| 1. |
- Baudin, Katarina, 1971-
(author)
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Assistive technology and welfare technology explorations : Aspects of perception, utilisation and decision-making
- 2021
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Doctoral thesis (other academic/artistic)abstract
- Aims: The overall aim of this thesis was to explore decision makers’ and professionals’ perceptions, utilisation, and decision-making about assistive technology (AT) and welfare technology (WT) within the interprofessional field of care for older adults. Methods: A literature review was conducted, including nine peer-reviewed scientific articles (I), analysed with a qualitative descriptive method. A web-based questionnaire, answered by 393 officials and health care providers in municipal eldercare (II and III), was analysed using content analysis of the open-ended answers (II) and descriptive and inferential statistics of the closed-ended answers (III). A semi-structured interview with 24 decision makers was also conducted and analysed with thematic reflexive analysis. Results: The studies revealed a lack of evidence-based decision models to support assistive and welfare technology decisions, partly due to the context being complex and multifaceted. The technology was perceived as progressive and cutting-edge, while organizational structure and culture were perceived as regressive and resistant to change. The results revealed personnel working with WT were generally very positive toward new technology, although there were age, gender, participation, and professional differences. Study IV results revealed that supportive aspects, technology aspects, patient aspects, and knowledge aspects influence AT-organizations' decision-making. Although AT/WT has been portrayed to have the potential to solve the challenges of an aging population, the decision-making regarding AT/WT is complex and evolving. Increased communication between government, regions, and municipalities to support the development of guidelines would enhance the goal of a person-centred care. Conclusion: This thesis contributes to knowledge of decision-making models, focusing on GATE´s model (Khasnabis et al., 2015) applicable in AT/WT. Further development and deepen knowledge in the area of AT/WT appears as needed due to results showing that there is a lack of structured knowledge about the decision-making processes and evaluations of effects of AT/WT.
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| 6. |
- Heller, Christina, et al.
(author)
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The Relationship Between Physical Housing Characteristics, Housing Accessibility and Different Aspects of Health Among Community-Dwelling Older People : A Systematic Review
- 2023
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In: Journal of Aging and Health. - : SAGE Publications Inc.. - 0898-2643 .- 1552-6887. ; 36:1-2, s. 120-132
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Research review (peer-reviewed)abstract
- Objectives : To synthesize the evidence on the relationships between physical housing characteristics or housing accessibility and different aspects of health among community-dwelling people 60 years and older. Methods : A systematic review of recent evidence with a narrative synthesis was conducted. Results : We included 15 studies and found three themes covering physical housing characteristics or housing accessibility that are associated with aspects of health among community-dwelling older adults: (1) interventions by home modifications targeting housing features both at entrances and indoors; (2) non-interventions targeting indoor features; (3) non-interventions targeting entrance features, that is, the presence of an elevator or stairs at the entrance. The overall quality of evidence across studies was assessed as very low. Discussion : The findings highlight the need for studies with a stronger research design and higher methodological quality that address the physical housing environment in relation to health among older adults to strengthen the body of evidence.
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| 7. |
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| 8. |
- Löfqvist, Charlotte, et al.
(author)
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Capacity-building for interdisciplinary research on aging and health – experiences of graduate level initiatives in a national and international context
- 2017
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Conference paper (peer-reviewed)abstract
- Abstract Body:Starting out from a joint Nordic collaboration initiative in 2008 resulting in the development of a Nordic Master Program in Gerontology (NordMaG), followed by the establishment of graduate schools integrated with two national excellence centers for aging research in Sweden, in 2014 the Swedish National Graduate School for Competitive Science on Aging and Health (SWEAH) was established. Structured in three presentations, based on experiences gained over the years we will describe and problematize what is needed for efficient capacity-building for interdisciplinary research on aging and health in a national and international context: Aiming to strengthen knowledge development and exchange in research on aging and health already at the Master’s level, through an integrated approach the NordMaG is linked to the specialization in Aging and Health within the Masters’ Program in Medical Sciences at Lund University (LU), Sweden. The Master’s program is truly interdisciplinary, situated in a research intensive and international educational context, enrolling students from health professions such as nurses, physiotherapists and occupational therapists. Integrated in the Centre for Aging and Supportive Environments (CASE) at LU, CASE Graduate School has been running for ten years, graduating 17 PhD students. With high quality interdisciplinary research on aging and supportive environments as the overarching ambition, seminars, courses, journal clubs, workshops and other student driven activities have evolved into a coherent program attracting national as well as international PhD students and guest researchers. Sparked by our experiences, in national competition in 2013 the Swedish Research Council granted funding for the development and establishment of SWEAH. This national graduate school offers a student driven curriculum for affiliated PhD students, open courses, postdoctoral training and networking opportunities, within Europe and beyond. With teaching and learning activities tailored to accommodate different disciplines and research traditions, junior researchers have access to unique resources in a national and international context. Contributing to capacity-building for research on aging and health, CASE and SWEAH are partners of the International Summer School on Aging and Health (ISSA). Taken together, these initiatives have been both challenging and rewarding. Spin-off effects in terms of international engagement and collaboration in supervision teams and examination committees have served to strengthen the interdisciplinary competence and capacity for international collaboration of the management teams and teachers involved.Objective 1:After attending this session, participants will be able to reflect on and discuss capacity-building for interdisciplinary higher education on aging and health in an international context.
