare professionals should navigate the older people to get to their desired direction.ClinicalTrials.gov, NCT02773914. Retrospectively registered 16 May 2016.
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| 2. |
- Arola, Lea Annikki, 1961, et al.
(author)
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Distribution and evaluation of sense of coherence among older immigrants before and after a health promotion intervention - results from the RCT study promoting aging migrants' capability
- 2018
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In: Clinical Interventions in Aging. - 1178-1998. ; 13, s. 2317-2328
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Journal article (peer-reviewed)abstract
- Background: The migration process can be a threat to a person's sense of coherence (SOC) and to their ability to experience life as comprehensible, manageable, and meaningful. Seen from a salutogenic perspective, this may have a negative impact on the experience of health. Purpose: We describe the distribution of SOC and its components among older persons with an immigrant background now aging in Sweden. In addition, we evaluated whether a group-based health promotion program with a person-centered approach could support the SOC among older persons in this group. Materials and methods: A randomized controlled trial with postintervention follow-ups at 6 and 12 months was conducted with 131 independently living persons aged >= 70 years from Finland and the Balkan Peninsula. Participants were randomly allocated to an intervention group (4 weeks of group intervention and one follow-up home visit) and a control group (no intervention but access to ordinary health care services). The outcome measure was the SOC measured by SOC-13. Chi-square and ORs were calculated. Results: There was a significant improvement in total SOC scores for the intervention group at 6-month follow-up. Also, the ORs for the SOC components were higher in the person-centered intervention group. However, we found no significant between-group differences nor did the effect last until the 12-month follow-up. Conclusion: Persons who have lived a long time in a host country after migration seem to have a SOC similar to native-born persons. Interventions with a person-centered approach could support the SOC by capturing individual life situations. Such interventions could support older persons by making everyday life more comprehensible and manageable and helping them to cope with challenges in daily life caused by aging.
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| 3. |
- Arola, Lea Annikki, 1961, et al.
(author)
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Impact of a person-centred group intervention on life satisfaction and engagement in activities among persons aging in the context of migration
- 2020
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In: Scandinavian Journal of Occupational Therapy. - : Informa UK Limited. - 1103-8128 .- 1651-2014. ; 27:4, s. 269-279
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Journal article (peer-reviewed)abstract
- Background: There is a growing need to support the health and wellbeing of older persons aging in the context of migration. Objectives: We evaluated whether a group-based health promotion program with person-centred approach, maintained or improved life satisfaction and engagement in activities of older immigrants in Sweden. Methods: A randomised controlled trial with post-intervention follow-ups at 6 months and 1 year was conducted with 131 older independently living persons aged ≥70 years from Finland and the Balkan Peninsula. Participants were randomly allocated to an intervention group (4 weeks of group intervention and a follow-up home visit) and a control group (no intervention). Outcome measures were life satisfaction and engagement in activities. Chi-square and odds ratios were calculated. Results: The odds ratios for maintenance or improvement of life satisfaction (for social contact and psychological health) were higher in the person-centred intervention group. More participants in the intervention group maintained or improved their general participation in activities compared with the control group. However, no significant between-group differences were found. Conclusion: Person-centred interventions can support older person’s capability to maintain their health in daily life when aging in migration. Further research is needed with a larger sample and longer intervention period to determine the effectiveness of the intervention.
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| 4. |
- Barenfeld, Emmelie, 1981, et al.
(author)
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Promoting aging migrants' capabilities: A randomized controlled trial concerning activities of daily living and self-rated health
- 2018
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In: Aims Public Health. - : American Institute of Mathematical Sciences (AIMS). - 2327-8994. ; 5:2, s. 173-188
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Journal article (peer-reviewed)abstract
- The aim was to evaluate the 6-month and 1-year effects of a person-centered group-based health-promoting intervention on independence in daily activities and self-rated health. The study was an RCT with follow-ups at 6 months and 1 year. A total of 131 independent living people (70+) who have migrated to Sweden from Finland or Western Balkan region were included. Participants were independent in activities of daily living and cognitively intact. They were randomized to an intervention group receiving four weekly group-meetings and a follow-up home visit, or a control group (no intervention). An overall chi-squared test was performed and the odds ratio calculated. A high proportion of the participants maintained independence in activities of daily living and improved or maintained self-rated health. However, no significant differences were found between the groups. The result indicates that the intervention was offered too early in the aging process to be able to detect effects. Methodological challenges were met during both the recruitment and implementation phases. In response to lessons learned, a multicenter design is recommended for future research in order to strengthen the findings. Furthermore, this study has contributed with experiences on both opportunities and challenges in terms of research with and about older people aging in the context of migration, as is discussed.
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| 5. |
- Barenfeld, Emmelie, 1981, et al.
(author)
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Supporting decision-making by a health promotion programme : Experiences of persons ageing in the context of migration
- 2017
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In: International Journal of Qualitative Studies on Health and Well-being. - : Taylor & Francis. - 1748-2623 .- 1748-2631. ; 12:1
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Journal article (peer-reviewed)abstract
- This study is part of the Promoting Aging Migrants’ Capabilities programme that applied person-centred group meetings and one individual home visit to prolong independence in daily activities among people ≥70 years who had migrated to Sweden from Finland or the Western Balkan region. With the purpose to understand programme outcomes, the study aimed to explore the participants’ everyday experiences of using health-promoting messages exchanged during the programme. Using a grounded theory approach, 12 persons aged 70- 83 years were interviewed six months to one year after their participation in the programme. The participants experienced how using health-promoting messages was a dynamic process of how to make decisions on taking action to satisfy health-related needs of oneself or others immediately or deferring action. Five sub-processes were also identified: gaining inner strength, meeting challenges in available resources, being attentive to what is worth knowing, approaching health risks, and identifying opportunities to advocate for others. The results suggest that the programme could develop personal skills to support older people who have migrated to overcome health-related challenges. They further demonstrate the importance of supporting their health literacy before personal resources hinder action, and call for research on programmes to overcome environmental barriers to health.
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| 6. |
- Barenfeld, Emmelie, 1981, et al.
