1.
Bai, Ge, et al.
(författare)
Frailty trajectories in three longitudinal studies of aging : Is the level or the rate of change more predictive of mortality?
2021
Ingår i: Age and Ageing. - : Oxford University Press. - 0002-0729 .- 1468-2834. ; 50:6, s. 2174-2182
Tidskriftsartikel (refereegranskat) abstract
BACKGROUND: frailty shows an upward trajectory with age, and higher levels increase the risk of mortality. However, it is less known whether the shape of frailty trajectories differs by age at death or whether the rate of change in frailty is associated with mortality.OBJECTIVES: to assess population frailty trajectories by age at death and to analyse whether the current level of the frailty index (FI) i.e. the most recent measurement or the person-specific rate of change is more predictive of mortality.METHODS: 3,689 individuals from three population-based cohorts with up to 15 repeated measurements of the Rockwood frailty index were analysed. The FI trajectories were assessed by stratifying the sample into four age-at-death groups: <70, 70-80, 80-90 and >90 years. Generalised survival models were used in the survival analysis.RESULTS: the FI trajectories by age at death showed that those who died at <70 years had a steadily increasing trajectory throughout the 40 years before death, whereas those who died at the oldest ages only accrued deficits from age ~75 onwards. Higher level of FI was independently associated with increased risk of mortality (hazard ratio 1.68, 95% confidence interval 1.47-1.91), whereas the rate of change was no longer significant after accounting for the current FI level. The effect of the FI level did not weaken with time elapsed since the last measurement.CONCLUSIONS: Frailty trajectories differ as a function of age-at-death category. The current level of FI is a stronger marker for risk stratification than the rate of change.
2.
Eckerblad, Jeanette, et al.
(författare)
To adjust and endure : a qualitative study of symptom burden in older people with multimorbidity
2015
Ingår i: Applied Nursing Research. - : Elsevier. - 0897-1897 .- 1532-8201. ; 28:4, s. 322-327
Tidskriftsartikel (refereegranskat) abstract
Context Older people with multimorbidity are vulnerable and often suffer from conditions that produce a multiplicity of symptoms and a reduced health-related quality of life. Objectives The aim of this study is to explore the experience of living with a high symptom burden from the perspective of older community-dwelling people with multi-morbidity.Method A qualitative descriptive design with semi-structured interviews, including 20 community-dwelling older people with multi-morbidity and a high symptom burden. The participants were 79-€“89 years old with a mean of 12 symptoms per person. Data were analyzed using content analyses.Results The experience of living with a high symptom burden revealed the overall theme, “To adjust and endure†and three sub-themes. The first sub-theme was "To feel inadequate and limited". Participants reported that they no longer had the capacity or the ability to manage, and they felt limited and isolated from friends or family. The second sub-theme was "To feel dependent". This was a new and inconvenient experience; the burden they put on others caused a feeling of guilt. The final sub-theme was "To feel dejected". The strength to manage and control their conditions was gone; the only thing left to do was to sit or lie down and wait for it all to pass.Conclusion This study highlights the importance of a holistic approach when taking care of older people with multi-morbidity. This approach should employ a broad symptom assessment to reveal diseases and conditions that are possible to treat or improve.
3.
Elden, Helen, 1959, et al.