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| 9. |
- Nilsson, Maria H, et al.
(author)
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Barriers and Facilitators for Participation in People with Parkinson's Disease
- 2015
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In: Journal of Parkinson's Disease. - 1877-718X. ; 5:4, s. 983-992
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Journal article (peer-reviewed)abstract
- Background: Activity performance is marked by the degenerative nature of Parkinson's disease (PD), but few qualitative studies have focused on how people with PD perceive participation in life situations. Objective: To identify and describe barriers and facilitators for participation from the perspective of people with PD. Methods: Qualitative data was obtained by the focus group method using a semi-structured interview guide. Participants were recruited by purposeful sampling until saturation was reached. Homogeneity within each focus group was based on self-rated PD severity (mild, moderate, severe). Nine focus groups (three per PD severity level) included a total of 29 participants. Results: Complex dynamics between the individual and the physical and social environment create barriers and facilitators for participation as described in the four categories which emerged out of the focus group discussions. The category Ambiguity of attitudes and the support of others describes how attitudes and support of other people act both as facilitators and barriers for participation. PD specific complexity of the body and physical environment interaction describes barriers for participation. Facilitators emerged in the two categories PD expertise in health care and social services and Information and education foster PD specific understanding. Conclusions: Our findings imply several potential means to facilitate participation for people with PD, taking the person as well as the environment into account in person-centred interventions. This involves aspects such as having access to PD specific expertise, increasing the knowledge and thereby the understanding of PD as well as providing support for maintained work-life.
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| 10. |
- Nilsson, Maria H, et al.
(author)
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Housing and Health: Very Old People with Self-Reported Parkinson's Disease versus Controls.
- 2013
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In: Parkinson's Disease. - : Hindawi Limited. - 2042-0080 .- 2090-8083. ; 2013
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Journal article (peer-reviewed)abstract
- Objectives. To explore whether aspects of housing and health among very old people with self-reported Parkinson's disease (PD) differ from matched controls. Methods. Data from the ENABLE-AGE Survey Study were used to identify people with self-reported PD (n = 20) and three matched controls/individual (n = 60). The matching criteria were age (mean = 82 years), sex, country, and type of housing. The analyses targeted problems in activities of daily living, objective and perceived aspects of housing, for example, number of environmental barriers, accessibility (i.e., person-environment fit), and usability. Results. The number of physical environmental barriers did not differ (P = 0.727) between the samples. The PD sample had more (P < 0.001) accessibility problems than controls and perceived their homes as less (P = 0.003) usable in relation to activities. They were less independent and had more functional limitations (median 5 versus 2; P < 0.001), and 70% experienced loss of stamina or poor balance. Conclusions. Due to the fact that they have more functional limitations than very old people in general, those with self-reported PD live in housing with more accessibility problems. This explorative study has implications for rehabilitation as well as societal planning, but larger studies including people with a confirmed PD diagnosis are needed.
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| 11. |
- Schmidt, Steven M., et al.
(author)
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Enabling Long-term Predictions and Cost-benefit Analysis Related to Housing Adaptation Needs for a Population Aging in Place : Protocol for a Simulation Study
- 2022
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In: JMIR Research Protocols. - : JMIR Publications Inc.. - 1929-0748. ; 11:8
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Journal article (peer-reviewed)abstract
- Background: Policies that promote aging in place are common in Sweden and many other countries. However, the current housing stock cannot sufficiently accommodate a population aging in place considering how functional capacity and housing needs change as people age. To be suitable for all regardless of their functional ability, housing should be designed or adapted to facilitate the performance of activities of daily living. Long-term planning and plausible projections of development 20 to 30 years into the future are needed. Objective: The overall aim is to develop simulation models that enable long-term predictions and analysis of potential consequences in terms of societal gains and costs for different large-scale measures and interventions in the ordinary housing stock. Methods: This study is designed as a simulation study and will broadly apply health impact assessment methods in collaboration with five municipalities in Sweden. Individual interviews and research circles were used to identify current and prioritize potential new policies to improve the accessibility of the housing stock. We will run a series of simulations based on an estimated willingness to pay from discussions with the municipalities. Two to three different prioritized policies will be compared simultaneously using Markov cohort analysis to estimate the potential costs and health impact on the population. Using data from a systematic review and existing population-based data sets with individual-level data on home and health variables, we will calculate parameter estimates for the relations between housing accessibility and health outcomes. The potential impact of selected policy interventions will be estimated in several microsimulations representing people living in the community. Sensitivity analyses will be conducted for each simulation. Results: As of April 2022, open access data was collected, and a systematic review was underway and expected to be completed by November 2022. Collaboration with five municipalities was established in autumn 2020. In spring 2021, the municipalities developed a list of prioritized policy interventions to be tested and used in the simulation models. Inventories of barrier frequencies in ordinary housing started in spring 2022 and are expected to be completed in autumn 2022. Data gathering and analyses for simulation inputs will be completed during 2022 followed by the simulation modeling analyses to be completed in 2023. Conclusions: Improved accessibility of the ordinary housing stock has the potential to maintain or improve the health of the aging population. This study will generate tools that enable long-term predictions and reliable cost-benefit estimates related to the housing adaptation needs for a population aging in place, thus providing support for the best-informed policy decisions.
