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  • 1.
    Andersson, Maria
    et al.
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    Wilde-Larsson, Bodil
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    Carlsson, Eva
    Örebro universitet.
    Persenius, Mona
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences (from 2013).
    Older people's perceptions of the quality of oral care in short-term care units: A cross-sectional study2018In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 13, no 2, p. 1-14, article id e12185Article in journal (Refereed)
    Abstract [en]

    Background: There is a lack of knowledge about oral care among older people living in short-term care (STC) units and how the quality of oral care provided by nursing staff is perceived by the older people. Aim: To (i) describe person-related conditions among older people in STC, (ii) describe and compare perceptions of the quality of oral care (including perceptions of care received and the subjective importance of such care), within and between older people who have the ability to perform oral self-care and those who are dependent on help with oral care and (iii) examine the relationship between person-related conditions and the quality of oral care. Methods: A cross-sectional study was conducted with 391 older people in STC units in Sweden based on self-reported questionnaire and clinical assessments. Results: The older people were assessed as having normal oral health (2%), moderate oral health problems (78%) or severe oral health problems (20%). When comparing older people's perceptions of quality of oral care in terms of perceived reality and subjective importance, significant differences appeared within and between groups. Psychological well-being had a significant relationship with perception of the quality of oral care (both perceived reality and subjective importance), and gender and oral health status had a significant relationship with subjective importance. Conclusions: Older people's perceptions of areas for improvement regarding quality of oral care is a new and important knowledge for nursing staff in STC units. Older people want personalised information regarding oral health and oral care. Registered Nurses who take the responsibility in nursing care for older people's oral health may avoid unnecessary suffering by older people caused by oral health problems. Implications for practice: Older people's perspective is an important component for quality work and might lead to improvements in the quality of oral care in STC. © 2018 John Wiley & Sons Ltd.

  • 2.
    Duppils Sörensen, Gill
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing. Högskolan Dalarna, Avdelningen för omvårdnad.
    Johansson, Inger
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Predictive value and validation of the NEECHAM Confusion Scale using DSM-IV criteria for delirium as gold standard2010In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 6, no 2, p. 133-142Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:Delirium is common among older people in hospital and various instruments have been developed for detecting delirium. One of these, the NEECHAM Confusion Scale, is easy for nurses to administrate but needs to be tested further.

    AIMS AND OBJECTIVES:The aim of the present study was to assess the validity and predictive value of the NEECHAM Confusion Scale.

    METHODS:The study was conducted among 149 patients aged ≥ 65, who had undergone surgery for a hip fracture. The patients were observed daily using DSM-IV criteria for delirium. The NEECHAM Confusion Scale was performed upon admission and prior to discharge.

    RESULTS:The incidence of DSM-IV related delirium was 24%. Patients who scored below 25 points on the NEECHAM scale had a 12 times higher risk of developing DSM-IV related delirium. During admission, the sensitivity of NEECHAM was zero because all patients with DSM-IV delirium were excluded, the specificity was 75%. On discharge, it was 100% and 91% respectively.

    CONCLUSIONS:This study adds to the body of knowledge that NEECHAM discriminates for delirium. It is a valid and reliable screening instrument for predicting delirium. The instrument can be used for clinical practice to identify patients who are at risk of contracting delirium and when considering prevention measures.

  • 3.
    From, Ingrid
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Johansson, Inger
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Athlin, Elsy
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Experiences of health and well-being, a question of adjustment and compensation: views of older people dependent on community care2007In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 2, no 4, p. 278-287Article in journal (Refereed)
    Abstract [en]

    Most studies concerning older people’s health and well-being have focused on their ill health, disease and complaints and have mainly been conducted with a quantitative design. Hence, there is still a need for qualitative studies in which these peoples’ own views on health and well-being are shown, especially when they are dependent on health care in a community setting. A qualitative approach was used in the study reported here and aimed at obtaining a deeper understanding of older peoples’ own views about their health and well-being. Interviews were carried out on two occasions with 19 older people living in their own homes and in sheltered accommodation. The data were analysed using content analysis. The findings suggested that the possibility to feel healthy was dependent both on the older person’s own ability to adjust or compensate to their situation, and on how their caregivers, relatives and friends could compensate for the obstacles the older person faced. The subcategories that captured the informants’ experiences of health and ill health were described as positive and negative poles of autonomy, togetherness, tranquillity and security in daily life. The significance of the caregivers was clearly evident. Their competence, commitment and treatment were prerequisites for the older person’s ability to experience health in spite of being dependent on care.

  • 4.
    From, Ingrid
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Johansson, Inger
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Athlin, Elsy
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    The meaning of good and bad care in the community care: older people's lived experiences2009In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 4, no 3, p. 156-165Article in journal (Refereed)
    Abstract [en]

    In spite of a considerable body of research in the past decades on what does or does not constitute good care for older people, there are still few studies addressing this question in which older people narrate their experiences of being dependent on community care. This study was therefore carried out aiming to explore older people's lived experiences of what good and bad care meant to them, when it was offered by community care services. Nineteen older persons in three Swedish communities participated in the study, which used a phenomenological-hermeneutic approach. Data were collected through unstructured interviews and Colaizzi's framework was utilized in the analysis of the data.The key theme arising from the analysis was that of being encountered as a human being by caregivers who, through the provision of safe and secure care, provide opportunities for living life as usual. When any of these circumstances are lacking, bad care will be the consequence. As the general intention in society is to ensure good quality of care to older people as well as others, the findings in our study should have important implications for providers of community care for older people.

