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Taranrød LB, Kirkevold Ø, Pedersen I, Eriksen S. The transition of care from farm-based daycare for people with dementia: The perspective of next of kin. Int J Qual Stud Health Well-being 2023; 18:2228047. [PMID: 38016039 PMCID: PMC10291912 DOI: 10.1080/17482631.2023.2228047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 06/18/2023] [Indexed: 11/30/2023] Open
Abstract
PURPOSE The aim of the present study was to explore the next of kin's experiences with the transition for people with dementia from a farm-based daycare (FDC) to another service in the municipality. METHODS The study has a qualitative, descriptive design. Eight semi-structured interviews with next of kin were conducted. The data were analysed in accordance with content analysis. RESULTS Through the analysis three main categories were developed: (1) Bearing the burden, (2) Being in transition, and (3) Feeling supported. The transition period was highly stressful for next of kin due to the exacerbation of their relatives' dementia symptoms. The next of kin focussed on optimizing the everyday lives of their relatives with dementia, even at the expense of their own well-being. Most participants experienced support from FDC, healthcare services and their informal network. CONCLUSIONS The study contributes important insights into the next of kin's experiences. Good quality service, close dialog, information, and support between the different part in the transition process, can be useful for the further development of services with good quality and to reduce the negative effects of care on next of kin.
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Affiliation(s)
- Liv Bjerknes Taranrød
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Øyvind Kirkevold
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Centre for Age Related Functional Decline and Diseases (AFS) at Innlandet Hospital Trust, Hamar, Norway
- Department of Health Sciences in Gjøvik, Norwegian University of Science and Technology (NTNU), Gjøvik, Norway
| | - Ingeborg Pedersen
- Department of Public Health Science, Ås, Norway, Norwegian University of Life Sciences, Ås, Norway
| | - Siren Eriksen
- Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Bachelor of Nursing, Lovisenberg Diaconal University College, Oslo, Norway
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Nilsen A, Lichtwarck B, Eriksen S, Mork Rokstad AM. Clinical expressions, characteristics and treatments of confirmed COVID-19 in nursing home residents: a systematic review. BMC Geriatr 2023; 23:101. [PMID: 36803435 PMCID: PMC9936944 DOI: 10.1186/s12877-023-03826-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 02/15/2023] [Indexed: 02/19/2023] Open
Abstract
BACKGROUND The coronavirus 2019 (COVID-19) pandemic has led to a high rate of infections, frequent outbreaks, and high mortality rates in nursing homes (NH) worldwide. To protect and improve the treatment and care of the vulnerable NH population, it is pivotal to systematise and synthesise data from cases of COVID-19 among NH residents. In our systematic review, we therefore aimed to describe the clinical expressions, characteristics, and treatments of NH residents confirmed to have COVID-19. METHODS We conducted two comprehensive literature searches in several electronic databases: (1) PubMed, (2) CINAHL, (3) AgeLine, (4) Embase, and (5) PsycINFO in April and July 2021. Of the 438 articles screened, 19 were included in our sample, and we used the Newcastle-Ottawa Assessment Scale to assess the quality of the reported studies. A weighted mean (Mweighted), was calculated to account for the large variation in sample sizes of the studies, and due to heterogeneity among the studies, we report our findings in a narrative synthesis. RESULTS According to the mean weights (Mweighted), common symptoms and signs in NH residents confirmed to have COVID-19 were fever (53.7%), cough (56.5%), hypoxia (32.3%), and delirium or confusion (31.2%). Common comorbidities were hypertension (78.6%), dementia or cognitive impairment (55.3%), and cardiovascular diseases (52.0%). Six studies presented data concerning medical and pharmacological treatments, such as inhalers, oxygen supplementation, anticoagulation, and parenteral/enteral fluids or nutrition. The treatments were used to improve outcomes, as part of palliative care, or as end-of-life treatment. Transfers to hospital for NH residents with confirmed COVID-19 were reported in six of the included studies, and the rate of hospital transfers ranged from 6.9% to 50% in this population. In the 17 studies reporting mortality, 40.2% of the NH residents died during the studies' observation periods. CONCLUSIONS Our systematic review allowed us to summarise important clinical findings about COVID-19 among NH residents and to identify the population's risk factors for serious illness and death caused by the disease. However, the treatment and care of NH residents with severe COVID-19 warrant further investigation.
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Affiliation(s)
- Anita Nilsen
- Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway.
| | - Bjørn Lichtwarck
- grid.412929.50000 0004 0627 386XThe Research Centre for Age-Related Functional Decline and Disease, Innlandet Hospital Trust, Ottestad, Norway
| | - Siren Eriksen
- grid.417292.b0000 0004 0627 3659Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway ,grid.458172.d0000 0004 0389 8311Lovisenberg Diaconal University College, Oslo, Norway
| | - Anne Marie Mork Rokstad
- grid.411834.b0000 0004 0434 9525Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway ,grid.417292.b0000 0004 0627 3659Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
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Julnes SG, Lichtwarck B, Eriksen S, Hillestad AH, Nilsen A, Tretteteig S, Rokstad AMM. Sykehjemslegers erfaringer med covid-19. En kvalitativ intervjustudie. TFO 2023. [DOI: 10.18261/tfo.8.3.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
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Sandmoe A, Myhre J, Iversen MH, Eriksen S, Lichtwarck B. Vold, overgrep, utelatt helsehjelp, forsømmelser og aggresjon:Begrepsbruk i en norsk sykehjemskontekst. TFO 2022. [DOI: 10.18261/tfo.8.3.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
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Eriksen S, Engedal K, Grov EK. Lifeworld perspectives of people with dementia: a meta-aggregation of qualitative studies. BMC Geriatr 2022; 22:970. [PMID: 36522618 PMCID: PMC9753383 DOI: 10.1186/s12877-022-03660-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 11/28/2022] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES This meta-aggregation aims to interpret and synthesize present knowledge on the lifeworld perspectives of people with dementia and develop a model for guidance in clinical practice. METHOD The data consist of four meta-syntheses describing different lifeworld perspectives in accordance with van Manen's existentials: lived relations, lived space, lived time and lived body. The meta-aggregation summarizes a range of views expressed by people with dementia in qualitative, interview-based studies, with the aim of generating a reliable model based on the studies' findings. RESULTS In total, 88 studies among 1,191 persons with dementia were included. Sixteen areas of focus were found, representing four perspectives: (a) lived relations, consisting of connectedness, independence, equality and competence; (b) lived space, consisting of belonging, meaningfulness, safety and security, and autonomy; (c) lived time, consisting of being rooted in the past, being in the present, viewing the future and being in process; and (d) lived body, consisting of being functional, trustworthy, adaptable and presentable. A model shaped as a tree trunk captures the lifeworld perspectives of people with dementia. CONCLUSION Sixteen areas were revealed from this meta-aggregation and form the basis of a model. This model may be used as a guide for health care personnel to ensure the overall lifeworld-perspectives of people with dementia in care for the target group and conduct lifeworld-preserving care with a person-centred approach.
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Affiliation(s)
- Siren Eriksen
- grid.417292.b0000 0004 0627 3659The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway ,grid.458172.d0000 0004 0389 8311Lovisenberg Diaconal University College, Oslo, Norway
| | - Knut Engedal
- grid.417292.b0000 0004 0627 3659The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway ,grid.55325.340000 0004 0389 8485Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Ellen Karine Grov
- grid.412414.60000 0000 9151 4445Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
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Rokstad AMM, Eriksen S, Bjørkløf GH. The facilitation of user-involvement for people with dementia as experienced by health care professionals: A qualitative study using focus groups. Aging Ment Health 2022; 26:2511-2517. [PMID: 34524946 DOI: 10.1080/13607863.2021.1975094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVE The main objective of this study was to explore how health care professionals experience adaptation of user-involvement for people with dementia receiving health and social care. METHOD A qualitative explorative design was used with eight focus groups as the method of data collection. A total of 49 health care professionals were included representing a variety of professions, municipal and specialized health services, and all health regions of Norway. The transcribed focus group interviews were analyzed using qualitative content analysis following six steps to identify categories and the overall theme. RESULTS Six main categories were identified: 1) facilitation of self-determination, 2) challenges of reduced or lack of awareness, 3) family caregivers' concern and protection, 4) open communication, 5) establishing a trustworthy relationship, and 6) clarifying expectations. To maintain independent lives for people with dementia, health care professionals must facilitate and support shared decision-making using an open and trustworthy communication. CONCLUSION To facilitate user-involvement, health care professionals need to develop and implement strategies that consider the perspectives of people with dementia and support the relationship between people with dementia and their informal caregivers.
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Affiliation(s)
- Anne Marie Mork Rokstad
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway
| | - Siren Eriksen
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Lovisenberg Diaconal University College, Oslo, Norway
| | - Guro Hanevold Bjørkløf
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
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Overen CK, Larsson M, Hillestad AH, Eriksen S. Process of pain assessment in people with dementia living in nursing homes: a scoping review protocol. BMJ Open 2022; 12:e063230. [PMID: 36171025 PMCID: PMC9528625 DOI: 10.1136/bmjopen-2022-063230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Pain is a common symptom in people with dementia; untreated, it reduces quality of life and causes suffering. People with dementia living in nursing homes most often have dementia in moderate to severe stages. The cognitive impairment, including language and communication difficulties, challenges pain assessment. Since pain is a subjective experience, self-reporting is the gold standard of assessment methods. Healthcare professionals are advised to help people with dementia communicate about their pain. The proposed scoping review is the first step in the development of a systematic pain assessment model for people with dementia living in nursing homes. The scoping review aims to identify, categorise and summarise knowledge on how pain assessment processes in this population are described in the literature, with a special focus on self-reporting. METHODS AND ANALYSIS The scoping review will be conducted following the six-stage framework developed by Arksey and O'Malley, in addition to recent methodological developments. Systematic searches in CINAHL, Embase, Medline and PsycInfo will be conducted. The protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols (PRISMA-P) and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklists, and the scoping review will adhere to the PRISMA-ScR checklist. The review will include research that concerns assessment of pain in people with dementia living in nursing homes. Studies will be evaluated for quality and ethical standards. The analysis process will follow Bradbury-Jones et al's PAGER framework. Patterns will be formed using thematic analysis. An overview of advances, gaps, evidence for practice and research recommendations associated with each pattern will be prepared. The research questions and results will be presented to and discussed in a reference group comprising nursing home residents, relatives, healthcare professionals and nursing home managers. ETHICS AND DISSEMINATION The scoping review aims to collect and summarise data from available publications and does not require ethical approval. The final manuscript will be submitted to a peer-reviewed, open-access journal. REGISTRATION IN OPEN SCIENCE FRAMEWORK: https://osf.io/8kaf5/.
