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  • 1.
    Björk, Sabine
    et al.
    Umeå University, Department of Nursing.
    Juthberg, Christina
    Umeå University, Department of Nursing.
    Lindkvist, Marie
    Umeå universitet, Department of Statistics, Umeå School of Business and Economics, Umeå University.
    Wimo, Anders
    Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics, Karolinska Institutet.
    Sandman, Per-Olof
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Winblad, Bengt
    Karolinska institutet, Department of Clinical Neuroscience and Family Medicine, Karolinska institute, Department of Geriatric Medicine, Umeå University, Department of Geriatric Medicine, Department of Clinical Physiology, Umeå university, Department of Neurology, Umeå university.
    Edvardsson, David
    Umeå University, Department of Nursing, Umeå university, School of Nursing and Midwifery, University of Dundee.
    Exploring the prevalence and variance of cognitive impairment, pain, neuropsychiatric symptoms and ADL dependency among persons living in nursing homes: a cross-sectional study2016Ingår i: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 16, nr 1, artikel-id 154Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BackgroundEarlier studies in nursing homes show a high prevalence of cognitive impairment, dependency in activities of daily living (ADL), pain, and neuropsychiatric symptoms among residents. The aim of this study was to explore the prevalence of the above among residents in a nationally representative sample of Swedish nursing homes, and to investigate whether pain and neuropsychiatric symptoms differ in relation to gender, cognitive function, ADL-capacity, type of nursing-home unit and length of stay.MethodsCross-sectional data from 188 randomly selected nursing homes were collected. A total of 4831 residents were assessed for cognitive and ADL function, pain and neuropsychiatric symptoms. Data were analysed using descriptive statistics and the chi-square test.ResultsThe results show the following: the prevalence of cognitive impairment was 67 %, 56 % of residents were ADL-dependent, 48 % exhibited pain and 92 % exhibited neuropsychiatric symptoms. The prevalence of pain did not differ significantly between male and female residents, but pain was more prevalent among cognitively impaired and ADL-dependent residents. Pain prevalence was not significantly different between residents in special care units for people with dementia (SCU) and general units, or between shorter-and longer-stay residents. Furthermore, the prevalence of neuropsychiatric symptoms did not differ significantly between male and female residents, between ADL capacities or in relation to length of stay. However, residents with cognitive impairment and residents in SCUs had a significantly higher prevalence of neuropsychiatric symptoms than residents without cognitive impairment and residents in general units.ConclusionsThe prevalence rates ascertained in this study could contribute to a greater understanding of the needs of nursing-home residents, and may provide nursing home staff and managers with trustworthy assessment scales and benchmark values for further quality assessment purposes, clinical development work and initiating future nursing assessments.

  • 2.
    Edvardsson, David
    et al.
    The Medical Faculty, Department of Nursing, Umeå University, .
    Sjögren, Karin
    The Medical Faculty, Department of Nursing, Umeå University, .
    Lood, Qarin
    The Medical Faculty, Department of Nursing, Umeå University, .
    Bergland, Ådel
    Department of Nursing Science, Faculty of Medicine, Institute of Health and Society, University of Oslo .
    Kirkevold, Marit
    Department of Nursing Science, Faculty of Medicine, Institute of Health and Society, University of Oslo.
    Sandman, Per-Olof
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    A person-centred and thriving-promoting intervention in nursing homes: study protocol for the U-Age nursing home multi-centre, non-equivalent controlled group before-after trial2017Ingår i: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 17, artikel-id 22Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    The literature suggests that person-centred care can contribute to quality of life and wellbeing of nursing home residents, relatives and staff. However, there is sparse research evidence on how person-centred care can be operationalised and implemented in practice, and the extent to which it may promote wellbeing and satisfaction. Therefore, the U-Age nursing home study was initiated to deepen the understanding of how to integrate person-centred care into daily practice and to explore the effects and meanings of this.

    Methods

    The study aims to evaluate effects and meanings of a person-centred and thriving-promoting intervention in nursing homes through a multi-centre, non-equivalent controlled group before-after trial design. Three nursing homes across three international sites have been allocated to a person-centred and thriving-promoting intervention group, and three nursing homes have been allocated to an inert control group. Staff at intervention sites will participate in a 12-month interactive educational programme that operationalises thriving-promoting and person-centred care three dimensions: 1) Doing a little extra, 2) Developing a caring environment, and 3) Assessing and meeting highly prioritised psychosocial needs. A pedagogical framework will guide the intervention. The primary study endpoints are; residents’ thriving, relatives’ satisfaction with care and staff job satisfaction. Secondary endpoints are; resident, relative and staff experiences of the caring environment, relatives’ experience of visiting their relative and the nursing home, as well as staff stress of conscience and perceived person-centredness of care. Data on study endpoints will be collected pre-intervention, post-intervention, and at a six-month follow up. Interviews will be conducted with relatives and staff to explore experiences and meanings of the intervention.