(author)
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Understanding the "black box" of a health-promotion program : Keys to enable health among older persons aging in the context of migration
- 2015
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In: International Journal of Qualitative Studies on Health and Well-being. - : Taylor & Francis. - 1748-2623 .- 1748-2631. ; 10:1
-
Journal article (peer-reviewed)abstract
- Although the need to make health services more accessible to persons who have migrated has been identified, knowledge about health-promotion programs (HPPs) from the perspective of older persons born abroad is lacking. This study explores the design experiences and content implemented in an adapted version of a group-based HPP developed in a researchercommunity partnership. Fourteen persons aged 70-83 years or older who had migrated to Sweden from Finland or the Balkan Peninsula were included. A grounded theory approach guided the data collection and analysis. The findings showed how participants and personnel jointly helped raise awareness. The participants experienced three key processes that could open doors to awareness: enabling community, providing opportunities to understand and be understood, and confirming human values and abilities. Depending on how the HPP content and design are being shaped by the group, the key processes could both inhibit or encourage opening doors to awareness. Therefore, this study provides key insights into how to enable health by deepening the understanding of how the exchange of health-promoting messages is experienced to be facilitated or hindered. This study adds to the scientific knowledge base of how the design and content of HPP may support and recognize the capabilities of persons aging in the context of migration.
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| 7. |
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| 8. |
- Behm, Lina, et al.
(author)
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Health Promotion Can Postpone Frailty : Results from the RCT Elderly Persons in the Risk Zone
- 2016
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In: Public Health Nursing. - : John Wiley & Sons. - 0737-1209 .- 1525-1446. ; 33:4, s. 303-315
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Journal article (peer-reviewed)abstract
- OBJECTIVE: Very old persons (80+) are often described as "frail", implying that they are particularly vulnerable to adverse health outcomes. Elderly Persons in the Risk Zone was designed to determine whether a preventive home visit or multiprofessional senior group meetings could postpone deterioration in frailty if the intervention is carried out when the person is not so frail. DESIGN AND SAMPLE: The study was a RCT with follow-ups at 1 and 2 years. A total of 459 persons (80+), still living at home, were included. Participants were independent in activities of daily life and cognitively intact. MEASURES: Frailty was measured in two complementary ways, with the sum of eight frailty indicators and with the Mob-T Scale measuring tiredness in daily activities. RESULTS: Both interventions showed favorable effects in postponing the progression of frailty measured as tiredness in daily activities for up to 1 year. However, neither of the two interventions was effective in postponing frailty measured with the sum of frailty indicators. CONCLUSIONS: The results in this study show the potential of health promotion to older persons. The multiprofessional approach, including a broad spectrum of information and knowledge, might have been an important factor contributing to a more positive view of aging.
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| 9. |
- Behm, Lina, 1978, et al.
(author)
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Multi-professional and multi-dimensional group education- a key to action in elderly persons
- 2013
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In: Disability and Rehabilitation. - : Informa UK Limited. - 1464-5165 .- 0963-8288. ; 35:5, s. 427-435
-
Journal article (peer-reviewed)abstract
- This study was intended to evaluate a multi-professional health-promoting and disease-preventive intervention organized as multi-professional senior group meetings, which addressed home-dwelling, independently living, cognitively intact elderly persons (80±), by exploring the participants’ experiences of the intervention. Method: The focus group methodology was used to interview a total of 20 participants. The informants had participated in four multi-professional senior group meetings at which information about the ageing process and preventive strategies for enhancing health were discussed. Results: The overall finding was that the elderly persons involved in the intervention lived in the present, but that the supportive environment together with learning a preventive approach contributed to the participants’ experiencing the senior meetings as a key to action. Conclusions: Elderly persons who are independent may have difficulty accepting information about preventing risks to health. However, group education with a multi-professional approach may be a successful model for achieving an exchange of knowledge, which may possibly empower the participants, give them role models, the opportunity to learn from each other and a sense of sharing problems with people in similar circumstances.
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| 10. |
- Behm, Lina, 1978, et al.
(author)
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Positive health outcomes following health-promoting and disease-preventive interventions for independent very old persons: Long-term results of the three-armed RCT Elderly Persons in the Risk Zone
- 2014
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In: Archives of gerontology and geriatrics. - : Elsevier BV. - 0167-4943 .- 1872-6976. ; 58:3, s. 376-383
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Journal article (peer-reviewed)abstract
- The aim of this study was to analyze the long-term effect of the two health-promoting and disease-preventive interventions, preventive home visits and senior meetings, with respect to morbidity, symptoms, self-rated health and satisfaction with health. The study was a three-armed randomized, single-blind, and controlled trial, with follow-ups at one and two years after interventions. A total of 459 persons aged 80 years or older and still living at home were included in the study. Participants were independent in ADL and without overt cognitive impairment. An intention-to-treat analysis was performed. The result shows that both interventions delayed a progression in morbidity, i.e. an increase in CIRS-G score (OR = 0.44 for the PHV and OR = 0.61 for senior meetings at one year and OR = 0.60 for the PHV and OR = 0.52 for the senior meetings at two years) and maintained satisfaction with health (OR = 0.49 for PHV and OR = 0.57 for senior meetings at one year and OR = 0.43 for the PHV and OR = 0.28 for senior meetings after two years) for up to two years. The intervention senior meetings prevented a decline in self-rated health for up to one year (OR = 0.55). However, no significant differences were seen in postponing progression of symptoms in any of the interventions. This study shows that it is possible to postpone a decline in health outcomes measured as morbidity, self-rated health and satisfaction with health in very old persons at risk of frailty. Success factors might be the multi-dimensional and the multi-professional approach in both interventions. Trial registration: NCT0087705. © 2014 Elsevier Ireland Ltd. All rights reserved.
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| 11. |
- Behm, Lina, et al.
(author)
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Preventive home visits and health : experiences among very old people.
- 2013
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In: BMC Public Health. - 1471-2458 .- 1471-2458. ; 13
-
Journal article (peer-reviewed)abstract
- BACKGROUND: As more people reach older age, there is a growing interest in improving old person's health, activity, independence and social participation, thereby adding quality to the extended years. Preventive home visits (PHV) programs for old people have received much attention in recent decades. A large body of research shows mixed effects, and argues that a home visit is a complex social process influenced by numerous factors. To evaluate the impact of PHV, as well as making decisions on whether, how, and to whom the service should be provided, requires a deeper understanding of PHV than we have now. Consequently, the aim of the study was to describe the variations in older people's (80+) experiences of a single preventive home visit and its consequences for health.METHODS: Seventeen participants between 80 and 92 years of age who had all received a structured PHV were interviewed in their own homes. The interviews were analyzed using the phenomenographic method, looking at the variations in the participants' experiences.RESULTS: The interviews revealed four categories: "The PHV made me visible and proved my human value"; "The PHV brought a feeling of security"; "The PHV gave an incentive to action"; and "The PHV was not for me".CONCLUSIONS: The experiences of a PHV were twofold. On one hand, the positive experiences indicate that one structured PHV was able to empower the participants and strengthen their self-esteem, making them feel in control over their situation and more aware of the importance of keeping several steps ahead. Together this could motivate them to take measures and engage in health-promoting activities. On the other hand, the PHV was experienced as being of no value by a few. These findings may partly explain the positive results from PHV interventions and emphasize that one challenge for health care professionals is to motivate older people who are healthy and independent to engage in health-promoting and disease-preventive activities.
