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1.
  • Blomqvist, Kerstin, 1953-, et al. (author)
  • Recognising pain in older adults living in sheltered accommodation : the views of nurses and older adults
  • 2001
  • In: International Journal of Nursing Studies. - : Elsevier. - 0020-7489 .- 1873-491X. ; 38:3, s. 305-318
  • Journal article (peer-reviewed)abstract
    • Sixty-six randomly selected older adults and their contact nurses participated in interviews based on standardised assessments of pain and open-ended questions focusing how pain was expressed and recognised. The sample included older adults with normal as well as cognitively impaired function. Seventy-nine percent of older adults with normal cognition were often in pain. Contact nurses assessed pain in 57% of cognitively impaired older adults. The content in the statements showed that pain recognition was a communicative interactive process based on verbal and non-verbal expressions. The process comprised attempts to understand the cause and intention of the expression and to verify the presence of pain. Changes in mood, facial expressions and physiological responses were described less often by older adults than by their nurses. Contact nurses of cognitively impaired older adults judged immobility as the source of pain, that it was possible to see when the person was in pain and that pain was expressed by paralinguistic and body language more often than contact nurses of cognitively healthy older adults. Characteristics of nurses and older adults could facilitate or hinder pain recognition. The findings indicate a need for reflective discussions in the staff group focusing on how to perform systematic assessments of verbal and non-verbal expressions and of hindrances and facilitators for recognising pain in older adults.
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2.
  • Borglin, Gunilla, et al. (author)
  • Older people in Sweden with various degrees of present quality of life : their health, social support, everyday activities and sense of coherence.
  • 2006
  • In: Health & Social Care in the Community. - : Blackwell Publishing. - 0966-0410 .- 1365-2524. ; 14:2, s. 136-146
  • Journal article (peer-reviewed)abstract
    • Public health policies in most European countries are concerned with how to keep older people living independently with a qualitatively good life in the community as long as possible. However, knowledge about what may characterise those seemingly 'healthy' older people is sparse. The aim of the study was to investigate the characteristics of a sample of people (75+) reporting various degrees of Quality of Life (QoL) with respect to QoL in different areas, as well as self-rated health, health problems, social support, everyday activities and sense of coherence. A postal questionnaire was sent out in spring 2001 to a randomly selected population-based sample (n= 600) in the southern parts of Sweden. A two-step cluster analysis was performed (n= 385, mean age 84.6, SD = 5.7) with 'present QoL' as clustering attribute. Three groups were disclosed, classified as high, intermediate and low present QoL, of which 33.8% could be regarded being at risk of low QoL. Those with low present QoL (18.4%) were the oldest and most vulnerable, a majority were women with 'poor or bad' self-rated health, high frequencies of health problems, low total QoL, low social support and sense of coherence and less physically active. Those with high present QoL (47.8%) reported more 'excellent or good' self-rated health, physical activity, satisfactory social support and higher sense of coherence and total QoL than the other two groups. Those with intermediate present QoL (33.8%) had more of 'poor or bad' self-rated health, more health problems were less physically active, had lower total QoL and sense of coherence, and less social support than those with high present QoL. The sample seemed to reflect the ageing process in that the respondents were at different stages of ageing. However, the fact that the level of social support, sense of coherence and self-rated health followed the same curve as QoL may indicate that some are more vulnerable to low present QoL given the same health and these should be targeted in preventive programmes since they report low QoL.
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3.
  • Andersson, Magdalena, et al. (author)
  • Old people receiving municipal care, their experiences of what constitutes a good life in the last phase of life : a qualitative study
  • 2008
  • In: International Journal of Nursing Studies. - : Elsevier. - 0020-7489 .- 1873-491X. ; 45:6, s. 818-828
  • Journal article (peer-reviewed)abstract
    • BackgroundOld people's life situation when receiving municipal help and care in their last period of life is sparsely investigated from their own perspective.ObjectiveThe aim of this study was to investigate the experiences of aspects that bring about a good life in the last phase of life among people (75+ years) receiving municipal care.ParticipantsOlder people living in a municipality in Southern Sweden being 75 years or older, receiving help and/or care from the municipality, and having a life-threatening disease and/or receiving palliative care were asked to participate. In all 17 people, 10 women and 7 men, aged 78–100 years were included.MethodsQualitative interviews, with the emphasis on their present life situation especially what brought about a good life, were performed. The interviews were analysed using qualitative content analysis.ResultsThe experience was interpreted to be Turning inwards to come to peace with the past, the present and approaching death while being trapped by health complaints. Six categories embraced the experience of aspects that constitute a good life in the last phase of life: Maintaining dignity, Enjoying small things, Feelings of “being at home”, Being in the hands of others, trying to adjust, Still being important for other people and Completing life while facing death.ConclusionThis study confirm theories suggesting that the last phase of life in old age meant focusing inwards, reflecting on the entire life as a way of completing it as well as enjoying small things and also viewing oneself in the perspective of contributing to the future. It also indicated that this phase of life meant being trapped by health complaints and functional limitations. The struggle to maintaining dignity as opposed to being in the hands of others implies that the concept of palliative care may be useful as a framework for providing nursing care to very old people, especially at the end of life.
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4.
  • Andersson, Magdalena, et al. (author)
  • The experience of being next of kin to an older person in the last phase of life
  • 2010
  • In: Palliative & Supportive Care. - : Cambridge University Press. - 1478-9515 .- 1478-9523. ; 8:1, s. 17-26
  • Journal article (peer-reviewed)abstract
    • OBJECTIVE: The aim of the study was to investigate the experience of being next of kin to an older person in the last phase of life as narrated after the older person's death.METHOD: Qualitative interviews were performed with the next of kin (n = 17) to people aged 75 years and older who had recently died and had received help and/or care from the municipality in the last phase of life. Eleven women and six men participated, of whom seven were spouses, nine were children, and one was a grandchild. The interviews were analysed using qualitative content analysis.RESULTS: The experience of the next of kin could be understood as being a devoted companion during the transition toward the inevitable end, embracing the categories of living in the shadow of death; focusing on the needs of the dying person, making adjustments to everyday life; feeling the major responsibility; struggling with the health and social care system; and gaining strength from support.SIGNIFICANCE OF RESULTS: Being next of kin to an old person at the end of life means being a devoted companion during the transition toward the inevitable end, including the feeling of bearing the major responsibility and the need to be acknowledged by professionals. This study points to the importance of having access to professional care when it is needed, to complement and support the next of kin when his or her own resources and strength falter. This also includes support to enable the next of kin to remain involved in the care of his or her loved ones, thereby fulfilling their own wishes.
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5.
  • Berg, Agneta, 1950-, et al. (author)
  • Nurses' reflections about dementia care, the patients, the care and themselves in their daily caregiving
  • 1998
  • In: International Journal of Nursing Studies. - : Elsevier. - 0020-7489 .- 1873-491X. ; 35:5, s. 271-282
  • Journal article (peer-reviewed)abstract
    • In this study the aim was, through interviews, to disclose 13 nurses personal knowledge about the patients, themselves, and care provision, using a phenomenological-hermeneutic analysing method. Caring for people with severe dementia meant an intertwined life world emanating from making and doing together and the delicate interpretative work that the care provision required. The intertwined life world consisted of the interaction between the nurses and the patients separate lives, their common life and the environment, culminating in mutual dependency. Making together signifies the relationship being based on the nurses knowledge and skills as nurses i.e. the task they had to perform. Doing together signifies the relationship being based on the oneness of the nurses and the patients with severe dementia as ordinary human beings. The delicate interpretation process required, to adapt care to the individual patient, was based on knowledge about the patients personality, life history and disease progression in combination with the nurses interpretation of the current situation. The nurses searched for meaning and that, in turn, meant that the patients inner world was determined by the nurses and thus the patient was seen as being in their hands. It seems important to further understand the human aspects of both the nurse and the patient and to examine this dynamic, ongoing, vulnerable interpretation process, critically, in order to achieve high quality nursing care for the patients with severe dementia, and an experience of well-being in nurses everyday working lives.
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6.