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| 13. |
- Sperens, Maria, 1958-
(author)
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Att leva med Parkinsons sjukdom : med fokus på konsekvenser i dagligt liv för kvinnor och män
- 2019
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Doctoral thesis (other academic/artistic)abstract
- Parkinson’s disease (PD) is a common, progressive neurodegenerative disorder. It is characterized by motor symptoms, such as stiff muscles, slowness of movements, tremor, gait and balance difficulties, and also by non-motor symptoms such as depression, sleeping disorders, fatigue, sexual dysfunction, cognitive decline and pain. In an advanced stage of the disease, dementia can be developed. The disease occurs in all ethnic groups and affects both women and men. In 2016, the world wide prevalence of PD was estimated to 6.1 million people (2.9 million women, 3.1 men). In Sweden there are currently about 20 000 persons diagnosed with PD. There is no cure for PD. The main goal of treatment is for the patient to achieve best possible quality of life. The basic treatment for PD is oral medication, but for some, with a more advanced disease, alternative ways to distribute medicine, and/or neurosurgery (deep brain stimulation, DBS) may be an alternative. Today, there is an increasing awareness of the need of medical research, based on sex/gender. Among those living with PD, more men than women undergo highly specialised treatment with neurosurgery, even though women after surgery experienced greater benefit in ADL, in emotions and in social life. In a progressive disease as PD, changes in ADL can appear both suddenly and gradually. Earlier studies have shown that PD affects ADL already in an early stage of the disease, and also that maintenance of activities is important for well-being in daily life.The overall aim of this thesis was to gain knowledge of daily life among women and men with Parkinson’s disease and to explore how they relate to and manage aspects of consequences of the disease. The specific aims were to investigate how persons with moderately advanced Parkinson’s disease manage consequences of the disease in their daily life, how they reason about DBS as a treatment alternative, to evaluate the development of ADL over time in persons living with PD, from the time of diagnosis up to eight years, and finally, to explore similarities and differences among women and men.Method: Qualitative interviews were conducted with 24 persons with PD (PwPD), 14 men and 10 women. The interviews were analysed according to Grounded Theory (GT). Comparisons between patterns in men and women were made. The quantitative study included 129 PwPD from the NYPUM project (Ny Parkinsonism in UMeå). Data from baseline assessment, and then from follow-ups at one, three, five and eight years have been used. Participants estimated their ability to perform daily activities based on the ADL-taxonomy. Data have been analysed statistically with respect to development over time, as well as differences between men and women. Linear Mixed Model was chosen for analyses.Results: To achieve the best possible everyday life, in spite of the difficulties PD caused, it was important for the participants to adapt to their medication regime and also to ongoing changes in their abilities. The interviewees tried to think in a positive way, prioritize among social relations and activities, to take advantage of positive environments and to exercise physically. Participants had a good knowledge of DBS as an alternative treatment method although it was not their choice at the actual time point. They worried about the neurosurgical procedure and were hesitant about the outcome of DBS. The treatment was seen as a step-way process, and DBS was seen as the last option. In the quantitative study, nine out of 12 activity domains showed a statistically significant change over time. Seven of these were basic, needed to be performed almost every day. The two remaining ADL-domains (Shopping and Cleaning) also showed a statistically significant difference between women and men, showing that women experienced a higher degree of detoriation. Those 32 remaining at eight years, still fulfilling the ADL-taxonomy, did not seem to experience that PD had a big impact on their ADL-ability. Overall, in these studies, there were more similarities than differences between women and men.Discussion: Our results support the importance of PwPD maintain routines regarding food, medicine and daily activities, adapt their way to perform tasks, and engage in meaningful and values activities as a way to achieve a good, daily life. Occupational therapists with good knowledge in PD could contribute in facilitating to use this strategies. Concerning DBS, the participants had comparatively low expectations on the outcome. This might be explained by a high level of education and a high percentage being member in a PD-society. Of the nine ADL domains showing change over time, seven were likely to be needed to be performed every day (e.g. Mobility and Dressing). The two remaining, (Shopping and Cleaning) are activities that are challenging for PwPD. They are also such activities where it is generally known that there are differences between women and men.Conclusion: Various aspects of activity appear to be important factors in the assessment, treatment and follow-up of PwPD. Meaningful activities, adapting the way of performing various tasks, as well as a functioning schedule based on food, medicines and activity are important elements in the strive for a good daily life. Deep brain stimulation (DBS) seems to be considered as the last step in a step-by-step approach to treatment options. Those who still perform self-assessment according to the ADL taxonomy at eight years follow-up, do not seem to experience that PD have a major impact on their perceived ability. The results also implies that men and women have a similar development over time regarding ADL ability and that they reason in a similar way with regard to strategies for achieving good daily life and about deep DBS as a treatment option.
