| 1. |
- Ahlström, Gerd, et al.
(author)
-
A Psychometric Evaluation of the Family Collaboration Scale and an Investigation of How the Close Family of Frail Older Patients Perceive the Collaboration with Healthcare Professionals on Acute Medical Wards at Hospitals in Sweden
- 2022
-
In: Healthcare. - : MDPI. - 2227-9032. ; 10:3
-
Journal article (peer-reviewed)abstract
- The inclusion of family members in the acute care of older persons with complex needs results in better coordination of care and reduces the frequency and/or duration of rehospitalisation. Therefore, healthcare professionals need a tool to assess the collaboration with family members on acute hospital wards. The aims were to test the psychometric properties of the Swedish version of the Family Collaboration Scale (FCS), to investigate family members' perception of collaboration with healthcare professionals on acute medical wards in Sweden and to compare the data with the corresponding Danish results. Three hundred and sixty family members of frail patients aged 65 or older from 13 acute medical wards answered the FCS questionnaire. In addition to descriptive statistics, psychometric methods were applied. The internal consistency of the Swedish version of the FCS was excellent, and confirmatory factor analysis revealed that its factor structure was equivalent to that of the original Danish FCS. The respondents' ratings indicated better perceived collaboration than in the Danish case. Older age than 60 was associated with worse collaboration with healthcare professionals regarding Influence on discharge than younger respondents. Those with compulsory and health or nursing education showed better collaboration. The Swedish version of the FCS should be further evaluated for its retest reliability and as an outcome measure in intervention studies.
|
|
| 2. |
- Ahlström, Gerd, et al.
(author)
-
Ageing people with intellectual disabilities and the association between frailty factors and social care : A Swedish national register study
- 2022
-
In: Journal of Intellectual Disabilities. - Thousand Oaks, CA : Sage Publications. - 1744-6295 .- 1744-6309. ; 26:4, s. 900-918
-
Journal article (peer-reviewed)abstract
- The aim of this study was to describe the social care provided for different age groups of people with intellectual disability, 55 years or above, and to investigate the association between such care and frailty factors for those with diagnosed level of intellectual disabilities. Descriptive and logistic regression analyses were used. Commonest forms of social care among the 7936 people were Residential care, Daily activities and Contact person. Home help and Security alarm increased with age. The frailty factors significantly associated with increased social care were age, polypharmacy and severe levels of intellectual disabilities. Persons most likely to be in residential care were in the age group 65–79 with polypharmacy and severe disability. The results indicate a need for further research of how frailty factors are considered in social care and longstanding medication, especially then severe intellectual disability hinders communication. A national strategic plan for preventive interventions should be developed to ensure the best possible healthy ageing. © The Author(s) 2021.
|
|
| 3. |
- Ahlström, Gerd, et al.
(author)
-
Breaking up and a new beginning when one’s partner goes into a nursing home : An interview study
- 2021
-
In: Healthcare. - : MDPI AG. - 2227-9032. ; 9:6
-
Journal article (peer-reviewed)abstract
- In aging societies worldwide, spouses take on great responsibility for care when their partner continues to live at home. Nursing home placement occurs when the partner becomes too frail due to multimorbidity, and this will cause a change in the spouse’s life. This study aimed to explore the spouse’s experience of their partner’s move to a nursing home. Two interviews were conducted at 9-month intervals within the project entitled “Implementation of Knowledge-Based Palliative Care in Nursing Homes”. Thirteen spouses from both urban and rural areas were included, with an age-range of 60–86 years (median 72). Qualitative content analysis was performed. The main findings were captured in two themes: Breaking up of close coexistence and Towards a new form of daily life. The first encompassed processing loneliness, separation and grief, exhaustion, increased burden, and a sense of guilt. The second encompassed a sense of freedom, relief, acceptance, support and comfort. Professionals in both home care and nursing home care need to develop and provide a support programme conveying knowledge of the transition process to prevent poor quality of life and depression among the spouses. Such a programme should be adaptable to individual needs and should ideally be drawn up in consultation with both partners.
|
|
| 4. |
- Ahlström, Gerd, et al.