  • Berg, Agneta, 1950-, et al. (author)
  • The meaning and significance of clinical group supervision and supervised individually planned nursing care as narrated by nurses' on a general team psychiatric ward
  • 2000
  • In: Australian and New Zealand Journal of Mental Health Nursing. - : Wiley-Blackwell. - 1324-3780 .- 1440-0979. ; 9:3, s. 110-127
  • Journal article (peer-reviewed)abstract
    • By interviewing 22 psychiatric nurses, the present study aimed to reveal the meaning and significance of systematic clinical group supervision and supervised individually planned nursing care, using latent content analysis. The interpreted meaning was 'confronting the complexity of ongoing life in daily nursing care' and the interpreted significance was 'strengthening the foundation for nursing care'. Reflection on action and confirmation seemed to be core components in the process of clinical supervision. Focusing on the relational and task aspects in nursing care within a group approach may have contributed to the positive experiences of development that occurred.
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7.
  • Borg, Christel, et al. (author)
  • Life satisfaction among older people (65+) with reduced self-care capacity : the relationship to social, health and financial aspects.
  • 2006
  • In: Journal of Clinical Nursing. - : Wiley-Blackwell. - 0962-1067 .- 1365-2702. ; 15:5, s. 607-18
  • Journal article (peer-reviewed)abstract
    • AIMS AND OBJECTIVES: This study aimed at investigating life satisfaction and its relation to living conditions, overall health, self-care capacity, feeling lonely, physical activities and financial resources among people (65+) with reduced self-care capacity. BACKGROUND: Knowledge about factors related to low life satisfaction among older people with reduced self-care capacity is sparse, although this is important in health care and nursing so that the care is adapted to their needs and perspective. Previous research has mainly focused on isolated aspects such as pain in relation to life satisfaction among older people in general and less among so those with reduced self-care capacity in general. DESIGN AND METHOD: A subsample of 522 persons was selected from a randomly selected cross-sectional survey using a modified form of the Older Americans' Resources Schedule and Life Satisfaction Index Z. RESULTS: The mean age in the total sample was 77.9; women (79.5) were significantly older than men (77.0). Low life satisfaction was found among women, as well as those living in special accommodations. Life Satisfaction Index Z was 15.3 (SD 5.6) in the total sample. Gender and living conditions did not explain life satisfaction whilst poor overall self-reported health and poor financial resources in relation to needs had the strongest explanatory value. Also of significant importance were loneliness, the degree of reduced self-care capacity and feeling worried. CONCLUSION: Life satisfaction in older people with reduced self-care capacity is determined by several factors, with social, physical, mental and financial aspects probably interacting with each other; especially feeling lonely, degree of self-care capacity, poor overall health, feeling worried and poor financial resources in relation to needs. These factors need to be considered in the care of these people to preserve or improve their life satisfaction. RELEVANCE TO CLINICAL PRACTICE: Nursing interventions in terms of preventive home visits, rehabilitation, health education directed towards physical, psychological, social and economic aspects of importance may help to preserve or improve life satisfaction for those with reduced self-care capacity.
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8.
  • Hovde, Boel, et al. (author)
  • Older immigrants' experiences of their life situation in the context of receiving public care in Sweden
  • 2008
  • In: International Journal of Older People Nursing. - : Wiley-Blackwell. - 1748-3735 .- 1748-3743. ; 3:2, s. 104-112
  • Journal article (peer-reviewed)abstract
    • Objectives.  The aim of this study was to illuminate older immigrants' experience of their life situation in the context of receiving public care in Sweden. Background.  To meet the varying needs from the growing number of older immigrants, more knowledge about the experience of their life situation, health, illness and family ties is needed, especially in the context of receiving public health care and service. Methods.  Data were collected through interviews with sixteen immigrants aged 65 years and older, originally from nine different countries, living in Southern Sweden and receiving continuous care and service. The texts were analysed using qualitative content analysis. Results.  The overall impression from the texts was that the informants expressed a debt of gratitude to Swedish society. Their experience could be understood as - being burdened with health complaints; experiencing painful losses; wanting to manage by oneself and feeling exposed and deserted. Conclusions.  The results show that older immigrants are vulnerable when receiving public care. This was related to previous life events, cultural differences as well as communication difficulties. When planning for and providing care for older immigrants, it is important to be aware of their exposed situation and to acknowledge their life history and family context.
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9.
  • Werntoft, Elisabet, et al. (author)
  • Older people's reasoning about age-related prioritization in health care
  • 2007
  • In: Nursing Ethics. - : SAGE Publications. - 0969-7330 .- 1477-0989. ; 14:3, s. 399-412
  • Journal article (peer-reviewed)abstract
    • The aim of this study was to describe the reasoning of people aged 60 years and over about prioritization in health care with regard to age and willingness to pay. Healthy people (n = 300) and people receiving continuous care and services (n = 146) who were between 60 and 101 years old were interviewed about their views on prioritization in health care. The transcribed interviews were analysed using manifest and latent qualitative content analysis. The participants' reasoning on prioritization embraced eight categories: feeling secure and confident in the health care system; being old means low priority; prioritization causes worries; using underhand means in order to be prioritized; prioritization as a necessity; being averse to anyone having precedence over others; having doubts about the distribution of resources; and buying treatment requires wealth.
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10.
  • Andersson, Pia, et al. (author)
  • Oral health problems in elderly rehabilitation patients
  • 2004
  • In: International Journal of Dental Hygiene. - : Wiley-Blackwell. - 1601-5029 .- 1601-5037. ; 2:2, s. 70-77
  • Journal article (peer-reviewed)abstract
    • A combination of poor oral hygiene and dry mouth may be hazardous to the oral health status. However, systematic assessments in order to detect oral health problems are seldom performed in the nursing care of the elderly. The aims of this study were to investigate the occurrence of oral health problems measured using the Revised Oral Assessment Guide (ROAG) and to analyse associations between oral health problems and age, gender, living conditions, cohabitation, reason for admission, number of drugs, and functional and nutritional status. One registered nurse performed oral health assessments using ROAG in 161 newly admitted elderly patients in rehabilitation care. Oral health problems were found in 71% of the patients. Thirty per cent of these patients had between four and eight problems. Low saliva flow and problems related to lips were the most frequent oral health problems. Problems in oral health status were significantly associated with presence of respiratory diseases (problems with gums, lips, alterations on the tongue and mucous membranes), living in special accommodation (low saliva flow, problems with teeth/dentures and alterations on the tongue), being undernourished (alterations on the tongue and low saliva flow) and being a woman (low saliva flow). The highest Odds ratio (OR) was found in problems with gums in relation with prevalence of respiratory diseases (OR 8.9; confidence interval (CI) 2.8–27.8; P < 0.0005). This study indicates the importance of standardised oral health assessments in order to detect oral health problems which can otherwise be hidden when the patients are admitted to the hospital ward.
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11.
  • Andersson, Magdalena, et al. (author)
  • Health care consumption and place of death among old people with public home care or in special accommodation in their last year of life
  • 2007
  • In: Aging Clinical and Experimental Research. - 1594-0667 .- 1720-8319. ; 19:3, s. 228-239
  • Journal article (peer-reviewed)abstract
    • BACKGROUND AND AIMS:Developing care for older people in the last phase of life requires knowledge about the type and extent of care and factors associated with the place of death. The aim of this study was to examine age, living conditions, dependency, care and service among old people during their last year of life, but also their place of death and factors predicting it.METHODS:The sample (n=1198) was drawn from the care and services part of the Swedish National Study on Ageing and Care (SNAC). Criteria for inclusion were being 75+ years, dying in 2001-2004, and having public care and services at home or in special accommodation.RESULTS:In the last year of life, 82% of persons living at home and 51% living in special accommodation were hospitalized; median stays were 10 and 6.7 days respectively. Those living at home were younger and less dependent in ADL than those living in special accommodation. Those living at home and those having several hospital stays more often died in hospital. In the total sample, more visits to physicians in outpatient care predicted dying in hospital, whereas living in special accommodation and PADL dependency predicted dying outside hospital.CONCLUSIONS: Old people in their last year of life consumed a considerable amount of both municipal care and outpatient and in-hospital medical care, especially those living at home, which in several cases ended with death in hospital.