  • 5.
    Helgesen, Ann Karin
    et al.
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Larsson, Maria
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Athlin, Elsy
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    ‘Patient participation’ in everyday activities in special care units for persons with dementia in Norwegian nursing homes2010In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 5, no 2, p. 169-178Article in journal (Refereed)
    Abstract [en]

    Aim.  The aim of this study was to explore ‘patient participation’ in everyday activities for persons with dementia living in special care units in nursing homes. Background.  Studies about how ‘patient participation’ appears in the context of special care units for persons with dementia are lacking. Design.  The study has an explorative design. Method.  Grounded theory was chosen. Data collection was carried out by means of open observations and additional conversations with residents and personnel. Simultaneously, data analysis was performed with open, axial and selective coding. Findings.  The findings showed that ‘patient participation’ concerned ‘A matter of presence’ as the core category. The other categories described as ‘presence of personnel’ and ‘presence of residents’, were strongly connected to the core category as well as to each other. Presence of personnel comprised three levels; being there in body, which required physical presence; being there in mind, which required presence with all senses based on knowledge and competence; and being there in morality which was understood as being fully present, as it was based on humanistic values and included the two other levels. Presence of residents comprised ‘ability and wish’ and ‘adaptation’. The presence of the personnel had a huge impact on the ability and will to participate of the residents. Organizational conditions concerning leadership, amount of personnel and routines as well as housing conditions concerning architecture and shared accommodation, could stimulate or hinder ‘patient participation’. Conclusions and implications.  The study highlighted the great impact of the personnel’s presence in body, mind and morality on the participation capacity of the residents. The great importance of the nurse leaders was stressed, as they were responsible for organizational issues and served as role models. Group supervision of the personnel and their leaders would be an implication to propose, as these kinds of reflection groups offer opportunities to reflect on values, actions and routines.

  • 6.
    Hommel, Ami
    et al.
    Lunds universitet.
    Bååth, Carina
    Karlstad University, Faculty of Health, Science and Technology (starting 2013), Department of Health Sciences. Country Council Varmland, Varmland, Sweden.
    A national quality registers as a tool to audit items of the fundamentals of care to older patients with hip fractures2016In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 11, no 2, p. 85-93Article in journal (Refereed)
    Abstract [en]

    Background The Swedish healthcare system has a unique resource in the national quality registers. A national quality registry contains individualised data concerning patient problems, medical interventions and outcomes after treatment, within all healthcare settings. Many healthcare settings face challenges related to the way they deliver the fundamentals of care, therefore, it is important to audit the outcome. It is estimated that the number of people aged 80 years or older will have almost quadrupled between 2000 and 2050. Hip fracture has been recognised as the most serious consequence of osteoporosis because of the risk of its complications, which include pain, acute confusional state, pressure ulcers, infections, disability, diminished quality of life and mortality.

    The aim of this study was therefore to explore if and how a national quality register can be used as an audit tool for the fundamentals of care when it concerns older patients suffering from a hip fracture.

    Method

    For this study we retrospectively selected and audited variables retrieved from the national quality hip fracture register. The audit included 1083 patients 80 years and older, consecutively admitted to a university hospital in the south of Sweden, in 2011–2013.

    Results

    Nearly half of the patients were admitted from their own homes and were living alone. Almost half of the patients could walk outdoors before the fracture occurred. After 4 months, 28.5% of the patients walked outdoors. Additionally, after 4 months about 30% of the patients were still suffering from pain after hip fracture surgery and still using analgesics. There was a reduction in length of stay between 2011 and 2013. As a part of the national quality register the questions from EQ5D were used before surgery and after 4 months. Before discharge from hospital there were less registered complications in 2012 and 2013 compared with 2011.

    Conclusions

    The national hip fracture quality register allows healthcare staff to analyse nursing outcomes and to highlight some fundamental aspects of care.

    Implications for practiceGreater awareness, among hospital staff, of risk factors for complications in hip fracture patients may lead to improved patient care. Through registration in a quality register and working with the results we as Registered Nurses can ensure quality health care for older adults.

  • 7.
    Hov, Reidun
    et al.
    Högskolan i Hedmark, Elverum.
    Hedelin, Birgitta
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Athlin, Elsy
    Karlstad University, Faculty of Social and Life Sciences, Department of Nursing.
    Nursing care for patients on the edge of life in nursing homes: obstacles are overshadowing opportunities2013In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 8, no 1, p. 50-60Article in journal (Refereed)
    Abstract [en]

    Background.  Patients in nursing homes have comprehensive needs for nursing care and medical treatment. Most patients benefit from the treatment, but some are ‘on the edge of life’-in a borderland between living and dying with an unpredictable outcome, and questions are sometimes raised whether to withhold/withdraw curative treatment.

    Aim.  The aim was to describe nurses’ conceptions of good nursing care, and how this could be carried out for patients on the edge of life in nursing homes.

    Design.  In order to discover variations in the nurses’ understandings a phenomenographic approach was chosen. Phenomenography is concerned with qualitatively different ways of conceiving a phenomenon.

    Methods.  Fourteen nurses from two nursing homes were individually interviewed twice. A phenomenographic analysis was used.

    Results.  The outcome-space included two main categories. The first, ‘good nursing care is to meet patients’ needs for dignity,’ included three description-categories: needs for ‘preparedness’, ‘human relationship’ and ‘bodily comfort and safety’. The second, ‘opportunities were overshadowed by obstacles’ in carrying out nursing care encompassed three description-categories: ‘organisational factors,’‘relational factors’ and ‘personal factors’.

    Conclusions.  This study shows nurses’ conceptions of the importance of good nursing care for comforting patients on the edge of life.

    Implications for practice.  Several obstacles related to resources, communication, cooperation and nurses' professional strength and power need to be overcome if good nursing care can be performed.

1 - 7 of 7
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