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Affiliation(s)
- Caroline Kreppen Overen
- Institute of Health Sciences, Department of Nursing, Karlstad University, Faculty of Health, Science and Technology, Karlstad, Sweden
- Bachelor Education in Nursing, Lovisenberg Diaconal University College, Oslo, Norway
| | - Maria Larsson
- Institute of Health Sciences, Department of Nursing, Karlstad University, Faculty of Health, Science and Technology, Karlstad, Sweden
| | | | - Siren Eriksen
- Bachelor Education in Nursing, Lovisenberg Diaconal University College, Oslo, Norway
- Norwegian National Centre for Ageing and Health, Tønsberg, Norway
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Finnanger-Garshol B, Pedersen I, Patil G, Eriksen S, Ellingsen-Dalskau LH. Emotional well-being in people with dementia - A comparative study of farm-based and regular day care services in Norway. Health Soc Care Community 2022; 30:e1734-e1745. [PMID: 34622521 DOI: 10.1111/hsc.13601] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 09/02/2021] [Accepted: 09/28/2021] [Indexed: 06/13/2023]
Abstract
There is a focus on how to provide care for the increasing number of people with dementia, and day care services have been highlighted as an important service. The present study aims to provide an in-depth comparison of the emotional well-being of participants at farm-based and regular day care services related to different aspects of the care environments. We used the Maastricht Electronic Daily Life Observation-tool to observe and register aspects of the care environment at the services. Observations took place at ten farm-based day care services, with 42 participants, and seven regular day care centres, with 46 participants. Observed mood was considered an indicator for the emotional well-being of the participants and used as the primary outcome. The analyses showed a general positive mood for all participants, regardless of type of day care service. The unadjusted analyses showed more emotional well-being for the participants at farm-based day care across a range of factors compared to regular day care. The linear mixed model found that regardless of service type the activities (1) exercise and dancing, and (2) quiz, music and spiritual activities were associated with emotional well-being. In addition, social interaction, either with one person or two or more people, were also associated with emotional well-being regardless of service type. The mixed model further demonstrated an association between attending farm-based day care services and positive mood compared to regular day care services. Based on the findings social interaction and social activities seem important to emotional well-being. This highlights the social aspect of the day care services and future research should investigate how one can facilitate good social interactions at day care services. The positive association between farm-based day care services and emotional well-being may potentially reflect a positive influence of the farm setting and the farm service providers.
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Affiliation(s)
| | - Ingeborg Pedersen
- Department of Public Health Science, Norwegian University of Life Sciences, Ås, Norway
| | - Grete Patil
- Department of Public Health Science, Norwegian University of Life Sciences, Ås, Norway
| | - Siren Eriksen
- National Advisory Unit for Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
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Telenius EW, Tangen GG, Eriksen S, Rokstad AMM. Fun and a meaningful routine: the experience of physical activity in people with dementia. BMC Geriatr 2022; 22:500. [PMID: 35689197 PMCID: PMC9188090 DOI: 10.1186/s12877-022-03149-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 05/16/2022] [Indexed: 11/18/2022] Open
Abstract
Background Physical activity is important to health and wellbeing. People with dementia are less physically active than their cognitively healthy counterparts. Reasons for this are multifaceted, and are thought to be social, psychological, and physiological. People with dementia often use services such as home care, day care centres and nursing home, and according to the stage of disease they are less or more dependent on other people to take part in activities. To develop appropriate services to this patient group, their needs and preferences regarding physical activity must be recognized. The aim of the study was therefore to provide insight into experiences with physical activity in people with dementia. Methods The current study is part of a larger research project on needs in people with dementia. The main project included qualitative semi-structured interviews with 35 persons with dementia. 27 of the participants talked about their experience with physical activity. In the current study, the relevant findings on this theme were analysed separately. A phenomenological hermeneutic research design was applied. Results The analysis revealed three main categories regarding experiences with physical activity. To be physically active provided positive experiences such as feelings of mastering and post-exercise euphoria. To be physically active was meaningful. The daily walk was an important routine to many, and it gave meaningful content to the day. Keeping up with activities confirmed identity. Lastly, to be active was perceived as challenging. Participants described different barriers to being physically active such as a decline of physical function, lack of motivation and being dependent on others to go out. Conclusions Many of the participants expressed that being physically active was important to them. It is essential that informal and formal carers are aware of the role physical activity plays in the lives of many people with dementia, so that appropriate measures can be taken to assure continued active living in order to preserve health and quality of life. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03149-6.
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Affiliation(s)
- Elisabeth Wiken Telenius
- The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, PO Box 2136, 3103, Tønsberg, Norway. .,Faculty of Health Studies, VID Specialized University, Oslo, Norway.
| | - Gro Gujord Tangen
- The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, PO Box 2136, 3103, Tønsberg, Norway.,Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Siren Eriksen
- The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, PO Box 2136, 3103, Tønsberg, Norway.,Lovisenberg Diaconal University College, Oslo, Norway
| | - Anne Marie Mork Rokstad
- The Norwegian National Centre for Ageing and Health, Vestfold Hospital Trust, PO Box 2136, 3103, Tønsberg, Norway.,Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway
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10
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Eriksen S, Grov EK, Ibsen TL, Mork Rokstad AM, Telenius EW. The experience of lived body as expressed by people with dementia: A systematic meta-synthesis. Dementia (London) 2022; 21:1771-1799. [PMID: 35437056 DOI: 10.1177/14713012221082369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION People with dementia undergo extensive bodily changes during the course of dementia. Even though this is largely unrecognised in the literature, these changes greatly impact on the persons' experiences of living with dementia. Consequently, health care professionals and family caregivers need to be aware of the implications this has for delivering care to people with dementia. Hence, a systematic review that synthesises the knowledge on this topic is called for. METHOD This article presents a qualitative systematic meta-synthesis of interview studies with people with dementia. The theoretical framework of lifeworlds by van Manen provided the context for the study. The Critical Appraisal Skills Program criteria for qualitative studies were used to appraise the studies. Thirty-nine qualitative research studies were included in the review. The analysis followed the principles of interpretive synthesis. FINDINGS When exploring people's experiences of their body when living with dementia, four categories emerge: (1) My body works; (2) My body betrays me; (3) Understanding and adapting to my body's changes; and (4) My body in relation to others. DISCUSSION/CONCLUSION Every individual has their own personal experience of living with dementia; however, if health professionals fail to regard the body as more than an object, this may lead to the person's alienation both from the relation and from the body. The lived body experience has relational aspects as people with dementia are aware that others observe them, and they also observe others. Others' behaviour may affect the person's experience of body; one can perceive oneself as approved or denounced. People with dementia describe that a body that is capable and strong gives access to the world and to participation.
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Affiliation(s)
- Siren Eriksen
- The Norwegian National Centre for Ageing and Health, 60512Vestfold Hospital Trust, Tønsberg, Norway / Lovisenberg Diaconal University College, Oslo, Norway
| | - Ellen K Grov
- Department of Nursing and Health Promotion, XXXOslo Metropolitan University, Oslo, Norway
| | - Tanja L Ibsen
- The Norwegian National Centre for Ageing and Health, 60499Vestfold Hospital Trust, Tønsberg, Norway
| | - Anne M Mork Rokstad
- The Norwegian National Centre for Ageing and Health, XXXVestfold Hospital Trust, Tønsberg, Norway / Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway
| | - Elisabeth W Telenius
- The Norwegian National Centre for Ageing and Health, XXXVestfold Hospital Trust, Tønsberg, Norway / VID Specialized University, Oslo, Norway
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Ibsen TL, Eriksen S. Interdisciplinary Research: An Important Contribution to Dementia Care. J Multidiscip Healthc 2022; 15:317-321. [PMID: 35237039 PMCID: PMC8883404 DOI: 10.2147/jmdh.s350132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 01/28/2022] [Indexed: 11/25/2022] Open
Abstract
Authorities and research institutions emphasise and encourage interdisciplinary research to meet complex societal health challenges as dementia. However, studies that describe an interdisciplinary approach for dementia research are limited. What does it take for research to become interdisciplinary? Is it enough to include researchers from different disciplines? This paper reflects on an interdisciplinary approach to dementia research. Based on existing literature and theories, we elaborate the concept of interdisciplinarity, and how the perspective can contribute and improve dementia care.
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Affiliation(s)
- Tanja Louise Ibsen
- Norwegian National Advisory Unit on Aging and Health (Aging and Health), Vestfold Hospital Trust, Tønsberg, Norway
- Correspondence: Tanja Louise Ibsen, Email
| | - Siren Eriksen
- Norwegian National Advisory Unit on Aging and Health (Aging and Health), Vestfold Hospital Trust, Tønsberg, Norway
- Lovisenberg Diaconal University College, Oslo, Norway
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Tretteteig S, Eriksen S, Hillestad AH, Julnes SG, Lichtwarck B, Nilsen A, Rokstad AMM. The Experience of Relatives of Nursing Home Residents with COVID-19: A Qualitative Study. NRR 2022. [DOI: 10.2147/nrr.s328336] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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13
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Taranrød LB, Pedersen I, Kirkevold Ø, Eriksen S. Being sheltered from a demanding everyday life: experiences of the next of kin to people with dementia attending farm-based daycare. Int J Qual Stud Health Well-being 2021; 16:1959497. [PMID: 34338623 PMCID: PMC8330702 DOI: 10.1080/17482631.2021.1959497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/20/2021] [Indexed: 11/21/2022] Open
Abstract
PURPOSE Farm-based daycare (FDC) is a type of daycare service for people with dementia. The aim of the present study was to explore the next of kin's experiences with FDC and how the service may affect their daily life. METHODS The study has a qualitative, descriptive design. Eight semi-structured interviews with next of kin were conducted. The data were analysed in accordance with content analysis. RESULTS We identified three main categories: (1) I am fine when you are fine, (2) Significant aspects of the service at the farm, and (3) FDC as a part of the dementia trajectory. The findings were summarized in one overarching, latent theme: "Being sheltered from a demanding everyday life". CONCLUSIONS The findings indicate that next of kin's experience of respite is closely connected to the well-being of their relatives at the FDC and the quality of the service. FDC provides significant support through a part of the trajectory of dementia. Despite experiencing respite and support, next of kin continue to struggle with ethical and moral decisions about the futures of their relatives with dementia.
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Affiliation(s)
- Liv Bjerknes Taranrød
- Vestfold Hospital Trust, Norwegian National Advisory Unit on Ageing and Health, Tønsberg, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Ingeborg Pedersen
- Department of Public Health Science, Norwegian University of Life Sciences, Ås, Ås, Norway
| | - Øyvind Kirkevold
- Vestfold Hospital Trust, Norwegian National Advisory Unit on Ageing and Health, Tønsberg, Norway
- Innlandet Hospital Trust, Centre for Age Related Functional Decline and Diseases (AFS), Hamar, Norway
- Department of Health Sciences, Norwegian University of Science and Technology (NTNU), Gjøvik, Norway
| | - Siren Eriksen
- Vestfold Hospital Trust, Norwegian National Advisory Unit on Ageing and Health, Tønsberg, Norway
- Department of Bachelor in Nursing, Lovisenberg Diaconal University College, Oslo, Norway
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14
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Eriksen S, Bartlett RL, Grov EK, Ibsen TL, Telenius EW, Mork Rokstad AM. The Experience of Lived Time in People with Dementia: A Systematic Meta-Synthesis. Dement Geriatr Cogn Disord 2020; 49:435-455. [PMID: 33176312 PMCID: PMC7949212 DOI: 10.1159/000511225] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 08/27/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION For people with dementia, lived time is important to understand, as the condition affects memory, perceptions of time, and life expectancy. The aim of this study was to locate, interpret, and synthesize the experience of lived time for people with dementia. METHOD This article presents a qualitative systematic meta-synthesis. The theoretical framework of lifeworlds by van Manen provided the context for the study. The Critical Appraisal Skills Programme criteria for qualitative studies were used to appraise the studies. Sixty-one qualitative research studies based on interviews with people with dementia were included in the review. The analysis followed the principles of interpretive synthesis. RESULTS Four categories were revealed: (1) rooted in the past - "I am the same as before"; (2) focussing on the present - "Nobody has tomorrow"; (3) thinking about the future - "What is going to happen to me?"; and (4) changes in the experience of self over time - "I used to…." The latent overall meaning was expressed as "being engaged with the dimensions of time." DISCUSSION/CONCLUSION The experience of lived time is an active and important one, enabling people to manage the dementia journey. Future work involving people with dementia should foreground the experience of lived time.