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12.
  • Andersson, Magdalena, et al. (author)
  • Health care consumption and place of death among old people with public home care or in special accommodation in their last year of life.
  • 2007
  • In: Aging clinical and experimental research. - 1720-8319. ; 19:3, s. 228-239
  • Journal article (peer-reviewed)abstract
    • BACKGROUND AND AIMS: Developing care for older people in the last phase of life requires knowledge about the type and extent of care and factors associated with the place of death. The aim of this study was to examine age, living conditions, dependency, care and service among old people during their last year of life, but also their place of death and factors predicting it. METHODS: The sample (n=1198) was drawn from the care and services part of the Swedish National Study on Ageing and Care (SNAC). Criteria for inclusion were being 75+ years, dying in 2001-2004, and having public care and services at home or in special accommodation. RESULTS: In the last year of life, 82% of persons living at home and 51% living in special accommodation were hospitalized; median stays were 10 and 6.7 days respectively. Those living at home were younger and less dependent in ADL than those living in special accommodation. Those living at home and those having several hospital stays more often died in hospital. In the total sample, more visits to physicians in outpatient care predicted dying in hospital, whereas living in special accommodation and PADL dependency predicted dying outside hospital. CONCLUSIONS: Old people in their last year of life consumed a considerable amount of both municipal care and outpatient and in-hospital medical care, especially those living at home, which in several cases ended with death in hospital. (Aging Clin Exp Res 2007; 19: 228-239) ©2007, Editrice Kurtis
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13.
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14.
  • Andersson, Magdalena, et al. (author)
  • The final period of life in elderly people in Sweden : factors associated with QOL
  • 2006
  • In: International Journal of Palliative Nursing. - 1357-6321 .- 2052-286X. ; 12:6, s. 286-293
  • Journal article (peer-reviewed)abstract
    • Whether elderly people in the final period of life have a high quality of life (QOL) and what factors relate QOL in this context, is not well known. The aim of this study was to examine the final period in life in elderly people (75 years or older) in need of help with instrumental activities of daily living (ADL), with the focus on quality of life, sense of coherence (SOC), health complaints and self-reported diseases. Also to investigate factors associated with QOL and factors predicting mortality. The sample consisted of 411 people, fifty of the respondents (the study group) had died within 1 year of data collection. The results showed that the study group had lower QOL than the comparison group. More admissions to hospital as well as the number of health complaints present negatively affected QOL for all respondents. Factors that predicted mortality included older age and higher number of health complaints.
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15.
  • Andersson, Magdalena, et al. (author)
  • The final period of life in elderly people in Sweden: factors associated with QOL.
  • 2006
  • In: International Journal of Palliative Nursing. - 1357-6321. ; 12:6, s. 93-286
  • Journal article (peer-reviewed)abstract
    • Whether elderly people in the final period of life have a high quality of life (QOL) and what factors relate QOL in this context, is not well known. The aim of this study was to examine the final period in life in elderly people (75 years or older) in need of help with instrumental activities of daily living (ADL), with the focus on quality of life, sense of coherence (SOC), health complaints and self-reported diseases. Also to investigate factors associated with QOL and factors predicting mortality. The sample consisted of 411 people, fifty of the respondents (the study group) had died within 1 year of data collection. The results showed that the study group had lower QOL than the comparison group. More admissions to hospital as well as the number of health complaints present negatively affected QOL for all respondents. Factors that predicted mortality included older age and higher number of health complaints.
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16.
  • Berg, Agneta, 1950-, et al. (author)
  • Effects from systematic clinical supervision on psychiatric nurses' sense of coherence, creativity, work related strain and job satisfaction : a pre-post design
  • 1999
  • In: Journal of Psychiatric and Mental Health Nursing. - 1351-0126 .- 1365-2850. ; 6:5, s. 371-381
  • Journal article (peer-reviewed)abstract
    • There are few investigations of the type and the outcome of interventions aimed at supporting nurses caring for psychiatric patients. Therefore a prepost–test design study was used in which 22 psychiatric nurses, on a general psychiatric ward were examined before, during and after one year of systematic clinical supervision combined with supervised documented, planned, individualized care. The methods used were the Sense of Coherence scale (SOC), the Creative Climate Questionnaire (CCQ), the Work-Related Strain Inventory and 34 statements from the Satisfaction with Nursing Care and Work Questionnaire (SNCW). In addition 14 statements were developed to evaluate the nurses' view of the effects from clinical supervision. The baseline values for the CCQ indicated a stagnant organization and a high score in the conflict dimension indicated personal and emotional tensions within the organization. The intervention led to a significantly increased creative and innovative climate in the dimensions for trust, idea time and reduced conflicts. However, the organizational climate remained stagnant. The nurses' view of the effects from clinical supervision also increased significantly. There were no significant changes in the nurses' SNCW, WRSI or SOC score. The result of the correlation analysis indicated that a strong sense of coherence was related to low work-related strain but not to unsatisfactory working conditions/milieu. The results gave some support to the idea that systematic clinical supervision and supervised nursing care plans constitute one type of support strategy that improves creativity and the organizational climate. It may, not, however, buffer for interpersonal problems. Further research is required to explore the need for and effects of various support systems depending on the circumstances in the organization.
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17.
  • Berg, Agneta, 1950-, et al. (author)
  • Nurses' creativity, tedium and burnout during 1 year of clinical supervision and implementation of individually planned nursing care : comparisons between a ward for severely demented patients and a similar control ward
  • 1994
  • In: Journal of Advanced Nursing. - 0309-2402 .- 1365-2648. ; 20:4, s. 742-749
  • Journal article (peer-reviewed)abstract
    • The aim of this study was to study creativity and innovative climate, tedium and burnout among the nurses on two wards during 1 year of systematic clinic supervision combined with the implementation of individualized care on an experimental ward (EW) for severely demented patients, as compared with a similar control ward (CW) EW nurses had systematic clinic supervision and each patient had his/her nursing care carefully planned, documented and evaluated The intervention was evaluated by means of the Creative Climate Questionnaire, Burnout Measure and the Maslach Burnout Inventory Creativity and innovative climate improved significantly among the EW nurses (n= 19) in eight out of 10 factors during the year of intervention while there was no change on the control ward (n= 20) Tedium and burnout decreased significantly among the EW nurses while no change was seen in this respect among the CW nurses It seems reasonable to assume that systematic clinical supervision and individualized planned care decreases the negative outcome of stress caused by the psychological burden imposed by nursing care It also increases nurses' creativity, which, in turn, may benefit patient care The findings of this study point to the necessity for a support system that focuses on the work itself, i e the nursing care Individualized planned care and systematic clinical supervision may offer this kind of support.
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18.
  • Berg, Agneta, et al. (author)
  • Nurses' creativity, tedium and burnout during 1 year of clinical supervision and implementation of individually planned nursing care : comparisons between a ward for severely demented patients and a similar control ward
  • 1994
  • In: Journal of Advanced Nursing. - : Wiley-Blackwell Publishing Ltd. - 0309-2402 .- 1365-2648. ; 20:4, s. 742-749
  • Journal article (peer-reviewed)abstract
    • The aim of this study was to study creativity and innovative climate, tedium and burnout among the nurses on two wards during 1 year of systematic clinic supervision combined with the implementation of individualized care on an experimental ward (EW) for severely demented patients, as compared with a similar control ward (CW) EW nurses had systematic clinic supervision and each patient had his/her nursing care carefully planned, documented and evaluated The intervention was evaluated by means of the Creative Climate Questionnaire, Burnout Measure and the Maslach Burnout Inventory Creativity and innovative climate improved significantly among the EW nurses (n= 19) in eight out of 10 factors during the year of intervention while there was no change on the control ward (n= 20) Tedium and burnout decreased significantly among the EW nurses while no change was seen in this respect among the CW nurses It seems reasonable to assume that systematic clinical supervision and individualized planned care decreases the negative outcome of stress caused by the psychological burden imposed by nursing care It also increases nurses' creativity, which, in turn, may benefit patient care The findings of this study point to the necessity for a support system that focuses on the work itself, i e the nursing care Individualized planned care and systematic clinical supervision may offer this kind of support.