(author)
-
Collaboration and guidelines for the coordination of health care for frail older persons with intellectual disability : A national survey of nurses working in municipal care
- 2021
-
In: Nursing Open. - : Wiley. - 2054-1058. ; 8:3, s. 1369-1379
-
Journal article (peer-reviewed)abstract
- Aims: To describe and compare perceptions of collaboration between care providers on the part of three groups of Registered Nurses working in municipal care and having particular responsibility concerning the care of frail older people with intellectual disability (ID); and, furthermore, to investigate the presence of and compliance with guidelines for the coordination of care. Design: National survey study with cross-sectional design. Methods: Nurses (N = 110) with key positions concerning people with ID answered a national questionnaire about collaboration, guidelines and coordinated individual plans. Descriptive and comparative statistical analyses were applied. Results: The meetings on cooperation and coordination of interventions were attended most frequently by nurses, and least frequently by social workers. The nurses were overall satisfied with the collaboration but perceived shortcomings in the case of inpatient and outpatient psychiatric care. Only in about half of the meetings for making care plans participated the people with intellectual disability and next of kin.
|
|
| 5. |
- Ahlström, Gerd, et al.
(author)
-
Quality of Life among Next of Kin of Frail Older People in Nursing Homes : An Interview Study after an Educational Intervention concerning Palliative Care
- 2022
-
In: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 19:5
-
Journal article (peer-reviewed)abstract
- One cornerstone of palliative care is improving the family’s quality of life (QoL). The principles of palliative care have not been sufficiently applied in nursing homes. The aim of this study was to investigate the experiences of QoL of next of kin of frail older persons in nursing homes after an educational intervention concerning palliative care. This qualitative interview study with 37 next of kin used an abductive design with deductive and inductive content analysis. The deductive analysis confirmed the three themes of QoL from the study before the implementation: (1) orientation to the new life-situation, (2) challenges in the relationship, and (3) the significance of the quality of care in the nursing home. The inductive analysis resulted in the sub-theme “Unspoken palliative care”. Being the next of kin of an older person living in a nursing home can be distressing despite round-the-clock care, so staff need to apply a more explicitly palliative care perspective. Future research needs to evaluate the influence of meaning-focused coping on next of kin’s QoL and integrate this knowledge in psychosocial interventions. Clinical Trial Database for Clinical Research: KUPA project NCT02708498.
|
|
| 6. |
- Ahlström, Gerd, et al.
(author)
-
Similarities and differences between China and Sweden regarding the core features of palliative care for people aged 60 or older : a systematic scoping review
- 2022
-
In: BMC Palliative Care. - : Springer Science and Business Media LLC. - 1472-684X. ; 21
-
Journal article (peer-reviewed)abstract
- BACKGROUND: Despite the increasing longevity of the world's population, with an unprecedented rise in the number of people who need palliative care (PC), there has been sparse research regarding palliative care for older people, especially when it comes to comparison of PC between healthcare systems and cultures. The aim of this systematic scoping review was to identify the characteristics of the body of literature and to examine the knowledge gaps concerning PC research for older people (> 60 years) in two healthcare systems and cultures, mainland China and Sweden.METHODS: The guidelines PRISMA (Preferred Reporting Items for Systematic Reviews), and PICOS (Patient/population, Intervention, Comparison/control, and Outcome) were used. Empirical studies on patients 60 years or older, next of kin or staff participating in a palliative care intervention or setting were included. They were conducted in mainland China or in Sweden during 2007-2019, were published in English and were extracted from seven databases: Embase, PubMed, Scopus, Cinahl, PsycInfo, Academic Search Complete and Cochrane Library. Two independent researchers conducted the selection of studies, data extraction and methodological evaluation. Any disagreements were resolved in consultation with a third researcher. The analysis was manifest directed content analysis based on PICOS domains.RESULTS: Of the 15 studies, four were from mainland China and 11 from Sweden. Both countries included older patients with cancer but also other end-stage diseases such as heart failure and dementia. The studies differed in design, method and the content of the interventions. The study in China based on traditional Chinese medicine concerns traditional Chinese folk music. The six qualitative studies from Sweden were evaluations of five interventions.CONCLUSIONS: Despite the high age of the participating patients, there was no focus on an ageing perspective concerning palliative care. To adapt to the changes taking place in most societies, future research should have increased focus on older persons' need for palliative care and should take account of issues concerning research ethics, ethnicity and culture.REGISTERED IN PROSPERO: CRD42020078685 , available from.
|
|
| 7. |
- Alftberg, Åsa, et al.
