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Ayalon L, Ulitsa N, AboJabel H, Engdau-Vanda S. "We Used to Have Four Seasons, but Now There Is Only One": Perceptions Concerning the Changing Climate and Environment in a Diverse Sample of Israeli Older Persons. J Appl Gerontol 2024; 43:527-535. [PMID: 38085273 PMCID: PMC10981184 DOI: 10.1177/07334648231212279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 09/21/2023] [Accepted: 10/18/2023] [Indexed: 04/01/2024] Open
Abstract
Solastalgia is the pain caused by the loss of solace and isolation from one's environment. Solastalgia is contrasted with nostalgia, which is defined as melancholy characterized by homesickness or the distance from one's home. The present study examines the two concepts of solastalgia and nostalgia in the context of climate change among diverse populations of older Israelis. In total, 50 older persons from four different population groups (e.g., veteran Israeli Jews, Israeli Arabs, immigrants from the former Soviet Union, and Ethiopian immigrants) were interviewed. All interviews were transcribed and analyzed thematically. Members of all four groups expressed emotional distress and grief associated with the changing climate, increased environmental pollution, and the disappearance of nature. Perceptions around the undesirability of these changes were quite unanimous, thus leading us to conclude that the outcomes associated with solastalgia and nostalgia are quite similar despite different etiological explanations.
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Jones CA, Jhangri GS, Yamamoto SS, Hogan DB, Hanson H, Levasseur M, Morales E, Légaré F. Social participation of older people in urban and rural areas: Canadian Longitudinal Study on Aging. BMC Geriatr 2023; 23:439. [PMID: 37464306 DOI: 10.1186/s12877-023-04127-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 06/22/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Although the positive influence of social activity on health is now well-established, a complex relationship exists among social participation, personal, social and the environment. Social participation of older adults was examined in rural and urban settings to identify features of the built-environment and perception of neighborhood specific to the locale. RESEARCH DESIGN AND METHODS Using cross-sectional data from the Canadian Longitudinal Study on Aging (CLSA), we examined social participation and health of older people (65 + yrs) in relation to the built environment and sociocultural contexts for urban and rural areas. A social participation index was derived from responses on the frequency of participating in 8 social activities over the past 12 months. Personal, household and neighborhood indicators were examined to develop multivariable regression models for social participation in urban and rural cohorts. RESULTS No meaningful differences were seen with the frequency of social participation between rural and urban settings; however, the type of community-related activities differed in that a greater proportion of urban participants reported sports and educational/cultural events than rural participants. Service club activities were greater for rural than urban participants. Different neighborhood features were statistically significant factors in explaining social participation in rural than in urban locales, although transportation was a significant factor regardless of locale. Trustworthiness, belonging and safety were perceived factors of the neighborhood associated with higher social participation for rural participants. DISCUSSION AND IMPLICATIONS The relationship between home and health becomes stronger as one ages. Social and physical features of built environment specific to urban and rural settings need to be considered when implementing appropriate social activities for older people.
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Affiliation(s)
- C Allyson Jones
- Dept of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, 2-50 Corbett Hall, Edmonton, AB, T6G 2G4, Canada.
| | - Gian S Jhangri
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - Shelby S Yamamoto
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | - David B Hogan
- Division of Geriatric Medicine, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Heather Hanson
- Alberta Health Services Provincial Seniors Health and Continuing Care, Calgary, AB, Canada
| | - Mélanie Levasseur
- School of Rehabilitation, Université de Sherbrooke, Sherbrooke, QC, Canada
- Research Centre on Aging, Estrie Integrated University Health and Social Services, Centre-Sherbrooke Hospital University Centre, Sherbrooke, QC, Canada
| | - Ernesto Morales
- Department of Rehabilitation, Université Laval, Quebec City, QC, Canada
| | - France Légaré
- Department of Family Medicine and Emergency Medicine, Centre De Recherche Sur Les soins et Les Services de Première Ligne de S'Université Laval (CERSSPL-UL), Université Laval, Quebec City, QC, Canada
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3
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Karlsson Å, Olofsson B, Stenvall M, Lindelöf N. Older adults' perspectives on rehabilitation and recovery one year after a hip fracture - a qualitative study. BMC Geriatr 2022; 22:423. [PMID: 35562681 PMCID: PMC9107124 DOI: 10.1186/s12877-022-03119-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 05/06/2022] [Indexed: 11/21/2022] Open
Abstract
Background In order to improve quality of care and recovery after hip fracture we need to include the perspectives of the individual older adults when evaluating different rehabilitation interventions. The aim of this study was therefore to explore older adults’ experiences of their rehabilitation after a hip fracture and of the recovery process during the 12 months following the fracture. Methods Qualitative interviews were conducted with 20 older adults (70–91 years of age) who had participated in a randomised controlled trial evaluating the effects of early discharge followed by geriatric interdisciplinary home rehabilitation compared to in-hospital care according to a multifactorial rehabilitation program. Ten participants from each group were interviewed shortly after the one-year follow-up when the study was completed. Data were analysed with qualitative content analysis. Results The analysis resulted in four themes: Moving towards recovery with the help of others; Getting to know a new me; Striving for independence despite obstacles; and Adapting to an altered but acceptable life. The participants emphasised the importance of having access to rehabilitation that was provided by skilled staff, and support from family members and friends for well-being and recovery. They experienced a change in their self-image but strove for independence despite struggling with complications and functional limitations and used adaptive strategies to find contentment in their lives. Conclusions Rehabilitation interventions provided by competent health care professionals, as well as support from family members and friends, were emphasised as crucial for satisfactory recovery. Participants’ experiences further highlight the importance of targeting both physical and psychological impacts after a hip fracture. To improve recovery, rehabilitation providers should customise future interventions to suit each individual´s wishes and needs and provide rehabilitation in various settings throughout the recovery process. Trial registration The trial is registered at Current Controlled Trials Ltd, ICRCTN 15738119. Date of registration 16/06/2008, retrospectively registered. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03119-y.