(författare)
Effects of craniosacral therapy as adjunct to standard treatment for pelvic girdle pain in pregnant women: A multicentre, single blind, randomised controlled trial
2013
Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : Wiley. - 0001-6349 .- 1600-0412. ; 92:7, s. 775-782
Tidskriftsartikel (refereegranskat) abstract
Objective. Pelvic girdle pain (PGP) is a disabling condition affecting 30% of pregnant women. The aim of this study was to investigate the efficacy of craniosacral therapy as an adjunct to standard treatment compared to standard treatment alone for PGP during pregnancy. Design. Randomised, multicentre, single blind, controlled trial. Setting. University hospital, a private clinic and 26 maternity care centres in Gothenburg, Sweden. Population. 123 pregnant women with PGP. Methods. Participants were randomly assigned to standard treatment (control group, n=60) or standard treatment plus craniosacral therapy (intervention group, n=63). Main Outcome Measures. Primary outcome measures: Pain intensity (Visual Analogue Scale 0-100mm) and sick leave. Secondary outcomes: function (Oswestery Disability Index), health-related quality of life (Euro-Qol), unpleasantness of pain (VAS), and assessment of the severity of PGP by an independent examiner. Results. Between-group differences for morning pain, symptom-free women and function in the last treatment week were in favor of the intervention group. VAS median was 27 mm (95%CI 24.6-35.9) vs. 35 mm (95%CI 33.5-45.7)(p=0.017) and the function disability index was 40 (range 34-46) vs. 48 (range 40-56)(p=0.016). Conclusions. Lower morning pain intensity and lesser deteriorated function was seen after craniosacral therapy in conjunction with standard treatment compared to standard treatment alone, but no effects regarding evening pain and sick-leave. Treatment effects were small and clinically questionable and conclusions should be drawn carefully. Further studies are warranted before reccomending craniosacral therapy for pelvic girdle pain.
4.
Pettersson, Cecilia, 1963, et al.
(författare)
Enablers and Barriers in the Physical Environment of Care for Older People in Ordinary Housing: A Scoping Review
2020
Ingår i: Journal of Housing for the Elderly. - : Informa UK Limited. - 0276-3893 .- 1540-353X. ; 34:3, s. 332-350
Forskningsöversikt (refereegranskat) abstract
Our aim was to explore enablers and barriers in ordinary housing for older people in care. We systematically searched Scopus, Web of Science, and Google Scholar for relevant published research and gray material. The search resulted in a final sample of eight publications, four of which focused on accessibility for older people with dementia. Thematic analysis resulted in two themes: safety and accessibility. Future studies should focus on modifications to ordinary housing to achieve safe and comfortable environments for people who want to age in place and those who provide them with care.
5.
6.
Sixsmith, Judith, et al.
(författare)
Healthy Ageing and Home: the Perspectives of Very Old People in Five European Countries
2014
Ingår i: Social Science and Medicine. - : Elsevier BV. - 0277-9536 .- 1873-5347. ; 106, s. 1-9
Tidskriftsartikel (refereegranskat) abstract
This paper reports on in-depth research, using a grounded theory approach, to examine the ways in which very old people perceive healthy ageing in the context of living alone at home within urban settings in five European countries. This qualitative study was part of a cross-national project entitled ENABLE-AGE which examined the relationship between home and healthy ageing. Interviews explored the notion of healthy ageing, the meaning and importance of home, conceptualisations of independence and autonomy and links between healthy ageing and home. Data analysis identified five ways in which older people constructed healthy ageing: home and keeping active; managing lifestyles, health and illness; balancing social life; and balancing material and financial circumstances. Older people reflected on their everyday lives at home in terms of being engaged in purposeful, meaningful action and evaluated healthy ageing in relation to the symbolic and practical affordances of the home, contextualised within constructions of their national context. The research suggests that older people perceive healthy ageing as an active achievement, created through individual, personal effort and supported through social ties despite the health, financial and social decline associated with growing older. The physicality and spatiality of home provided the context for establishing and evaluating the notion of healthy ageing, whilst the experienced relationship between home, life history and identity created a meaningful space within which healthy ageing was negotiated.
7.
Thorvaldsson, Valgeir, 1976, et al.