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| 12. |
- Behm, Lina, 1978, et al.
(author)
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Preventive home visits and health - experiences among very old people.
- 2013
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In: BMC public health. - : Springer Science and Business Media LLC. - 1471-2458. ; 13
-
Journal article (peer-reviewed)abstract
- As more people reach older age, there is a growing interest in improving old person's health, activity, independence and social participation, thereby adding quality to the extended years. Preventive home visits (PHV) programs for old people have received much attention in recent decades. A large body of research shows mixed effects, and argues that a home visit is a complex social process influenced by numerous factors. To evaluate the impact of PHV, as well as making decisions on whether, how, and to whom the service should be provided, requires a deeper understanding of PHV than we have now. Consequently, the aim of the study was to describe the variations in older people's (80+) experiences of a single preventive home visit and its consequences for health.
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| 13. |
- Berge, Isak, et al.
(author)
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A real eye-opener: Nursing home staff experiences of co-designing nursing home services together with residents
- 2022
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In: Journal of Aging Studies. - : Elsevier BV. - 0890-4065 .- 1879-193X. ; 62
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Journal article (peer-reviewed)abstract
- Introduction: Research and healthcare services struggle to fulfil the desires and needs of nursing home residents, and there is a call for person-centredness in both research and healthcare practice. Involvement of people outside academia in research has been advocated in an effort to increase the relevance and impact of research findings for the public. However, little is known on how to involve nursing home residents in research, and the purpose of this study was, therefore, to learn from professional experiences of working with this group. More specifically, the aim of the study was to explore nursing home staff experiences of co-designing nursing home services with the residents. Method: Focus group methodology was used. A total of 17 nursing home staff members (15 women and two men) from two nursing homes participated in four focus groups. Both homogeneity and heterogeneity were strived for during recruitment. Results: The analysis is summarised in one theme and five sub-themes, describing the co-design process as an eye-opener for staff in terms of realising their own, as well as the residents', hidden abilities, and the importance of combining personal and professional knowledge of the residents in daily care and services. Conclusion: The major finding is the contribution of knowledge on how co-designing processes in nursing homes could change the dynamics of the relationships between the people involved, and that this, in turn, could realise the resources and knowledge within each person. What researchers in ageing and health can learn from the present findings is the importance of developing genuine and person-centred relationships with both nursing home residents and staff.
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| 14. |
- Berge, Isak, et al.
(author)
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Challenging oneself on the threshold to the world of research : frail older people's experiences of involvement in research.
- 2020
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In: BMC Geriatrics. - 1471-2318 .- 1471-2318. ; 20:1
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Journal article (peer-reviewed)abstract
- BACKGROUND: User involvement of people outside academia in research is argued to increase relevance of research for society and to empower the involved lay persons. Frail older people can be a hard to reach group for research and thus an underrepresented group in research. There is a lack of knowledge how collaboration with frail older people should be best performed. Therefore, the aim of this study was to explore frail older people's experiences of involvement in research.METHODS: In this study we have invited people, 75 years of age or older screened as physically frail and who have previously participated in a study as data sources, to share their experiences by intensive interviewing. Data was collected and analysed in parallel inspired by a constructivist grounded theory approach.RESULTS: The results demonstrate how frail older people have different incentives, how their context of ageing and the unusual position of being involved in research altogether influenced how, where and in what way they wished to be involved in research. This is described in three categories: Contributing to making a difference for oneself and others, Living a frail existence and Being on somebody else's turf. The categories compose the core category, Challenging oneself on the threshold to the world of research, which symbolises the perceived distance between the frail older people themselves and the research world, but also the challenges the frail older people could go through when choosing to be involved in research.CONCLUSIONS: Frail older people have a varied capacity to participate in research, but in what way and how is difficult to know before they have been involved in the process of research. Our results advocate that it is problematic to exclude frail older people a priori and that there is a potential for new perspectives and knowledge to be shaped in the encounter and in the relationship between the researcher and the frail older person. For research to be able to cater for frail older people's needs of health services, their voices need to be heard and taken into consideration.
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| 15. |
- Berge, Isak, et al.
(author)
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Challenging oneself on the threshold to the world of research – frail older people’s experiences of involvement in research
- 2020
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In: BMC Geriatrics. - : Springer Science and Business Media LLC. - 1471-2318. ; 20:1
-
Journal article (peer-reviewed)abstract
- Background: User involvement of people outside academia in research is argued to increase relevance of research for society and to empower the involved lay persons. Frail older people can be a hard to reach group for research and thus an underrepresented group in research. There is a lack of knowledge how collaboration with frail older people should be best performed. Therefore, the aim of this study was to explore frail older people’s experiences of involvement in research. Methods: In this study we have invited people, 75 years of age or older screened as physically frail and who have previously participated in a study as data sources, to share their experiences by intensive interviewing. Data was collected and analysed in parallel inspired by a constructivist grounded theory approach. Results: The results demonstrate how frail older people have different incentives, how their context of ageing and the unusual position of being involved in research altogether influenced how, where and in what way they wished to be involved in research. This is described in three categories: Contributing to making a difference for oneself and others, Living a frail existence and Being on somebody else’s turf. The categories compose the core category, Challenging oneself on the threshold to the world of research, which symbolises the perceived distance between the frail older people themselves and the research world, but also the challenges the frail older people could go through when choosing to be involved in research. Conclusions: Frail older people have a varied capacity to participate in research, but in what way and how is difficult to know before they have been involved in the process of research. Our results advocate that it is problematic to exclude frail older people a priori and that there is a potential for new perspectives and knowledge to be shaped in the encounter and in the relationship between the researcher and the frail older person. For research to be able to cater for frail older people’s needs of health services, their voices need to be heard and taken into consideration.
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| 16. |
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| 17. |
- Berglund, Helene, 1957, et al.
(author)
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Effect of a care process programme on frail older people’s life satisfaction
- 2019
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In: Nursing Open. - : John Wiley & Sons. - 2054-1058. ; 6:3, s. 1097-1104
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Journal article (peer-reviewed)abstract
- Aim: The aim of this study was to analyse the effects of a full-scale implementation of a care process programme on life satisfaction among frail older people, as compared with those receiving usual care. Design: The study includes participants from a full-scale care process programme (N = 77) and participants from a historical control group (N = 66). The care process programme establishes a comprehensive continuum of care through components including case management, interprofessional teamwork and care-planning meetings in the older people's own homes. Methods: Questionnaires were used and data were collected at baseline, with follow-ups at three, six and 12 months. Results: The implementation of the full-scale care process programme had a positive effect on life satisfaction among frail older people. From 6-month–12-month follow-ups, a higher proportion of participants in the care process programme had positive life satisfaction outcomes, as compared with the historical control group.