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Affiliation(s)
- Åsa Karlsson
- Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, 90187, Umeå, Sweden. .,Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, 90187, Umeå, Sweden.
| | - Birgitta Olofsson
- Department of Nursing and Department of Surgical and Perioperative Science, Orthopedics, Umeå University, 90187, Umeå, Sweden
| | - Michael Stenvall
- Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, 90187, Umeå, Sweden
| | - Nina Lindelöf
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, 90187, Umeå, Sweden
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McKay K, Eggleton K. A Place-based Evaluation of a Healthy Homes Initiative. Health Promot J Austr 2022; 34:530-535. [PMID: 35485840 DOI: 10.1002/hpja.609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 04/22/2022] [Indexed: 11/12/2022] Open
Abstract
ISSUE ADDRESSED Limited qualitative evaluations of healthy homes initiatives exist in the literature and even fewer look past physical health benefits to wider health outcomes. A qualitative evaluation of Manawa Ora, a healthy homes initiative implemented by a Māori health provider in Northland, New Zealand, was conducted to ascertain the wider health benefits a healthy homes initiative. METHODS Participants of Manawa Ora were recruited, their experiences were analysed through qualitative semi-structured interviews. RESULTS Two main themes emerged from the semi-structured interviews. "Becoming active actors" pertains to improved health, both physical and mental, following the programme. It also describes the way participants have redirected their focus from their illness to broader, more purposeful activity. "From a simple space to a place with meaning" highlights the way Manawa Ora improved the home environment by creating a 'place' that holds meaning. CONCLUSIONS Healthy homes initiatives can improve physical health as well as wider health outcomes. Through the provision of beds, bedding, insulation and heating Manawa Ora has created a 'therapeutic place' out of the home that promotes healing and wellbeing. SO WHAT Greater focus on connections to place in public health initiatives may bring about wider health gains.
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Schmidt SM, Chiatti C, Ekstam L, Haak M, Heller C, Nilsson MH, Slaug B. Enabling Long-term Predictions and Cost-benefit Analysis Related to Housing Adaptation Needs for a Population Ageing in Place: Protocol for a Simulation Study (Preprint). JMIR Res Protoc 2022; 11:e39032. [PMID: 35969445 PMCID: PMC9419049 DOI: 10.2196/39032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 05/30/2022] [Accepted: 05/30/2022] [Indexed: 11/13/2022] Open
Abstract
Background Objective Methods Results Conclusions International Registered Report Identifier (IRRID)
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Affiliation(s)
- Steven M Schmidt
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | | | - Lisa Ekstam
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Maria Haak
- Department of Nursing Education and Integrated Health Sciences, Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
| | - Christina Heller
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Maria H Nilsson
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Faculty of Medicine, Lund University, Malmö, Sweden
- Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Björn Slaug
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
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6
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Brini S, Hodkinson A, Davies A, Hirani S, Gathercole R, Howard R, Newman SP. In-home dementia caregiving is associated with greater psychological burden and poorer mental health than out-of-home caregiving: a cross-sectional study. Aging Ment Health 2022; 26:709-715. [PMID: 33554655 PMCID: PMC8959387 DOI: 10.1080/13607863.2021.1881758] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
INTRODUCTION Caregivers who live with a person with dementia who receives care, compared with those who live elsewhere, are often considered to experience greater levels of psychological and affective burden. The evidence for this is, however, only limited to studies employing small sample sizes and that failed to examine caregivers' psychological wellbeing. We address these issues in a large cohort of dementia caregivers. METHODS We conducted a cross-sectional study comparing caregivers living with a dementia care recipient (n = 240) to caregivers living elsewhere (n = 255) on caregivers' burden, anxiety, and depression. RESULTS We found that caregivers living with the care recipient relative to those living elsewhere showed significantly greater burden and depression, but we found no group difference in anxiety. CONCLUSIONS Our study adds to the evidence by showing that cohabiting with a care recipient with dementia is associated with greater burden and poorer psychological wellbeing. Strategies aiming to improve caregivers' burden and psychological wellbeing should take account of caregivers' living arrangements.
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Affiliation(s)
- S. Brini
- School of Health Sciences, City, University of London, London, UK
| | - A. Hodkinson
- National Institute for Health Research (NIHR) School for Primary Care Research, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
| | - A. Davies
- School of Health Sciences, City, University of London, London, UK,Centre for Academic Child Health, University of Bristol, Bristol, UK
| | - S. Hirani
- School of Health Sciences, City, University of London, London, UK
| | - R. Gathercole
- Division of Psychiatry, University College London, London, UK
| | - R. Howard
- Division of Psychiatry, University College London, London, UK
| | - S. P. Newman
- School of Health Sciences, City, University of London, London, UK,CONTACT Stanton Newman
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Heller C, Ekstam L, Haak M, Schmidt SM, Slaug B. Exploring housing policies in five Swedish municipalities: alternatives and priorities. BMC Public Health 2022; 22:260. [PMID: 35135523 PMCID: PMC8827245 DOI: 10.1186/s12889-022-12672-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 01/24/2022] [Indexed: 11/10/2022] Open
Abstract
Introduction Housing shortage due to population growth within metropolitan areas, combined with an ageing population, has put pressure on current housing provision in Sweden. Thus, there is an urgent need to develop sustainable housing policies to accommodate the growing number of seniors in accessible home environments. This study aimed to gain an in-depth understanding of how municipalities currently address housing accessibility issues and to explore what types of policy solutions they consider for the future. Material and methods Five Swedish municipalities were selected to represent a diversity of the population, housing provision approaches, and geographical areas. To understand current housing policies, two key actors (e.g. public officials, housing adaptation grant managers, city architects, etc.) from each municipality participated in semi-structured interviews (N = 10). Subsequently, those key actors, two senior citizens, and three researchers participated in a research circle to explore future policy solutions. Data were analyzed using content analysis. Results The interviews revealed common approaches to deal with housing accessibility issues such as regular renovations and maintenance, individual adaptations based on specific needs, and seeking collaboration with private housing actors on housing provision matters. Possible measures suggested for the future included increasing the national coordination of housing accessibility policies, amending legislation to only allow the construction of housing according to strengthened accessibility standards, and introducing economic incentives for seniors to move from housing with poor accessibility to more accessible accommodations. Conclusions Municipalities struggle with the lack of accessible and affordable housing for their ageing population, despite a large variety of policies from economic incentives to research and development policies. The results suggest that collaboration needs to be improved between all actors involved in housing policies. Preventive measures within the current laws may be needed to strengthen the construction of more accessible and affordable housing for populations ageing in place.
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Affiliation(s)
- Christina Heller
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
| | - Lisa Ekstam
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Maria Haak
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden.,Department of Nursing Education and Integrated Health Sciences, Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
| | - Steven M Schmidt
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Björn Slaug
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
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Andersson N, Slaug B, Nilsson MH, Iwarsson S. Environmental barriers and housing accessibility problems for people with Parkinson's disease: A three-year perspective. Scand J Occup Ther 2021:1-12. [PMID: 34871133 DOI: 10.1080/11038128.2021.2007998] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Although housing accessibility is associated with important health outcomes in other populations, few studies have addressed this in a Parkinson's disease population. AIM To determine the most severe environmental barriers in terms of housing accessibility problems and how these evolved over 3 years among people with Parkinson's disease. MATERIAL AND METHODS 138 participants were included (men = 67%; mean age = 68 years). The most severe environmental barrier were identified by the Housing Enabler instrument and ranked in descending order. The paired t-test was used to analyse changes in accessibility problems over time. RESULTS The top 10 barriers remained largely unchanged over 3 years, but with notable changes in order and magnitude. 'No grab bar in hygiene area' and 'Stairs only route' were top-ranked in generating accessibility problems at baseline but decreased significantly (p = 0.041; p = 0.002) at follow-up. 'Difficulties to reach refuse bin' was top-ranked at follow-up, with a significant increase (p < 0.001) of related accessibility problems. CONCLUSIONS AND SIGNIFICANCE The new knowledge about how accessibility problems evolve over time could be used by occupational therapists to recommend more effective housing adaptations taking the progressive nature of Parkinson's disease into account. On societal level, the results could be used to address accessibility problems systematically.