(författare)
Better Cognition in New Birth Cohorts of 70 Year Olds, But Greater Decline Thereafter
2017
Ingår i: The journals of gerontology. Series B, Psychological sciences and social sciences. - Cary, NC : Oxford University Press. - 1079-5014 .- 1758-5368. ; 72:1, s. 16-24
Tidskriftsartikel (refereegranskat) abstract
ObjectivesTo evaluate birth cohort differences in level of cognition and rate of change in old age.MethodsData were drawn from three population-based Swedish samples including age-homogenous cohorts born 1901/02, 1906/07, and 1930, and measured on the same cognitive tests at ages 70, 75, and 79 as part of the Gerontological and Geriatric Populations Studies in Gothenburg (H70). We fitted growth curve models to the data using a Bayesian framework and derived estimates and inferences from the marginal posterior distributions.ResultsWe found moderate to large birth cohort effects in level of performance on all cognitive outcomes. Later born cohorts, however, showed steeper linear rate of decline on reasoning, spatial ability, and perceptual- and motor-speed, but not on picture recognition memory and verbal ability.DiscussionThese findings provide strong evidence for substantial birth cohort effects in cognition in older ages and emphasize the importance of life long environmental factors in shaping cognitive aging trajectories. Inferences from cognitive testing, and standardization of test scores, in elderly populations must take into account the substantial birth cohort differences. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved.
8.
Westgård, Theresa, 1969, et al.
(författare)
Feeling respected as a person: a qualitative analysis of frail older people's experiences on an acute geriatric ward practicing a Comprehensive Geriatric Assessment
2019
Ingår i: Geriatrics. - : MDPI AG. - 0016-867X .- 2308-3417. ; 4:1
Tidskriftsartikel (refereegranskat) abstract
Comprehensive geriatric assessment (CGA) practices multidimensional, interdisciplinary, and diagnostic processes as a means to identify care needs, plan care, and improve outcomes of frail older people. Conventional content analysis was used to analyze frail older people’s experiences of receiving CGA. Through a secondary analysis, interviews and transcripts were revisited in an attempt to discover the meaning behind the participants’ implied, ambiguous, and verbalized thoughts that were not illuminated in the primary study. Feeling “respected as a person” is the phenomenon participants described on a CGA acute geriatric ward, achieved by having a reciprocal relationship with the ward staff, enabling their participation in decisions when engaged in communication and understanding. However, when a person was too ill to participate, then care was person-supportive care. CGA, when delivered by staff practicing person-centered care, can keep the frail older person in focus despite them being a patient. If a person-centered care approach does not work because the person is too ill, then person-supportive care is delivered. However, when staff and/or organizational practices do not implement a person-centered care approach, this can hinder patients feeling “respected as a person”.
9.
Wongsala, Manothai, et al.
(författare)
Applying the PDSA cycle to a group activity promoting lifestyle change for the active ageing of older Thai adults - a focused ethnography
2022
Ingår i: BMC Geriatrics. - : NLM (Medline). - 1471-2318. ; 22:1
Tidskriftsartikel (refereegranskat) abstract
BACKGROUND: The proportion of the older Thai population is increasing rapidly. Lifestyle may impact active ageing in later life. Interventions that empower older Thai adults to initiate and carry out lifestyle changes are needed. This study applied the Plan-Do-Study-Act (PDSA) cycle, a tool for improving lifestyle changes, with the aim of exploring interactions among older Thai adults when participating in group activities. METHOD: Focused ethnography was used based on participant observations, field notes and video recordings of 15 older Thai adults aged 62-78 years. RESULTS: Older Thai adults faced difficulties at the beginning since they were unfamiliar with initiating and carrying out lifestyle changes according to the PDSA concept. This provided a learning opportunity enabling older Thai adults to reach their individual goals of lifestyle change. CONCLUSIONS: The PDSA cycle has the potential to empower older adults in group contexts to promote lifestyle changes related to active ageing.
10.
Falk Erhag, Hanna, et al.
(författare)
Introduction
2022
Ingår i: A Multidisciplinary Approach to Capability in Age and Ageing. - Cham : Springer. - 9783030780654
Bokkapitel (övrigt vetenskapligt/konstnärligt) abstract
In 2020, for the first time in history, there were more people in the world aged 60 years and over than there were children below the age of 5 years. The population aged over 65 years is projected to increase from one billion in 2019 to more than two billion in 2050, and those aged over 80 years are projected to increase from 143 to 426 million, with the largest increase occurring in the developing world (UN World Population Prospects, 2019). This demographic trend constitutes the largest global health challenge, according to the World Health Organisation (WHO). The European Union has set it as one of the major challenges in Horizon 2020 and it has important societal implications (European Commission, 2020). The proportion of retired individuals will increase, leading to an increased ratio between those who have exited the workforce and those still active in the labour market. Thus, ageing represents a global societal and scientific challenge requiring integrated efforts, multidisciplinary translational research approaches and social innovations that build on ideas of potentials and capabilities, emphasising the value of old age.