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Affiliation(s)
- Siren Eriksen
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Lovisenberg Diaconal University College, Oslo, Norway
| | - Ruth Louise Bartlett
- Faculty of Health Studies, VID Specialized University, Oslo, Norway
- School of Health Sciences, University of Southampton, Southampton, United Kingdom
| | - Ellen Karine Grov
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Tanja Louise Ibsen
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
| | - Elisabeth Wiken Telenius
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
| | - Anne Marie Mork Rokstad
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway,
- Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway,
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15
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Taranrød LB, Eriksen S, Pedersen I, Kirkevold Ø. Characteristics, Burden of Care and Quality of Life of Next of Kin of People with Dementia Attending Farm-Based Day Care in Norway: A Descriptive Cross-Sectional Study. J Multidiscip Healthc 2020; 13:1363-1373. [PMID: 33173299 PMCID: PMC7646404 DOI: 10.2147/jmdh.s268818] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 09/11/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose Caring for people with dementia is often associated with burden of care and may influence the quality of life of the next of kin. The aim of this study was to describe the characteristics of the next of kin to people with dementia attending farm-based day care service (FDC) and identify characteristics associated with burden of care and quality of life (QoL) of next of kin. Participants and Methods Ninety-four dyads of people with dementia and their next of kin were included from 25 FDCs in Norway in this descriptive cross-sectional study. The Relative Stress Scale (RSS) and the QoL–Alzheimer’s Disease Scale (QoL-AD) were used as outcomes measures. Results The participants consisted of those who lived with a person with dementia (spouse/partner, 62%) and those who did not (children), with significant differences in age, education level, work employment, perceived social support, depression symptoms, burden of care, and QoL. In multiple regression models, RSS and QoL were associated with living with the person with dementia, anxiety symptoms and perceived social support. In addition, RSS was associated with neuropsychiatric symptoms (NPS) in the people with dementia. Conclusion Our findings underline the importance of obtaining knowledge about the next of kin’s burden of care and QoL, of people with dementia attending an FDC. This knowledge is essential for those responsible for providing the best possible services for the next of kin and for developing targeted interventions to support the next of kin.
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Affiliation(s)
- Liv Bjerknes Taranrød
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,University of Oslo, Faculty of Medicine, Oslo, Norway
| | - Siren Eriksen
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Department of Bachelor Education, Lovisenberg Diaconal University College, Oslo, Norway
| | - Ingeborg Pedersen
- Department of Public Health Science, Norwegian University of Life Sciences, Ås, Norway
| | - Øyvind Kirkevold
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Centre of Old Age Psychiatry Research, Innlandet Hospital Trust, Brumunddal, Norway.,Norwegian University of Science and Technology (NTNU), Department of Health Sciences in Gjøvik, Trondheim, Norway
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16
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Ibsen TL, Kirkevold Ø, Patil GG, Eriksen S. Dropout from farm-based day care for people with dementia in Norway: a follow-up study. BMC Geriatr 2020; 20:428. [PMID: 33109115 PMCID: PMC7590676 DOI: 10.1186/s12877-020-01826-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 10/12/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Farm-based day care services (FDCs) for people with dementia are intending to provide social relationships and meaningful activities in an agricultural landscape and offer respite for next of kin. As this requires a certain cognitive and physical functioning, it is of interest to investigate how this service contribute during the course of dementia. In this study we aim to explore the individual characteristics predicting dropout from FDC. Furthermore, we investigate whether the participants who drop out of the service continue to live at home with another day care service or if they move to a residential care facility. METHODS The study includes 92 people with dementia attending FDCs in Norway, assessed with standardized instruments at baseline between January 2017 and January 2018. They were followed for 1 year, and dropouts from FDC during this period were mapped. The association between individual characteristics and dropout was assessed using a Cox proportional hazards regression analysis. RESULTS Thirty-eight people stopped attending FDCs during the study. Twenty-six moved to residential care. Among the 12 who continued to live in their own homes, 9 people started in a regular day care service. Higher score on educational level and more severe dementia, as well as lower scores on social support, increased the probability of stopping FDC. CONCLUSION FDCs appeared as a service that is stable over time for most participants, as more than two-third could use the care facility until the need of residential care. The transfers within care services and levels of care seemed to be characterized by continuity. More research on the growing population of educated older adults with dementia are warranted, to facilitate for their course of care needs. Finally, extended knowledge is needed to improve the collaboration between private and public networks, such as day care services, to improve the experience of social support for people with dementia.
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Affiliation(s)
- T L Ibsen
- Norwegian National Advisory Unit on Ageing and Health (Ageing and Health), Vestfold Hospital Trust, Tønsberg, Norway. .,Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - Ø Kirkevold
- Norwegian National Advisory Unit on Ageing and Health (Ageing and Health), Vestfold Hospital Trust, Tønsberg, Norway.,Norwegian University of Science and Technology (NTNU) Department of Health Sciences in Gjøvik, Gjøvik, Norway.,Centre of Old Age Psychiatry Research, Innlandet Hospital Trust, Gjøvik, Norway
| | - G G Patil
- Department of Public Health Science, Faculty of Landscape and Society, Norwegian University of Life Sciences, Ås, Norway
| | - S Eriksen
- Norwegian National Advisory Unit on Ageing and Health (Ageing and Health), Vestfold Hospital Trust, Tønsberg, Norway.,Lovisenberg Diaconal University College, Oslo, Norway
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17
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Abstract
OBJECTIVE Many people with dementia receive community services. These services are often based on the needs of informal caregivers and professional caregivers' assessment. User involvement and participation are main objectives in the Norwegian National Dementia Plan 2020. To enhance user involvement and individual tailoring of healthcare services, more information is required about the needs of people with dementia. The aim of this study was to explore the experienced needs of people with dementia in order to facilitate user involvement in provided services. METHODS An explorative cross-sectional study design was used. We performed semistructured interviews with people with dementia who were recruited from all regions of Norway. The sample comprised 35 participants diagnosed with dementia. The interviews were audio-recorded and transcribed, and the data material was analysed using a qualitative content analysis. RESULTS Three main categories emerged from the interviews: (1) to stay connected; (2) to be active and participate; and (3) to live for the moment. The overarching theme was: the need to be who I am. CONCLUSIONS People with dementia participating in the study were heterogeneous regarding wants and requirements. Most of them expressed the need and wish to hold on to who they are. Close and robust relations with family and friends can give significant support to people with dementia. However, living with dementia might put considerable strain on relations. Services should provide support to enhance relationships, encourage existing networks to remain stable and facilitate participation in meaningful activities for people living with dementia.
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Affiliation(s)
- Elisabeth Wiken Telenius
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
| | - Siren Eriksen
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Lovisenberg Diaconal University College, Oslo, Norway
| | - Anne Marie Mork Rokstad
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
- Molde University College, Molde, Norway
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18
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Ibsen TL, Eriksen S. The experience of attending a farm-based day care service from the perspective of people with dementia: A qualitative study. Dementia (London) 2020; 20:1356-1374. [PMID: 32722922 DOI: 10.1177/1471301220940107] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
People with dementia have different needs, and it is important to have variation in the services that are offered for this population. Farm-based day care aims to meet this diversity in need, but research on such services is lacking. The present study provides knowledge about how people with dementia experience attending farm-based day care services in Norway. Ten semi-structured interviews were conducted for five different services, while the participants were at the farm. The interviews were analysed in accordance with the content analysis of Graneheim, U., & Lundman, B. (2004) [Nurse Education Today, 24(2), 105-112] and revealed three main categories that included (1) social relations, (2) being occupied at the farm, and (3) individually tailored service. The findings were summarised in the overall theme that attending day care at a farm makes me feel like a real participant. Our findings indicate that the farm-based day cares in the present study provide person-centred care. The farm setting facilitates services that are tailored to the individual, where the participants get to use their remaining resources and spend time outdoors. Further, farm-based day care was described as being suitable for people with or without farm experience and must be seen as an important supplement to regular day care for those who could benefit from a more active service.
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Affiliation(s)
- Tanja L Ibsen
- Norwegian National Advisory Unit on Ageing and Health (Ageing and Health), 60512Vestfold Hospital Trust, Norway; Faculty of Medicine, University of Oslo, Norway
| | - Siren Eriksen
- Norwegian National Advisory Unit on Ageing and Health (Ageing and Health), 60512Vestfold Hospital Trust, Norway; Lovisenberg Diaconal University College, Norway
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19
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Ibsen TL, Kirkevold Ø, Patil GG, Eriksen S. People with dementia attending farm-based day care in Norway - Individual and farm characteristics associated with participants' quality of life. Health Soc Care Community 2020; 28:1038-1048. [PMID: 31884707 DOI: 10.1111/hsc.12937] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 11/29/2019] [Accepted: 12/10/2019] [Indexed: 06/10/2023]
Abstract
Farm-based day care for people with dementia is supposed to improve the participants quality of life by using activities and resources of the farm environment to promote mental and physical health. In this paper, we describe the characteristics of those attending farm-based day care services in Norway and explore the association between individual and farm characteristics and the quality of life. A sample of 94 people with dementia who attended farm-based day care was recruited from 25 farms between January 2017 and January 2018. The data collection was performed using standardized instruments. Information about the farms was retrieved from a former study. The association between the participants' quality of life and their individual and/or farm characteristics was examined with a linear multilevel regression model. The participants had a mean age of 76 years, 62% were men, and 68% had additional education after primary school. Most of them had mild (54.3%) or questionable dementia (18.3%). A few participants used antipsychotics (3.7%), tranquilizers (9.9%) and painkillers (13.6%), while a higher number used antidepressants (30.9%). Quality of life was associated with the experience of having social support (p = .023), a low score on depressive symptoms (p < .001), and spending time outdoors at the farm (p < .001). The variation between the farm-based day care services in the participants' reported quality of life was related to time spent outdoors at the farm. In light of the present study, it seems as farm-based day care is addressing people with dementia in an early stage, dominated by men, with quite good physical and medical condition. The strong association between quality of life and spending time outdoors underscores that facilitation for outdoor activity should be prioritized in all types of dementia care.
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Affiliation(s)
- Tanja L Ibsen
- Norwegian National Advisory Unit on Aging and Health (Aging and Health), Vestfold Hospital Trust, Tønsberg, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Øyvind Kirkevold
- Norwegian National Advisory Unit on Aging and Health (Aging and Health), Vestfold Hospital Trust, Tønsberg, Norway
- Department of Health Sciences, Norwegian University of Science and Technology (NTNU), Gjøvik, Norway
- Centre of Old Age Psychiatry Research, Innlandet Hospital Trust, Gjøvik, Norway
| | - Grete G Patil
- Department of Public Health Science, Faculty of Landscape and Society, Norwegian University of Life Sciences, Ås, Norway
| | - Siren Eriksen
- Norwegian National Advisory Unit on Aging and Health (Aging and Health), Vestfold Hospital Trust, Tønsberg, Norway
- Faculty of Health Studies, VID Specialized University, Oslo, Norway
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20
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Eriksen S, Grov EK, Lichtwarck B, Holmefoss I, Bøhn K, Myrstad C, Selbæk G, Husebø B. Palliative treatment and care for dying nursing home patients with COVID-19. Tidsskr Nor Laegeforen 2020; 140:20-0306. [PMID: 32463205 DOI: 10.4045/tidsskr.20.0306] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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21
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de Bruin SR, Pedersen I, Eriksen S, Hassink J, Vaandrager L, Patil GG. Care Farming for People with Dementia; What Can Healthcare Leaders Learn from This Innovative Care Concept? J Healthc Leadersh 2020; 12:11-18. [PMID: 32210657 PMCID: PMC7071884 DOI: 10.2147/jhl.s202988] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 02/27/2020] [Indexed: 01/25/2023] Open
Abstract
There is growing recognition that traditional dementia care models fall short for people with dementia and their family caregivers. This has led to a call for new dementia care approaches. In response to this call, innovations in long-term dementia care are taking place both in the community and in residential care. One of these innovations is the care concept called “care farming.” Care farms are farms that combine agricultural activities with care and support services for a variety of client groups, including people with dementia. Although the concept is being implemented in an increasing number of countries, the Netherlands and Norway are still front-runners in providing and researching this innovative dementia care approach. Over the last couple of years, several research projects have been carried out in these countries addressing a wide range of issues related to dementia care provision at care farms and using a wide range of research methods. This paper synthesizes the knowledge that has been generated in these research projects. By sharing the knowledge obtained in the Netherlands and Norway, we hope to inspire leaders in healthcare undertaking similar efforts to innovate care for the increasing number of people with dementia. By providing starting-points for future research, we additionally hope to contribute to a research agenda to further advance the field.