    Discussion

    The study is expected to provide evidence that can inform further research, policy and practice development on if and how person-centred care may improve wellbeing, thriving and satisfaction for people who reside in, visit or work in nursing homes. The combination of quantitative and qualitative data will illuminate the operationalisation, effects and meaning of person-centred and thriving-promoting care.

  • 3.
    Jonasson, Stina B.
    et al.
    Department of Health Sciences, Lund University.
    Nilsson, Maria H.
    Department of Health Sciences, Lund University.
    Lexell, Jan
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering. Department of Health Sciences, Lund University, .
    Carlsson, Gunilla
    Department of Health Sciences, Lund University.
    Experiences of fear of falling in persons with Parkinson’s disease: a qualitative study2018Ingår i: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 18, nr 1, artikel-id 44Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background

    Fear of falling is common among persons with Parkinson’s disease and is negatively associated with quality of life. However a lack of in-depth understanding of fear of falling as a phenomenon persists. This qualitative study aimed to explore the experiences of fear of falling in persons with Parkinson’s disease.

    Methods

    Individual interviews were performed with twelve persons with Parkinson’s disease (median age 70 years, median Parkinson duration 9 years, 50% women). The interviews were semi-structured and followed a study-specific interview guide. The transcribed interviews were analyzed using qualitative content analysis.

    Results

    Fear of falling was experienced as a disturbing factor in everyday life. It generated a feeling of vulnerability and made daily activities and everyday environments seem potentially hazardous. Persons also missed performing previous activities. The fear of falling was a varying experience, fueled by an awareness of falls and near falls, Parkinson-related symptoms and disabilities, and by others in their environment. The persons adopted different strategies to handle their fear of falling. Activities were adapted, avoided, performed with help, or carried out despite their fear of falling.

    Conclusions

    The experiences of fear of falling were complex, multifaceted and varied over time and in relation to different activities and environments. This indicates that interventions targeting fear of falling need to be individually tailored for persons with Parkinson’s disease and should focus on several aspects, such as Parkinson-related symptoms and disabilities, activities and environmental factors. This study provides new information that increases the understanding of fear of falling, which has implications for researchers as well as clinicians working with persons with Parkinson’s disease and fear of falling.

  • 4.
    Lindbo, Agnes
    et al.
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå university.
    Gustafsson, Maria
    Department of Pharmacology and Clinical Neuroscience, Division of Clinical Pharmacology, Umeå University.
    Isaksson, Ulf
    Department of Nursing, Umeå University.
    Sandman, Per-Olof
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Omvårdnad.
    Lövheim, Hugo
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University.
    Dysphoric symptoms in relation to other behavioral and psychological symptoms of dementia, among elderly in nursing homes2017Ingår i: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 17, nr 1, artikel-id 206Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND:

    Behavioral and psychological symptoms of dementia (BPSD) are common and varied in the elderly. The aim of the current study was to explore associations between BPSD and dysphoric symptoms at different levels of cognitive impairment.

    METHODS:

    Assessments of 4397 elderly individuals living in nursing homes in Sweden were performed. Data on cognitive function and BPSD were collected using the Multi-Dimensional Dementia Assessment Scale (MDDAS). The relationships between dysphoria and eight BPSD factors were plotted against cognitive function to investigate how dysphoria affects BPSD throughout the dementia disease.

    RESULTS:

    Overall, dysphoric symptoms were most prevalent in persons with moderate cognitive impairment. However, moderate to severe dysphoric symptoms showed no clear variation with cognitive impairment. Furthermore, aggressive behavior, verbally disruptive/attention-seeking behavior, hallucinatory symptoms and wandering behavior were more common with concurrent dysphoria regardless of cognitive function. In contrast, passiveness was more common with concurrent dysphoria in mild cognitive impairment but not in moderate to severe cognitive impairment.

    CONCLUSIONS:

    BPSD, including aggressive behavior and hallucinations, were more common with concurrent dysphoric symptoms, providing insight into behavioral and psychological symptoms among individuals with cognitive impairment. Apathy was more commonly associated with concurrent dysphoria at early stages of cognitive decline but not at later stages, indicating that apathy and dysphoria represent separate syndromes among elderly patients with moderate to severe cognitive impairment.