11.
Gustafsson, Susanne, et al.
(författare)
Long-term outcome for ADL following the health-promoting RCT-Elderly persons in the risk zone
2013
Ingår i: The Gerontologist. - : Oxford University Press. - 0016-9013 .- 1758-5341. ; 53:4, s. 654-663
Tidskriftsartikel (refereegranskat) abstract
Purpose: To examine independence in activities of daily living (ADL) at the 1- and 2-year followups of the health-promoting study Elderly Persons in the Risk Zone. Design and Method: A randomized, three-armed, single-blind, and controlled study. A representative sample of 459 independent and community-dwelling older adults, 80 years and older, were included. A preventive home visit was compared with four weekly multiprofessional senior group meetings including a follow-up home visit. Results: Analysis showed a significant difference in favor of the senior meetings in postponing dependence in ADL at the 1-year follow-up (odds ratio [OR] = 1.92, 95% confidence interval [CI] = 1.19-3.10) and also in reducing dependence in three (OR = 0.52, 95% CI = 0.31-0.86) and four or more ADL (OR = 0.40, 95% CI = 0.22-0.72) at the 2-year follow-up. A preventive home visit reduced dependence in two (OR = 0.40, 95% CI = 0.24-0.68) and three or more ADL (OR = 0.37, 95% CI = 0.17-0.80) after 1 year. Implications: A long-term evaluation of Elderly Persons in the Risk Zone showed that both senior meetings and a preventive home visit reduced the extent of dependence in ADL after 1 year. The senior meetings were superior to a preventive home visit since additional significant effects were seen after 2 years. To further enhance the long-term effects of the senior meetings and support the process of self-change in health behavior, it is suggested that booster sessions might be a good way of reinforcing the intervention.
12.
13.
14.
Kiadaliri, Ali
(författare)
Psychometric properties of the EQ-5D-5L in patients with knee or hip osteoarthritis : confirmatory factor analysis and item response theory
2024
Ingår i: Osteoarthritis and Cartilage. - 1063-4584. ; 32:Suppl 1, s. 196-197
Konferensbidrag (refereegranskat) abstract
Purpose (the aim of the study): There is limited evidence on psychometric properties of EQ-5D-5L among people with osteoarthritis (OA) undertaking non-surgical treatment. The aim of the current study was to evaluate the psychometric properties of the EQ-5D-5L among individuals with knee or hip OA participating in a digitally delivered education and exercise therapy.Methods: Secondary analysis of data obtained from individuals aged 40+ years participating in the digital treatment during the year 2021 with the responses to EQ-5D-5L at enrolment. Confirmatory factor analysis (CFA) with the weighted least square mean and variance adjusted estimator was used to assess dimensionality. Local independency assumption was assessed using residual correlations between item pairs with r>0.2 as violation of the assumption. Monotonicity was evaluated using Mokken analysis. Item response theory was implemented by generalized partial credit model. The item parameters (discrimination and difficulty) were estimated using the maximum marginal likelihood estimation. Targeting was assessed by inspecting the item-person map (the Wright map). Differential item functioning (DIF) by sex, age (≤65 years vs. >65 years) and OA site (knee vs. hip) were assessed and items with a McFadden pseudo-R2 change of ≥0.02 were flagged for potential DIF. All analyses were conducted in RStudio version 2022.02.0.Results: A total of 16,200 individuals with mean (standard deviation) age 64.3 (9.1), 74.0% females and 59.6% with knee OA were included. The included subjects reported 609 of the 3,125 possible health profiles of the EQ-5D-5L with slight or moderate problems with pain/discomfort dimension and no problems on the other dimensions (i.e. profiles “11121” and “11131”) being the first and second most common profiles (9.4% and 4.4% of respondents, respectively). CFA confirmed the unidimensionality of the EQ-5D-5L with factor loading ranged from 0.49 for anxiety/depression to 0.85 for usual activity dimensions, and an average variance extracted of 0.53 suggesting adequate convergent validity. Local independence and monotonicity assumptions were met. The fit statistics suggested an adequate fit of IRT model. Among five dimensions, pain/discomfort was the most affected (least difficult to endorse) while self-care was the least affected (most difficult to endorse). No disordered response thresholds were identified. EQ-5D-5L showed adequate reliability (>0.7) over a wide range of the underlying trait (76.4% of total