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| 16. |
- Thordardottir, Björg, et al.
(author)
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"You plan, but you never know" - participation among people with different levels of severity of Parkinson's disease.
- 2014
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In: Disability and Rehabilitation. - : Informa UK Limited. - 0963-8288 .- 1464-5165. ; 36:26, s. 2216-2224
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Journal article (peer-reviewed)abstract
- Abstract Purpose: The aim of this study was to improve our understanding of important aspects of participation in everyday life for people with different levels of severity of Parkinson's disease (PD). Methods: A qualitative design was used, with empirical data obtained from focus groups. The participants had all been diagnosed with PD at least one year prior to the start of the study. Purposeful sampling was used to ensure that both sexes, with variations in age, marital status, living arrangements, education and employment, were represented. Recruitment continued until saturation was reached and resulted in 29 participants. Homogeneity within each focus group was based on self-rated PD severity (mild, moderate or severe). Findings: The aspects that influence participation at different stages of PD are that those with PD stand out in public, as a result of disease-specific features, and that the disease is unpredictable. Planning was highlighted as a strategy that is required to support participation and cope with stress and to compensate for the fact that everyday activities demanded a great deal of time and energy. Conclusion: These findings are of importance to the development of rehabilitation interventions that support people with PD in maintaining their participation in everyday life, throughout the course of the disease. Implications for Rehabilitation PD severity and disease-specific problems (e.g. freezing of gait) need to be taken into account when tackling restrictions that affect participation. Interventions that aim to facilitate participation require different components and expertise depending on PD severity, as well as on individual preferences and needs. Structuring and planning everyday life might not facilitate participation for all those with PD, but concrete measures, such as making a schedule in order to structure daily life, may benefit those with milder PD.
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| 18. |
- 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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| 19. |
- 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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| 20. |
- 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
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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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| 23. |
- Bergström, Aileen, et al.
(author)
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The jigsaw puzzle of activities for mastering daily life; service recipients and professionals’ perceptions of gains and changes attributed to reablement : A qualitative meta-synthesis
- 2022
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In: Scandinavian Journal of Occupational Therapy. - : Taylor and Francis Ltd.. - 1103-8128 .- 1651-2014. ; , s. 1-12
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Research review (peer-reviewed)abstract
- Background: Reablement services are intended to make a difference in the daily lives of older adults. Outcomes are often described in terms of independence, improving quality of life, improving ADL functioning, or reducing services. However, little is known if the older adults or next-of-kin experience these outcomes when talking about participating in reablement services. Aim: This study aims to explore how older adults, next-of-kin, and professionals narrate the reablement recipients’ possible outcomes as gains and changes in everyday life during and after the reablement period. Materials and methods : This meta-synthesis included 13 studies. Data were analyzed with a meta-ethnographic approach, searching for overarching metaphors, in three stages. Results: The metaphor ‘the jigsaw puzzle of activities for mastering daily life again’ illustrates that re-assembling everyday life after reablement is not a straightforward process of gains and changes but includes several daily activities that must be organized and fit together. To obtain a deeper understanding of the participants’ gains, and changes after reablement, we use the theoretical framework of ‘doing, being, becoming, and belonging’. Conclusion: The findings indicate the complexity of reablement services as well as the need for a holistic approach. Significance: Outcome measures should be meaningful for reablement recipients.
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| 24. |
- Carlsson, Gunilla, et al.
(author)
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Self-reported versus professionally assessed functional limitations in community-dwelling very old individuals.