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Affiliation(s)
- Nilla Andersson
- Department of Health Sciences, Lund University, Lund, Sweden.,Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Björn Slaug
- Department of Health Sciences, Lund University, Lund, Sweden
| | - Maria H Nilsson
- Department of Health Sciences, Lund University, Lund, Sweden.,Memory Clinic, Skåne University Hospital, Malmö, Sweden.,Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
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9
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Understanding the Wicked Problem of Providing Accessible Housing for the Ageing Population in Sweden. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18031169. [PMID: 33525734 PMCID: PMC7908410 DOI: 10.3390/ijerph18031169] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 01/19/2021] [Accepted: 01/22/2021] [Indexed: 11/18/2022]
Abstract
While accessible housing is known as important to promote healthy ageing, the societal issue of providing accessible housing for the ageing population bears the characteristics of a “wicked problem”. The aim of this study was to gain a better understanding of crucial variables for decision-making about the provision of accessible housing for the ageing population in Sweden. Materials used for a deductive content analysis were elicited through a research circle involving three researchers and twelve non-academic representatives. Brown and colleagues’ conceptual five-dimension framework to address wicked problems was used for the understanding of crucial variables in decision-making about housing provision. The findings show that such reasoning is dominated by the socioeconomic dimension. Findings in the biophysical dimension reveal well-known challenges pertaining to the definition and interpretation of the concept of accessibility and its operationalization. The dimensions are intertwined in a complex manner, which is essential for effective and efficient decision-making. The findings could make decision-makers aware of the diversity of individual thinking involved when addressing this wicked problem. Acting upon the crucial variables identified in this study could contribute to progressive decision-making and more efficient ways to develop and provide accessible housing to promote health ageing.
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10
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Norin L, Slaug B, Haak M, Iwarsson S. Housing adaptations and housing accessibility problems among older adults with long-standing spinal cord injury. Br J Occup Ther 2020. [DOI: 10.1177/0308022620979516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction Adults with spinal cord injuries are living longer than previously, and a majority are living in ordinary housing in the community. Housing accessibility is important for maintaining independent occupational performance for this population, but knowledge in this area is insufficient. We investigated housing adaptations and current accessibility problems among older adults with long-standing (>10 years) spinal cord injuries. Method Data from home visits among 122 older adults with spinal cord injuries in Sweden were used. Housing adaptations and environmental barriers were descriptively analysed. Findings Kitchens, entrances, and hygiene areas were common locations for housing adaptations and environmental barriers that generated accessibility problems. The most common adaptations were ramps, wheelchair-accessible stovetops, and ceiling-lifts. Wall-mounted cupboards and high shelves (kitchen), inaccessible storage areas (outside the dwelling), and a lack of grab bars (hygiene area) generated the most accessibility problems. Conclusion Despite housing adaptations, there are considerable accessibility problems in the dwellings of older adults with long-standing spinal cord injuries in Sweden, indicating that long-term follow-up of the housing situation of this population is necessary. Focusing on accessible housing as a prerequisite for occupational performance is at the core of occupational therapy, deserving attention on the individual as well as the societal level.
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Affiliation(s)
- Lizette Norin
- Department of Health Sciences, Lund University, Lund, Sweden
| | - Björn Slaug
- Department of Health Sciences, Lund University, Lund, Sweden
| | - Maria Haak
- Department of Health Sciences, Lund University, Lund, Sweden
- Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
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11
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Salma J, Jones A, Ali SA, Salami B, Yamamoto S. A Qualitative Exploration of Immigrant Muslim Older Adults' Experiences and Perceptions of Physical Activity. J Aging Phys Act 2020; 28:765-773. [PMID: 32434148 DOI: 10.1123/japa.2019-0297] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 02/06/2020] [Accepted: 02/19/2020] [Indexed: 11/18/2022]
Abstract
Physical activity is essential for healthy aging; however, there has been little exploration of physical activity in Muslim older immigrants in Canada. Over one million Canadians identify as Muslim, the majority is first-generation immigrants, with increasing cohorts entering older age. A community-based participatory research project on healthy aging was conducted with 68 older adults and community members from South Asian, Arab, and African Muslim ethnocultural communities in a Canadian urban center. A combination of individual interviews and focus groups discussions were completed, followed by thematic analysis of data. Participating community groups emphasized the importance of physical activity in older age and prioritized the need for physical activity programs. The four themes highlight Muslim older immigrants' perspectives on physical activity in Canada: (a) values and approaches to staying active; (b) health factors: pain and health limitations; (c) social factors: culture, religion, and belonging; and (d) environmental factors: safety and accessibility.
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12
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Granbom M, Perrin N, Szanton S, K M Cudjoe T, Gitlin LN. Household Accessibility and Residential Relocation in Older Adults. J Gerontol B Psychol Sci Soc Sci 2020; 74:e72-e83. [PMID: 30388250 DOI: 10.1093/geronb/gby131] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES It is unclear how home environmental factors influence relocation decisions. We examined whether indoor accessibility, entrance accessibility, bathroom safety features, housing type, and housing condition were associated with relocations either within the community or to residential care facilities. METHODS We used prospective data over 4 years from the nationally representative National Health and Aging Trends Study in the United States of Medicare beneficiaries 65 years and older living in the community (N = 7,197). We used multinomial regression analysis with survey weights. RESULTS Over the 4 years, 8.2% of the population moved within the community, and 3.9% moved to residential care facilities. After adjusting for demographics and health factors, poor indoor accessibility was found to be associated with moves within the community but not to residential care facilities. No additional home environmental factors were associated with relocation. DISCUSSION One-floor dwellings, access to a lift, or having a kitchen, bedroom, and bathroom on the same floor may help older adults age in place. Understanding which modifiable home environmental factors trigger late-life relocation, and to where, has practical implications for developing policies and programs to help older adults age in their place of choice.