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| 18. |
- Berglund, Helene, 1957, et al.
(author)
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The impact of socioeconomic conditions, social networks, and health on frail older people's life satisfaction: a cross-sectional study
- 2016
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In: Health Psychology Research. - : Open Medical Publishing. - 2420-8124. ; 4:1, s. 26-31
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Journal article (peer-reviewed)abstract
- It has been shown that frailty is associated with low levels of wellbeing and life satisfaction. Further exploration is needed, however, to better understand which components constitute life satisfaction for frail older people and how satisfaction is related to other life circumstances. The aim of this study was to examine relationships between frail older people's life satisfaction and their socioeconomic conditions, social networks, and health-related conditions. A cross-sectional study was conducted (n=179). A logistic regression analysis was performed, including life satisfaction as the dependent variable and 12 items as independent variables. Four of the independent variables made statistically significant contributions: financial situation (OR 3.53), social contacts (OR 2.44), risk of depression (OR 2.26), and self rated health (OR 2.79). This study demonstrates that financial situation, self-rated health conditions and social networks are important components for frail older people's life satisfaction. Health and social care professionals and policy makers should consider this knowledge in the care and service for frail older people; and actions that benefit life satisfaction such as social support should be promoted.
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| 19. |
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| 20. |
- Bångsbo, Angela, 1968, et al.
(author)
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Barriers for Inter-Organisational Collaboration: What Matters for an Integrated Care Programme?
- 2022
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In: International Journal of Integrated Care. - : Ubiquity Press, Ltd.. - 1568-4156. ; 22:22
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Journal article (peer-reviewed)abstract
- Introduction: Inter-organisational collaboration is challenging but essential in managing the complex and comprehensive needs of frail older people. Therefore, there is a need to investigate the influence of different barriers to inter-organisational collaboration when implementing an integrated care programme. The aim of this study was to investigate both inpatient and outpatient staff views on the factors they deemed to be influential to inter-organisational collaboration for an integrated care programme. Methods: The study was a cross-sectional study and included staff from hospitals, primary care and municipal health and social care. Results: There were no significant differences between staff from inpatient and outpatient care in measuring factors that may cause difficulties for inter-organisational collaboration. Staff views diverged significantly on all factors, such as educational level at long physical distances, laws and regulations, knowledge of each others work settings, experience from inter-organisational collaboration, different professions, variations in professional status and power, psychosocial factors such as positive work environment and interpersonal chemistry. Discussion: A multidisciplinary team culture and avenues for inter-organisational collaboration need to be developed for improved care continuity. Conclusion: The staffs’ educational level influenced what was perceived as barriers to inter-organisational collaboration, and may guide future development of integrated care programmes.
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| 21. |
- Bångsbo, Angela, 1968, et al.
(author)
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Collaboration in discharge planning in relation to an implicit framework
- 2017
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In: Applied Nursing Research. - : Elsevier BV. - 0897-1897 .- 1532-8201. ; 36, s. 57-62
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Journal article (peer-reviewed)abstract
- Aim: The aim of our study was to explore healthcare and social care professionals’ experiences of preconditions for interorganizational and interprofessional collaboration to support frail elderly patients in discharge planning conferences. Background: At the time for hospital discharge, healthcare and social care professionals have to balance safe care, need for continuity of care, and elderly patients’ own expectations with economical demands. Therefore, collaboration interorganizationally and interprofessionally is essential, since deficiencies are risks to patient safety. Methods: Four focus groups, which consisted of 30 participants—occupational therapists, social workers, physiotherapists, and nurses from hospital, primary care, municipal health, and social welfare—were held. Results: The tacit framing of normative and contextual aspects that influenced discharge conferences’ outcomes, such as around decision-making about post-discharge activities, was identified as a main category in the results, comprised of the following four categories: (1) Different perceptions of prioritizing the elderly patients’ involvement in practice; (2) Choice of method for information transferal affecting collaboration; (3) The limited timeframe affecting assessments and choice of actions; (4) Underlying professional hierarchies. Conclusions: Overall, we found professional hierarchies and organizational administrative demands on efficiency reduced collaboration interorganizationally and between healthcare and social care professionals. Based on our findings, it is our opinion further development is needed both locally at hospitals and at a systemic level in Sweden.
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| 22. |
- Bångsbo, Angela, PhD, 1968-, et al.
(author)
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Preconditions to implementation of an integrated care process programme
- 2021
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In: Journal of Integrated Care. - : Emerald Group Publishing Limited. - 1476-9018.
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Journal article (peer-reviewed)abstract
- PurposeThe purpose of this study was to investigate the preconditions of a full-scale implementation of an integrated care process programme for frail older people from the staff's understanding, commitment and ability to change their work procedures with comparisons over time and between organisations.Design/methodology/approachA repeated cross-sectional study was conducted in a hospital, municipal health and social care setting.FindingsStaff commitment decreased to the importance of a permanent municipal contact from baseline compared to the 12-months follow-up (p = 0.02) and the six- and 12-months follow-up (p = 0.05), to the information transfer from emergency department from the six- to the 12-months follow-up (p = 0.04), to discharge planning at the hospital at six- and 12-months follow-up (p = 0.04) and towards discharge planning at home from baseline to the six-month follow-up (p = 0.04). Significant differences occurred between the organisations about information transfer from the emergency department (p = 0.01) and discharge planning at home (p = 0.03). The hospital staff were the most committed.Practical implicationsThe results can guide the implementation of complex interventions in organisations with high-employee turnover and heavy workload.Originality/valueThe study design, allowing the comparison of implementation results over time and between organisations in a later phase, gives this study a unique perspective.
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| 23. |
- Castro, Daniela, 1974, et al.
(author)
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Chilenska arbetsterapeuters erfarenheter av kultur - ur ett personligt och professionellt perspektiv
- 2015
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In: Arbetsterapiforum. 15-16 april 2015. Göteborg, Sverige..
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Conference paper (other academic/artistic)abstract
- Bakgrund: Intresset för kultur har ökat inom det arbetsterapeutiska fältet i sista år. Det finns en brist på kunskap om hur kulturen erfars av arbetsterapeuter utanför de dominerande regionerna i professionell utveckling. Syfte: Att öka förståelsen för hur Chilenska arbetsterapeuter erfar kultur både ur ett personligt och professionellt perspektiv, och hur kultur tar sig i uttryckt i deras arbete Metod: En kvalitativ metod används, och data analyseras med Content Analysis. Prel. Resultat: Kultur erfar som en kontinuerlig och pågående förhandling mellan arbetsterapeuternas personliga och professionella kulturer, och deras klienter och dess omgivande kontextuella kultur. Erfarenheter av kulturen är komplexa, kaotiska, och mycket kontextberoende. Slutsats: Kulturellt relevanta metoder krävs i arbetsterapi. Kulturella barriärer visas även om avståndet mellan utövare och klienter den uppfattas som inte bred. Studien öppnar för möjligheten att vidare undersöka hur olika aktörer med anknytning till arbetsterapeutiska interventioner upplever kultur i olika sammanhang av metoder i Chile.