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Affiliation(s)
- Simone R de Bruin
- National Institute for Public Health and the Environment, Bilthoven, the Netherlands.,Department of Social Sciences, Wageningen University & Research, Health and Society, Wageningen, the Netherlands
| | - Ingeborg Pedersen
- Faculty of Landscape and Society, Department of Public Health Science, Norwegian University of Life Sciences, As, Norway
| | - Siren Eriksen
- Faculty of Health Sciences, Norwegian Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway; VID Specialized University, Oslo, Norway
| | - Jan Hassink
- Wageningen University & Research, Wageningen Plant Research, Agrosystems Research, Wageningen, the Netherlands
| | - Lenneke Vaandrager
- Department of Social Sciences, Wageningen University & Research, Health and Society, Wageningen, the Netherlands
| | - Grete Grindal Patil
- Faculty of Landscape and Society, Department of Public Health Science, Norwegian University of Life Sciences, As, Norway
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22
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Eriksen S, Grov EK, Lichtwarck B, Holmefoss I, Bøhn K, Myrstad C, Selbæk G, Husebø B. Rettelse: Behandling, omsorg og pleie for døende sykehjemspasienter med covid-19. Tidsskriftet 2020; 140:20-0374. [DOI: 10.4045/tidsskr.20.0374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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23
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Bakker LP, Eriksen S, Reichelt JG, Grov EK. The experiences of dealing with consequences of an avalanche - surviving soldiers' perspectives. Int J Qual Stud Health Well-being 2019; 14:1689066. [PMID: 31713468 PMCID: PMC6853213 DOI: 10.1080/17482631.2019.1689066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/31/2019] [Indexed: 12/01/2022] Open
Abstract
Purpose: The aim of the study was to explore and describe experiences of daily life after having experienced an avalanche three decades ago.Method: This paper presents a qualitative study of 12 male survivors of an avalanche during their military service, interviewed 30 years post-disaster.Findings: A comprehensive understanding of the categories led to the latent theme "Finding my own way of managing and dealing with life". Findings revealed three categories describing experiences of daily living: (i) A comfortable life; (ii) A challenging, yet accomplished life; (iii) A demanding life. The first category represents a greater degree of using adaptive coping strategies for managing everyday life compared to the other two categories. The third category represents the group having the most challenging consequences. Among the three, the latter category conveys the most maladaptive coping strategies.Conclusions:The participants had different experiences with regards to their health and how they coped with their everyday life after the avalanche disaster. Insights into coping strategies may provide a guide for appropriate interventions for survivors dealing with traumatic events.
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Affiliation(s)
- Lars-Petter Bakker
- Norwegian Armed Forces Joint Medical Services, Institute of Military Psychiatry, Oslo, Norway
| | - Siren Eriksen
- Faculty of Health Studies, Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway, and VID Specialized university, Oslo, Norway
| | - Jon Gerhard Reichelt
- Norwegian Armed Forces Joint Medical Services, Institute of Military Psychiatry, Oslo, Norway
| | - Ellen Karine Grov
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
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24
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Bjørkløf GH, Helvik AS, Ibsen TL, Telenius EW, Grov EK, Eriksen S. Balancing the struggle to live with dementia: a systematic meta-synthesis of coping. BMC Geriatr 2019; 19:295. [PMID: 31666020 PMCID: PMC6822397 DOI: 10.1186/s12877-019-1306-9] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 10/07/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND People with dementia describe experiences of loss that threaten their autonomy and ability to contribute to society. They often have difficulties with orientation, loss of roll function, and fear about the future, and need help from others. An increasing body of literature also focuses on how people with dementia search for meaning and maintaining of quality to life, and how they find strategies to live with dementia. A review of the scientific literature on coping and dementia is warranted and can help to advice and inform healthcare personnel and decision makers on how they can support and plan for appropriate healthcare services for people with dementia. The aim of this systematic meta-synthesis was therefore to interpret and synthesize knowledge regarding people with dementia's experience of coping. METHODS We conducted a systematic, computerised search of Medline, Embase, Cinahl Complete, PsycINFO and Age Line combining MeSH terms and text words for different types of dementia with different descriptions of experience. Studies comprised 1) a sample of people with dementia, 2) a qualitative interview as a research method and 3) a description of experiences of coping were included. The search resulted in 7129 articles, of which 163 were read in full text, 80 were excluded due to the exclusion criteria or low quality according. The analysis was conducted in line with qualitative content analyses. RESULTS This interpretative qualitative meta-synthesis included 74 articles of good quality encompassing interviews with 955 persons with dementia. The material revealed two main resources of coping: (1) Humour and (2) Practical and emotional support, and four overall strategies in which people with dementia cope with the challenges they experience: (1) Keep going and holding on to life as usual; (2) Adapting and adjusting to the demands from the situation; (3) Accepting the situation; and (4) Avoiding the situation A comprehensive understanding of the categories led to the latent theme: Balancing the struggle of living with dementia. CONCLUSION This meta-synthesis indicates that people with dementia cope in different ways and using several parallel strategies. This insight is essential in dementia care to facilitate a supportive environment.
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Affiliation(s)
- Guro Hanevold Bjørkløf
- Norwegian National Advisory Unit on Ageing and Health (Ageing and Health), Postbox 2136, N-3103 Tønsberg, Norway
| | - Anne-Sofie Helvik
- Norwegian National Advisory Unit on Ageing and Health (Ageing and Health), Postbox 2136, N-3103 Tønsberg, Norway
- Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway
| | - Tanja Louise Ibsen
- Norwegian National Advisory Unit on Ageing and Health (Ageing and Health), Postbox 2136, N-3103 Tønsberg, Norway
| | - Elisabeth Wiken Telenius
- Norwegian National Advisory Unit on Ageing and Health (Ageing and Health), Postbox 2136, N-3103 Tønsberg, Norway
| | - Ellen Karine Grov
- Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Siren Eriksen
- Norwegian National Advisory Unit on Ageing and Health (Ageing and Health), Postbox 2136, N-3103 Tønsberg, Norway
- VID Spesialized University, Faculty of Health Studies, Oslo, Norway
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25
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Kerpershoek L, Wolfs C, Verhey F, Jelley H, Woods B, Bieber A, Bartoszek G, Stephan A, Selbaek G, Eriksen S, Sjölund B, Hopper L, Irving K, Marques MJ, Gonçalves‐Pereira M, Portolani D, Zanetti O, Vugt M. Optimizing access to and use of formal dementia care: Qualitative findings from the European Actifcare study. Health Soc Care Community 2019; 27:e814-e823. [PMID: 31293018 PMCID: PMC6851600 DOI: 10.1111/hsc.12804] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 05/27/2019] [Accepted: 06/04/2019] [Indexed: 06/09/2023]
Abstract
This paper reports on qualitative data from the Actifcare study investigating experiences, attitudes, barriers and facilitators concerning access to and use of formal care. A total of 85 semi-structured in-depth interviews were conducted in eight European countries. Results were analysed with a deductive content analysis, first within country and then integrated in a cross-national analysis. Overall, analysis of the in-depth interviews revealed two major themes with five subcategories. The results can be summarised in an optimal pathway for access to dementia care. This pathway includes fixed factors such as disease-related factors and system-related factors. In addition there are personal factors that are subject to change such as attitudes towards care. An important finding consisted of the necessity of having sufficient information about the disease and available care and having a key contact person to guide you through the process of finding suitable care while monitoring your needs. In addition, it is important to involve your social network as they can take on care-giving tasks. It is helpful to have a diagnosis (in most countries). Concerning decision-making, the person closest to the person with dementia is in the majority of cases the one who makes the ultimate decision to access and use services and he/she should therefore be supported in this process. These results provide insight into the factors that influence the pathway to formal care use and help professionals to enhance access to formal dementia care by focusing on factors that can be modified.
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Affiliation(s)
| | - Claire Wolfs
- Alzheimer Centre LimburgMaastricht UniversityMaastrichtNetherlands
| | - Frans Verhey
- Alzheimer Centre LimburgMaastricht UniversityMaastrichtNetherlands
| | | | | | - Anja Bieber
- Martin‐Luther University Halle‐WittenbergHalleGermany
| | | | | | - Geir Selbaek
- Norwegian National Advisory Unit on Ageing and HealthVestfold HospitalTonsbergNorway
- Centre for Old Age Psychiatry ResearchInnlandet Hospital TrustOttestadNorway
- Faculty of MedicineUniversity of OsloOsloNorway
| | - Siren Eriksen
- Norwegian National Advisory Unit on Ageing and HealthVestfold HospitalTonsbergNorway
| | - Britt‐Marie Sjölund
- Aging Research Center (ARC), Department of Neurobiology, Care Sciences and Society (NVS)Karolinska Institutet and Stockholm UniversityStockholmSweden
- Faculty of Health and Occupational Studies, Department of Health and Caring SciencesUniversity of GävleGävleSweden
| | - Louise Hopper
- School of Nursing and Human SciencesDublin City UniversityDublinIreland
| | - Kate Irving
- School of Nursing and Human SciencesDublin City UniversityDublinIreland
| | - Maria J. Marques
- CEDOC, Nova Medical School, Faculdade de Ciências MédicasUniversidade Nova de LisboaLisbonPortugal
| | - Manuel Gonçalves‐Pereira
- CEDOC, Nova Medical School, Faculdade de Ciências MédicasUniversidade Nova de LisboaLisbonPortugal
| | - Daniel Portolani
- IRCCS Istituto Centro San Giovanni di Dio FatebenefratelliBresciaItaly
| | - Orazio Zanetti
- IRCCS Istituto Centro San Giovanni di Dio FatebenefratelliBresciaItaly
| | - Marjolein Vugt
- Alzheimer Centre LimburgMaastricht UniversityMaastrichtNetherlands
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26
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Eriksen S, Bjørkløf GH, Helvik AS, Larsen M, Engedal K. The validity of the hospital anxiety and depression scale and the geriatric depression scale-5 in home-dwelling old adults in Norway ✰. J Affect Disord 2019; 256:380-385. [PMID: 31212233 DOI: 10.1016/j.jad.2019.05.049] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 03/20/2019] [Accepted: 05/27/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Little is known about the validity of the Norwegian versions of the Geriatric Depression Scale-5 (GDS-5) and the Hospital Anxiety and Depression Scale-D (HADS-D). The aim of this study was therefor to validate the two assessment tools in a population of home-dwelling persons of 60 years of age and above. METHODS A sample of 194 home-dwelling old adults with and without depressive symptoms were recruited. The participants were examined for depressive symptoms (GDS-5, HADS-D) and cognitive impairment. Sociodemographic information was collected. The participants underwent a blinded diagnostic evaluation for a depressive episode according to the diagnostic criteria of ICD-10. RESULTS In all, 56 (28.9%) participants fulfilled criteria for a depressive episode according to ICD-10. The Receiver Operating Characteristics analyses of HAD-D and GDS-5 using the diagnostic criteria of ICD-10 for depression as gold standard was performed. For GDS-5 the Areal under the Curve was 0.81 and for HAD-D 0.75. The cut-off points of the measures that produced the highest accuracies were ≥2 for GDS-5 with a sensitivity of 73.2% and a specificity of 73.2% and ≥4 for HADS-D with a sensitivity of 70.3% and a specificity of 69.6%. LIMITATIONS A larger sample would have given the opportunity for analyzing home dwelling old adults with and without home health care separately. The participants were talked through the self-filling questionnaires. The procedure could have influenced the participants' answers. CONCLUSION GDS-5 and HADS-D are useful screening tools for old adults, but only fairly good to identify depression according to criteria of ICD-10.