information were within -1 to 4 standard deviation of average level of poor HRQoL) with an overall reliability of 0.80 (Figure 1). Usual activity and anxiety/depression were the most and least informative items. Inspecting the item-person map (Figure 2) suggested that while EQ-5D-5L covered the full range of HRQoL levels in the sample, it targeted, on average, a poorer HRQoL than experienced by the participants in the study. No DIF (uniform or nonuniform) was detected.Conclusions: The EQ-5D-5L demonstrated acceptable psychometric properties among subjects with hip or knee OA participating in a digital education and exercise therapy. These results support the use of EQ-5D-5L among people with less severe knee or hip OA.
15.
Larsson, Simon B., et al.
(författare)
Self-reported symptom severity, general health, and impairment in post-acute phases of COVID-19: retrospective cohort study of Swedish public employees
2022
Ingår i: Scientific Reports. - : Springer Science and Business Media LLC. - 2045-2322. ; 12:1
Tidskriftsartikel (refereegranskat) abstract
This study aimed to examine current symptom severity and general health in a sample of primarily non-hospitalized persons with polymerase chain reaction (PCR) confirmed COVID-19 in comparison to PCR negative controls. During the first quarter of 2021, we conducted an online survey among public employees in West Sweden, with a valid COVID-19 test result. The survey assessed past-month severity of 28 symptoms and signs, self-rated health, the WHO Disability Assessment Schedule (WHODAS) 2.0 and illness severity at the time of test. We linked participants' responses to their SARS-CoV-2 PCR tests results. We compared COVID-19 positive and negative participants using univariable and multivariable regression analyses. Out of 56,221 invited, 14,222 (25.3%) responded, with a response rate of 50% among SARS-CoV-2 positive individuals. Analysis included 10,194 participants (86.4% women, mean age 45 years) who tested positive 4-12 weeks (N = 1425; subacute) and > 12 weeks (N = 1584; postcovid) prior to the survey, and 7185 PCR negative participants who did not believe that they had had COVID-19. Symptoms were highly prevalent in all groups, with worst symptoms in subacute phase participants, followed by postcovid phase and PCR negative participants. The most specific symptom for COVID-19 was loss of smell or taste. Both WHODAS 2.0 score and self-rated health were worst in subacute participants, and modestly worse in postcovid participants than in negative controls. Female gender, older age and acute illness severity had larger effects on self-rated health and WHODAS 2.0 score in PCR positive participants than in PCR negative. Studies with longer follow-up are needed to determine the long-term improvement after COVID-19.
16.
Marcheschi, Elizabeth, 1980, et al.
(författare)
To come home after a stroke: patients' early experiences of health and recovery in their home settings
2018
Konferensbidrag (övrigt vetenskapligt/konstnärligt) abstract
Healthcare systems and services for stroke patients are increasingly performed within home settings where both, people with moderate and severe disability can receive care. However, at present little knowledge is available in regard to early stroke phases and how the interaction with the physical environment of home settings might affect rehabilitation outcomes. The aim of this work was thus, to increase our understanding in regard to the interplay between home settings and people’s rehabilitation process, a month after stroke onset. A cross-sectional interdisciplinary investigation was conducted using validated measures in face-to-face interviews and by observing the participants’ interactions with their home settings. People with stroke (N = 16) that had a mild disability, and cognitive and communicative abilities to participate in an interview of approximately 2 hours, were recruited in the study and their data was collected within 4 to 7 weeks after stroke onset. Information was collected in regard to their experience of the physical and social home environment, their attachment to place, self-efficacy and the quality of continuity of care from the hospital to the home. Moreover, data about their recovery and overall health were collected with, Stroke Impact Scale and the EQ-5D. Preliminary results suggests the existence of a relation between recovery levels, self-efficacy and the perceived quality of the physical environment of home settings. More detailed results and their implication for early rehabilitation phases of stroke patients within home settings will be discussed.