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Affiliation(s)
- Marianne Granbom
- Department of Community-Public Health, Center for Innovative Care in Aging, School of Nursing, Johns Hopkins University, Baltimore, Maryland.,Department of Health Sciences, Lund University, Sweden
| | - Nancy Perrin
- Department of Community-Public Health, Center for Innovative Care in Aging, School of Nursing, Johns Hopkins University, Baltimore, Maryland
| | - Sarah Szanton
- Department of Community-Public Health, Center for Innovative Care in Aging, School of Nursing, Johns Hopkins University, Baltimore, Maryland
| | - Thomas K M Cudjoe
- Center on Aging and Health, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Laura N Gitlin
- Department of Community-Public Health, Center for Innovative Care in Aging, School of Nursing, Johns Hopkins University, Baltimore, Maryland.,College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania
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13
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Salminen M, Laine J, Vahlberg T, Viikari P, Wuorela M, Viitanen M, Viikari L. Factors associated with institutionalization among home-dwelling patients of Urgent Geriatric Outpatient Clinic: a 3-year follow-up study. Eur Geriatr Med 2020; 11:745-751. [PMID: 32500517 PMCID: PMC7550301 DOI: 10.1007/s41999-020-00338-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 05/17/2020] [Indexed: 11/28/2022]
Abstract
Aim To examine the effect of predictive factors on institutionalization among home-dwelling patients of Urgent Geriatric Outpatient Clinic during a 3-year follow-up. Findings The rates of institutionalization and mortality were 29.9% and 46.1%, respectively. The use of home care, dementia, higher age and falls during the previous 12 months significantly predicted institutionalization during the follow-up. Message Cognitive and/or functional impairment mainly predicted institutionalization among older patients of UrGeriC having health problems and acute difficulties in managing at home. Purpose To examine the effect of predictive factors on institutionalization among older patients. Methods The participants were older (aged 75 years or older) home-dwelling citizens evaluated at Urgent Geriatric Outpatient Clinic (UrGeriC) for the first time between the 1st of September 2013 and the 1st of September 2014 (n = 1300). They were followed up for institutionalization for 3 years. Death was used as a competing risk in Cox regression analyses. Results The mean age of the participants was 85.1 years (standard deviation [SD] 5.5, range 75–103 years), and 74% were female. The rates of institutionalization and mortality were 29.9% and 46.1%, respectively. The mean age for institutionalization was 86.1 (SD 5.6) years. According to multivariate Cox regression analyses, the use of home care (hazard ratio 2.43, 95% confidence interval 1.80–3.27, p < 0.001), dementia (2.38, 1.90–2.99, p < 0.001), higher age (≥ 95 vs. 75–84; 1.65, 1.03–2.62, p = 0.036), and falls during the previous 12 months (≥ 2 vs. no falls; 1.54, 1.10–2.16, p = 0.012) significantly predicted institutionalization during the 3-year follow-up. Conclusion Cognitive and/or functional impairment mainly predicted institutionalization among older patients of UrGeriC having health problems and acute difficulties in managing at home.
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Affiliation(s)
- Marika Salminen
- City of Turku, Welfare Division/Turku City Hospital, Kunnallissairaalantie 20, 20700, Turku, Finland.
- Faculty of Medicine, Unit of Family Medicine, University of Turku, Joukahaisenkatu 3-5 A, 20014, Turku, Finland.
| | - Jonna Laine
- Faculty of Medicine, Department of Geriatrics, Turku City Hospital, University of Turku, Kunnallissairaalantie 20, 20700, Turku, Finland
| | - Tero Vahlberg
- Institute of Clinical Medicine, Biostatistics, University of Turku, Kiinamyllynkatu 10, 20014, Turku, Finland
| | - Paula Viikari
- City of Turku, Welfare Division/Turku City Hospital, Kunnallissairaalantie 20, 20700, Turku, Finland
- Faculty of Medicine, Department of Geriatrics, Turku City Hospital, University of Turku, Kunnallissairaalantie 20, 20700, Turku, Finland
| | - Maarit Wuorela
- City of Turku, Welfare Division/Turku City Hospital, Kunnallissairaalantie 20, 20700, Turku, Finland
- Faculty of Medicine, Department of Geriatrics, Turku City Hospital, University of Turku, Kunnallissairaalantie 20, 20700, Turku, Finland
| | - Matti Viitanen
- Faculty of Medicine, Department of Geriatrics, Turku City Hospital, University of Turku, Kunnallissairaalantie 20, 20700, Turku, Finland
- Division of Clinical Geriatrics, NVS, Karolinska Institutet, Karolinska University Hospital, Huddinge, 14186, Stockholm, Sweden
| | - Laura Viikari
- City of Turku, Welfare Division/Turku City Hospital, Kunnallissairaalantie 20, 20700, Turku, Finland
- Faculty of Medicine, Department of Geriatrics, Turku City Hospital, University of Turku, Kunnallissairaalantie 20, 20700, Turku, Finland
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14
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Slaug B, Granbom M, Iwarsson S. An Aging Population and an Aging Housing stock – Housing Accessibility Problems in Typical Swedish Dwellings. JOURNAL OF AGING AND ENVIRONMENT 2020. [DOI: 10.1080/26892618.2020.1743515] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Björn Slaug
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Marianne Granbom
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
- Department of Community-Public Health, Center for Innovative Care in Aging, Johns Hopkins University, Baltimore, MD, USA
| | - Susanne Iwarsson
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
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15
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Granbom M, Szanton S, Gitlin LN, Paulsson U, Zingmark M. Ageing in the right place - a prototype of a web-based housing counselling intervention for later life. Scand J Occup Ther 2019; 27:289-297. [PMID: 31305191 DOI: 10.1080/11038128.2019.1634756] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: Despite a strong desire among most older adults to age in place, there are few widely available services to support planning and preparing for one's future housing needs.Objective: To develop a prototype of a web-based housing counselling intervention for use in later life, by employing a user-centred design.Material and Methods: As the first step in intervention development, we employed a development process based on research circle methodology. Nine older adults participated in three sessions. Findings from literature reviews, a meeting with a technology and design panel (n = 6) and interviews with representatives of nonprofit organizations, companies, and municipalities (n = 7) served as discussion points.Result: An on-paper prototype was derived, composed of the THINK, LEARN and ACT module reflecting different stages of the decision-making process. Each module addressed preferences, health, home and social and financial resources. Key design features and theoretical underpinnings were included.Conclusion and Significance: A user-centred design process can result in services that are aligned with older adults' preferences for obtaining housing information. Services for planning and preparing future housing needs have the potential to increase older adults´ well-being at home as well as reduce costs for care and housing provision by the municipalities.
