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Assessing the physical environment of older people's residential care facilities: development of the Swedish version of the Sheffield Care Environment Assessment Matrix (S-SCEAM).

https://arctichealth.org/en/permalink/ahliterature271825
Source
BMC Geriatr. 2015;15:3
Publication Type
Article
Date
2015
Author
Susanna Nordin
Marie Elf
Kevin McKee
Helle Wijk
Source
BMC Geriatr. 2015;15:3
Date
2015
Language
English
Publication Type
Article
Keywords
Aged
Environment Design
Female
Health Facility Environment
Homes for the Aged
Humans
Male
Observer Variation
Quality of Life
Reproducibility of Results
Sweden
Translations
Abstract
There is emerging evidence that the physical environment is important for health, quality of life and care, but there is a lack of valid instruments to assess health care environments. The Sheffield Care Environment Assessment Matrix (SCEAM), developed in the United Kingdom, provides a comprehensive assessment of the physical environment of residential care facilities for older people. This paper reports on the translation and adaptation of SCEAM for use in Swedish residential care facilities for older people, including information on its validity and reliability.
SCEAM was translated into Swedish and back-translated into English, and assessed for its relevance by experts using content validity index (CVI) together with qualitative data. After modification, the validity assessments were repeated and followed by test-retest and inter-rater reliability tests in six units within a Swedish residential care facility that varied in terms of their environmental characteristics.
Translation and back translation identified linguistic and semantic related issues. The results of the first content validity analysis showed that more than one third of the items had item-CVI (I-CVI) values less than the critical value of 0.78. After modifying the instrument, the second content validation analysis resulted in I-CVI scores above 0.78, the suggested criteria for excellent content validity. Test-retest reliability showed high stability (96% and 95% for two independent raters respectively), and inter-rater reliability demonstrated high levels of agreement (95% and 94% on two separate rating occasions). Kappa values were very good for test-retest (??=?0.903 and 0.869) and inter-rater reliability (??=?0.851 and 0.832).
Adapting an instrument to a domestic context is a complex and time-consuming process, requiring an understanding of the culture where the instrument was developed and where it is to be used. A team, including the instrument's developers, translators, and researchers is necessary to ensure a valid translation and adaption. This study showed preliminary validity and reliability evidence for the Swedish version (S-SCEAM) when used in a Swedish context. Further, we believe that the S-SCEAM has improved compared to the original instrument and suggest that it can be used as a foundation for future developments of the SCEAM model.
Notes
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PubMed ID
25563507 View in PubMed
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Nurses' perceptions of climate and environmental issues: a qualitative study.

https://arctichealth.org/en/permalink/ahliterature272072
Source
J Adv Nurs. 2015 Aug;71(8):1883-91
Publication Type
Article
Date
Aug-2015
Author
Anna Anåker
Maria Nilsson
Åsa Holmner
Marie Elf
Source
J Adv Nurs. 2015 Aug;71(8):1883-91
Date
Aug-2015
Language
English
Publication Type
Article
Keywords
Climate change
Humans
Nursing Staff - psychology
Qualitative Research
Sweden
Abstract
The aim of this study was to explore nurses' perceptions of climate and environmental issues and examine how nurses perceive their role in contributing to the process of sustainable development.
Climate change and its implications for human health represent an increasingly important issue for the healthcare sector. According to the International Council of Nurses Code of Ethics, nurses have a responsibility to be involved and support climate change mitigation and adaptation to protect human health.
This is a descriptive, explorative qualitative study.
Nurses (n = 18) were recruited from hospitals, primary care and emergency medical services; eight participated in semi-structured, in-depth individual interviews and 10 participated in two focus groups. Data were collected from April-October 2013 in Sweden; interviews were transcribed verbatim and analysed using content analysis.
Two main themes were identified from the interviews: (i) an incongruence between climate and environmental issues and nurses' daily work; and (ii) public health work is regarded as a health co-benefit of climate change mitigation. While being green is not the primary task in a lifesaving, hectic and economically challenging context, nurses' perceived their profession as entailing responsibility, opportunities and a sense of individual commitment to influence the environment in a positive direction.
This study argues there is a need for increased awareness of issues and methods that are crucial for the healthcare sector to respond to climate change. Efforts to develop interventions should explore how nurses should be able to contribute to the healthcare sector's preparedness for and contributions to sustainable development.
PubMed ID
25810044 View in PubMed
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Exploring Environmental Variation in Residential Care Facilities for Older People.