17.
Morris, Ann, 1964, et al.
(författare)
Professional´s skills in assment of perineal tears after childbirth - a systematic review
2013
Ingår i: Open Journal of Obstetrics and Gynecology. - 2160-8792 .- 2160-8806. ; 2013:3, s. 7-15
Tidskriftsartikel (refereegranskat) abstract
Perineal tears are one of the most common complications of vaginal births and may cause discomfort and pain long time after childbirth. Visual and digital examination of perineal tears is the most common way to assess and classify a perineal tear. Recent research indicates that many tears diagnosed are misclassified. The aim of this systematic literature review was to outline research that investigates healthcare professionals’ clinical knowledge in assessment and classification of perineal tears in connection with childbirth. Searches were performed in PubMed and CINAHL. Six studies on the topic were identified and used to collect data for questionnaires. An integrative review was used in the analysis. Poor knowledge in perineal anatomy and lack of training in clinical assessment and classification of perineal trauma was evident among both physicians and midwives. These findings indicate that healthcare providers lack adequate knowledge and that they make incorrect assessments and errors in classification of perineal tears. The training in assessment and classification is crucial. Midwives are in a unique position to improve the standard of care in this field since they are often the first and many times the only to assess the injury.
18.
Mosallanezhad, Z., et al.
(författare)
A structural equation model of the relation between socioeconomic status, physical activity level, independence and health status in older Iranian people
2017
Ingår i: Archives of Gerontology and Geriatrics. - : Elsevier BV. - 0167-4943 .- 1872-6976. ; 70, s. 123-129
Tidskriftsartikel (refereegranskat) abstract
Background and aim: Health status is an independent predictor of mortality, morbidity and functioning in older people. The present study was designed to evaluate the link between socioeconomic status (SES), physical activity (PA), independence (I) and the health status (HS) of older people in Iran, using structural equation modelling. Methods: Using computerized randomly selection, a representative sample of 851 75-year-olds living in Tehran (2007-2008), Iran, was included. Participants answered questions regarding indicators of HS, SES and also PA and I through interviews. Both measurement and conceptual models of our hypotheses were tested using Mplus 5. Maximum-likelihood estimation with robust standard errors (MLR estimator), chisquare tests, the goodness of fit index (and degrees of freedom), as well as the Comparative Fit Index (CFI), and the Root Mean Square Error of Approximation (RSMEA) were used to evaluate the model fit. Results: The measurement model yielded a reasonable fit to the data, chi(2) = 110.93, df = 38; CFI = 0.97; RMSEA = 0.047, with 90% C.I. = 0.037-0.058. The model fit for the conceptual model was acceptable; chi(2) = 271.64, df = 39; CFI = 0.91; RMSEA = 0.084, with 90% C.I. = 0.074-0.093. SES itself was not a direct predictor of HS (beta = 0.13, p = 0.059) but it was a predictor of HS either through affecting PA (beta = 0.31, p < 0.001) or I (beta = 0.57, p < 0.001). Conclusion: Socioeconomic status appeared to influence health status, not directly but through mediating some behavioral and self-confidence aspects including physical activity and independence in ADL. (C) 2017 Elsevier B.V. All rights reserved.
19.
Nilsson, Maria H, et al.
(författare)
Fatigue in Parkinson's Disease: Measurement Properties of a Generic and a Condition-specific Rating Scale.