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| 24. |
- Castro, Daniela, 1974, et al.
(author)
-
Development of a Cultural Awareness Scale for Occupational Therapy Students in Latin America: A Qualitative Delphi study
- 2016
-
In: Occupational Therapy International. - : Wiley. - 0966-7903 .- 1557-0703. ; 23:2, s. 196-205
-
Journal article (peer-reviewed)abstract
- Cultural awareness is a key issue in health care worldwide. Valid and reliable assessments are needed to assess cultural awareness for occupational therapy students. The purpose of this study was to develop a scale to assess cultural awareness for Latin American occupational therapy students. A Delphi design was implemented considering four rounds with experts from four countries. A 30-item scale in Spanish was developed to assess three categories of items: personal, therapeutic strategies and persons’ cultures. The experts highlighted local features for professional practice as a key aspect of the scale. Local differences in practice were considered with the profession’s traditions and prevailing knowledge across the scale. A participatory strategy and an international group of experts enriched the cultural relevance. A subsequent study of statistical reliability is required (the scale is not presented in an extended version here). Further research should consider the application of the scale and strategies to improve cultural awareness across the curricula.
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| 25. |
- Castro, Daniela, 1974, et al.
(author)
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Feeling like a stranger: negotiations with culture as experienced by Chilean occupational therapists
- 2016
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In: Scandinavian Journal of Occupational Therapy. - : Informa UK Limited. - 1103-8128 .- 1651-2014. ; 23:6, s. 425-436
-
Journal article (peer-reviewed)abstract
- Background Although occupational therapy has begun to focus on the subject of culture, few studies have examined how occupational therapists outside the English-speaking countries reflect on it. Aim To explore how Chilean occupational therapists reflect on their personal and professional experiences in regard to the complexity of culture, and its different understandings and expressions. Methods This qualitative study uses content analysis to establish common trends in participants’ experiences. A validation phase and data triangulation were implemented to ensure trustworthiness. Results Culture is experienced as a continuous negotiation in personal and professional terms. One central theme, ‘negotiating through the dynamism of culture’, and three categories, ‘dealing with power’, ‘understanding local and global identities’, and ‘crossing the boundaries into the client’s land’, emerged. These experiences are complex, chaotic, and highly context-dependent. Discussion During therapeutic encounters, practitioners and clients may experience cultural barriers even if their differences are not obvious in cultural terms. As a result of this finding, we recommend the inclusion of culture and cultural issues in professional training. The impact of a multicultural research team is discussed. Future research should explore how the construct of culture is introduced in occupational therapy professional training in Chile.
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| 26. |
- Castro, Daniela, 1974, et al.
(author)
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Kultur i arbetsterapeutisk teori och praktik: En litteraturstudie
- 2013
-
In: At-FORUM 2013, 24-25 April 2013, Stockholm, Sverige.
-
Conference paper (other academic/artistic)abstract
- Bakgrund: I den arbetsterapeutiska litteraturen beskrivs sedan länge begreppet kultur på olika sätt och i olika dimensioner På senare tiden har en fokus legat på att förklara hur aktiviteter och individer ingår som en del i ett socialt sammanhang. Några författare har påvisat ett behov att begreppsliggöra arbetsterapi som en äkta klientcentrerad disciplin där samhället (med mångfalden som en kärnfråga bland kulturer) betraktas som en egen aktör med egna behov och möjligheter till förändring. I en sådan omvärdering är det angeläget att utveckla teoretiska ansatser som betonar kulturell mångfald. Syfte: Att identifiera och förstå innebörden i begreppet kultur (och tillhörande konstruktioner) så som arbetsterapeuter använder eller uttrycker det i den vetenskapliga litteraturen. Tillvägagångssätt och analys: Studien är en integrativ litteraturstudie med utgång i vetenskapliga artiklar publicerade mellan åren 2006 och 2011 i indexerade tidskrifter. Analysen består av en övergripande kartläggning och kategorisering av de olika slag eller konstruktioner som är kopplade till begreppet kultur (mångfald, kompetens, organisatoriska, etnicitet osv.) samt hur dessa används för att förbättra praxis och teoriutveckling. Resultat/förväntat resultat: Studien är pågående. Den förväntade betydelsen av studien är att kunna påvisa olika uppfattningar om kultur inom disciplinen arbetsterapi och att främja implementering av kulturfokuserad teori och praktik som riktas direkt mot meningen och betydelsen av aktiviteter i samhället.
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| 27. |
- Castro, Daniela, 1974, et al.
(author)
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Occupational therapy and culture: a literature review
- 2014
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In: Scandinavian Journal of Occupational Therapy. - : Informa UK Limited. - 1103-8128 .- 1651-2014. ; 21:6, s. 401-414
-
Research review (peer-reviewed)abstract
- Background: Occupational therapy has culture as a relevant phenomenon of interest. Culture appears increasingly often in occupational therapy research, from diverse approaches and foci. As culture is difficult to define, and has political and ethical implications, an investigation into its usage is warranted. Aim: To identify and describe how culture as a broad phenomenon is expressed in OT research published between 2006 and 2011, regarding knowledge development in the discipline and its impact on practice. Methods: A qualitative study was carried out, using an integrative literature review. Thirty-nine studies in English were included. Results: From the analysis, two dimensions concerning expressions of culture emerged: “culture is alive” and “occupational therapy as a culture”. Aside from these dimensions, a group of forces that have an impact on these dimensions is described. Conclusions: In its understanding of expressions of culture, occupational therapy stands at a crossroads between traditional and critical approaches. A lack of critical insight into professional knowledge increases the risk that occupational therapy will remain satisfied with the current understanding of culture, based on the dominant knowledge. The discipline could fail to address the political, ethical, and theoretical issues required to reach the targeted diversity in its practice.
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| 28. |
- Castro, Daniela, 1974, et al.
(author)
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Occupational therapy and culture: a literature review
- 2014
-
In: 16th International Congress of the World Federation of Occupational Therapists, 18-21 Juni 2014, Yokohama, Japan.