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Affiliation(s)
- S Eriksen
- Norwegian National Advisory Unit on Ageing and Health, Postboks 2136, N-3103 Tønsberg, Norway.
| | - G H Bjørkløf
- Norwegian National Advisory Unit on Ageing and Health, Postboks 2136, N-3103 Tønsberg, Norway
| | - A-S Helvik
- Norwegian National Advisory Unit on Ageing and Health, Postboks 2136, N-3103 Tønsberg, Norway; Department of Public Health and General Practice, Norwegian University of Science and Technology, Postboks 8905, N-7491 Trondheim, Norway
| | - M Larsen
- Department of Geriatric Psychiatry, Diakonhjemmet, Oslo, Postboks 23, Vinderen, N-0319 Oslo, Norway
| | - K Engedal
- Norwegian National Advisory Unit on Ageing and Health, Postboks 2136, N-3103 Tønsberg, Norway
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Eriksen S, Pedersen I, Taranrød LB, Ellingsen-Dalskau LH, Finnanger Garshol B, Ibsen TL, Kirkevold Ø, Strandli E, Patil GG. Farm-based day care services - a prospective study protocol on health benefits for people with dementia and next of kin. J Multidiscip Healthc 2019; 12:643-653. [PMID: 31616153 PMCID: PMC6698602 DOI: 10.2147/jmdh.s212671] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 07/22/2019] [Indexed: 11/23/2022] Open
Abstract
Introduction The increasing number of people with dementia will place a considerable challenge on the health care system and will necessitate innovation and new solutions. Day care services aim to provide meaningful activities and coping experiences for the target group. The aim of the present study is to explore the experience and potential health benefits for people with dementia attending farm-based day care services in Norway and their next of kin. Methods and design The present study is a prospective study organized into several qualitative and quantitative sub-studies. Study period will last from 2016-2020. We use a multi-method approach and both an empirical and a constructivist view on knowledge to explore this multi-facetted phenomenon. Discussion Several challenges are expected, for instance, the ability to include participants with dementia and keep them within the study for the whole study period. The functioning level of participants regarding language and understanding could challenge their ability to answer. Despite having several limitations, we believe that this study with its different approaches and methods will add important knowledge to the field. Knowledge from our study could be essential for creating day care services of good quality for people with dementia and such services could reduce the burden of care for their next of kin.
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Affiliation(s)
- Siren Eriksen
- Norwegian National Advisory Unit on Aging and Health, Vestfold Hospital Trust , Tønsberg, Norway.,Faculty of Health Studies, Vid Specialized University, Oslo, Norway
| | - Ingeborg Pedersen
- Department of Public Health Science, Faculty of Landscape and Society, Norwegian University of Life Sciences, Ås, Norway
| | - Liv Bjerknes Taranrød
- Norwegian National Advisory Unit on Aging and Health, Vestfold Hospital Trust , Tønsberg, Norway
| | - Lina Harvold Ellingsen-Dalskau
- Department of Public Health Science, Faculty of Landscape and Society, Norwegian University of Life Sciences, Ås, Norway
| | - Bjørnar Finnanger Garshol
- Department of Public Health Science, Faculty of Landscape and Society, Norwegian University of Life Sciences, Ås, Norway
| | - Tanja Louise Ibsen
- Norwegian National Advisory Unit on Aging and Health, Vestfold Hospital Trust , Tønsberg, Norway
| | - Øyvind Kirkevold
- Norwegian National Advisory Unit on Aging and Health, Vestfold Hospital Trust , Tønsberg, Norway.,Centre of Old Age Psychiatry Research, Innlandet Hospital Trust , Gjøvik, Norway.,Norwegian University of Science and Technology (NTNU) Department of Health Sciences in Gjøvik , Norway
| | - Elin Strandli
- Norwegian National Advisory Unit on Aging and Health, Vestfold Hospital Trust , Tønsberg, Norway
| | - Grete Grindal Patil
- Department of Public Health Science, Faculty of Landscape and Society, Norwegian University of Life Sciences, Ås, Norway
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Eriksen S. Impact of early intervention and rehabilitation on functional decline in patients hospitalised for acute heart failure. Physiotherapy 2019. [DOI: 10.1016/j.physio.2018.11.184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Eriksen S. Patient experience of physiotherapy input on a specialist heart failure unit. Physiotherapy 2019. [DOI: 10.1016/j.physio.2018.11.114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
Background Day care services provide meaningful activities and coping experiences in a safe environment for people with dementia, as well as improve quality of life. Such services vary in types and settings. Farm-based day care (FDC) services are described as services that have been adapted from the farm setting, using farm resources to promote health. There is limited knowledge on the service offered in both FDC and regular day care services for people with dementia. The present study aims to investigate FDC in Norway and describe the services and the participants’ care environment. Materials and methods We mapped the existing farms offering day care in Norway by the spring 2017 (N=33) and collected information through two cross-sectional surveys (N=32) answered by the service providers at the farms. Results The farms included in this survey provided day care services to 227 people with dementia, located in most regions of Norway. The services varied in terms of group size and half of the services had young people with dementia (≤65 years) and people with dementia at an early stage as their primary target group. About half of the staff had health care education (47.5%), and there were staff with agricultural competence available in most FDCs. All farms reported that the participants spent time outdoors every day, and all services, except two, had animals. The providers highlighted the opportunity to choose activities that were individually tailored for each participant, as the diversity of resources in the farm made it possible to organize different activities. Conclusion FDC services have similarities in organization, daily structure, and number of health education personnel to other day care services, but differ in type of care environment with a wide range of activities and available resources like farm buildings, gardens, animals, and outdoor areas.
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Affiliation(s)
- Tanja Louise Ibsen
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway,
| | - Siren Eriksen
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway,
| | - Grete Grindal Patil
- Department of Public Health Science, Faculty of Landscape and Society, Norwegian University of Life Sciences, Ås, Norway
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Stephan A, Bieber A, Hopper L, Joyce R, Irving K, Zanetti O, Portolani E, Kerpershoek L, Verhey F, de Vugt M, Wolfs C, Eriksen S, Røsvik J, Marques MJ, Gonçalves-Pereira M, Sjölund BM, Jelley H, Woods B, Meyer G. Barriers and facilitators to the access to and use of formal dementia care: findings of a focus group study with people with dementia, informal carers and health and social care professionals in eight European countries. BMC Geriatr 2018; 18:131. [PMID: 29866102 PMCID: PMC5987478 DOI: 10.1186/s12877-018-0816-1] [Citation(s) in RCA: 119] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2017] [Accepted: 05/14/2018] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND People with dementia and informal carers often access formal care late in the process of dementia. The barriers and facilitators to service use from the perspectives of different stakeholders involved are not well understood. Thus, we aimed to explore the barriers and facilitators of access to and utilisation of formal care from the perspectives of people with dementia, their informal carers and health and social care professionals. METHOD Focus groups with people with dementia, informal carers and professionals were conducted in eight European countries. Recruitment targeted people with dementia, informal carers with experience of formal care and professionals involved in providing (access to) formal care. Qualitative content analysis using open coding was used on a national level. Cross-national synthesis was based on the translated national reports. RESULTS Overall, 55 focus groups with 261 participants were conducted, involving 51 people with dementia, 96 informal carers and 114 professionals. Sixteen categories describing barriers and facilitators were identified, referring to three global themes: Aspects related to 1) individuals involved, 2) the system or 3) overarching aspects. The attitudes and beliefs of people with dementia and their carers may have a major impact, and they often serve as barriers. Formal care was perceived as a threat to the individual independence of people with dementia and was thus avoided as long as possible. A healthcare professional serving as a constant key contact person could be an essential facilitator to overcome these barriers. Contact should be initiated proactively, as early as possible, and a trusting and consistent relationship needs to be established. Beyond that, the findings largely confirm former research and show that barriers to accessing and using formal care still exist across Europe despite a number of national and European initiatives. CONCLUSION Further investigations are needed to elaborate how the concept of a key contact person could be integrated with existing case management approaches and how the independence and autonomy of people with dementia can be strengthened when formal care needs to be accessed and used. These may be meaningful facilitators regarding enhanced access to formal care for people with dementia and their families.
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Affiliation(s)
- Astrid Stephan
- Institute for Health and Nursing Science, Martin Luther University Halle-Wittenberg, Magdeburger Straße 8, 06112, Halle (Saale), Germany.
| | - Anja Bieber
- Institute for Health and Nursing Science, Martin Luther University Halle-Wittenberg, Magdeburger Straße 8, 06112, Halle (Saale), Germany
| | - Louise Hopper
- School of Nursing and Human Sciences, Dublin City University, Glasnevin, Dublin 9, Ireland
| | - Rachael Joyce
- School of Nursing and Human Sciences, Dublin City University, Glasnevin, Dublin 9, Ireland
| | - Kate Irving
- School of Nursing and Human Sciences, Dublin City University, Glasnevin, Dublin 9, Ireland
| | - Orazio Zanetti
- Alzheimer Unit, IRCCS S. Centro Giovanni di Dio "Fatebenefratelli", Via Pilastroni 4, Brescia (BS), Italy
| | - Elisa Portolani
- Alzheimer Unit, IRCCS S. Centro Giovanni di Dio "Fatebenefratelli", Via Pilastroni 4, Brescia (BS), Italy
| | - Liselot Kerpershoek
- Alzheimer Center Limburg, Maastricht University, Maastricht, The Netherlands
| | - Frans Verhey
- Alzheimer Center Limburg, Maastricht University, Maastricht, The Netherlands
| | - Marjolein de Vugt
- Alzheimer Center Limburg, Maastricht University, Maastricht, The Netherlands
| | - Claire Wolfs
- Alzheimer Center Limburg, Maastricht University, Maastricht, The Netherlands
| | - Siren Eriksen
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
| | - Janne Røsvik
- Department of Geriatric Medicine, Oslo University Hospital, Aldring og Helse, Oslo, Norway
| | - Maria J Marques
- Chronic Diseases Research Center, Nova Medical School
- Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Campo Mártires da Pátria, 130, 1169-056, Lisbon, Portugal
| | - Manuel Gonçalves-Pereira
- Chronic Diseases Research Center, Nova Medical School
- Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Campo Mártires da Pátria, 130, 1169-056, Lisbon, Portugal
| | - Britt-Marie Sjölund
- Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, University of Gävle, Gävle, Sweden
| | - Hannah Jelley
- Dementia Services Development Centre Wales, Bangor University, Bangor, LL57 2PZ, UK
| | - Bob Woods
- Dementia Services Development Centre Wales, Bangor University, Bangor, LL57 2PZ, UK
| | - Gabriele Meyer
- Institute for Health and Nursing Science, Martin Luther University Halle-Wittenberg, Magdeburger Straße 8, 06112, Halle (Saale), Germany.