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19.
  • Berg, Agneta, 1950-, et al. (author)
  • Psychiatric nurses' lived experiences of working with in-patient care on a general team psychiatric ward
  • 2000
  • In: Journal of Psychiatric and Mental Health Nursing. - 1351-0126 .- 1365-2850. ; 7:4, s. 323-333
  • Journal article (peer-reviewed)abstract
    • To reveal the meaning of being a nurse working with inpatient care on a team psychiatric ward in Sweden, 22 psychiatric nurses were interviewed and the transcribed texts were analysed by means of latent content analysis. Three themes emerged from the analysis: developing a working relationship with the patient in everyday caregiving; encountering and handling the unforseeable in daily living; and struggling with professional independence and dependency. Developing a working relationship with the patient in everyday caregiving meant that the nurse–patient relationship was the foundation of the caregiving and included being with, as well as doing for, and with, the patient. Four different approaches in daily caregiving were revealed: networking, teaching, containing and protecting. The nurses' approaches in the nurse–patient relationship alternated between being an 'expert' and a 'collaborator'. Encountering and handling unforeseeable situations meant that the nurses were exposed to and had to be prepared for unpredictable situations where they were on their own, handling sometimes strong emotional reactions and relying on their own ability to act. Struggling with professional independence and dependency meant that the nurses seemed to lack professional confidence, although they had many responsibilities, but also less authority to decide about overall care planning. Contextual aspects such as organizational hindrance, unsatisfactory work-environment and co-operation difficulties were illuminated. The result indicates the need for a stable and predictable organizational structure if nurses are to manage the demanding nurse–patient relationships that everyday caregiving requires. A question highlighted by this study is whether multidisciplinary team organization has been effectively developed in Sweden, as uncertainty about the roles and responsibilities of nurses was apparent.
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20.
  • Blomqvist, Kerstin, 1953-, et al. (author)
  • Managing pain in older persons who receive home-help for their daily living : perceptions by older persons and care providers
  • 2002
  • In: Scandinavian Journal of Caring Sciences. - 0283-9318 .- 1471-6712. ; 16:3, s. 319-328
  • Journal article (peer-reviewed)abstract
    • Pain is a common problem for older persons who need professional help for their daily living. In this study 94 older persons (75+) in persistent pain were compared with 52 care providers concerning the pain management methods they had used/administered during the previous week and how helpful they perceived these methods to be. Interviews were based on 16 items from the original version of the pain management inventory (PMI). Both groups perceived prescribed medication, rest and distraction as the most frequently utilized methods. Specific methods such as transcutaneous electrical nerve stimulation (TENS) or bracing/splinting or bandaging the affected body part were seldom employed, although most users perceived these methods as helpful. Care providers perceived most methods for managing pain as more effective than older persons did. The results imply that care providers need skills in a variety of pharmacological and nonpharmacological methods to manage pain and a need to evaluate effectiveness of the methods in a systematic way.
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21.
  • Blomqvist, Kerstin, 1953-, et al. (author)
  • Pain in older adults living in sheltered accommodation : agreement between assessments by older adults and staff
  • 1999
  • In: Journal of Clinical Nursing. - 0962-1067 .- 1365-2702. ; 8:2, s. 159-169
  • Journal article (peer-reviewed)abstract
    • This study aimed to investigate the presence of pain, pain duration, localization(s), intensity, type and pharmacological treatment among older adults living in sheltered accommodation or receiving rehabilitation, as well as the agreement between pain assessments performed by staff and the older adults. Twenty-nine randomly selected older adults (65+ years) and the staff who looked after them participated in a structured interview based on standardized measures for pain assessment and physical, intellectual and communicative functions. Pain was found to be common, with a majority of participants experiencing it every day or all of the time. Nine out of 22 of the older adults in pain had no pain relief drugs at all. Agreement between assessments by the older adults and the staff was no higher than moderate and in general pain levels were underestimated. The findings indicate that older adults were at risk of undetected and untreated pain and the risk was even higher for those with speech difficulties. The provision of good nursing care for older adults in sheltered accommodation requires systematic routines for frequent pain assessments.
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22.
  • Borg, Christel, et al. (author)
  • Life satisfaction among older people (+65) with reduced self-care capacity : the relationship to social, health and financial aspects
  • 2006
  • In: Journal of Clinical Nursing. - 0962-1067. ; 15, s. 607-618
  • Journal article (peer-reviewed)abstract
    • Life satisfaction among older people (65þ) with reduced self-care capacity: the relationship to social, health and financial aspects Aims and objectives. This study aimed at investigating life satisfaction and its relation to living conditions, overall health, self-care capacity, feeling lonely, physical activities and financial resources among people (65þ) with reduced selfcare capacity. Background. Knowledge about factors related to low life satisfaction among older people with reduced self-care capacity is sparse, although this is important in health care and nursing so that the care is adapted to their needs and perspective. Previous research has mainly focused on isolated aspects such as pain in relation to life satisfaction among older people in general and less among so those with reduced self-care capacity in general. Design and method. A subsample of 522 persons was selected from a randomly selected cross-sectional survey using a modified form of the Older Americans’ Resources Schedule and Life Satisfaction Index Z. Results. The mean age in the total sample was 77Æ9; women (79Æ5) were significantly older than men (77Æ0). Low life satisfaction was found among women, as well as those living in special accommodations. Life Satisfaction Index Z was 15Æ3 (SD 5Æ6) in the total sample. Gender and living conditions did not explain life satisfaction whilst poor overall self-reported health and poor financial resources in relation to needs had the strongest explanatory value. Also of significant importance were loneliness, the degree of reduced self-care capacity and feeling worried. Conclusion. Life satisfaction in older people with reduced self-care capacity is determined by several factors, with social, physical, mental and financial aspects probably interacting with each other; especially feeling lonely, degree of self-care capacity, poor overall health, feeling worried and poor financial resources in relation to needs. These factors need to be considered in the care of these people to preserve or improve their life satisfaction. Relevance to clinical practice. Nursing interventions in terms of preventive home visits, rehabilitation, health education directed towards physical, psychological, social and economic aspects of importance may help to preserve or improve life satisfaction for those with reduced self-care capacity.
  •  
23.
  • Bökberg, Christina, et al. (author)
  • Professional care providers and stakeholders’ views of best practice in the care for persons with dementia in Sweden
  • 2013
  • In: The Journal of Nutrition, Health & Aging. - Heidelberg : Springer. - 1279-7707 .- 1760-4788. ; 17:Suppl. 1, s. S369-S370
  • Journal article (peer-reviewed)abstract
    • Introduction: Dementia implies progressive loss of mental and physical functions during the trajectory of the disease (Porter & Kaplan, 2012). Persons with dementia need involvement of various and several care providers throughout the stages of dementia, and more knowledge is needed about best practice strategies in this complexity of care (Gurner, 2001). The aim of the study was to explore professional care providers and stakeholders’ views of best practice in concepts of information, collaboration and communication in the care for persons with dementia in Sweden.Method: The study had a qualitative approach based on three focus group interviews with a variation among participants regarding professions and workplaces to represent different types of care for persons with dementia from diagnosis to end of life care. The transcribed verbatim was analyzed with qualitative content analysis.Preliminary results: In early stages primary health care specialized in dementia had close collaboration, training and mentoring, with memory clinic and home care. In the later stages the person with dementia had less frequent contacts with primary health care. Day care played an important role in information delivery of the disease, in collaboration with home and institutional care. In the latest stage the family had an important role as a proxy for the person with dementia about desires in the care.Conclusion: A well-functioning network in professional care seems to have an impact on persons with dementia to remain at home despite loss of mental and physical functions.On the behalf of RightTimePlaceCare consortium. http://www.righttimeplacecare.eu.
  •  
24.