- 2012
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In: International Journal of Rehabilitation Research. - 1473-5660. ; 35:4, s. 299-304
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Journal article (peer-reviewed)abstract
- The objective of this study was to examine the relationship between self-reported and professionally assessed functional limitations in community-dwelling very old individuals. In total, 306 single-living adults aged 81-90 years were included in this cross-sectional study. The main outcome measure was the presence and absence of self-reported and professionally assessed functional limitations. A significant correlation was found between the total number of self-reported and professionally assessed functional limitations in the total sample (intraclass correlation=0.65) as well as in subgroups with respect to sex, age, and depression. When item-wise differences in the two assessments were assessed, the results showed significant differences for nine of the 15 functional limitations. In general, the participants reported more functional limitations as present than the professional did. In conclusion, research on self-reported and professionally assessed functional limitations contributes toward the understanding of how different modes of data collection influence the results. In this study, functional limitations were examined on a broad basis, including physical as well as cognitive and perceptual limitations. Once the assessments of self-reporting have been refined, we will have a more nuanced picture of functional limitations, incorporating self-report as well as professional assessments.Ziel der vorliegenden Studie war die Untersuchung der Beziehung zwischen selbst und professionell beurteilten Funktionseinschränkungen bei in der Gemeinschaft lebenden Menschen hohen Alters. Insgesamt wurden 306 allein lebende Erwachsene im Alter von 81-90 Jahren in diese Querschnittsstudie eingeschlossen. Die wichtigste verwendete ergebnisorientierte Messgröße war das Vorhandensein oder Fehlen von selbst und professionell beurteilten Funktionseinschränkungen. Es bestand eine signifikante Korrelation zwischen der Gesamtanzahl der selbst und professionell beurteilten Funktionseinschränkungen in der Stichprobe insgesamt (Intraclass-Korrelation=0.65) sowie in den Subgruppen mit Bezug auf Geschlecht, Alter und Depression. Bei der Beurteilung der Unterschiede unter Berücksichtigung der einzelnen Items wiesen die Ergebnisse signifikante Unterschiede bei neun der 15 Funktionseinschränkungen auf. Im Allgemeinen berichteten die Teilnehmer von mehr vorhandenen Funktionseinschränkungen als die Experten. Abschließend kann gesagt werden, dass die Forschung im Bereich der selbst und professionell beurteilten Funktionseinschränkungen zu einem besseren Verständnis dessen beiträgt, wie verschiedene Methoden der Datenerfassung die Ergebnisse beeinflussen. Im Rahmen dieser Studie wurden Funktionseinschränkungen, darunter physischer, kognitiver und perzeptiver Art, breit angelegt beurteilt. Sobald die Beurteilungsmethoden der Selbstanzeige weiterentwickelt sind, besitzen wir ein nuancierteres Bild der Funktionseinschränkungen mit eigener und professioneller Auswertung.El objetivo de este estudio fue examinar la relación entre las limitaciones funcionales indicadas por los propios sujetos y las evaluadas por profesionales en individuos de edad avanzada pertenecientes a una comunidad. En total, 306 adultos que vivían solos y de edad comprendida entre los 81 y los 90 años participaron en este estudio transversal. Los principales resultados obtenidos se basaron en la presencia y la ausencia de limitaciones funcionales indicadas por los propios sujetos y evaluadas por profesionales. Se observó una correlación significativa entre el número total de limitaciones funcionales indicadas por los propios sujetos y las evaluadas por profesionales (correlación intraclase=0.65), así como en los subgrupos, en relación con el sexo, la edad y la depresión. Tras analizar las diferencias entre los dos tipos de evaluación con respecto a las distintas variables, los resultados difirieron significativamente en nueve de las quince limitaciones funcionales. En general, los participantes indicaron que padecían más limitaciones funcionales que los profesionales. Como conclusión, la investigación sobre las limitaciones funcionales indicadas por los propios sujetos y evaluadas por profesionales contribuye a comprender cómo las distintas formas de recopilación de datos influyen en los resultados. En este estudio, las limitaciones funcionales se examinaron de manera general, incluyendo las limitaciones físicas, además de las cognitivas y las perceptivas. Una vez que se perfeccionen las evaluaciones realizadas por los propios sujetos, se poseerá una visión más clara de las limitaciones funcionales, que podrán incorporar tanto autoevaluaciones como evaluaciones realizadas por profesionales.Cette étude avait pour objet d'examiner la relation entre les limitations fonctionnelles auto-déclarées et professionnellement évaluées chez les personnes très âgées vivant dans la collectivité. Au total, 306 adultes de 81-90 ans vivant seuls ont été inclus dans cette étude transversale. Le critère de mesure principal était la présence ou l'absence de limitations fonctionnelles auto-déclarées ou professionnellement évaluées. Une corrélation significative a été observée entre le nombre total de limitations fonctionnelles autodéclarées et professionnellement évaluées dans l'échantillon total (corrélation interclasses=0.65) ainsi que dans les sous-groupes définis par sexe, âge et dépression. Lorsque les différences sur l'ensemble d'un item entre les deux évaluations ont été évaluées, les résultats ont fait apparaître des différences significatives pour neuf des 15 limitations fonctionnelles. En général, les participants ont signalé la présence d'un plus grand nombre de limitations fonctionnelles que les professionnels. En conclusion, les recherches sur les limitations fonctionnelles autodéclarées et professionnellement évaluées contribuent à la compréhension de la manière dont les différents modes de collecte des données influent sur les résultats. Dans cette étude, les limitations fonctionnelles ont été examinées sur une base large, en incluant notamment les limitations physiques ainsi que cognitives et perceptives. Une fois les évaluations autodéclarées affinées, nous aurons une image plus nuancée des limitations fonctionnelles, qui intégrera l'auto-évaluation ainsi que les évaluations professionnelles.