  • 5.
    Sandlund, Marlene
    et al.
    Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University.
    Skelton, Dawn A
    School of Health and Life Sciences, Glasgow Caledonian University.
    Pohl, Petra
    Department of Rehabilitation and Department of Medical and Health Sciences, Linköping University.
    Ahlgren, Christina
    Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University.
    Melander Wikman, Anita
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Lundin-Olsson, Lillemor
    Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University.
    Gender perspectives on views and preferences of older people on exercise to prevent falls: mixed studies review2017Ingår i: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 17, nr 1, artikel-id 58Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUNDTo offer fall prevention exercise programs that attract older people of both sexes there is a need to understand both women's and men's views and preferences regarding these programs. This paper aims to systematically review the literature to explore any underlying gender perspectives or gender interpretations on older people's views or preferences regarding uptake and adherence to exercise to prevent falls.METHODSA review of the literature was carried out using a convergent qualitative design based on systematic searches of seven electronic databases (PubMed, CINAHL, Amed, PsycINFO, Scopus, PEDro, and OTseeker). Two investigators identified eligible studies. Each included article was read by at least two authors independently to extract data into tables. Views and preferences reported were coded and summarized in themes of facilitators and barriers using a thematic analysis approach.RESULTSNine hundred and nine unique studies were identified. Twenty five studies met the criteria for inclusion. Only five of these contained a gender analysis of men's and women's views on fall prevention exercises. The results suggests that both women and men see women as more receptive to and in more need of fall prevention messages. The synthesis from all 25 studies identified six themes illustrating facilitators and six themes describing barriers for older people either starting or adhering to fall prevention exercise. The facilitators were: support from professionals or family; social interaction; perceived benefits; a supportive exercise context; feelings of commitment; and having fun. Barriers were: practical issues; concerns about exercise; unawareness; reduced health status; lack of support; and lack of interest. Considerably more women than men were included in the studies.CONCLUSIONAlthough there is plenty of information on the facilitators and barriers to falls prevention exercise in older people, there is a distinct lack of studies investigating differences or similarities in older women's and men's views regarding fall prevention exercise. In order to ensure that fall prevention exercise is appealing to both sexes and that the inclusion of both men and women are encouraged, more research is needed to find out whether gender differences exists and whether practitioners need to offer a range of opportunities and support strategies to attract both women and men to falls prevention exercise.

  • 6.
    Sjödahl Hammarlund, Catharina
    et al.
    Department of Health Sciences, Lund University.
    Lexell, Jan
    Luleå tekniska universitet, Institutionen för hälsovetenskap, Hälsa och rehabilitering.
    Brogårdh, Christina
    Department of Health Sciences, Lund University.
    Perceived consequences of ageing with late effects of polio and strategies for managing daily life: a qualitative study2017Ingår i: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 17, nr 1, artikel-id 179Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    AbstractBACKGROUND:

    New or increased impairments may develop several decades after an acute poliomyelitis infection. These new symptoms, commonly referred to as late effects of polio (LEoP), are characterised by muscular weakness and fatigue, generalised fatigue, pain at rest or during activities and cold intolerance. Growing older with LEoP may lead to increased activity limitations and participation restrictions, but there is limited knowledge of how these persons perceive the practical and psychological consequences of ageing with LEoP and what strategies they use in daily life. The aim of this qualitative study was therefore to explore how ageing people with LEoP perceive the their situation and what strategies they use for managing daily life.

    METHODS:

    Seven women and seven men (mean age 70 years) were interviewed. They all had a confirmed history of acute poliomyelitis and new impairments after a stable period of at least 15 years. Data were transcribed verbatim and analysed using systematic text condensation.

    RESULTS:

    The latent analysis resulted in three categories 'Various consequences of ageing with LEoP', 'Limitations in everyday activities and participation restrictions', and 'Strategies for managing daily life when ageing with LEoP' and 12 subcategories. The new impairments led to decreased physical and mental health. The participants perceived difficulties in performing everyday activities such as managing work, doing chores, partaking in recreational activities and participating in social events, thereby experiencing emotional and psychological distress. They managed to find strategies that mitigated their worries and upheld their self-confidence, for example finding practical solutions, making social comparisons, minimising, and avoidance.

    CONCLUSION:

    Ageing with LEoP affected daily life to a great extent. The participants experienced considerable impact of the new and increased impairments on their life situation. Consequently, their ability to participate in various social activities also became restricted. Social comparisons and practical solutions are strategies that facilitate adaptation and acceptance of the new situation due to LEoP. This emphasises the need to design rehabilitation interventions that focus on coping, empowerment and self-management for people ageing with LEoP.

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