-
Conference paper (other academic/artistic)abstract
- Introduction: Culture and cultural issues appear increasingly often in research in the field of occupational therapy, reflecting both a growing interest in cultural diversity and a critical reflection on the culture of the discipline and its practices. As the term is difficult to define and has political and ethical implications, an investigation into its usage is warranted. Objectives: To identify and describe how “culture” has been used in occupational therapy research (2006-2011). Methods: A qualitative study has been carried out using an integrative literature review. 39 studies were included. Results: Two main categories emerged in the analysis. First one, expresses the multidimensional quality of culture, from the visible to invisible aspects; the importance of the cultural aspects to determine identity and membership to social groups; as well as temporal aspects. Second category, presents Occupational Therapy’s culture, from its theories to practice, as well as diverse paradoxes and gaps across the discipline. Conclusion: The meaning of what culture is for the profession has been contested, and there is a lack of agreement on their usage among researchers, given the strong western influences over its theoretical development. By approaching this issue critically, it is possible to gain a better perspective on culture as a complex phenomenon inside the discipline. Lack of critical insight increases the risk that occupational therapy remains satisfied with the current understanding of culture, correlated with the dominant western discourse, and fails to address urgent political, ethical and theoretical issues. Contribution to Occupational Therapy: Culture is a very complex phenomenon in occupational therapy. The study offers a critical approach over it, as a core concept for the discipline, considering the close relationship with occupation. If unequal power distribution in knowledge development worldwide is not addressed, political, ethical and theoretical issues will have a pervasive effect on the discipline.
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| 29. |
- Castro, Daniela, 1974, et al.
(author)
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Test-retest reliability evaluation of the Escala de Conciencia Cultural para Estudiantes de Terapia Ocupacional en América Latina (ECCETO) – Cultural Awareness Scale for Occupational Therapy Students in Latin America
- 2017
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In: Cadernos Brasileiros de Terapia Ocupacional/Brazilian Journal of Occupational Therapy. - 0104-4931. ; 25:1, s. 3-20
-
Journal article (peer-reviewed)abstract
- Abstract: Introduction: Cultural awareness is an important consideration in healthcare, particularly in occupational therapy. Personal values are often challenged in service provision. Culturally relevant scales are needed to evaluate this across the professional education. Evaluation of psychometric properties is a critical issue in scale development. The test – retest reliability of the Escala de Conciencia Cultural para Estudiantes de Terapia Ocupacional en América Latina (ECCETO), (Cultural Awareness Scale for Occupational Therapy students in Latin America) has not yet been evaluated. Objective: To evaluate the test-retest reliability of the ECCETO. Method: The Svensson’s method was used to evaluate the ECCETO responses of 10 newly graduated Chilean occupational therapists and 26 occupational therapy students from four Latin American countries. Results: The scale had test-retest reliability, based on a reduced number of items presenting systematic disagreement, and showed good internal consistency. Conclusion: There were differences in the scale’s categories and between the study phases. Using the scale in larger groups of students may support reflective opportunities that promote early development of cultural awareness. Cultural awareness should be included in occupational therapy education in Latin America and worldwide. Adaptations of the ECCETO, should carefully consider the local practice context to preserve the cultural relevance in different regions.
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| 30. |
- Cederfeldt, Marie, 1957, et al.
(author)
-
Concurrent validity of the Executive Function Performance Test in people with mild stroke
- 2011
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In: The British Journal of Occupational Therapy. - 0308-0226 .- 1477-6006. ; 74:9, s. 443-449
-
Journal article (peer-reviewed)abstract
- Introduction: Studies have shown that executive dysfunction is common in adults after stroke. Occupational therapists working in acute care assess the performance of activities of daily living; most instruments focus on personal care. However, the assessment of instrumental activities of daily living has been shown to discriminate executive dysfunction more effectively. An instrument for assessing executive dysfunction in more complex activities that is easy to handle in acute care is consequently required for clinical use. The Executive Function Performance Test (EFPT) was recently introduced into Sweden. The purpose of this study was to evaluate the concurrent validity of the EFPT in acute care for patients with mild stroke. Method: Twenty-three patients from an acute stroke unit were assessed with both the EFPT and the Assessment of Motor and Process Skills (AMPS). Results: The correlation between the EFPT and the AMPS assessments was highly significant (p = 0.003) and the concurrent validity was rho = 0.61. Conclusion: Since there is a risk that adult patients with mild stroke are discharged without rehabilitation, and there is a lack of a relevant instrument for occupational therapists that discriminates executive dysfunction in acute stroke care, the EFPT may be a suitable instrument to use with these patients.
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| 31. |
- Cederfeldt, Marie, 1957, et al.
(author)
-
Inter-rater reliability and face validity of the Executive Function Performance Test (EFPT)
- 2015
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In: British Journal of Occupational Therapy. - : SAGE Publications. - 0308-0226 .- 1477-6006. ; 78:9, s. 563-569
-
Journal article (peer-reviewed)abstract
- Occupational therapists need an instrument to assess executive dysfunctions before patients are discharged from acute wards. The Executive Function Performance Test (EFPT) appears to be suitable, since it evaluates dysfunctions in complex activities. The aim of this study was to translate the EFPT from English into Swedish and to evaluate its properties when used with older persons with mild stroke in an acute setting. Method The study consisted of three parts: (1) a translation procedure using a forward and backward method; (2) evaluation of face validity; (3) inter-rater reliability by four raters (two pairs) who made 34 assessments in 17 older patients with mild stroke in an acute ward. Results The inter-rater reliability for the EFPT was good. The median was 88% of the percentage agreement. No occasional disagreement was found between the raters, but there was a systematic disagreement in one out of 20 items. The translation and face validity process resulted in further clarification of the semantic and cultural equivalence of the EFPT, and the manual was changed accordingly. Conclusion This study showed that inter-rater reliability was good and that the EFPT was found to be an interesting assessment, although further research is needed.
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| 32. |
- Cederfeldt, Marie, 1957, et al.
(author)
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Mellanbedömarreliabilitet av instrumentet Executive Function Performance Test (EFPT)
- 2011
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In: Poster.
-
Conference paper (peer-reviewed)abstract
- Bakgrund: Studier har visat att nedsatt exekutiv funktion är vanligt hos personer som fått stroke. Arbetsterapeuter som arbetar inom akutvården bedömer hur patienten klarar aktiviteter i det dagliga livet, men de flesta instrumenten som används är inom personlig vård. Instrument som bedömer mer komplexa aktiviteter har visat sig vara de mest effektiva avseende att upptäcka nedsatt exekutiv funktion. Eftersom instrumentet Assessment of Motor and Process Skills (AMPS) kan vara allt för omfattande att göra i den akuta fasen, skulle det kunna vara användbart att ha ett instrument som är mer lätthanterbart i det akuta skedet. Executive Function Performance Test (EFPT) är ett bedömningsinstrument som nyligen introducerats i Sverige. Studier saknas avseende validitet och reliabilitet utifrån Svenska förhållande. När ett nytt instrument skall användas är det viktigt att det har god validitet och reliabilitet. Syftet med denna studie var att utvärdera innehållsvaliditet och inter-bedömar validitet. Metoden innefattar en “forward” och en “backward” översättning av EFPT och en utvärdering av interbedömar reliabilitet genom att sjutton patienter från en stroke enhet har bedömts av två oberoende arbetsterapeuter. Studien är ett samarbete med kärnsjukhuset i Skövde. Resultatet håller på att analyseras och preliminära resultat kommer att presenteras på AT-forum.