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Affiliation(s)
- Marianne Granbom
- Center for Innovative Care in Aging, Johns Hopkins School of Nursing, Baltimore, MD, USA.,Department of Health Sciences, Lund University, Lund, Sweden
| | - Sarah Szanton
- Center for Innovative Care in Aging, Johns Hopkins School of Nursing, Baltimore, MD, USA
| | - Laura N Gitlin
- College of Nursing and Health Professions, Drexel University, Philadelphia, PA, USA
| | - Ulrika Paulsson
- Municipality of Östersund, Health and Social Care Administration, Östersund, Sweden
| | - Magnus Zingmark
- Municipality of Östersund, Health and Social Care Administration, Östersund, Sweden.,Department of Epidemiology and Public Health, Umeå University, Umea, Sweden
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16
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Boman E, Glasberg AL, Levy-Malmberg R, Fagerström L. 'Thinking outside the box': advanced geriatric nursing in primary health care in Scandinavia. BMC Nurs 2019; 18:25. [PMID: 31303862 PMCID: PMC6604267 DOI: 10.1186/s12912-019-0350-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 06/25/2019] [Indexed: 11/17/2022] Open
Abstract
Background Older people are frequent users of primary health care (PHC) services. PHC services have been critiqued, mainly regarding limited accessibility and continuity of care. In many countries, investment in nurse practitioners (NPs) has been one strategy to improve PHC services. In the North of Europe, the NP role is still in its infancy. The aim of this study was to explore the feasibility of introducing geriatric nurse practitioners (GNPs) in PHC in Scandinavia, from multiprofessional and older persons’ perspectives. Methods The study had a qualitative design, including 25 semi-structured interviews with nurses, nurse leaders, physicians, politicians and older persons from several communities in Scandinavia. The material was analysed by means of qualitative content analysis. Results The results highlight current challenges in health services for the older population, i.e. comorbid older patients with complex care needs aging in place, lack of competent staff, and organisational challenges. The results present an envisioned GNP scope of practice in health services for the older population, including bringing advanced competence closer to the patient, an autonomous role including task-shifting, and a linking role. The results also present factors influencing implementation of the GNP role, i.e. GNP competence level, unclear role and scope of practice, and openness to reorganisation. Conclusions The results indicate that it is feasible to implement the GNP role in primary health care in Scandinavia. Notwithstanding, there are factors influencing implementation of the GNP role that should be considered. Electronic supplementary material The online version of this article (10.1186/s12912-019-0350-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Erika Boman
- Department of Nursing and Health Sciences, University of South-Eastern Norway, Drammen, Norway.,Department of Nursing, Åland University of Applied Sciences, Neptunigatan 17, 22100 Mariehamn, Åland Finland
| | - Ann-Louise Glasberg
- Department of Nursing, University of Applied Sciences, Novia, Vaasa, Finland
| | - Rika Levy-Malmberg
- Department of Nursing and Health Sciences, University of South-Eastern Norway, Drammen, Norway.,Department of Nursing, University of Applied Sciences, Novia, Vaasa, Finland
| | - Lisbeth Fagerström
- Department of Nursing and Health Sciences, University of South-Eastern Norway, Drammen, Norway.,4Faculty of Education and Welfare Studies, Åbo Akademi University, Vaasa, Finland
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Norell Pejner M, Ourique de Morais W, Lundström J, Laurell H, Skärsäter I. A Smart Home System for Information Sharing, Health Assessments, and Medication Self-Management for Older People: Protocol for a Mixed-Methods Study. JMIR Res Protoc 2019; 8:e12447. [PMID: 31038459 PMCID: PMC6658282 DOI: 10.2196/12447] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 02/05/2019] [Accepted: 03/19/2019] [Indexed: 01/07/2023] Open
Abstract
Background Older adults often want to stay in a familiar place, such as their home, as they get older. This so-called aging in place, which may involve support from relatives or care professionals, can promote older people’s independence and well-being. The combination of aging and disease, however, can lead to complex medication regimes and difficulties for care providers in correctly assessing the older person's health. In addition, the organization of health care is fragmented, which makes it difficult for health professionals to encourage older people to participate in their own care. It is also a challenge to perform adequate health assessments and to engage in appropriate communication between health care professionals. Objective The purpose of this paper is to describe the design for an integrated home-based system that can acquire and compile health-related evidence for guidance and information-sharing among care providers and care receivers in order to support and promote medication self-management among older people. Methods The authors used a participatory design approach for this mixed-methods project, which was divided into four phases. Phase I, Conceptualization, consists of the conceptualization of a system to support medication self-management, objective health assessments, and communication between health care professionals. Phase II, Development of a System, consists of building and bringing together the conceptualized systems from Phase I. Phase III, Pilot Study, and Phase IV, Full-Scale Intervention, are described briefly. Results Participants in Phase I were people who were involved in some way in the care of older adults and included older adults themselves, relatives of older adults, care professionals, and industrial partners. With input from Phase I participants, we identified two relevant concepts for promoting medication self-management, both of which related to systems that participants believed could provide guidance for the older adults themselves, relatives of older adults, and care professionals. The systems will also encourage information-sharing between care providers and care receivers. The first is the concept of the Intelligent Age-Friendly Home (IAFH), defined as an integrated residential system that evolves to sense, reason, and act in response to individuals’ needs, preferences, and behaviors as these change over time. The second concept is the Medication safety, Objective assessments of health-related behaviors, and Personalized medication reminders (MedOP) system, a system that would be supported by the IAFH, and which consists of three related components: one that assesses health behaviors, another that communicates health data, and a third that promotes medication self-management. Conclusions The participants in this project were older adults, relatives of older adults, care professionals, and our industrial partners. With input from the participants, we identified two main concepts that could comprise a system for health assessment, communication, and medication self-management: the IAFH and the MedOP system. These concepts will be tested in this study to determine whether they can facilitate and promote medication self-management among older people. International Registered Report Identifier (IRRID) DERR1-10.2196/12447
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Affiliation(s)
- Margaretha Norell Pejner
- Department of Health and Care, School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | | | - Jens Lundström
- Technical Science, School of Information Technology, Halmstad University, Halmstad, Sweden
| | - Hélène Laurell
- Innovation Science, School of Business, Engineering and Science, Halmstad University, Halmstad, Sweden
| | - Ingela Skärsäter
- Department of Health and Care, School of Health and Welfare, Halmstad University, Halmstad, Sweden
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18
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Lind J, Mahler M. A systematic mixed methods review: Recovering from a hip fracture in a health promoting perspective. Nurs Open 2019; 6:313-329. [PMID: 30918683 PMCID: PMC6419295 DOI: 10.1002/nop2.214] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 08/30/2018] [Accepted: 09/17/2018] [Indexed: 11/10/2022] Open
Abstract
AIM To describe and interpret how older adults who have returned home to recover from a hip fracture cope with life in a health promoting perspective. DESIGN Data were collected through the search in seven electronic databases during 2014. Inclusion criteria were peer reviewed, empirical studies. The keywords were hip fracture, coping, empowerment, self-efficacy, elderly, frail elderly, oldest old. Seventeen papers published 1991-2014 were eligible for inclusion. Analysis of the qualitative and quantitative papers was conducted separately guided by the key words coping, empowerment and self-efficacy. Due to diversity of studies, a meta-analysis was not performed. The findings were reported in a narrative synthesis. RESULTS Recovery is an individual process of regaining health. It is important to include the person's resources and own goals in life. Physical training must be combined with psychosocial interventions to promote personal engagement and health.