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Kirkevold M, Kildal Bragstad L, Bronken BA, Kvigne K, Martinsen R, Gabrielsen Hjelle E, Kitzmüller G, Mangset M, Angel S, Aadal L, Eriksen S, Wyller TB, Sveen U. Promoting psychosocial well-being following stroke: study protocol for a randomized, controlled trial. BMC Psychol 2018; 6:12. [PMID: 29615136 PMCID: PMC5883408 DOI: 10.1186/s40359-018-0223-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2017] [Accepted: 03/11/2018] [Indexed: 11/25/2022] Open
Abstract
Background Stroke is a major public health threat globally. Psychosocial well-being may be affected following stroke. Depressive symptoms, anxiety, general psychological distress and social isolation are prevalent. Approximately one third report depressive symptoms and 20% report anxiety during the first months or years after the stroke. Psychosocial difficulties may impact significantly on long-term functioning and quality of life, reduce the effects of rehabilitation services and lead to higher mortality rates. The aim of the study is to evaluate the effect of a previously developed and feasibility tested dialogue-based psychosocial intervention aimed at promoting psychosocial well-being and coping following stroke among stroke survivors with and without aphasia. Methods The study will be conducted as a multicenter, randomized, single blind controlled trial with one intervention and one control arm. It will include a total of 330 stroke survivors randomly allocated into either an intervention group (dialogue-based intervention to promote psychosocial well-being) or a control group (usual care). Participants in the intervention group will receive eight individual sessions of supported dialogues in their homes during the first six months following an acute stroke. The primary outcome measure will be psychosocial well-being measured by the General Health Questionnaire (GHQ). Secondary outcome measures will be quality of life (SAQoL), sense of coherence (SOC), and depression (Yale). Process evaluation will be conducted in a longitudinal mixed methods study by individual qualitative interviews with 15–20 participants in the intervention and control groups, focus group interviews with the intervention personnel and data collectors, and a comprehensive analysis of implementation fidelity. Discussion The intervention described in this study protocol is based on thorough development and feasibility work, guided by the UK medical research council framework for developing and testing complex interventions. It combines classical effectiveness evaluation with a thorough process evaluation. The results from this study may inform the development of further trials aimed at promoting psychosocial well-being following stroke as well as inform the psychosocial follow up of stroke patients living at home. Trial registration NCT02338869; registered 10/04/2014 (On-going trial).
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Affiliation(s)
- Marit Kirkevold
- Institute of Health and Society and Research Center for habilitation and rehabilitation services and models (CHARM), University of Oslo, P.O.Box 1130, Blindern, 0318, Oslo, Norway.
| | - Line Kildal Bragstad
- Institute of Health and Society and Research Center for habilitation and rehabilitation services and models (CHARM), University of Oslo, P.O.Box 1130, Blindern, 0318, Oslo, Norway
| | - Berit A Bronken
- Inland Norway University of Applied Sciences, P.O.Box 400, 2418, Elverum, Norway
| | - Kari Kvigne
- Inland Norway University of Applied Sciences, P.O.Box 400, 2418, Elverum, Norway
| | - Randi Martinsen
- Inland Norway University of Applied Sciences, P.O.Box 400, 2418, Elverum, Norway
| | - Ellen Gabrielsen Hjelle
- Institute of Health and Society and Research Center for habilitation and rehabilitation services and models (CHARM), University of Oslo, P.O.Box 1130, Blindern, 0318, Oslo, Norway
| | - Gabriele Kitzmüller
- Faculty of Health UIT, The Arctic University of Norway, Campus, Narvik, Norway
| | - Margrete Mangset
- Department of Geriatric Medicine, Oslo University Hospital, P.O box 4956, Nydalen, 0424, Oslo, Norway
| | - Sanne Angel
- Institute of Public Health, Aarhus University, Hoegh-Guldbergs Gade 6 A, 8000, Aarhus, Denmark
| | - Lena Aadal
- Hammel Neurorehabilitation and Research Centre, Voldbyvej 15 8450, Hammel, Denmark
| | - Siren Eriksen
- Norwegian National Advisory Unit on Ageing and Health (Ageing and Health), P. O. Box 2136, 3103, Tønsberg, Norway
| | - Torgeir B Wyller
- Institute of Clinical Medicine, University of Oslo, and Department. of Geriatric Medicine, Oslo University Hospital, P.O box 4956 Nydalen, 0424, Oslo, Norway
| | - Unni Sveen
- Dept. of Geriatric Medicine, and Dept. of Physical Medicine and Rehabilitation, Oslo University Hospital, P.O box 4956 Nydalen, 0424, Oslo, Norway
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Abstract
Purpose Acute skin toxicity is experienced by 70%–100% of patients receiving radiation therapy following breast cancer. Most studies focus on skin appearances and treatment of such reactions, not the experience. Increased knowledge about patients’ experience will contribute to provide tailored patient care. Thus, the purpose was to investigate patients’ experiences of acute skin toxicity following radiation therapy for breast cancer. Patients and methods Semi-structured in-depth interviews were conducted with seven women, 2–3 weeks post-treatment. Five broad areas of inquiry were investigated: 1) experiences from the development of skin reactions; 2) experiences in day-to-day life; 3) coping strategies; 4) experiences of information; and 5) experiences from the aftercare. The interviews were analyzed in line with qualitative content analysis. Results The main theme “Not so bad itself, but it comes on top of everything else” was identified, based upon three categories: 1) unique experience of the skin; 2) it is something about the psychological aspect; and 3) experience of information. Conclusion Acute skin toxicity following breast cancer treatment may affect many dimensions of patients’ lives. Experiences are complex, individual, and not necessarily consistent with visible changes of the skin. A holistic approach is necessary to provide treatment and support according to patients’ individual needs.
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Affiliation(s)
- Eivind Richter Andersen
- Department of Radiotherapy, Division of Hematology and Oncology, Stavanger University Hospital, Stavanger, Norway.,Department of Optometry, Radiography and Lighting Design, University College of Southeast Norway, Drammen, Norway
| | - Grethe Eilertsen
- Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, University College of Southeast Norway, Drammen, Norway
| | - Aud Mette Myklebust
- Department of Optometry, Radiography and Lighting Design, University College of Southeast Norway, Drammen, Norway
| | - Siren Eriksen
- Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, University College of Southeast Norway, Drammen, Norway.,Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway
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Førsund LH, Grov EK, Helvik AS, Juvet LK, Skovdahl K, Eriksen S. The experience of lived space in persons with dementia: a systematic meta-synthesis. BMC Geriatr 2018; 18:33. [PMID: 29390970 PMCID: PMC5795848 DOI: 10.1186/s12877-018-0728-0] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 01/23/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Identifying how persons with dementia experience lived space is important for enabling supportive living environments and creating communities that compensate for the fading capabilities of these persons. Several single studies have explored this topic; however, few studies have attempted to explicitly review and synthesize this research literature. The aim of this systematic meta-synthesis was therefore to interpret and synthesize knowledge regarding persons with dementia's experience of space. METHODS A systematic, computerized search of AgeLine, CINAHL Complete, Embase, Medline and PsycINFO was conducted using a search strategy that combined MeSH terms and text words for different types of dementia with different descriptions of experience. Studies with 1) a sample of persons with dementia, 2) qualitative interviews as a research method and 3) a description of experiences of lived space were included. The search resulted in 1386 articles, of which 136 were identified as eligible and were read and assessed using the CASP criteria. The analysis was inspired by qualitative content analyses. RESULTS This interpretative qualitative meta-synthesis included 45 articles encompassing interviews with 672 persons with dementia. The analysis showed that living in one's own home and living in long-term care established different settings and posed diverse challenges for the experience of lived space in persons with dementia. The material revealed four main categories that described the experience of lived space: (1) belonging; (2) meaningfulness; (3) safety and security; and (4) autonomy. It showed how persons with dementia experienced a reduction in their lived space due to the progression of dementia. A comprehensive understanding of the categories led to the latent theme: "Living with dementia is like living in a space where the walls keep closing in". CONCLUSION This meta-synthesis reveals a process whereby lived space gradually becomes smaller for persons with dementia. This underscores the importance of being aware of the experiences of persons with dementia and the spatial dimensions of their life-world. To sustain person-centred care and support the preservation of continuity and identity, one must acknowledge not only the physical and social environment but also space as an existential experience for persons with dementia.
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Affiliation(s)
- Linn Hege Førsund
- Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, University College of Southeast Norway, Postbox 7053, N- 3007 Drammen, Norway
| | - Ellen Karine Grov
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Anne-Sofie Helvik
- Norwegian National Advisory Unit on Ageing and Health, Tønsberg, Norway
- Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway
| | - Lene Kristine Juvet
- Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, University College of Southeast Norway, Postbox 7053, N- 3007 Drammen, Norway
- The National Institute of Public Health, Oslo, Norway
| | - Kirsti Skovdahl
- Department of Nursing and Health Sciences, Faculty of Health and Social Sciences, University College of Southeast Norway, Postbox 7053, N- 3007 Drammen, Norway
| | - Siren Eriksen
- Norwegian National Advisory Unit on Ageing and Health, Tønsberg, Norway
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Eriksen S, Helvik AS, Juvet LK, Skovdahl K, Førsund LH, Grov EK. The Experience of Relations in Persons with Dementia: A Systematic Meta-Synthesis. Dement Geriatr Cogn Disord 2018; 42:342-368. [PMID: 27866199 DOI: 10.1159/000452404] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/10/2016] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Dementia influences a person's experience of social relationships, as described in several studies. In this systematic meta-synthesis of qualitative studies, we aim to interpret and synthesize the experiences of persons with dementias and their relations with others. SUMMARY Living with dementia changes life, leading to new social roles and different social statuses. Persons with dementia experience being disconnected and dependent on others, feeling like being a burden, and being a person who is treated in paternalistic ways. Family, friends and others with dementia might play significant roles in their ability to maintain a meaningful life. Key Messages: Three categories emerged from the data, change in life, change in relations, and maintenance of meaningful aspects in life; these categories are intertwined and essential in sustaining a lifeline for persons with dementia. The comprehensive meaning of the material is understood as the expression: Living a meaningful life in relational changes.
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Affiliation(s)
- Siren Eriksen
- Norwegian National Advisory Unit on Ageing and Health, Tønsberg, Norway
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Broda A, Bieber A, Meyer G, Hopper L, Joyce R, Irving K, Zanetti O, Portolani E, Kerpershoek L, Verhey F, Vugt MD, Wolfs C, Eriksen S, Røsvik J, Marques MJ, Gonçalves-Pereira M, Sjölund BM, Woods B, Jelley H, Orrell M, Stephan A. Perspectives of policy and political decision makers on access to formal dementia care: expert interviews in eight European countries. BMC Health Serv Res 2017; 17:518. [PMID: 28774307 PMCID: PMC5543593 DOI: 10.1186/s12913-017-2456-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Accepted: 07/18/2017] [Indexed: 11/10/2022] Open
Abstract
Background As part of the ActifCare (ACcess to Timely Formal Care) project, we conducted expert interviews in eight European countries with policy and political decision makers, or representatives of relevant institutions, to determine their perspectives on access to formal care for people with dementia and their carers. Methods Each ActifCare country (Germany, Ireland, Italy, The Netherlands, Norway, Portugal, Sweden, United Kingdom) conducted semi-structured interviews with 4–7 experts (total N = 38). The interview guide addressed the topics “Complexity and Continuity of Care”, “Formal Services”, and “Public Awareness”. Country-specific analysis of interview transcripts used an inductive qualitative content analysis. Cross-national synthesis focused on similarities in themes across the ActifCare countries. Results The analysis revealed ten common themes and two additional sub-themes across countries. Among others, the experts highlighted the need for a coordinating role and the necessity of information to address issues of complexity and continuity of care, demanded person-centred, tailored, and multidisciplinary formal services, and referred to education, mass media and campaigns as means to raise public awareness. Conclusions Policy and political decision makers appear well acquainted with current discussions among both researchers and practitioners of possible approaches to improve access to dementia care. Experts described pragmatic, realistic strategies to influence dementia care. Suggested innovations concerned how to achieve improved dementia care, rather than transforming the nature of the services provided. Knowledge gained in these expert interviews may be useful to national decision makers when they consider reshaping the organisation of dementia care, and may thus help to develop best-practice strategies and recommendations. Electronic supplementary material The online version of this article (doi:10.1186/s12913-017-2456-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Anja Broda
- Martin Luther University Halle-Wittenberg, Institute of Health and Nursing Sciences, Magdeburger Straße 8, D-06112, Halle (Saale), Germany.