2013
Ingår i: Journal of Pain and Symptom Management. - : Elsevier BV. - 1873-6513 .- 0885-3924. ; 46:5, s. 737-746
Tidskriftsartikel (refereegranskat) abstract
CONTEXT: High-quality fatigue rating scales are needed to advance the understanding of fatigue and determine the efficacy of interventions. Several fatigue scales are used in Parkinson's disease, but few have been tested using modern psychometric methodology (Rasch analysis). OBJECTIVES: To examine the measurement properties of the generic Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) scale and the condition-specific 16-item Parkinson Fatigue Scale (PFS-16) using Rasch analysis. METHODS: Postal survey data (n=150; 47% women; mean age 70 years) were Rasch analyzed. The PFS-16 scores were tested according to both the original polytomous and the suggested alternative dichotomized scoring methods. RESULTS: The PFS-16 showed overall Rasch model fit, whereas the FACIT-F showed signs of misfit, which probably was the result of a sleepiness-related item and mixing of positively/negatively worded items. There was no differential item functioning by disease duration but by fatigue status (greater likelihood of needing to sleep or rest during the day among people classified as nonfatigued) in the PFS-16 and FACIT-F. However, this did not impact total score-based estimated person measures. Targeting and reliability (≥0.86) were good, but the dichotomized PFS-16 showed compromised measurement precision. Polytomous and dichotomized PFS-16 and FACIT-F scores identified six, three, and four statistically distinct sample strata, respectively. CONCLUSION: We found general support for the measurement properties of both scales. However, polytomous PFS-16 scores exhibited advantages compared with dichotomous PFS-16 and FACIT-F scores. Dichotomization of item responses compromises measurement precision and the ability to separate people, and should be avoided.
20.
21.
22.
Ottenvall Hammar, Isabelle, 1984, et al.
(författare)
From Intervention Trial to Full-scale Implementation Research: Positive Tendencies for Frailty and Self-rated Health in Frail Older People.
2018
Ingår i: International Journal of Geriatrics and Gerontology. - 2577-0748. ; 2018:2
Tidskriftsartikel (refereegranskat) abstract
A continuum of care for frail older people was created to link the chain between the hospital, and discharge to the person’s home. Despite earlier positive findings, it remains unclear if the benefits are sustainable in a real-life context. The present longitudinal study aimed at evaluate the effects of the implementation of a full-scale process program for frail older people in a real-life context regarding levels of frailty, self-rated health and activities of daily living up to one year later. The sample consisted of a total of 143 frail people aged 75 years and older, divided in the two groups: 77 participants from the full-scale process program and 66 historical controls. The findings showed that at the six months follow-up, the participants partaking in the full-scale process program had a significantly higher odds of displaying decreased frailty (p=0.015), and at twelve months, this sample had a significant lower likelihood of reporting decreased self-rated health (p=0.023). Thus, the findings showed positive results on frailty level and self-rated health when implementing the intervention in real life, indicating that a person-centred, multi-professional team with a case manager is beneficial for frail older people.
23.
Religa, D., et al.
(författare)
SveDem, the Swedish Dementia Registry - A tool for improving the quality of diagnostics, treatment and care of dementia patients in clinical practice
2015
Ingår i: PLoS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 10:2
Tidskriftsartikel (refereegranskat) abstract
Background: The Swedish Dementia Registry (SveDem) was developed with the aim to improve the quality of diagnostic work-up, treatment and care of patients with dementia disorders in Sweden. Methods: SveDem is an internet based quality registry where several indicators can be followed over time. It includes information about the diagnostic work-up, medical treatment and community support (www.svedem.se). The patients are diagnosed and followed-up yearly in specialist units, primary care centres or in nursing homes. Results: The database was initiated in May 2007 and covers almost all of Sweden. There were 28 722 patients registered with a mean age of 79.3 years during 2007-2012. Each participating unit obtains continuous online statistics from its own registrations and they can be compared with regional and national data. A report from SveDem is published yearly to inform medical and care professionals as well as political and administrative decision-makers about the current quality of diagnostics, treatment and care of patients with dementia disorders in Sweden. Conclusion: SveDem provides knowledge about current dementia care in Sweden and serves as a framework for ensuring the quality of diagnostics, treatment and care across the country. It also reflects changes in quality dementia care over time. Data from SveDem can be used to further develop the national guidelines for dementia and to generate new research hypotheses.