(author)
-
Ambivalence among staff regarding ageing with intellectual disabilities : Experiences and reflections
- 2021
-
In: Journal of Intellectual Disabilities. - : Sage Publications. - 1744-6295 .- 1744-6309. ; 25:2, s. 192-209
-
Journal article (peer-reviewed)abstract
- This study explores the experiences and reflections of staff in intellectual disability (ID) services concerning ageing with ID. Qualitative interviews were conducted with 24 staff members in group homes and daily activity centres. The findings showed that the staff were uncertain about the signs of ageing in people with intellectual disabilities; they compared the life conditions of these people with conditions in older people without intellectual disabilities. Their emphasis on an active lifestyle was very strong. The staff members also mentioned uncertainty about how to facilitate assistive devices and whether ‘ageing in place’ was the best solution. The overall theme was manifested as ambivalence where notions of older people with intellectual disabilities seemed incompatible with notions of old age in general and could be explained by the theoretical concept of age coding. The findings of this study indicate the need to provide education about ageing to staff working in ID services.
|
|
| 8. |
- Axmon, Anna, et al.
(author)
-
Incidents resulting in health care among older people with intellectual disability in comparison with the general population : A national register study
- 2020
-
In: Journal of Intellectual and Developmental Disability. - : Informa UK Limited. - 1366-8250 .- 1469-9532. ; 45:2, s. 139-143
-
Journal article (peer-reviewed)abstract
- Background: Older people with intellectual disability (ID) are at high risk of incidents leading to hospital visits. Method: Through national registers, 7936 people with ID, aged 55+ years in 2012, and a same-aged referent cohort from the general population were identified. Information on diagnoses made in inpatient and outpatient specialist health care during 2002–2012 was collected. Results: Compared to their age-peers in the general population, people with ID were 41% more likely to seek care for effects of foreign body entering through natural orifice, and 92% more for poisoning by drugs, medicaments and biological substances. Conclusions: There is a need to develop and evaluate evidence-based interventions to prevent unnecessary suffering and early death related to poisoning or respiratory diseases among older people with ID. To do this, implementation of risk assessments and increased knowledge of the consequences of poisoning and incidents of foreign bodies entering the respiratory organs are necessary.
|
|
| 9. |
- Bökberg, Christina, et al.
(author)
-
Caring and Health of Close Family Members of Frail Older Persons Recently Discharged from Acute Hospital Care : A Comparative Cross-Sectional Study
- 2024
-
In: Nursing Reports. - : MDPI. - 2039-439X .- 2039-4403. ; 14:2, s. 901-912
-
Journal article (peer-reviewed)abstract
- Multimorbidity in older people is strongly linked to the need for acute hospital care, and caregiving activities usually become more complex after patients are discharged from hospital. This may negatively impact the health of close family members, although this has not been comprehensively investigated. This study aimed to explore the general and mental health of close family members caring for frail older (>65) persons recently discharged from acute hospital care, making assessments in terms of gender, relationship to the older person, and aspects of caring. A comparative cross-sectional study was conducted involving 360 close family members caring for frail older persons recently discharged from hospital. The statistical analyses included subgroup comparisons and associations to caring were examined. Half of the family members reported that their general and mental health was poor, with spouses reporting the poorest health. Female participants had significantly more severe anxiety, while males had significantly more severe depression. Providing care for more than six hours per week was associated with poor general health (OR 2.31) and depression (OR 2.59). Feelings of powerless were associated with poor general health (OR 2.63), anxiety (6.95), and depression (3.29). This knowledge may provide healthcare professionals with better tools in order to individualise support, preventing family members from exceeding their resources during these demanding periods.
|
|
| 10. |
- Bökberg, Christina, et al.
(author)
-
Evaluating person-centredness for frail older persons in nursing homes before and after implementing a palliative care intervention
- 2020
-
In: Nursing Open. - : John Wiley & Sons. - 2054-1058. ; 7:1, s. 439-448
-
Journal article (peer-reviewed)abstract
- Aim To evaluate person-centeredness in nursing homes from the perspective of frail older persons, before and after implementing an educational intervention about palliative care. Design A crossover design. Methods Forty-four older persons living in nursing homes were interviewed. A convergent mixed-method was used to analyse data. Results The older persons expressed feelings of unsafety related to shortcomings in staff. These shortcomings implied that the responsibilities of everyday activities and making the residents' existence more bearable were transferred to the next of kin. The dropout rate related to death and not enough energy was considerably high (51%) even though one of the inclusion criteria was to have enough energy to manage a 1-hr interview. This result supports previous research describing the difficulties in retaining older persons in research and indicated that the dose of the intervention was not sufficient to improve person-centred care.
|
|