| | - Anja Bieber
- Martin Luther University Halle-Wittenberg, Institute of Health and Nursing Sciences, Magdeburger Straße 8, D-06112, Halle (Saale), Germany
| | - Gabriele Meyer
- Martin Luther University Halle-Wittenberg, Institute of Health and Nursing Sciences, Magdeburger Straße 8, D-06112, Halle (Saale), Germany
| | - Louise Hopper
- Dublin City University, School of Nursing and Human Sciences, Dublin, Ireland
| | - Rachael Joyce
- Dublin City University, School of Nursing and Human Sciences, Dublin, Ireland
| | - Kate Irving
- Dublin City University, School of Nursing and Human Sciences, Dublin, Ireland
| | - Orazio Zanetti
- IRCCS S. Giovanni di Dio "Fatebenefratelli", Brescia, Italy
| | | | - Liselot Kerpershoek
- Alzheimer Center Limburg, Maastricht University, Maastricht, The Netherlands
| | - Frans Verhey
- Alzheimer Center Limburg, Maastricht University, Maastricht, The Netherlands
| | - Marjolein de Vugt
- Alzheimer Center Limburg, Maastricht University, Maastricht, The Netherlands
| | - Claire Wolfs
- Alzheimer Center Limburg, Maastricht University, Maastricht, The Netherlands
| | - Siren Eriksen
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Oslo, Norway
| | - Janne Røsvik
- Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Oslo, Norway.,Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Maria J Marques
- CEDOC, Chronic Diseases Research Center, Nova Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Manuel Gonçalves-Pereira
- CEDOC, Chronic Diseases Research Center, Nova Medical School/Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Britt-Marie Sjölund
- Aging Research Center (ARC), Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet and Stockholm University, Stockholm, Sweden.,Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, University of Gävle, Gävle, Sweden
| | - Bob Woods
- Bangor University, Dementia Services Development Centre, Bangor, UK
| | - Hannah Jelley
- Bangor University, Dementia Services Development Centre, Bangor, UK
| | - Martin Orrell
- Nottingham University, Institute of Mental Health, Nottingham, UK
| | - Astrid Stephan
- Martin Luther University Halle-Wittenberg, Institute of Health and Nursing Sciences, Magdeburger Straße 8, D-06112, Halle (Saale), Germany
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Abstract
Since anxiety in patients with dementia is a complex, understudied phenomenon, this paper presents clinicians' experiences of anxiety in this population. Semi-structured interviews were conducted with seven clinicians experienced with dementia in elderly patients (65 years and above), and then evaluated via qualitative content analysis. Analysis revealed three main categories: A reaction to loss and worries, symptoms of anxiety and depression interfere with each other, and anxiety in dementia-a multidisciplinary task. Anxiety in this population is perhaps best understood as a reaction to loss and worries, and existential in nature by the participants. Care interventions can reduce or prevent anxiety symptoms in this population. However, when anxiety co-exists with depression it might be difficult to attenuate these symptoms through care measures alone. To better identify and treat the condition, valid dementia-specific anxiety-screening instruments are necessary.
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Affiliation(s)
- Alka R Goyal
- Section of Old Age Psychiatry, Vestre Viken Hospital trust, Norway; Norwegian National Advisory Unit on Aging and Health, Norway; Centre of Old Age Psychiatry Research, Innlandet Hospital Trust, Norway
| | - Knut Engedal
- Norwegian National Advisory Unit on Aging and Health, Norway
| | - Siren Eriksen
- Norwegian National Advisory Unit on Aging and Health, Norway
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38
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Abstract
PURPOSE The aim of this study was to describe the course of post-stroke depression (PSD) during the first 18 months after first-ever stroke and to examine differences in the course of depressive symptoms in relation to patient demographic and clinical characteristics in the acute phase. METHODS As part of a longitudinal cohort study, data were collected from medical records and in face-to-face interviews using standardized questionnaires within 15 days after stroke and 6, 12 and 18 months later. The sample consisted of 94 patients with first-ever stroke. PSD was measured with the Beck Depression Inventory II. Repeated measures analysis of variance was used to evaluate the course of depressive symptoms over time and in relation to demographic and clinical variables. RESULTS Depression levels were stable during the 18 months after first-ever stroke. However, depression scores were significantly higher among patients who had lower physical functioning in the acute phase, were living alone or were not employed at the time of stroke. CONCLUSIONS Several demographic and acute phase factors were associated with a more severe PSD course following stroke. Psychosocial support that begins in the acute phase and continues throughout the rehabilitation process may be helpful in improving both physical and psychological outcomes following stroke. IMPLICATIONS FOR REHABILITATION Depression levels are stable during the first 18 months after first-ever stroke. The course of post-stroke depression is related to the level of physical functioning in the acute phase, whether the stroke survivors live alone and their employment status at the time of stroke. Psychological support that begins in the acute phase and continues throughout the rehabilitation process may be helpful in improving both physical and psychological outcomes following stroke.
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Affiliation(s)
- Siren Eriksen
- a Faculty of Health Sciences , Buskerud and Vestfold University College , Drammen , Norway
| | - Caryl L Gay
- b USCF School of Nursing , San Francisco , CA , USA .,c Department of Research , Lovisenberg Diakonale Hospital , Oslo , Norway , and
| | - Anners Lerdal
- c Department of Research , Lovisenberg Diakonale Hospital , Oslo , Norway , and.,d Department of Nursing Science , University of Oslo , Oslo , Norway
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Doolittle ND, Petrillo A, Bell S, Cummings P, Eriksen S. Blood-brain barrier disruption for the treatment of malignant brain tumors: The National Program. J Neurosci Nurs 1998; 30:81-90. [PMID: 9642616 DOI: 10.1097/01376517-199804000-00002] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Chemotherapy delivery for the treatment of malignant brain tumors is markedly enhanced when given in conjunction with osmotic opening of the blood-brain barrier. Osmotic opening or disruption of the blood-brain barrier is achieved while the patient is under general anesthesia, by the infusion of mannitol into the internal carotid or vertebral artery circulation. The mannitol infusion is followed by administration of intraarterial chemotherapy. A National Blood-Brain Barrier Program now exists and includes six universities. Within the National Program over 4200 blood-brain barrier disruption procedures have been performed in over 400 patients. Patients with primary central nervous system (CNS) lymphoma, glioma, primitive neuroectodermal tumor (PNET), germ cell and metastatic cancer are eligible for treatment. Results in patients with primary CNS lymphoma, recently reported in the Cancer Journal, include the first example of a durable response in a primary brain tumor without loss of cognitive function and without use of radiotherapy. Results with PNET and germ cell tumors are also very encouraging. Advanced practice nurses coordinate the care of blood-brain barrier disruption patients. Care includes patients selection, education, close neurological observation, maintenance of fluid and electrolyte balance and managing effects of high-dose chemotherapy. Both acute and long-term medical and psychological follow-up are an essential component of the program, as well as patient and family support.
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Affiliation(s)
- N D Doolittle
- Department of Neurology, Oregon Health Sciences University, Portland 97201, USA
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Ruge Holte H, Eriksen S, Skulberg O, Aas P. The effect of water soluble cyanotoxin(s) produced by two species of Anabaena on the release of acetylcholine from the peripheral cholinergic nervous system of the rat airway. Environ Toxicol Pharmacol 1998; 5:51-59. [PMID: 21781850 DOI: 10.1016/s1382-6689(97)10007-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/1997] [Revised: 08/20/1997] [Accepted: 09/03/1997] [Indexed: 05/31/2023]
Abstract
A water extract of the lyophilised fresh-water alga Anabaena flos-aquae enhanced substantially the release of [(3)H]acetylcholine ([(3)H]acetylcholine and [(3)H]choline) from cholinergic nerves of rat bronchi. Parallel experiments performed with the related species Anabaena lemmermannii did not demonstrate this effect. The effect on the release of [(3)H]acetylcholine by A. flos-aquae extract was concentration dependent. The A. flos-aquae induced [(3)H]acetylcholine release was not reduced by exposure to a low concentration of Ca(2+), but ω-conotoxin GVIA (1.0 μM), a blocker of N-type Ca(2+) channels reduced the release of [(3)H]acetylcholine induced by the A. flos-aquae extract. Addition of verapamil in a concentration (1.0 μM) specific for inhibition of L-type Ca(2+) channels had no effect on the neurotransmitter release. A reduction in the release was, moreover, observed with the intracellular Ca(2+) chelator BAPTA/AM (30 μM) and with the Na(+) channel blocker tetrodotoxin (3.0 μM). During patch-clamp studies of GH(4)C(1) neuronal cells, which have L- and T-type Ca(2+) channels, but no Na(+) channels, it was shown that a water extract of A. flos-aquae depolarised these cells and reduced, rather than enhanced, the influx of Ca(2+). Such an effect was not seen following exposure of GH(4)C(1) cells to water extracts of A. lemmermannii. In addition to its presynaptic activity, the water extract of A. flos-aquae showed an antimuscarinic effect by displacing [(3)H]QNB binding from muscarinic receptors in homogenates of rat bronchi. A similar but more potent effect was observed during experiments with water extract of A. lemmermannii. None of the respective water extracts showed any effects on cholinesterase activities in rat bronchial smooth muscle. The present observations suggest, therefore, that water extracts of A. flos-aquae may depolarise cells by activation of mono and divalent cation channels in cholinergic nerve cells. These channels are probably Na(+) channels and N-type, but not L- or T-type Ca(2+) channels. L- and T-type Ca(2+) channels were blocked in experiments with GH(4)C(1) cells and high concentrations of Ca(2+) channel blockers were necessary to reduce the effects of A. flos-aquae extract in cholinergic nerves in the airways. Furthermore, A. flos-aquae extract may also mobilise Ca(2+) from intracellular compartments. A. lemmermannii, on the other hand, does not contain components which alter mono and divalent cation-fluxes across cell membranes, but may rather have substances with more potent antagonistic effects on muscarinic cholinergic receptors than what is observed in experiments with A. flos-aquae.