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| 25. |
- Dahlin-Ivanoff, Synneve, 1950, et al.
(author)
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Research collaboration with older people as a matter of scientific quality and ethics: a focus group study with researchers in ageing and health.
- 2024
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In: Research involvement and engagement. - : BioMed Central Ltd.. - 2056-7529. ; 10:1
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Journal article (peer-reviewed)abstract
- Society is placing increasing demands on collaboration with actors outside the academia to be involved in the research process, and the responsibility for turning this into reality lies with the researchers. As research collaboration is a way to increase the societal relevance of research and since older people have the right to be actively involved in research that concerns them, this study is addressed to researchers who work with and for older people. The purpose of this article is to explore researchers' experiences of research collaboration with the heterogeneous group of older people, from healthy to frail.The focus group method was applied based on a qualitative approach that is based on a social constructivist research tradition. It differs from other qualitative methods, such as interviews, in that it encourages interaction between research participants and contributes to shedding light on a collective understanding of the world. A total of 14 researchers participated in four focus groups (three to five participants/group).The results provided support for the overall theme: "Good scientific quality and ethics are balanced against the needs and abilities of older people". This means a balance between the researcher and the older people collaborating with them to receive the best possible scientific quality. This is highlighted in the core category "Positioning for research collaboration" with the subcategories "Involvement or not", "Traditional or innovative thinking" and "Selectivity or representativeness", and the core category "Research collaboration - an ethical issue of power" with the subcategories "Research collaboration a risk for freedom of research", "Research collaboration a risk of abuse of power" and "Discriminatory academic power structures create ethical issues".Addressing the balancing act of collaborating with older people in research, the findings contribute with an understanding of the importance of researchers' awareness of social and academic structures to minimise the risk of epistemic injustices in research on ageing and health. We want to highlight the researchers' voice and clarify the role that researchers have in terms of the opportunities for older people to become part of the collective understanding of ageing and health and make their voices heard.
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| 26. |
- Dahlin-Ivanoff, Synneve, 1950, et al.
(author)
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The multiple meaning of home as experienced by very old Swedish people.
- 2007
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In: Scandinavian journal of occupational therapy. - : Informa UK Limited. - 1103-8128 .- 1651-2014. ; 14:1, s. 25-32
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Journal article (peer-reviewed)abstract
- The aim of this study was to explore aspects of the meaning of home as experienced by very old single-living people in Sweden. A grounded theory approach was used, and interviews were conducted with 40 men and women aged 80-89. The findings indicate that home has a central place in the lives of very old people because it is where they live and spend so much time. The significance of the home is based on the fact that it means so many different things to the participants. The theme comprises two key categories: home means security and home means freedom. Each of these has three sub-categories. In home means security, these are: living in a familiar neighborhood, everything functions, and having memories to live on. Home means freedom comprises a place for reflection, a social meeting-point, and leaving your own mark. Home is part of the environment and influences the meaning and selection of activities that very old people decide to engage in. When occupational therapists prescribe assistive devices or recommend changes in the home environment, they must be very well aware of and reflect on what home means to their clients and base their measures on that.
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| 27. |
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| 28. |
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| 29. |
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| 30. |
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| 31. |
- Dinse, Daniella, et al.
(author)
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The influence of the Covid-19 pandemic on municipal meeting places arranging group exercise for older persons
- 2023
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In: International Journal of Qualitative Studies on Health and Well-being. - Abingdon : Taylor & Francis. - 1748-2623 .- 1748-2631. ; 18:1
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Journal article (peer-reviewed)abstract
- PURPOSE: Many municipalities today, together with other stakeholders, offer group exercises for the older population via municipal meeting places, focusing on promoting good health. During the Covid-19 pandemic, these group exercises either continued in a modified form or ceased. The aim of this study was to explore involved stakeholders' experiences of group exercises for older persons arranged via municipal meeting places during the Covid-19 pandemic. METHODS: Six online focus group interviews were conducted with 25 stakeholders, such as decision-makers and representatives from the non-profit sector, from seven municipalities in Sweden. Data were analysed using thematic analysis. FINDINGS: The collaboration around the group exercises was challenged due to affected communication and decision-making. The stakeholders described the importance of adapting and finding new ways to offer group exercise. Furthermore, the re-arranging of group exercises created concerns about the well-being of the older persons but also happiness with the older persons ability to act for their own well-being during the pandemic. CONCLUSIONS: This study highlights the importance of the municipalities exchanging experiences, making the older persons more involved in the decision-making process, enabling a person-centred encounter with the older persons when exercising in groups, and strengthening supportive environments by sharing the ownership of arranging the group exercises with the older persons.