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| 33. |
- Claesson, Lisbeth, 1955, et al.
(author)
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Comparison of visual acuity charts identifying visual impairment among older people outside the eye clinic
- 2013
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In: Disability and Rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 35:16, s. 1394-1400
-
Journal article (peer-reviewed)abstract
- Purpose: Evaluate the construct validity and describe sensitivity, specificity and predictive value of two short charts of visual acuity (VA) and examine whether these can identify and detect signs of visual impairment among older people. Method: The study included 43 persons, >65 years, with age related eye disease, living in their own homes. An ophthalmologist assessed the individuals' VA at an eye clinic with the 5 m KM chart. A research assistant assessed individuals' VA by the 1 m KM chart and the Visual Acuity Screening Test in their home environment. Results: All persons with a VA level of <0.5 were correctly identified by both instruments. The instruments have good positive and negative predictive values for the 1 m KM chart (73% and 100%) and for the Visual Acuity Screening Test (69% and 100%). The construct validity between the instruments was good, but the assessment at the eye clinic assessed the participants as having higher VA level. Conclusions: Both instruments have good construct validity, considering they were carried out in poorer lighting conditions and a good predictive value for screening out VA levels <0.5. The 1 m KM chart showed the best agreement with the 5 m KM chart.
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| 34. |
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| 35. |
- Copolillo, Al, et al.
(author)
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Assistive technology and home modification for people with neurovisual deficits
- 2011
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In: NeuroRehabilitation. - 1053-8135. ; 28:3, s. 211-220
-
Journal article (peer-reviewed)abstract
- People with neurovisual deficits from acquired brain injuries and other neurological disabilities can benefit from the array of assistive technologies and home modifications available to the larger vision impairment population, especially when symptoms are mild and associated neurological conditions are few. Optics, proper lighting, and magnification to increase the perceived size of both objects and reading material and to improve contrast sensitivity have been shown to be beneficial. Innovative technologies, universally designed for safe independent living and community participation are gradually developing and show promise for addressing the needs of this population. This article highlights technologies that may be useful for people with neurovisual deficits and describes the evidence to support their training and use. The use of various types of eyewear to reduce falls; prisms and telescopic lenses to improve visual attention and minimize the impact of visual field deficits; and technologies to improve computer use, wayfinding, and home safety are discussed. While there remains substantial need for further research and development focusing on the needs of people with vision impairments from neurological conditions, practitioners can use technology with caution to improve functional outcomes
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| 36. |
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| 37. |
- Dahlin-Ivanoff, Synneve, 1950, et al.
(author)
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A health education program for elderly persons with visual impairments and perceived security in the performance of daily occupations: a randomized study.
- 2002
-
In: The American journal of occupational therapy. : official publication of the American Occupational Therapy Association. - 0272-9490. ; 56:3, s. 322-30
-
Journal article (peer-reviewed)abstract
- OBJECTIVE: The purpose of this randomized, longitudinal study was to investigate the impact of a health education program on perceived security in the performance of daily occupations 4 months after the intervention period. METHOD: Two groups of persons with age-related macular degeneration were compared: Those who had followed a newly developed health education program that was based on occupation and those who took part in a standard individual intervention program. RESULTS: Significant differences in the level of perceived security between the groups were found for 13 of 28 occupations. Participants in the health education group maintained or improved their level of perceived security in 22 daily occupations, whereas those in the individual intervention group declined to a lower level in 17 daily occupations. CONCLUSION: This study provides support for the effectiveness of the health education program to enhance security and hinder a progressive decline in perceived security in daily occupations.
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| 38. |
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| 39. |
- Dahlin-Ivanoff, Synneve, 1950, et al.
(author)
-
Assistive devices in activities of daily living used by persons with age-related macular degeneration: a population study of 85-year-olds living at home.
- 2005
-
In: Scandinavian journal of occupational therapy. - 1103-8128. ; 12:1, s. 10-7
-
Journal article (peer-reviewed)abstract
- The purpose of this study was to investigate the overall use of assistive devices among persons with age-related macular degeneration (ARMD) and how it is related to dependence in daily activities. This was a retrospective, descriptive, cross-sectional population study of 85-year-olds. The most common category of assistive devices was bathing devices followed by mobility devices. The overall use of assistive devices was 82%, and around 80% of the device users were independent in activities of daily living. They were multiple device users (57%) and used more mobility devices and personal assistance in mobility. In conclusion, the ARMD group comprises very frequent users of assistive devices and uses assistive devices to remain independent. This implies that health services should provide assistive devices at an early stage in the disablement process to avoid the development of dependence and should consider the likelihood of multiple health problems when assessing the needs of assistive devices among persons with ARMD.
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| 40. |
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| 41. |
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| 42. |
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| 43. |
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| 44. |
- Dahlin-Ivanoff, Synneve, 1950, et al.
(author)
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Changes in the use of assistive devices among 90-year-old persons.
- 2005
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In: Aging clinical and experimental research. - 1594-0667. ; 17:3, s. 246-51
-
Journal article (peer-reviewed)abstract
- BACKGROUND AND AIMS: The growing numbers of elderly people are expected to lead to an increasing demand for assistive devices. The purpose of this study was to examine changes in the use of assistive devices over time and their relation to dependence in daily activities among 90-year-old persons living at home. METHODS: This retrospective longitudinal study examined the 90-year-old population at the ages of 85 and 90, and 195 persons participated. RESULTS: 92% of the 90-year-old population used assistive devices at the age of 90, compared with 74% at the age of 85. Between this interval, 19% became new users, 73% were permanent users, and 7% did not make any use of assistive devices. There was a significantly higher proportion of device-users among those who were dependent in both personal daily activities (PADL) and instrumental activities of daily living (IADL) (98.5%, p < 0.001) and among those who were dependent in IADL (94%, p < 0.001) compared with those who were independent in ADL (72%). At the age of 90, bathing and mobility devices were the most frequently used. Mobility devices such as walking-frames and wheel-chairs were the most widely distributed devices in this group. CONCLUSIONS: The use of assistive devices increases with age, very few 90-year-olds remain nonusers at age 90, and the multiple use of assistive devices at 90 years of age is very common. This complexity put great demands on health care services, and highly skilled professionals are needed to meet these demands.