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Affiliation(s)
- Johanne Lind
- Department of Nursing, Faculty of Health and TechnologyUniversity College MetropolCopenhagen NDenmark
| | - Marianne Mahler
- Department of Education, Learning and PhilosophyAalborg University CopenhagenCopenhagen SVDenmark
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19
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Sociodemographic characteristics and psychosocial wellbeing of elderly with chronic illnesses who live with family at home. ENFERMERIA CLINICA 2019. [DOI: 10.1016/j.enfcli.2018.11.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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20
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Clancy A, Gürgens Gjaerum R. Home as a place for giving birth-A circumpolar study of the experiences of mothers and midwifes. Health Care Women Int 2019; 40:121-137. [PMID: 30681940 DOI: 10.1080/07399332.2018.1531002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This article explores what home birth mothers and midwives say about the birth experience and the interaction between mother, partner and midwife. It is based on an explorative empirical study of the narratives of seven home birth mothers and the experiences of five midwives. The authors examine how these subjective experiences can help us to understand the phenomenon of home birth. The article is grounded in a philosophy of place and feminist theory, understood within a health promotion framework. Home birth manifests itself as a place-based esthetic experience characterized by gender, body, nature and culture. The participants spoke of the significance of giving birth at home. The authors discover that giving birth at home involves celebration, togetherness and ontological security. It also encompasses a broad understanding of risk, power structures, responsibility and co-determination. Openness about the challenges of home births can boost the position of home birth among both clinicians and the general public.
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Affiliation(s)
- Anne Clancy
- a Department of Health and Care Sciences , UiT The Arctic University of Norway , Harstad , Tromso , Norway
| | - Rikke Gürgens Gjaerum
- b Department of Social Education , UiT The Arctic University of Norway , Harstad , Tromso , Norway
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21
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Petersen JD, Siersma VD, Christensen RD, Storsveen MM, Nielsen CT, Waldorff FB. The risk of fall accidents for home dwellers with dementia-A register- and population-based case-control study. ALZHEIMER'S & DEMENTIA: DIAGNOSIS, ASSESSMENT & DISEASE MONITORING 2018; 10:421-428. [PMID: 30151421 PMCID: PMC6107894 DOI: 10.1016/j.dadm.2018.05.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Introduction Institutionalized people with dementia have an increased risk of fall accidents, but little is known about whether this increased risk holds for home dwellers. Methods This register- and population-based study comprised 115,584 cases and 394,679 controls. Cases were individuals with any fall between 2009 and 2014, and matched with up to six controls on age, sex, and geographic location. Individuals were excluded if they (1) had any fall in 2008, or (2) lived in a nursing home on the date of the fall. Dementia, other chronic diseases, and sedative medicines were assessed from Danish national registers. Results After adjusting for potential confounders, older people with dementia living at home had a 1.89-fold higher risk of fall (odds ratio = 1.89, 95% confidence interval [1.84–1.94], P < .001). Discussion Dementia almost doubles the risk of fall for older Danish people living at home. This highlights the need for effective fall preventions that target people with dementia.
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Affiliation(s)
- Jindong Ding Petersen
- Research Unit for General Practice, Department of Public Health, University of Southern Denmark, Odense C, Denmark
- Mental Health Services in the Region of Southern Denmark, Department of Mental Health, Kolding-Vejle, Denmark
- Corresponding author. Tel.: +45 6550 9531; Fax: +45 6591 8296.
| | - Volkert Dirk Siersma
- Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - René dePont Christensen
- Research Unit for General Practice, Department of Public Health, University of Southern Denmark, Odense C, Denmark
| | - Maria Munch Storsveen
- Research Unit for General Practice, Department of Public Health, University of Southern Denmark, Odense C, Denmark
| | - Connie Thurøe Nielsen
- Mental Health Services in the Region of Southern Denmark, Department of Mental Health, Kolding-Vejle, Denmark
| | - Frans Boch Waldorff
- Research Unit for General Practice, Department of Public Health, University of Southern Denmark, Odense C, Denmark
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22
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Haglund BJA, Tillgren P. Milestones in Nordic Health Promotion research. Scand J Public Health 2018; 46:7-19. [PMID: 29552959 DOI: 10.1177/1403494817744930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Based on the storytelling tradition and analyses of conference material, this article provides an overview of the evolving Nordic Health Promotion Research Network (NHPRN) and its conferences over the last 20 years. The story goes from the planning of the first conference in Bergen, Norway, back in 1996 to the eighth conference in Jyväskylä, Finland, in 2016. There have been three phases of development. During the first phase, 1996-2007, the five first conferences were initiated and implemented by departments of public health in the Nordic countries. The World Health Organization (WHO) collaborative centres of Health Promotion in Bergen University and a group at Karolinska Institute, Department of Social Medicine, creating supportive environments for health in Stockholm played key roles in initiating and supporting NHPRN. During the second phase, 2007-2014, the network was strengthened and supported by the Nordic School of Public Health (NHV) in Gothenburg. The third phase started when NHV closed down in 2015 and networking activities were transferred to the European Office of WHO in Copenhagen. The Nordic Health Promotion Research Conference series has served several purposes and will continue to do so. They are important Nordic meeting places, stimulating Health Promotion research, as well as explicitly managing ongoing concerns in the international Health Promotion community. This is reflected in the shift of foci over time. The content of the conferences has been highly responsive to whatever challenges are particularly relevant at different points in time, while also contributing to developing Health Promotion as a discipline, given that every conference has built on the previous ones.