24.
Roos, John Magnus
(författare)
Personality and E-shopping : Insights from a Nationally Representative Study
2019
Ingår i: Digital Transformation and Global Society. - Cham : Springer. - 9783030378578 - 9783030378585 ; 1038 CCIS, s. 257-267
Bokkapitel (refereegranskat) abstract
According to previous research, a high degree of Openness and Neuroticism, and a low degree of Agreeableness are personality determinants of e-shopping. This study aims to explore the relationship between the Five-factor model of personality (i.e. Openness, Conscientiousness, Extraversion, Agreeableness, and Neuroticism) and e-shopping in a Swedish context. In a nationally representative sample, a questionnaire was distributed to 3400 citizens. The response rate was 53 percentage (N = 1812). The questionnaire included measures of the Five-factor model of personality (BFI-ten) and e-shopping. Multiple regression analyses were conducted to test if the Five-factor model of personality predicted e-shopping. The dependent variable was self-reported frequencies of e-shopping during the last 12 months. The first analysis showed that Openness is predicting e-shopping. However, this effect disappeared, when age, educational attainment and income were controlled for. Our conclusion is that the Five-factor model of personality is a poor predictor of e-shopping and that e-shopping frequencies are unrelated to the personality of internet users. Methodological limitations are discussed, for instance the use of a single-item for measuring e-shopping and a short-scale for measuring personality. There are difficulties comparing our findings with previous findings, since the concepts personality and e-shopping have not been defined uniformly. The analyses revealed significant variation in definitions, measurements and methodologies. Caution should also be taken in generalizing the present results to other countries and other time periods. © 2019, Springer Nature Switzerland AG.
25.
Smedback, Jonas, et al.
(författare)
Palliative care during the final week of life of older people in nursing homes : A register-based study
2017
Ingår i: Palliative & Supportive Care. - : Cambridge University Press. - 1478-9515 .- 1478-9523. ; 15:4, s. 417-424
Tidskriftsartikel (refereegranskat) abstract
Objective: Our aim was to explore the presence of symptoms, symptom relief, and other key aspects of palliative care during the final week of life among older people residing in nursing homes. Method: Our study employed data from the Swedish Palliative Care Register on all registered individuals aged 60 and older who had died in nursing homes during the years 2011 and 2012. Variables pertaining to monitoring and treatment of symptoms, end-of-life discussions, circumstances around the death, and the individual characteristics of deceased individuals were explored using descriptive statistics. Results: The most common underlying causes of death among the 49,172 deceased nursing home residents were circulatory diseases (42.2%) and dementia (22.7%). The most prevalent symptom was pain (58.7%), followed by rattles (42.4%), anxiety (33.0%), confusion (21.8%), shortness of breath (14.0%), and nausea (11.1%). Pain was the symptom with the highest degree of total relief (46.3%), whereas shortness of breath and confusion were totally relieved in 6.1 and 4.3% of all individuals, respectively. The use of valid instruments for symptom assessment was reported for pain in 12.3% and for other symptoms in 7.8% of subjects. The most prevalent individual prescriptions for injection PRN (pro re nata, according to circumstances) were for pain treatment (79.5%) and rattles (72.8%). End-of-life discussions were performed with 27.3% of all the deceased individuals and with 53.9% of their relatives. Of all individuals, 82.1% had someone present at death, and 15.8% died alone. Of all the nursing home resident deaths recorded, 45.3% died in their preferred place. Significance of results: There were large variations in degree of relief from different symptoms during the final week of life. Pain was the most prevalent symptom, and it was also the symptom with the highest proportion of total/partial relief. Other symptoms were less prevalent but also less well-relieved. Our results indicate a need for improvement of palliative care in nursing home settings, focusing on management of distressing symptoms and promotion of end-of-life discussions.