  • Bökberg, Christina, et al. (author)
  • Professional care providers and stakeholders’ views of best practice in the chain of care for persons with dementia in Sweden
  • 2013
  • In: Nordic Advances in Health Care Sciences Research. ; , s. 98-98
  • Conference paper (peer-reviewed)abstract
    • Background: To meet the increasing needs for persons with dementia and their relatives a well-functioning health care system in which resources are used optimally is needed. For this to be achieved requires strategy and planning of synergies between the different cares providers. This study will explore professional caregivers’ and stakeholders’ views of best practice in terms of information, collaboration and communication in dementia care.Aim: The aim of the study was to explore professional care providers’ and stakeholders' views of best practice in concepts of information, collaboration and communication throughout the trajectory of care from diagnosis to end of life care for persons with dementia in Sweden.Method: The study had a qualitative approach based on three focus group interviews with a variation among participants regarding professions and workplaces to represent different types of care for persons with dementia from diagnosis to end of life care. The transcribed verbatim was analyzed with qualitative content analysis.Preliminary results: In early stages primary health care specialized in dementia had close collaboration, training and mentoring, with memory clinic and home care. In the later stages the person with dementia had less frequent contacts with primary health care. Day care played an important role in information delivery of the disease, in collaboration with home and institutional care. In the latest stage the family had an important role as a proxy for the person with dementia about desires in the care.Conclusion: A well-functioning network in professional care seems to have an impact on persons with dementia to remain at home despite loss of mental and physical functions.
  •  
25.
  • Fagerström, Cecilia, Docent, 1973-, et al. (author)
  • ADL capacity and feeling hindered by health problems at 60 years and above
  • 2006
  • In: GERIATRICS 2006 International Congress Of Elderly Health. - Istanbul, Turkey.
  • Conference paper (peer-reviewed)abstract
    • A common consequence of health problems such as diseases is a reduced ability to manage activities in daily living (ADL). Despite ADL capacity is frequently used to identify the impact of health problems on daily living it is still not well known what make people feel hindered in daily life with more or less inability to perform ADL. Such knowledge about feeling hindered by health problems can be useful when planning for interventions in an early stage already when people, regarding to ADL-rating scales have modest impaired ability to perform ADL or even not captured by ADL-scales. The aim of this study was to investigate feeling hindered by health problems among people (n=958) age 60-96 years living in ordinary home in relation to ADL capacity, health problems as well as social and financial resources, sense of coherence and life satisfaction. The data is taken from a questionnaire and a medical examination which were carried out in a baseline survey in one of the four including centres (Blekinge) of the longitudinal multi-centre cohort study The Swedish National study on Ageing and Care (SNAC) (Lagergren et al., 2004). Data indicated that people feel hindered by their health problems before they became impaired in ADL capacity. Feeling greatly hindered by health problems was mainly associated with factors linked to the person’s musculoskeletal system but also to fatigue as well as avoiding being outdoors afraid to fall and had a varying association with feeling hindered in various levels of ADL capacity. The broader question about feeling hindered by health problems used in this study might be an early marker of the impact of functional limitations in daily activities. Combining people’s ADL capacity with the question of feeling hindered may also be a more sensitive way to identify those in need of rehabilitation or other interventions, especially at early stages of health decline compared to investigate ADL capacity solely.
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26.
  • Fagerström, Cecilia, et al. (author)
  • Determinants of Feeling Hindered by Health Problems in Daily Living at 60 Years and Above
  • 2008
  • In: Scandinavian Journal of Caring Sciences. - Oxford : Blackwell Publishing. - 0283-9318 .- 1471-6712. ; 22:3, s. 410-421
  • Journal article (peer-reviewed)abstract
    • Although the ability to perform activities of daily living (ADL) is frequently used to identify the impact on daily living caused by health problems such as diseases, impaired eyesight or hearing, it is still not well known what makes people feel hindered in daily living with more or less inability to perform ADL. The aim of this study was to investigate feeling hindered by health problems in daily living among people (n = 958, 60-96 years) in relation to ADL capacity, health problems as well as social and financial resources, sense of coherence and life satisfaction. The data are taken from a baseline survey in one of the four included centres (Blekinge) of the longitudinal multicentre cohort study, The Swedish National Study on Aging and Care. The result showed that people felt hindered by their health problems despite no impairment in ADL capacity. Feeling greatly hindered by health problems was associated with factors linked to mobility but also to fatigue, no help when needed, and avoiding being outdoors due to fear of falling. Factors associated with feeling greatly hindered differed depending on whether people were impaired in ADL capacity or not. In people with excellent ADL capacity feeling hindered was associated with picking up things from the floor and rising from a chair and fatigue, whereas avoiding being outdoors, no help when needed and rising from a chair were found to be associated with feeling hindered by health problems among people with impaired ADL capacity. Combining people's ADL capacity with questions about feeling hindered may provide knowledge of determinant factors of feeling hindered in relation to ADL capacity, impaired or not, to identify people in need of rehabilitation or other interventions.
  •  
27.
  • Fagerström, Cecilia, et al. (author)
  • Feeling hindered by health problems and functional capacity at 60 years and above
  • 2007
  • In: Archives of gerontology and geriatrics (Print). - : Elsevier. - 0167-4943 .- 1872-6976. ; 44:2, s. 181-201
  • Journal article (peer-reviewed)abstract
    • It is common to use activities of daily living (ADL) rating scales to identify the impact of health problems such as diseases, impaired eyesight or hearing on daily life. However, for various reasons people with health problems might feel hindered in daily life before limitations in ability to perform ADL have occurred. In addition, there is sparse knowledge of what makes people feel hindered by health problems in relation to their ADL capacity. The aim was to investigate feeling hindered by health problems among 1297 people aged 60–89 living at home in relation to ADL capacity, health problems, life satisfaction, self-esteem, and social and financial resources, using a self-reported questionnaire, including questions from OARS (Older Americans’ Resources and Services schedule), Rosenberg’s self-esteem and Life Satisfaction Index Z. People feeling greatly hindered by health problems rarely had anyone who could help when they needed support, had lower life satisfaction and self-esteem than those not feeling hindered. Feeling hindered by health problems appeared to take on a different meaning depending on ADL capacity, knowledge that seems essential to include when accomplishing health promotion and rehabilitation interventions, especially at the early stages of reduced ADL capacity.
  •  
28.
  • Fagerström, Cecilia, et al. (author)
  • Feeling hindered by health problems in relation to ADL capacity at 60 years and above
  • 2005
  • Conference paper (peer-reviewed)abstract
    • Health problems as impaired mobility, eyesight or hearing problems in old age are often associated with reduced ADL (activities of daily living) capacity and as a result people may give up activities that contribute to well-being. However, the knowledge is sparse about the relation between feeling hindered by health problems in relation to ADL capacity, decreased or not. Such knowledge may be useful when outlining interventions to people already when people have no or modest impaired ability to perform ADL. Such information can not be captured through ADL-scales but by an overarching question about feeling hindered in daily living by health problems. Purpose: This study presents data on people’s (n=1524) 60-89 years feeling hindered by health problems in relation to their ability to perform ADL, health problems, social and financial resources, self-esteem and life satisfaction. Method: OARS (Older Americans Resources and Services schedule), Rosenberg’s self-esteem and Life Satisfaction Index Z. Results: People who felt greatly hindered by health problems had rarely someone who could help them when needing support, had lower life satisfaction and self-esteem compared to those not. Different factors were associated with feeling greatly hindered by health problems at different levels of ADL ability. Conclusions: Data from this study suggest that feeling hindered in daily living takes on a different meaning depending on functional capacity and thus preventive and visiting work should start early and be outlined differently depending on their ADL capacity. Also such an overarching question may be useful in detecting those in need of interventions.
  •  
29.