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Affiliation(s)
- Bo J A Haglund
- 1 Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden
| | - Per Tillgren
- 2 School of Health, Care and Social Welfare, Västerås, Sweden
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23
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Róin Á. Person-centredness in elder care: A secondary analysis of data from a study among home-dwelling men and women in the Faroe Islands. J Clin Nurs 2017; 27:2416-2424. [PMID: 29121413 DOI: 10.1111/jocn.14161] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2017] [Indexed: 11/26/2022]
Abstract
AIMS AND OBJECTIVES As individuals in Western societies age, there is increasing demand for home-based care to help older people stay in their homes for as long as possible and provide services that ensure a person's quality of life in old age. Numerous attempts are made to develop a framework to secure quality of care. However, research has shown insufficient quality in care for older people. In this study, the purpose is to study how older people's experiences with home care reflect a person-centred approach to care. Data derived from an earlier study on ageing among home-dwelling men and women who are aged 67-91 and living in the Faroe Islands. BACKGROUND Person-centredness as a concept is an often quoted, but ill-defined concept. Most studies concerning person-centred care are conducted within hospital wards or long-term care institutions. Empirical studies concerning home-dwelling older people receiving home care are scarce. METHODS The study is a secondary analysis of data from an earlier qualitative study. Latent thematic analysis was used which meant coding issues of potential interest and collecting these codes into themes. RESULTS Three themes appeared to combine the initial codes: sense of involvement, sense of meaningfulness and contextual conditions. Overall, the analysis showed that the users were seldom involved in planning or scheduling the care they received. What they were offered did not always make sense to them or correspond to their needs or preferences. CONCLUSIONS The number of interviews included was limited. However, findings from this study point at some possible barriers to successful implementation of person-centredness within elder care. Especially, contextual conditions seem to limit the facilitation of person-centred practices. RELEVANCE TO CLINICAL PRACTICE Healthcare providers must take the user's preferences, resources and networks into consideration when coordinating and planning home care and, importantly, be open for negotiating needs. It is important to draw attention to the contrast between political intentions regarding elder care and the limited options for putting the intentions into practice.
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Affiliation(s)
- Ása Róin
- Department of Health and Nursing Science, University of the Faroe Islands, Tórshavn, Faroe Islands
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24
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Slaug B, Iwarsson S, Ayala JA, Nilsson MH. Housing accessibility problems for people with Parkinson's disease. Acta Neurol Scand 2017; 136:501-510. [PMID: 28393348 DOI: 10.1111/ane.12763] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Promoting accessible housing for all citizens is high on the political agenda. Knowledge is, however, limited regarding housing accessibility problems for people with Parkinson's disease (PD). The objectives were to investigate housing accessibility problems among people with PD at different stages of disease severity and to analyze the potential impact of improved functional ability on accessibility problems. MATERIALS AND METHODS The study included 253 participants with PD (61% men; mean age 70 years). Disease severity was assessed by the Hoehn and Yahr (HY) I-V stages: HY I, n=50; II, n=73, III, n=66; IV-V, n=64. Using the Housing Enabler (HE) instrument, accessibility problems were investigated by combining assessments of the person's functional capacity with assessments of physical barriers in the housing environment into a person-environment fit measure (HE-score). To analyze potential impact of improved functional ability on housing accessibility problems, data simulation was applied. RESULTS HE-scores differed significantly (P<.001) in relation to HY stages. Overall balance problems explained 22% and walking devices 17% of the HE-scores, whereas environmental barriers contributed to a lesser extent. The environmental barriers generating the most HE-scores were "no grab bar at shower/bath/toilet" and "wall-mounted cupboards and shelves placed high". A simulation of improved balance significantly (P<.001) lowered the HE-scores in all HY stages. CONCLUSIONS The results suggest that actions targeting balance problems and dependence on walking devices have the greatest potential for reducing housing accessibility problems for people with PD. The study also details environmental barriers that need specific attention when providing housing adaptation services.
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Affiliation(s)
- B. Slaug
- Department of Health Sciences; Faculty of Medicine; Lund University; Lund Sweden
| | - S. Iwarsson
- Department of Health Sciences; Faculty of Medicine; Lund University; Lund Sweden
| | - J. A. Ayala
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine; Faculty of Health Sciences; Universidad Rey Juan Carlos; Alcorcón, Madrid Spain
| | - M. H. Nilsson
- Department of Health Sciences; Faculty of Medicine; Lund University; Lund Sweden
- Memory Clinic; Skåne University Hospital; Malmö Sweden
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RETRACTED ARTICLE: Predictors of institutionalization among home-dwelling older Finnish people: a 22-year follow-up study. Aging Clin Exp Res 2017; 29:507. [PMID: 26802003 DOI: 10.1007/s40520-016-0530-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Accepted: 01/05/2016] [Indexed: 10/22/2022]
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Salminen M, Vire J, Viikari L, Vahlberg T, Isoaho H, Lehtonen A, Viitanen M, Arve S, Eloranta S. Predictors of institutionalization among home-dwelling older Finnish people: a 22-year follow-up study. Aging Clin Exp Res 2017; 29:499-505. [PMID: 28213740 DOI: 10.1007/s40520-016-0722-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 11/25/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND Identification of predictive factors on institutionalization provides the basis for the development and application of preadmission assessment. There is a lack of evidence for predictors of institutionalization for older people. AIMS To examine the effect of predictive factors on institutionalization in home-dwelling 70-year-old people. METHODS The data were collected in 1991 by the clinical examinations, a postal questionnaire, and an interview from the residents of Turku, Finland, born in 1920 (n = 1032). Institutionalization was defined as entry into a nursing home or sheltered housing at any time during a 22-year follow-up. RESULTS A rate of institutionalization was 22.0%. In multivariable Cox regression analysis, impaired cognitive function (MMSE 18-26) (hazard ratio 1.71, confidence interval 1.24-2.36) and low BMI (<25 kg/m2) (compared to both BMI of 25-29.9 and that of ≥30, respectively, 1.88, 1.32-2.67, and 1.66, 1.05-2.60), having several falls during the previous year (2.50, 1.28-4.90). CONCLUSIONS We conclude that impaired cognitive function, low BMI, and frequent falling predicted institutionalization during the 22-year follow-up. To reduce or postpone institutionalization, interventions should target risk factors, such as frailty, physical limitations, and falling. In addition, community-based services according to the needs and functional ability of the home-dwelling older people should be developed.
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Affiliation(s)
- Marika Salminen
- Unit of Family Medicine, Faculty of Medicine, University of Turku, Lemminkäisenkatu 1, 20014, Turku, Finland.