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| 45. |
- Dahlin-Ivanoff, Synneve, 1950, et al.
(author)
-
Comprehensive geriatric assessment of frail older people: ideals and reality
- 2018
-
In: Journal of Interprofessional Care. - : Informa UK Limited. - 1356-1820 .- 1469-9567. ; 32:6, s. 728-734
-
Journal article (peer-reviewed)abstract
- We explored different professionals’ views on and experiences of comprehensive geriatric assessment (CGA) of frail older people. Forty-six professionals working in hospitals, primary care, or municipal health and social care participated in 10 focus groups. Professional groups comprised of occupational therapists, physiotherapists, nurses, physicians, and social workers. Participants shared an ideal image of how the CGA of frail elderly people should be conducted. Experience-based competence was more often used as an assessment tool than standardized tests. The ideal image contrasted with reality, listening to the needs expressed, with the person’s problems, needs, and priorities in the foreground, as described by the categories: a need that can be met; different perspectives on needs; needs can be hidden; and needs assessment is affected by the collaboration around the person, by the context, and by the dialogue. The health and social care professionals’ first priority is to make a person-centred tailor-made comprehensive geriatric assessment and not be bound to instruments. Clear guidelines need to be developed, stating which profession assesses what, when and how in order to ensure that person-centred needs are assessed including structures and procedures for how communication and collaboration within the team as well as between the organizations are achieved in order to perform a good person-centred CGA.
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| 46. |
- Dahlin-Ivanoff, Synneve, 1950
(author)
-
Development and evaluation of a health education programme for elderly persons with age-related macular degeneration
- 2000
-
Doctoral thesis (other academic/artistic)abstract
- The overall aim of this thesis was to develop and evaluate a health education programme for elderly persons with age-related macular degeneration (AMD). I. In order to plan the programme focus group methodology was used with the aim to learn how persons with the diagnosis AMD perceived and described their disease and how the disease had changed their daily occupations. The participants perceived insecurity in performing daily occupations. They used a number of strategies to continue to perform daily occupations. The participants expressed uncertainty about and a desire to know more about the disease and its consequences both at micro and macro level.II. A cross-sectional population study was performed with the purpose of describing disability in activities of daily living and its relation to visual impairment, focusing on AMD. Especially people with AMD were found to be more dependent on help in both personal and instrumental activities of daily living. The proportion of participants with disability in ADL and the relative risk of developing ADL dependence increased with the decrease in visual acuity (VA). The relationship between ADL and VA was, however, weak, implying that people adapt to the consequences of the disease, though to different degrees. III. Focus group methodology was used to improve the programme. The results indicated that the participants were, on the whole, pleased with the content of the programme, but they did not understand all the information provided. Social support, regained hope and meeting others with the same disease were reported as positive aspects of the programme. The role of the group leader and the composition of the groups were considered important. Several suggestions for improving the programme were put forward.IV. A non-parametric statistical method was used to develop an evaluative instrument that could measure and detect (in)security as an early signs of occupational dysfunction. The study showed that the instrument had a high level of test-retest stability and was responsive. V. A randomised study showed that the programme was effective as the participants in the health education programme developed a significantly higher level of security, according to the instrument developed in study IV, than found in the individual intervention group. The health education programme slow down the progression of decline in daily occupation
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| 47. |
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| 48. |
- Dahlin-Ivanoff, Synneve, 1950, et al.
(author)
-
Development of a health education programme for elderly with age-related macular degeneration: a focus group study.
- 1998
-
In: Patient education and counseling. - 0738-3991. ; 34:1, s. 63-73
-
Journal article (peer-reviewed)abstract
- Age-related macular degeneration is a serious public health problem, and in most cases no cure exists. One available intervention is low vision rehabilitation, and there is a lack of programmes for the elderly. The purpose of this paper is to present the results of an evaluation of a group-based health education programme. This programme comprised six to eight 2-3 hour meetings, once a week, for persons with age-related macular degeneration. Each group consisted of four to six participants. The goal of the programme, which has its roots in the health belief model, was to sustain and restore the participants' performance of their daily activities. The tool used for process evaluation was focus group methodology, and eight focus groups were involved. Forty five persons, whose average age was 80 years, took part in the evaluation. The results indicated that the participants were, on the whole, pleased with the content of the programme. There were, however, some indications that they did not understand all the information provided. Social support, regained hope and meeting others with the same disease were reported as positive aspects of the health education programme. The importance of the group leader's role in guiding this health education programme was emphasised. Furthermore, with regard to the composition of the groups, the participants pointed out that it was important to consider variation in visual acuity, so as to provide different models for comparison, and whether both sexes should participate in all groups. Finally, several suggestions for improving the programme are put forward.
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| 49. |
- Dahlin-Ivanoff, Synneve, 1950, et al.
(author)
-
Development of an ADL instrument targeting elderly persons with age-related macular degeneration.
- 2001
-
In: Disability and rehabilitation. - 0963-8288. ; 23:2, s. 69-79
-
Journal article (peer-reviewed)abstract
- BACKGROUND: In order to estimate the needs of early intervention in a health education program, an ADL instrument measuring feelings of (in)security was needed. The instrument was intended to detect early signs of decline and to evaluate ADL performance among persons with AMD. An evaluative instrument must have a high level of responsiveness, which is the ability to detect true changes over time but must also show a high level of intra-individual agreement in a test-retest assessment. PURPOSE: The purpose of this study was to develop an ADL instrument for evaluative purposes and to establish the reliability and the responsiveness of the instrument. METHOD: The target group comprised all persons referred by an ophthalmologist for low vision rehabilitation, 65 years and older, living at home, with aged-related macular degeneration as the primary diagnosis and with distance visual acuity of the better eye with best correction not lower than 0.1. A non-parametric statistical method that is developed for paired ordered parametrical data was applied in order to measure the systematic and occasional intra-rater disagreement separately and to measure the responsiveness. CONCLUSION: The test-retest study showed that the ADL-instrument had a high level of test-retest stability, which is a condition for responsiveness. The instrument was found to be responsive. It could therefore detect true longitudinal changes and be used for evaluative purposes targeting elderly with AMD.
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| 50. |
- Dahlin-Ivanoff, Synneve, 1950, et al.
(author)
-
Du behöver inte känna dig osäker
- 2009
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In: Livslots för seniorer. Dahlin Ivanoff S, redaktör. - : Vårdalinstitutet 2009. ; , s. 85-92
-
Book chapter (other academic/artistic)
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