  • Fagerström, Cecilia, et al. (author)
  • Life satisfaction and associated factors among people aged 60 years and above in six European countries
  • 2007
  • In: Applied Research in Quality of Life. - : Springer. - 1871-2584 .- 1871-2576. ; 2, s. 33-50
  • Journal article (peer-reviewed)abstract
    • Life satisfaction is a concept frequently used to measure wellbeing of older people. However, there is still a lack of cross-national comparative research investigating factors associated with life satisfaction. There may be unique and common factors associated with life satisfaction across European countries. This study aimed to investigate life satisfaction among people aged 60–89 years in six European countries in relation to health problems, ADL capacity, self-esteem, social and financial resources. A cross-sectional study was performed, including 7699 people aged 60–89 years, in Sweden, the UK, the Netherlands, Luxemburg, Austria and Italy, participating in the European Study of Adult Wellbeing, using questions from the Older Americans Resources and Services schedule, Multidimensional Functional Assessment Questionnaire, Life Satisfaction Index Z and Rosenberg’s Self-Esteem Scale. Logistic regression analysis was performed to determine factors associated with life satisfaction in the six national samples. In cases where people were less satisfied with their life it was fairly satisfactory and unsatisfactory social contacts (Odds Ratio (OR) 1.5–13.8), poor financial resources (OR 1.7–15.1), feeling greatly hindered by health problems (OR 2.2–5.4) and self-esteem (OR 2.1–5.1) rather than the ability to perform activities of daily living and the extent of social contacts that gave the greatest risk of low life satisfaction in all the six European countries. There were both common and country-specific factors important for life satisfaction in the six European countries. However, the importance of satisfactory social contacts, financial resources, self-esteem and feeling hindered by health problems seems universal in the six included countries and thus important to target in preventive interventions.
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30.
  • Fagerström, Cecilia, Docent, 1973-, et al. (author)
  • People’s (60+) perception of feeling hindered by health problems in relation to ADL capacity
  • 2005
  • In: 18th Congress of the International Association of Gerontology.
  • Conference paper (peer-reviewed)abstract
    • Health problems as impaired mobility, eyesight or hearing problems in old age are often associated with reduced ADL (activities of daily living) capacity and as a result people may give up activities that contribute to well-being. However, the knowledge is sparse about the relation between feeling hindered by health problems in relation to ADL capacity, decreased or not. Such knowledge may be useful when outlining interventions to people already when people have no or modest impaired ability to perform ADL. Such information can not be captured through ADL-scales but by an overarching question about feeling hindered in daily living by health problems. Purpose: This study presents data on people’s (n=1524) 60-89 years feeling hindered by health problems in relation to their ability to perform ADL, health problems, social and financial resources, self-esteem and life satisfaction. Method: OARS (Older Americans Resources and Services schedule), Rosenberg’s self-esteem and Life Satisfaction Index Z. Results: People who felt greatly hindered by health problems had rarely someone who could help them when needing support, had lower life satisfaction and self-esteem compared to those not. Different factors were associated with feeling greatly hindered by health problems at different levels of ADL ability. Conclusions: Data from this study suggest that feeling hindered in daily living takes on a different meaning depending on functional capacity and thus preventive and visiting work should start early and be outlined differently depending on their ADL capacity. Also such an overarching question may be useful in detecting those in need of interventions.
  •  
31.
  •  
32.
  • Hallberg, Ingalill R., et al. (author)
  • Satisfaction with nursing care and work during a year of clinical supervision and individualized care : Comparison between two wards for the care of severely demented patients
  • 1993
  • In: Journal of Nursing Management. - : Hindawi Limited. - 0966-0429 .- 1365-2834. ; 1:6, s. 297-307
  • Journal article (peer-reviewed)abstract
    • An intervention study was set up to explore the effects of the implementation of planned individualized care and regular systematic clinical supervision regarding nurses' degree of satisfaction with nursing care and work. All nurses on two similar wards caring for severely demented patients participated as experimental ward (EW) (n= 19) and control ward (CW) (n=20). Data were collected before intervention and at 6 months and 12 months during intervention, by means of a questionnaire developed in Sweden which assesses aspects of satisfaction with nursing care and work. Analysis was performed by means of principal component analysis, Wilcoxon rank sum test and Friedman two-way ANOVA. The baseline data showed no significant differences in the responses from the nurses on the two wards; they were found to be more satisfied than dissatisfied with their job although recognition from management was poor. During the intervention, the experimental ward nurses' experience of praise, professional growth, autonomy and quality of care, as well as their feeling of co-operation with colleagues and comfort improved significantly, while no changes occurred on the control ward. The quality of the written documentation on patients' needs and care improved significantly, and the experimental ward nurses also rejected significantly more strongly that their knowledge about patients and work was unsatisfactory. Their improved satisfaction with nursing care and work was believed to be related to the support they received in cognitive and emotional coping, the possibility of reflective learning and the change in management style associated with intervention.
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33.
  • Hallberg, Ingalill R, et al. (author)
  • Structure of long-term home and institutional care available to people with dementia in eight European countries
  • 2011
  • In: International psychogeriatrics. - Cambridge : Cambridge University Press. - 1041-6102 .- 1741-203X. ; 23:Suppl. 1, s. S31-S31
  • Journal article (peer-reviewed)abstract
    • The RTPC project also concerns the structure of long-term home and institutional care throughout the trajectory of dementia. To describe and analyse the European health, social care and welfare systems, advocacy and informal caregiver support systems for patients/consumers with dementia a template has been developed for the use of homogenous terminology, covering possible care and service interventions from diagnosis to end of life. The structure of the national health care and social service system was described as related to elderly in general and to people with dementia specifically. The system differs between the eight countries in particular in terms of the demands on informal caregivers, financially, the distribution and the emphasis on home care versus nursing home care. Resembling findings throughout the 8 countries were that few had a diagnosis at early disease stage, support to family caregivers still can be improved and palliative care concepts are sparsely applied.
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34.
  • Hallberg, Ingalill R, et al. (author)
  • Structure of long term home and institutional care systems in Europe
  • 2011
  • Reports (other academic/artistic)abstract
    • The aim of this part of the RightTimePlaceCare study (WP2) was to describe and analyse the European health, social care and welfare systems, advocacy and informal caregiver support systems for patients with dementia. The description and analyses covers the continuum of care from diagnosis, informal care, contributions from civic society, public home care and the intermediate forms of care, to the long-term institutionalised care, and end of life care. In a first step, the terminology was developed and meanings of different terms used in relation to dementia care were collected, analysed, defined and categorised. Thereafter the terminology was used to develop a template organised on the Y-axis as being the course of the dementia disease as described by the OECD in 2004, and on the X-axis as being the type of care provided, organised in accordance with the process of the disease from dementia screening to end of life care. In addition each country was asked to provide an overall description of the care system they offered with regard to the national directives and financing of their dementia care system. The primary source of information was written reports from different sources. Official documents, epidemiological studies and descriptions of the care system, in particular dementia care system offered in their country. In addition interviews with responsible managers, providers or the equivalent in relevant care and service organisations, with persons in consumer/user organisations, with staff, professional employees and purchasers in a municipality or another representative for a civic administrative area were recommended.
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35.
  • Hallberg, Ingalill R, et al. (author)
  • The dementia care system in the eight RTPC European countries
  • 2013
  • In: The Journal of Nutrition, Health & Aging. - Heidelberg : Springer. - 1279-7707 .- 1760-4788. ; 17:Suppl. 1, s. S212-S212
  • Journal article (peer-reviewed)abstract
    • Introduction: Exploring the care and service activities offered throughout the trajectory of dementia is an opportunity for countries to learn from each other. As part of the RightTimePlaceCare project’s general objective to develop best practice strategies this presentation describes development, content and application of a template to explore the dementia health, social care and welfare systems from early sign, diagnosis, intermediate and moderate stage and to the late stage of the disease. It also describes some of the findings with regard to the chain of care and service for people with dementia.Method: A step-wise consensus procedure was applied to identify, define and develop a template covering care and service throughout the disease trajectory. In addition the professionals involved were identified and defined as for their educational level.Results: In total 50 care and service activities compiled in seven groups were identified: 1) Screening, diagnostic procedure, treatment of dementia and complications; 2) Outpatient care facilities; 3) Care at home; 4) Institutional care; 5) Palliative care; 6) Informal caregiving and support; 7) Civic activities. The largest differences in terms of availability were found for care activities specifically for people with dementia. Non-pharmacological treatment was not commonly utilized in whilst pharmacological treatment for BPSD was common. Also education and social support to family caregivers was sparsely utilized.Conclusion: The care and service offered to people with dementia and family caregivers covers a wide range of activities. Facilities specifically for dementia varies among countries.There are more similarities among countries than differences.