- City of Turku, Welfare division, Yliopistonkatu 30, Turku, Finland.
| | - Jenni Vire
- Department of Geriatrics, Faculty of Medicine, University of Turku, Kunnallissairaalantie 20, Turku, Finland
| | - Laura Viikari
- Department of Geriatrics, Faculty of Medicine, University of Turku, Kunnallissairaalantie 20, Turku, Finland
| | - Tero Vahlberg
- Institute of Clinical Medicine, Biostatistics, University of Turku, Turku, Finland
| | - Hannu Isoaho
- Statcon Ltd., Savenvalajankatu 3 B 25, Turku, Finland
| | - Aapo Lehtonen
- Department of Geriatrics, Faculty of Medicine, University of Turku, Kunnallissairaalantie 20, Turku, Finland
| | - Matti Viitanen
- Department of Geriatrics, Faculty of Medicine, University of Turku, Kunnallissairaalantie 20, Turku, Finland
- Division of clinical geriatrics Karolinska Institute, Karolinska University Hospital, Huddinge, 141 86, Stockholm, Sweden
| | - Seija Arve
- Department of Nursing Science, Faculty of Medicine, University of Turku, Lemminkäisenkatu 1, Turku, Finland
| | - Sini Eloranta
- Department of Nursing Science, Faculty of Medicine, University of Turku, Lemminkäisenkatu 1, Turku, Finland
- Hospital District of Southwest Finland, Kiinanmyllynkatu 4-8, Turku, Finland
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Stolt M, Eloranta S, Elo S, Isola A, Suhonen R. A scoping review of Finnish doctoral dissertations in older people nursing science. ACTA ACUST UNITED AC 2017. [DOI: 10.1177/2057158517691919] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Scientific research is important in guiding the development of evidence-based, cost-effective and comprehensive healthcare. The purpose of this scoping review was to analyse the current stage of research in the field of older people nursing science based on doctoral dissertations completed in Finnish universities. Altogether 418 doctoral dissertations in nursing science were published (1990–2015), and 44 of these (11%) represented older people nursing. The majority of the dissertations focused on patient and family or nursing activities. Usual topics were care procedures and clinical nursing (36%); self-care ability, independence (23%) and existence, being and feeling as an individual person (18%). Only one randomised controlled trial was conducted. The main informants were older people (78%) who were typically interviewed or surveyed. Research in older people nursing science in Finland is focusing on traditional clinical nursing settings. More innovative research is necessary from the perspective of health promotion and technological solutions.
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Affiliation(s)
- Minna Stolt
- Department of Nursing Science, University of Turku, Finland
- Turku University Hospital, Finland
| | - Sini Eloranta
- Department of Nursing Science, University of Turku, Finland
- Turku University of Applied Sciences, Health and Wellbeing, Finland
| | - Satu Elo
- Nursing Science and Health Management Research Group, Medical Research Centre Oulu (MRC), Finland
| | - Arja Isola
- Nursing Science and Health Management Research Group, Medical Research Centre Oulu (MRC), Finland
| | - Riitta Suhonen
- Department of Nursing Science, University of Turku, Finland
- Turku University Hospital, Finland
- City of Turku, Welfare Division, Finland
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Berge MS. Telecare - where, when, why and for whom does it work? A realist evaluation of a Norwegian project. J Rehabil Assist Technol Eng 2017; 4:2055668317693737. [PMID: 31186924 PMCID: PMC6453039 DOI: 10.1177/2055668317693737] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Accepted: 01/09/2017] [Indexed: 11/16/2022] Open
Abstract
Introduction Evaluations of telecare demonstrate disparate results, which are of little help for understanding what the users need from further policy and development. This study aims to provide a more nuanced approach to telecare evaluations. Methods Realist evaluation is used to scrutinize what it is about telecare that works for whom, why, how and in which circumstances. Sequential interviews were conducted with telecare users and relatives at pre- and post-implementation stages. Result Some users experienced the intended effects from telecare, such as increased feeling of safety, whereas others did not. Various contextual elements influenced how people reasoned about the resources provided by telecare and affected the individual outcomes. Discussion The desire to remain in own home appeared to be a major driving force in accepting telecare. Users had surprisingly high tolerance to side effects of telecare, which might indicate that much was at stake. Some users disapproved of having telecare due to contextual reasons; however, readjustments proved successful to some. Conclusion This study illuminates how and why telecare works differently in different situations, and thus leads to different outcomes. When telecare is correctly adjusted to match the user's needs, abilities and contexts it enables them to feel safe and remain in their own homes.
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Affiliation(s)
- Mari S Berge
- School of Applied Social Science, University of Stirling, UK.,Centre of Care Research, Western Norway University of Applied Sciences
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Granbom M, Iwarsson S, Kylberg M, Pettersson C, Slaug B. A public health perspective to environmental barriers and accessibility problems for senior citizens living in ordinary housing. BMC Public Health 2016; 16:772. [PMID: 27514631 PMCID: PMC4982418 DOI: 10.1186/s12889-016-3369-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Accepted: 07/23/2016] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Housing environments that hinder performance of daily activities and impede participation in social life have negative health consequences particularly for the older segment of the population. From a public health perspective accessible housing that supports active and healthy ageing is therefore crucial. The objective of the present study was to make an inventory of environmental barriers and investigate accessibility problems in the ordinary housing stock in Sweden as related to the functional capacity of senior citizens. Particular attention was paid to differences between housing types and building periods and to identify environmental barriers generating the most accessibility problems for sub-groups of senior citizens. METHODS Data on environmental barriers in dwellings from three databases on housing and health in old age was analysed (N = 1021). Four functional profiles representing large groups of senior citizens were used in analyses of the magnitude and severity of potential accessibility problems. Differences in terms of type of housing and building period were examined. RESULTS High proportions of one-family houses as well as multi-dwellings had substantial numbers of environmental barriers, with significantly lower numbers in later building periods. Accessibility problems occurred already for senior citizens with few functional limitations, but more profound for those dependent on mobility devices. The most problematic housing sections were entrances in one-family houses and kitchens of multi-dwellings. CONCLUSIONS Despite a high housing standard in the Swedish ordinary housing stock the results show substantial accessibility problems for senior citizens with functional limitations. To make housing accessible large-scale and systematic efforts are required.
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Affiliation(s)
- Marianne Granbom
- Department of Health Sciences, Lund University, Box 157, 221 00 Lund, Sweden
| | - Susanne Iwarsson
- Department of Health Sciences, Lund University, Box 157, 221 00 Lund, Sweden
| | - Marianne Kylberg
- Department of Health Sciences, Lund University, Box 157, 221 00 Lund, Sweden
| | - Cecilia Pettersson
- Department of Health Sciences, Lund University, Box 157, 221 00 Lund, Sweden
| | - Björn Slaug
- Department of Health Sciences, Lund University, Box 157, 221 00 Lund, Sweden
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Abstract
The purpose of this article is to describe research and teaching activities related to healthy ageing, narrative methods and research ethics at the Nordic School of Public Health NHV during 1999 - 2012. Healthy ageing was conceived in terms of The World Health Organization's (WHO) model of active ageing and of quality of life defined as a sense of well-being, meaning and value. Qualitative research on ageing and health conducted at NHV showed how elderly people themselves experience health and what they perceive to be health promoting. Narrative method was one the qualitative methods used in research at NHV. By adopting holistic and categorical content analysis the life stories of elderly Finnish migrants, the stories of home-dwelling persons about falls, and working persons' stories of alcohol use were studied. The courses on research ethics took their point of departure in a model that describes the role of scientific, economic, aesthetic and ethical values in research.
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