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| 32. |
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| 33. |
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| 34. |
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| 35. |
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| 36. |
- Fischl, Caroline, 1974-
(author)
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Ageing in a digital society : an occupational perspective on social participation
- 2020
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Doctoral thesis (other academic/artistic)abstract
- Background: For older adults to continue being healthy and active participants in an evolving digitalized society, there is a need to support their social participation through engagement in occupations that they need, want, or are expected to do in accordance to the roles that they assume. Occupational therapists together with other professionals face emerging challenges to promote older adults’ engagement in occupations mediated by digital technology. It is therefore relevant to acquire an understanding about how older adults continue to participate in their daily lives and engage in the occupations within their particular contexts. It is also relevant to explore ways to tailor supports for engaging in contemporary occupations and to measure the outcomes of such supports. Aim: The overall aim of this thesis was to develop knowledge to support older adults’ social participation through engagement in occupations mediated by digital technology. Developing knowledge entailed an exploration of older adults’ engagement in occupations mediated by digital technology (Study I), their contexts surrounding social participation (Study II), and tailoring supports for engagement (Study III). Additionally, part of developing knowledge also entailed an investigation of how outcomes of tailoring – specifically ability to perform occupation mediated by digital technology and ability to manage technology – could be measured and related (Study IV).Methods: Study participants were selected from rural and urban municipalities in Northern Sweden. In Study I, data was gathered through concurrent think aloud protocol and observations of ten older adults, aged 66-79 years, while they engaged in occupations that involved digital technology. Narrative inquiry was used to illuminate features in their occupational engagement and participation in daily life. In Study II, focus group interviews of eighteen older adults, aged 66-81 years, were conducted and analyzed using qualitative content analysis. Study III used a multiple case study methodology that included nine cases. Each case involved one adult who participated in a collaborative process to tailor supports for engagement in occupations mediated by digital technology. Data was gathered through questionnaires, observations, fieldnotes, memos for tailoring, and interviews, and then analyzed through cross-case synthesis. Nine older adults, aged 74-95 years, participated. In Study IV, twenty-five older adults, aged 71-93 years, were observed in their performances of digital technology-mediated occupations and scored on the Assessment of Computer-Related Skills and the Management of Everyday Technology Assessment. Data was analyzed using Rasch analysis and Spearman correlation test. Results: Findings in Study I were presented as three stories reflecting facets of participation – Being alone, Belonging together, and Being alone together. The stories illuminated older adults’ participation involving digital technology as a negotiation of needs and values, refinement of identities, and experience of meaning during interactions with technological and social environments. Findings in Study II were sorted in three categories – Experiencing conditions for social participation in a state of flux, Perceiving drawbacks of urbanization on social participation, and Welcoming digital technology that facilitates daily and community living – and encapsulated in the theme The juxtaposition of narrowing offline social networks and expanding digital opportunities for social participation. The findings suggested that facilitating satisfactory use of digital technologies and co-creating usable digitalized services could support older adults’ social participation through occupations that they find relevant in their lives, and subsequently, might enable them to live longer at home. Study III resulted in a proposed scheme for tailoring to support older adults’ engagement in digital technology-mediated occupations. The scheme included various intervention strategies tailored to persons in their contexts, such as adapting visual settings on the device and forming instructional materials based on the older adults' needs and preferences. Tailoring interventions require collaboration with other professionals. Results in Study IV indicated preliminary evidence of internal validity and reliability in two aforementioned instruments on a small sample of older adults. Results also showed that there is a significant and strong positive correlation between the ability to engage in digital technology-mediated occupations and the ability to manage digital technology. It implies that an older person who is more able to engage in digital technology-mediated occupations will likely have more ability to manage digital technology and vice versa. In the same manner, an older person who is less able to engage in digital technology-mediated occupations will likely have less ability to manage digital technology and vice versa.Conclusions: In the contexts of ageing, narrowing social networks, and expanding digital possibilities, participation through satisfactory digital technology use can provide older adults opportunities to continue being active members of society. A scheme has been proposed to tailor supports for older adults’ occupational engagement, which needs further testing in various practice settings. Instruments for measuring outcomes of tailored supports have also been identified but need further validation in studies with older people.
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| 37. |
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| 38. |
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| 39. |
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| 40. |
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| 41. |
- Granbom, Marianne, et al.