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36.
  • Hallberg R., Ingalill, et al. (author)
  • The parallel process in clinical supervision with a schizophrenic client
  • 1994
  • In: Perspectives in psychiatric care. - 0031-5990 .- 1744-6163. ; 30:2, s. 26-32
  • Journal article (peer-reviewed)abstract
    • The authors analyze a male nurse's account of how he experienced his interaction with a female schizophrenic client during sessions of systematic clinical supervision. Notes taken during 15 sessions were analyzed by means of open coding. The analysis revealed the importance of being aware of the parallel process that occurs among the client, the primary nurse, and the unit staff.
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37.
  •  
38.
  •  
39.
  •  
40.
  • Karlsson, Staffan, 1959-, et al. (author)
  • Antipsychotic medication in relation to national directives in people with dementia in Sweden
  • 2017
  • In: Innovation in Aging. - Oxford : Oxford University Press. - 2399-5300. ; 1:S1, s. 348-349
  • Journal article (peer-reviewed)abstract
    • The aim of this study was to explore trends in treatment with antipsychotic medication in Swedish dementia care as reported in the most recent empirical studies on the topic, and to relate these trends to directives and recommendations from national authorities.The study included two scoping review studies and two empirical studies. The scoping studies reviewed published data in electronic databases as well as Swedish recommendations and directives in the field.During the past decade, recommendations have been developed regarding antipsychotic medication in Sweden. These recommendations were generic at first, but have become increasingly specific and restrictive with time. The scoping review showed that treatment with antipsychotic drugs varied between 6% and 38%, and was higher in younger older persons and those with moderate cognitive impairment and living in nursing homes for people with dementia. A trend towards a decrease in antipsychotic use has been seen over the last 15 years. The empirical studies showed that the medication with antipsychotics decreased from 23.4% in 2001 to 11.5% in 2007, for older people in general as well as for older people with dementia. Among older people with dementia, 10% were utilizing antipsychotic medication, with no difference between those cared for at home and those in nursing homes.Directives from Swedish national authorities seem to have had an impact on antipsychotic medication for people with dementia. Treatment with antipsychotic medication has decreased, while other psychotropic medication has increased. National directives may possibly be even more effective, if applied in combination with systematic follow-ups.
  •  
41.
  • Karlsson, Staffan, 1959-, et al. (author)
  • Antipsychotic medication in relation to national directives in people with dementia in Sweden
  • 2017
  • In: Program Abstracts from the 21st International Association of Gerontology and Geriatrics (IAGG) World Congress. - Washington, DC : The Gerontological Society of America. ; , s. 348-349
  • Conference paper (peer-reviewed)abstract
    • The aim of this study was to explore trends in treatment with antipsychotic medication in Swedish dementia care as reported in the most recent empirical studies on the topic, and to relate these trends to directives and recommendations from national authorities.The study included two scoping review studies and two empirical studies. The scoping studies reviewed published data in electronic databases as well as Swedish recommendations and directives in the field.During the past decade, recommendations have been developed regarding antipsychotic medication in Sweden. These recommendations were generic at first, but have become increasingly specific and restrictive with time. The scoping review showed that treatment with antipsychotic drugs varied between 6% and 38%, and was higher in younger older persons and those with moderate cognitive impairment and living in nursing homes for people with dementia. A trend towards a decrease in antipsychotic use has been seen over the last 15 years. The empirical studies showed that the medication with antipsychotics decreased from 23.4% in 2001 to 11.5% in 2007, for older people in general as well as for older people with dementia. Among older people with dementia, 10% were utilizing antipsychotic medication, with no difference between those cared for at home and those in nursing homes.Directives from Swedish national authorities seem to have had an impact on antipsychotic medication for people with dementia. Treatment with antipsychotic medication has decreased, while other psychotropic medication has increased. National directives may possibly be even more effective, if applied in combination with systematic follow-ups.
  •  
42.
  • Karlsson, Staffan, 1959-, et al. (author)
  • Best practice and needs of improvement in the chain of care for persons with dementia in Sweden
  • 2014
  • Conference paper (peer-reviewed)abstract
    • INTRODUCTION: The fragmentation of responsibilities in the chain of care may result in information lost, duplications and discontinuity. This may in turn lead to consequences for the person with dementia dealing with unmet care needs.AIM: The aim of the study was to explore professional care providers’ and stakeholders' views of best practice and needs of improvement of information, collaboration and communication in the chain of care for persons with dementia in Sweden.METHOD: The study was carried out with an explorative qualitative design based on three focus group interviews. The text was analysed with qualitative content analysis.RESULTS: The participants’ views of best practices and needs of improvement resulted in six themes following the trajectory of dementia. “Dementia diagnosis significant for receiving care”, “Day care for person with dementia supportive to home care”, “Collaboration between staff important for information delivery”, “Skilled staff for person-centred care”, “The life story of the person with dementia important source of information”,  and “Relatives participation for continuity in the chain of care”. CONCLUSION: A well-functioning network between different professional care providers seems to have an impact on best practice in the chain of care for persons with dementia so they could remain at home despite loss of mental and physical functions.
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43.
  • Karlsson, Staffan, 1959-, et al. (author)
  • Care satisfaction among older people receiving public care and service, at home or in special accommodation
  • 2012
  • In: 21st Nordic Congress of Gerontology : Dilemmas In Ageing Societies. ; , s. 136-136
  • Conference paper (peer-reviewed)abstract
    • In order to be able to provide care and service of high quality to older people, knowledge about factors influencing their experience of satisfaction with the care is essential.Aim: The aim was to explore care satisfaction in relation to health related quality of life, functional dependency, health complaints and place of living among people 65 years or older, receiving formal care and service.Methods: 166 people receiving care and service from the municipality were interviewed regarding demography, functional ability, perceived health complaints and care. Health related quality of life was measured with SF-12, and care satisfaction was measured with a questionnaire.Results: The people were in mean 84 years old and those at home were more often cohabitating, less dependent in activities of daily living, less cognitively impaired and had fewer health complaints regarding mobility, faeces incontinence and pressure ulcer, compared to those in special accommodation (equivalent to nursing home). Low care satisfaction was associated with IADL dependency, blindness, faeces incontinence and anxiety, while high care satisfaction was associated with PADL dependency. Those at home rated an overall higher care satisfaction and were more satisfied with care continuity, personal relations and that staff have plenty of time, are respectful and quiet, than those in special accommodation.Conclusions: Care satisfaction and health related quality of life (HRQoL) among older people was found to be more associated to functional impairment and health complaints than to whether care and service is received at home or in special accommodation.
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44.
  • Karlsson, Staffan, 1959-, et al. (author)
  • Care satisfaction among older people receiving public care and service, at home or in special accommodation
  • 2011
  • In: Positioning Nursing for the Future: Advancing Nurses´Role in Community and Home Care. ; , s. 100-100
  • Conference paper (peer-reviewed)abstract
    • In order to be able to provide care and service of high quality to older people, knowledge about factors influencing their experience of satisfaction with the care is essential.Purpose: To explore care satisfaction in relation to health related quality of life, functional dependency, health complaints and place of living among people 65 years or older, receiving formal care and service.Methods: 166 people receiving care and service from the municipality were interviewed regarding demography, functional ability, perceived health complaints and care. Health related quality of life was measured with SF-12, and care satisfaction was measured with a questionnaire.Results: The people were in mean 84 years old and those at home were more often cohabitating, less dependent in activities of daily living, less cognitively impaired and had fewer health complaints regarding mobility, faeces incontinence and pressure ulcer, compared to those in special accommodation (equivalent to nursing home). Low care satisfaction was associated with IADL dependency, blindness, faeces incontinence and anxiety, while high care satisfaction was associated with PADL dependency. Those at home rated an overall higher care satisfaction and were more satisfied with care continuity, personal relations and that staff have plenty of time, are respectful and quiet, than those in special accommodation.Conclusions: Care satisfaction and health related quality of life (HRQoL) among older people was found to be more associated to functional impairment and health complaints than to whether care and service is received at home or in special accommodation.