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Affiliation(s)
- H Ruge Holte
- Norwegian Defence Research Establishment, Division for Environmental Toxicology, P.O. Box 25, N-2007 Kjeller, Norway
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Aas P, Eriksen S, Kolderup J, Lundy P, Haugen JE, Skulberg OM, Fonnum F. Enhancement of acetylcholine release by homoanatoxin-a from Oscillatoria formosa. Environ Toxicol Pharmacol 1996; 2:223-232. [PMID: 21781731 DOI: 10.1016/s1382-6689(96)00059-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/1996] [Revised: 06/13/1996] [Accepted: 06/28/1996] [Indexed: 05/31/2023]
Abstract
The strain NIVA-CYA 92 of Oscillatoria formosa Bory ex Gormont produces phycotoxins with neurotoxic properties. Chemical analysis by gas chromatography/mass spectrometry of a water extract of lyophilized material of the organism showed the presence of only homoanatoxin-a. The mechanism of action of homoanatoxin-a on peripheral cholinergic nerves is so far not known. The neurotoxicity of O. formosa containing homoanatoxin-a was investigated in rat bronchi, rat brain synaptosomes and in GH(4)C(1) cells. The water extract of lyophilized material of the organism produced a concentration-dependent reversible increase in the release of [(3)H]acetylcholine from both K(+) (51 mM) depolarised and non-depolarised cholinergic nerves of the rat bronchial smooth muscle. The K(+)-evoked release of [(3)H]acetylcholine was enhanced by about 75% by a water extract from 15-20 mg/ml of lyophilized algal material. The enhanced release of [(3)H]acetylcholine was substantially reduced by the L-type Ca(2+)-channel blocker verapamil (100 μM) and not by the N-type Ca(2+)-channel blocker ω-conotoxin GVIA (1.0 μM) or the P-type Ca(2+)-channel blocker ω-agatoxin IV-A (0.2 μM). Chelation of intra-cellular Ca(2+) by 1,2-bis-(aminofenoxi)etan-N,N,N',N'-tetraacidic acid/acetoxymethyl (BAPTA/AM) (30 μM) had no effect on the phycotoxin-induced release of [(3)H]acetylcholine, indicating that an extracellular pool of Ca(2+) was important for the action of the phycotoxin on the release of [(3)H]acetylcholine from peripheral cholinergic nerves. In rat brain synaptosomes the algal extract enhanced the influx of (45)Ca(2+) in a tetrodotoxin (1.0 μM) and ω-conotoxin MVIIC (blocker of N-, P- and Q-type Ca(2+) channels) (1.0 μM) insensitive manner. Patch-clamp studies showed that the phycotoxin opened endogenous voltage dependent L-type Ca(2+) channels in neuronal GH(4)C(1) cells. These Ca(2+) channels and the effect of the toxin on the channels were blocked by the L-type Ca(2+)-channel antagonist gallopamil (200 μM). The present results suggest, therefore, that the investigated strain of O. formosa contains homoanatoxin-a, which enhances the release of acetylcholine from peripheral cholinergic nerves through opening of endogenous voltage dependent neuronal L-type Ca(2-) channels.
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Affiliation(s)
- P Aas
- Norwegian Defence Research Establishment, Division for Environmental Toxicology, P.O. Box 25, N-2007 Kjeller, Norway
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Aas P, Pagenhart A, Eriksen S, Kolderup J, Fonnum F. The effect of trimethyltin on acetylcholine release in the guinea-pig trachea. Environ Toxicol Pharmacol 1996; 1:257-268. [PMID: 21781691 DOI: 10.1016/1382-6689(96)00019-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/1995] [Revised: 04/04/1996] [Accepted: 04/15/1996] [Indexed: 05/31/2023]
Abstract
The purpose of the present work was to characterise the effects of trimethyltin on the release of acetylcholine from parasympathetic nerves and its effect on the postjunctional cholinergic stimulation of a smooth muscle. The guinea-pig trachea has been used as a model. Prejunctionally, trimethyltin (3.0 × 10(-3) M) significantly enhanced in a reversible manner the high K(+) (75 mM) evoked release of endogenous acetylcholine and [(3)H]acetylcholine. The evoked release of endogenous acetylcholine and [(3)H]acetylcholine was released from a pool of acetylcholine being independent of extraneuronal Ca(2+) in the presence, but not in the absence of trimethyltin. The effect of trimethyltin on the release was not inhibited by low Ca(2+) (0 mM and 1.0 × 10(-4) M) or by Ca(2+) channel blockers (verapamil, 1.0 × 10(-4) M, flunarizine, 1.0 × 10(-4) M, ω-conotoxin GVIA, 2.0 × 10(-7) M and ω-agatoxin, 2.0 × 10(-7) M). The present results also demonstrate that trimethyltin induce emptying of a non-vesicular, probably a cytoplasmic storage pool of acetylcholine, since AH5183 (2.0 × 10(-5) M), an inhibitor of the translocation of acetylcholine into synaptic vesicles, and α-latrotoxin (1.0 × 10(-8) M), a toxin from black widow spider venom inducing vesicle depletion, had no inhibitory effects on the release of [(3)H]acetylcholine evoked by trimethyltin (3.0 × 10(-3) M). The release of [(3)H]acetylcholine was moreover enhanced by trimethyltin when the vesicular uptake of [(3)H]acetylcholine was inhibited by AH5183, probably as a result of a higher cytoplasmic concentration of [(3)H]acetylcholine. Trimethyltin also reduced the neuronal uptake of [(3)H]choline and this was probably due to a depolarising effect of trimethyltin on the cholinergic nerve terminals. A similar depolarisation induced by trimethyltin was observed during patch clamping of GH(4) C(1) neuronal cells. Postjunctionally, trimethyltin had no effect by itself or on the carbachol-induced smooth muscle contraction, indicating that trimethyltin did not have a general depolarising effect on smooth muscle cells or an effect on muscarinic receptors. Furthermore, the reduced electrical field-induced contraction and the subsequent increase in the basal smooth muscle tension that was observed by addition of trimethyltin was activity-dependent, and was most probably due to emptying of a nervous non-vesicular storage pool of acetylcholine, followed by rapid hydrolysis of acetylcholine by acetyl- and pseudocholinesterases.
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Affiliation(s)
- P Aas
- Norwegian Defence Research Establishment, Division for Environmental Toxicology, P.O. Box 25, N-2007 Kjeller, Norway
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Kolderup J, Meldahl AS, Eriksen S, Haug E, Fonnum F, Sand O. Toxin of the marine alga Prymnesium patelliferum enhances voltage dependent Ca(2+)-currents, elevates the cytosolic Ca(2+)-concentration and facilitates hormone release in clonal rat pituitary cells. Acta Physiol Scand 1995; 154:321-7. [PMID: 7572230 DOI: 10.1111/j.1748-1716.1995.tb09916.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The marine flagellate Prymnesium patelliferum produces toxins lethal to fish. The toxin extracted from the alga has haemolytic, cytotoxic and neurotoxic effects, but the action mechanisms of the toxin are not known in detail. We have examined the toxin effects on the voltage sensitive Ca(2+)-currents, the cytosolic Ca(2+)-level ([Ca2+]i) and the prolactin release in clonal rat anterior pituitary GH4C1 cells, which possess T- and L-type Ca(2+)-channels. The trans-membrane Ca(2+)-current was recorded using whole-cell voltage clamp. After 5-15 min exposure to the algal toxin at a final concentration of 50,000-100,000 cells mL-1, the Ca(2+)-currents through both the T- and L-channels showed a 2-3-fold enhancement. The voltage sensitivity of the Ca(2+)-currents was not affected by the algal toxin, and the toxin-induced currents were inhibited by 100 microM of the Ca(2+)-channel blocker D-600. In toxin-exposed cells microfluorometric measurements based on fura-2 revealed an increase of [Ca2+]i from 100-150 to 300-500 nM. This elevation was delayed and partially inhibited by 100 microM D-600. The algal toxin induced prolactin release in a dose-dependent manner, and this effect was inhibited by the Ca(2+)-channel blocker verapamil. We therefore conclude that the toxin of P. patelliferum affects the Ca2+ homeostasis of the pituitary cells by increasing the leak through voltage sensitive Ca(2+)-channels, resulting in increased [Ca2+]i and secretion of prolactin.
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Affiliation(s)
- J Kolderup
- Department of Biology, University of Oslo, Norway
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Eriksen S. Response from eriksen et al. Trends Microbiol 1995. [DOI: 10.1016/s0966-842x(00)88912-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Eriksen S, Olsnes S, Sandvig K, Sand O. Diphtheria toxin at low pH depolarizes the membrane, increases the membrane conductance and induces a new type of ion channel in Vero cells. EMBO J 1994; 13:4433-9. [PMID: 7523112 PMCID: PMC395374 DOI: 10.1002/j.1460-2075.1994.tb06765.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Receptor-dependent translocation of diphtheria toxin across the surface membrane of Vero cells was studied using patch clamp techniques. Translocation was induced by exposing cells with surface-bound toxin to low pH. Whole cell current and voltage clamp recordings showed that toxin translocation was associated with membrane depolarization and increased membrane conductance. The conductance increase was voltage independent, with a reversal potential of approximately 15 mV. This value was unaffected by changing the Cl- gradient across the membrane and microfluorometric measurements showed that the cytosolic Ca2+ concentration was only marginally elevated by the translocation. The conductance increase is thus mainly due to monovalent cations. Exposing outside-out and cell-attached patches with bound toxin to low pH induced a new type of ion channel in the membrane. The channel current was inward at negative membrane potentials and the single channel conductance was approximately 30 pS. This value is about three times larger than for receptor-independent channels induced by diphtheria toxin or toxin fragments in artificial lipid membranes.
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Affiliation(s)
- S Eriksen
- Department of Biology, University of Oslo, Norway
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Abstract
Long-term treatment of young spontaneously hypertensive rats (SHR) with angiotensin-converting enzyme (ACE) inhibitors has a persistent effect on blood pressure when treatment is withdrawn. The aim of the present study was to determine whether this effect could be mediated by the effect of treatment on resistance-artery structure. We determined the dose dependence of ACE-inhibitor therapy on blood pressure and small-artery structure during treatment and on the recovery of blood pressure when treatment was withdrawn. SHR (40 per group) were treated from age 4 to 24 weeks with one of three doses of perindopril (0.4, 0.8, or 1.5 mg/kg per day). Control groups were untreated SHR and Wistar-Kyoto rats. At 24 weeks, treatment was stopped and small arteries were taken from half of the rats from the mesenteric, femoral, cerebral, and coronary vascular beds for morphological and functional measurements. The blood pressure of the other half of the rats was followed until 36 weeks of age. During treatment, perindopril caused a dose-dependent reduction in blood pressure and in the media-lumen ratio and media area of the small arteries, whereas there was a dose-dependent increase in lumen diameter. The effect of treatment on the structure of arteries from the different vascular beds was homogeneous. Compared with values from Wistar-Kyoto rats, blood pressure normalization in SHR was not associated with full normalization of structure. After withdrawal of treatment, there was an inverse relation between perindopril dose and the persistent effect.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- N K Thybo
- Department of Pharmacology, University of Aarhus, Denmark
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Abstract
Both the selection of doses of pharmaceutical agents and comparisons between pharmaceutical agents have long been based on the nonquantified concept of the risk-benefit ratio. Though useful, this concept implies a data comparison that is difficult to make: the toxicity versus the efficacy of a drug compound. This research demonstrates an approach for weighing risks and benefits by combining utility functions for human efficacy and toxicity with animal and laboratory toxicity information to develop an overall multiattribute utility function for an ophthalmic pharmaceutical agent, I-bunolol, intended for the treatment of glaucoma. With this multiattribute function and a small portion of the published data available for this drug, the expected utilities for six doses (including a control) could be compared and the value of this approach in drug-dosage selection demonstrated.
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Affiliation(s)
- S Eriksen
- Graduate School of Management, University of California, Irvine
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Fitzpatrick H, Luckham P, Eriksen S, Hammond K. Use of x-ray photoelectron spectroscopy to study protein adsorption to mica surfaces. J Colloid Interface Sci 1992. [DOI: 10.1016/0021-9797(92)90384-x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
A microscopic investigation was undertaken to quantify the amount of particulate contamination in the injectates of bupivacaine 0.5% in spinal analgesia. No differences were found between samples prepared with either a glass syringe or a disposable plastic syringe, nor could differences be documented between groups where atraumatic opening of vials, perforation of vial stoppers or opening of glass ampoules was performed. The use of commercially available bacterial filters was followed by a significant increase in the amount of particulate contamination, probably filter debris. The clinical use of such filters in spinal analgesia is therefore questionable.
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Affiliation(s)
- S Eriksen
- Department of Anaesthesia, Haderslev Sygehus, Denmark
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