(author)
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Residential normalcy and environmental experiences of very old people: Changes in residential reasoning over time.
- 2014
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In: Journal of Aging Studies. - : Elsevier BV. - 0890-4065. ; 29:Jan 6, s. 9-19
-
Journal article (peer-reviewed)abstract
- The decision to relocate in old age is intricately linked to thoughts and desires to stay put. However, most research focuses either on strategies that allow people to age in place or on their reasons for relocation. There is a need for more knowledge on very old peoples' residential reasoning, including thoughts about aging in place and thoughts about relocation as one intertwined process evolving in everyday life. The aim of this study was to explore what we refer to as the process of residential reasoning and how it changes over time among very old people, and to contribute to the theoretical development regarding aging in place and relocation. Taking a longitudinal perspective, data stem from the ENABLE-AGE In-depth Study, with interviews conducted in 2003 followed up in interviews in 2011. The 16 participants of the present study were 80-89years at the time of the first interview. During analysis the Theoretical Model of Residential Normalcy by Golant and the Life Course Model of Environmental Experience by Rowles & Watkins were used as sensitizing concepts. The findings revealed changes in the process of residential reasoning that related to a wide variety of issues. Such issues included the way very old people use their environmental experience, their striving to build upon or dismiss attachment to place, and their attempts to maintain or regain residential normalcy during years of declining health and loss of independence. In addition, the changes in reasoning were related to end-of-life issues. The findings contribute to the theoretical discussion on aging in place, relocation as a coping strategy, and reattachment after moving in very old age.
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| 42. |
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| 43. |
- Haak, Maria, et al.
(author)
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Cross-national and multi-language qualitative research: challenges and recommendations
- 2013
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In: British Journal of Occupational Therapy. - 1477-6006. ; 76:7, s. 333-336
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Journal article (peer-reviewed)abstract
- Interest in cross-national partnership is increasing in Europe, a situation very much reflected in calls for funding. Multi-language qualitative research methodologies need to be strengthened in order to support this growing trend toward the promotion of cross-national collaboration. This practice analysis reports on our experience of carrying out cross-national and multi-language based qualitative research. Based on this, we recommend taking into account the potential challenges of language and national culture from the planning phase onwards, handling them in a structured, predefined way throughout the research process and using software to assist with the challenges brought about in a multi-language environment.
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| 44. |
- Haak, Maria, et al.
(author)
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Cross-National User Priorities for Housing Provision and Accessibility - Findings from the European innovAge Project.
- 2015
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In: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1660-4601. ; 12:3, s. 2670-2686
-
Journal article (peer-reviewed)abstract
- To develop an innovative information and communication technology (ICT) tool intended to help older people in their search for optimal housing solutions, a first step in the development process is to gain knowledge from the intended users. Thus the aim of this study was to deepen the knowledge about needs and expectations about housing options as expressed and prioritized by older people, people ageing with disabilities and professionals. A participatory design focus was adopted; 26 people with a range of functional limitations representing the user perspective and 15 professionals with a variety of backgrounds, participated in research circles that were conducted in four European countries. An additional 20 experts were invited as guests to the different research circle meetings. Three themes illustrating cross-national user priorities for housing provision and accessibility were identified: "Information barrier: accessible housing", "Information barrier: housing adaptation benefits", and "Cost barrier: housing adaptations". In conclusion, early user involvement and identification of cross-national differences in priorities and housing options will strengthen the development of a user-friendly ICT tool that can empower older people and people with disabilities to be more active consumers regarding housing provision.
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| 45. |
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| 46. |
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| 47. |
- Haak, Maria, et al.
(author)
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Home as a signification of independence and autonomy: experiences among very old Swedish people.
- 2007
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In: Scandinavian journal of occupational therapy. - : Informa UK Limited. - 1103-8128 .- 1651-2014. ; 14:1, s. 16-24
-
Journal article (peer-reviewed)abstract
- The aim of this study was to explore independence in the home as experienced by very old single-living people in Sweden. A grounded theory approach was used and interviews were conducted with 40 men and women aged 80-89. Data analysis revealed the core category "Home as a signification of independence" with two main categories: "Struggle for independence" and "Governing daily life". The findings showed that home is strongly linked to independence, and being independent is extremely valued. Explicit descriptions of the ageing process as an individual process of changing living conditions within the home emerged from the findings. Hence, the ageing process influences the participants' perception of themselves as independent persons. Along the ageing process the participants' view of independence changed from being independent in activity performance without help from others to experiencing independence in being able to make autonomous decisions concerning daily life at home. Consequently, there is a need to develop strategies to support very old people in staying as active and independent as possible in their own homes. In addition, since the findings highlight that independence is a complex construct, there is a need for conceptual differentiation between independence and a construct often used synonymously, namely autonomy.
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| 48. |
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| 49. |
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| 50. |
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