  •  
45.
  • Karlsson, Staffan, 1959-, et al. (author)
  • Dementia care in eight European countries from the perspective of recipients and their caregivers
  • 2015
  • In: Abstract Booklet. ; , s. 318-318
  • Conference paper (peer-reviewed)abstract
    • Objectives: To investigate persons with dementia and their informal caregivers’ views of inter-sectoral information, communication and collaboration throughout the trajectory of dementia care, in eight European countriesMethods: 137 persons with dementia and their informal caregivers participated in focus group interviews. Content analysis generated a tentative model of information, communication and collaboration for people with dementia and their caregivers.Results: The core nding was that information, communication and collaboration were to be focused on the persons with dementia and the informal caregivers. Entering into the trajectory of the disease and its consequences was addressed as an important point of departure. The relation to professional care required establishing a trusting relationship, tailor-made intervention and a single person or organisation to contact. Professional knowledge and commitment, variation in service, and care adapted to needs were important.Conclusion: As focus of care is on the person with dementia and their informal caregivers, a dyadic approach seems most suitable for dementia care. A trusting relationship and a speci c person or organisation to contact seem to be indicators of best practice, as does adaptation to the needs of the person with dementia and their informal caregiver. 
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46.
  •  
47.
  • Karlsson, Staffan, 1959-, et al. (author)
  • Institutional care for older people with dementia in an European perspective
  • 2013
  • In: The Journal of Nutrition, Health & Aging. - Heidelberg : Springer. - 1279-7707 .- 1760-4788. ; 17:Suppl. 1, s. S419-S419
  • Journal article (peer-reviewed)abstract
    • Introduction: Cognitive impairment has been found to be a main predictor for institutionalization. Various types of institutional care are available for persons with dementia, but knowledge is sparse about how the institution should be designed and scaled, and if it should be specialised in dementia or mixed with other older people. To explore various types of institutional care for older people with dementia in eight European countries.Method: Estonia, Finland, France, Germany, Netherlands, Spain, Sweden and UK were included in the study. A template was developed for collecting data among other areas also about various institutional care. Terminology was reviewed by experts and agreed between the countries. The template covers 50 types of care provided in relation to the dementia trajectory, from diagnosis to end of life stage. Questions about various types of institutional care were analysed. Each question covered estimation of availability, utilization and professionals involved.Results: In the description of the care system, preliminary results showed that residential home or nursing home not specifically organised for persons with dementia was the most common institution through all stages. Institutions more specialised in dementia care was less common and mostly available for those in moderate to end of life stage. The professionals were more educated in dementia in the specialised institutions compared to non specialised institutions.Conclusion: For people with dementia disease, institutions not specific for those with dementia were common in all eight countries, while institutions more specialised were available for few. On the behalf of RightTimePlaceCare consortium. http://www.righttimeplacecare.eu
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48.
  • Karlsson, Staffan, 1959-, et al. (author)
  • The trends in treatment with antipsychotic medication in relation to national directives in people with dementia : Review in a Swedish context
  • 2017
  • In: Capacity, Creativity and Ageing in Clinical Practice. ; , s. 36-36
  • Conference paper (peer-reviewed)abstract
    • Background: Antipsychotic medication has been commonly used in dementia treatment despite various side effects, which differ for different drug generations. As there is no clear evidence for treatment with antipsychotic medication among older people with dementia, may a review of empirical studies and national directives be beneficial.Objectives: The aim of this study was to explore trends in treatment with antipsychotic medication in Swedish dementia care in nursing homes as reported in the most recent empirical studies on the topic, and to relate these trends to directives from the national authorities.Methods: The study included two scoping review studies based on searches of electronic databases as well as the Swedish directives in the field.Findings: During the past decade, directives have been developed for antipsychotic medication in Sweden. These directives were generic at first, but have become increasingly specific and restrictive with time. The scoping review showed that treatment with antipsychotic drugs varied between 6% and 38%, and was higher in younger older persons and in those with moderate cognitive impairment and living in nursing homes for people with dementia. A decreasing trend in antipsychotic use has been seen over the last 15 years.Conclusions: Directives from the authorities in Sweden may have had an impact on treatment with antipsychotic medication for people with dementia. Treatment with antipsychotic medication has decreased, while treatment with combinations of psychotropic medications is common. National directives may possibly be even more effective, if applied in combination with systematic follow-ups.
  •  
49.
  • Karlsson, Staffan, 1959-, et al. (author)
  • Treatment with antipsychotic medication in relation to national directives in people with dementia in a Swedish context
  • 2016
  • In: 26th Alzheimer Europe Conference – Excellence in dementia research and care. ; , s. 52-52
  • Conference paper (peer-reviewed)abstract
    • The aim of this study was to explore trends in treatment with antipsychotic medication in Swedish dementia care as reported in the most recent empirical studies on the topic, and to relate these trends to directives and recommendations from national authorities.The study included two scoping review studies and two empirical studies. The scoping studies reviewed published data in electronic databases as well as Swedish recommendations and directives in the field.During the past decade, recommendations have been developed regarding antipsychotic medication in Sweden. These recommendations were generic at first, but have become increasingly specific and restrictive with time. The scoping review showed that treatment with antipsychotic drugs varied between 6% and 38%, and was higher in younger older persons and those with moderate cognitive impairment and living in nursing homes for people with dementia. A trend towards a decrease in antipsychotic use has been seen over the last 15 years. The empirical studies showed that the medication with antipsychotics decreased from 23.4% in 2001 to 11.5% in 2007, for older people in general as well as for older people with dementia. Among older people with dementia, 10% were utilizing antipsychotic medication, with no difference between those cared for at home and those in nursing homes.Directives from Swedish national authorities seem to have had an impact on antipsychotic medication for people with dementia. Treatment with antipsychotic medication has decreased, while other psychotropic medication has increased. National directives may possibly be even more effective, if applied in combination with systematic follow-ups.
  •  
50.
  • Karlsson, Staffan, 1959-, et al. (author)
  • Treatment with antipsychotic medication in relation to national directives in people with dementia in a Swedish context
  • 2016
  • In: Presented at the 26th Alzheimer Europe Conference: Excellence in dementia research and care, Copenhagen, Denmark, October 31-November 2, 2016. ; , s. 52-52
  • Conference paper (peer-reviewed)abstract
    • Background: The aim of this study was to explore trends in treatment with antipsychotic medication in Swedish dementia care in the most recent empirical studies on the treatment with antipsychotic treatment and relate it to directives and recommendations from national authorities.Methods: The study included; two scoping review studies and two empirical studies. The scoping studies were review of published data in electronic databases as well as Swedish recommendations and directives in the area.Results: The last decade, recommendations were developed regarding antipsychotic medication in Sweden, in the beginning overviewing to be more and more specific and restrictive. The scoping review showed that the treatment with antipsychotic drugs varied between 6%-38%, and was higher in younger older persons and those with moderate cognitive impairment and living in nursing homes for people with dementia. A trend of a decreased treatment with antipsychotics was seen over the last 15 years. The empirical studies showed that the medication with antipsychotics decreased from 23.5 % in 2001 to 12 % in 2007, for older people in general as well as for older people with dementia. In older people with dementia only, 10% were utilizing antipsychotic medication, with no difference between those in ordinary homes compared to those in nursing homes.Conclusions: Directives from Swedish national authorities seems to have had an impact on antipsychotic medication in people with dementia. The treatment with antipsychotic medication decreased, while other psychotropic medication increased. National directives complemented with systematic follow-ups may possibly be even more effective.Conclusion: Treatment with orexin suppressed phagocytosis and degradation of Aβ. Further investigation suggested that the effects of orexin may be mainly on, or mediated through actin. Further investigations concerning the effects of orexin antagonists may be able to offer new methods to arrest the progress of, or possibly treat, AD.
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