https://arctichealth.org/en/permalink/ahliterature286186
Source
HERD. 2017 Jan;10(2):49-65
Publication Type
Article
Date
Jan-2017
Author
Susanna Nordin
Kevin McKee
Helle Wijk
Marie Elf
Source
HERD. 2017 Jan;10(2):49-65
Date
Jan-2017
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Cross-Sectional Studies
Environment Design
Health Facility Environment
Homes for the Aged
Humans
Long-Term Care
Sweden
Abstract
The aim of this study was to explore variation in environmental quality in Swedish residential care facilities (RCFs) using the Swedish version of the Sheffield Care Environment Assessment Matrix (S-SCEAM).
Well-designed physical environments can positively impact on health and well-being among older persons with frail health living in RCFs and are essential for supporting person-centered care. However, the evidence base for informing the design of RCFs is weak, partly due to a lack of valid and reliable instruments that could provide important information on the environmental quality.
Twenty RCFs were purposively sampled from several regions, varying in their building design, year of construction, size, and geographic location. The RCFs were assessed using S-SCEAM and the data were analyzed to examine variation in environmental quality between and within facilities.
There was substantial variation in the quality of the physical environment between and within RCFs, reflected in S-SCEAM scores related to specific facility locations and with regard to domains reflecting residents' needs. In general, private apartments and dining areas had high S-SCEAM scores, while gardens had lower scores. Scores on the safety domain were high in the majority of RCFs, whereas scores for cognitive support and privacy were relatively low.
Despite high building standard requirements, the substantial variations regarding environmental quality between and within RCFs indicate the potential for improvements to support the needs of older persons. We conclude that S-SCEAM is a sensitive and unique instrument representing a valuable contribution to evidence-based design that can support person-centered care.
PubMed ID
27240564 View in PubMed
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Using system dynamics for collaborative design: a case study.

https://arctichealth.org/en/permalink/ahliterature162031
Source
BMC Health Serv Res. 2007;7:123
Publication Type
Article
Date
2007
Author
Marie Elf
Mariya Putilova
Lena von Koch
Kerstin Ohrn
Author Affiliation
Chalmers University of Technology, Göteborg, Sweden. marie.elf@chalmers.se
Source
BMC Health Serv Res. 2007;7:123
Date
2007
Language
English
Publication Type
Article
Keywords
Computer simulation
Cooperative Behavior
Group Processes
Hospital Planning - organization & administration
Hospital Units - organization & administration
Humans
Leadership
Models, organizational
Organizational Case Studies
Organizational Objectives
Planning Techniques
Questionnaires
Stroke - rehabilitation - therapy
Sweden
Systems Analysis
Abstract
In order to facilitate the collaborative design, system dynamics (SD) with a group modelling approach was used in the early stages of planning a new stroke unit. During six workshops a SD model was created in a multiprofessional group.
To explore to which extent and how the use of system dynamics contributed to the collaborative design process.
A case study was conducted using several data sources.
SD supported a collaborative design, by facilitating an explicit description of stroke care process, a dialogue and a joint understanding. The construction of the model obliged the group to conceptualise the stroke care and experimentation with the model gave the opportunity to reflect on care.
SD facilitated the collaborative design process and should be integrated in the early stages of the design process as a quality improvement tool.
Notes
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PubMed ID
17683519 View in PubMed
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A comparative study of patients' activities and interactions in a stroke unit before and after reconstruction-The significance of the built environment.

https://arctichealth.org/en/permalink/ahliterature286083
Source
PLoS One. 2017;12(7):e0177477
Publication Type
Article
Date
2017
Author
Anna Anåker
Lena von Koch
Christina Sjöstrand
Julie Bernhardt
Marie Elf
Source
PLoS One. 2017;12(7):e0177477
Date
2017
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Aged, 80 and over
Environment Design
Female
Humans
Male
Middle Aged
Residential Facilities
Stroke
Stroke rehabilitation
Sweden
Abstract
Early mobilization and rehabilitation, multidisciplinary stroke expertise and comprehensive therapies are fundamental in a stroke unit. To achieve effective and safe stroke care, the physical environment in modern stroke units should facilitate the delivery of evidence-based care. Therefore, the purpose of this study was to explore patients' activities and interactions in a stroke unit before the reconstruction of the physical environment, while in a temporary location and after reconstruction. This case study examined a stroke unit as an integrated whole. The data were collected using a behavioral mapping technique at three different time points: in the original unit, in the temporary unit and in the new unit. A total of 59 patients were included. The analysis included field notes from observations of the physical environment and examples from planning and design documents. The findings indicated that in the new unit, the patients spent more time in their rooms, were less active, and had fewer interactions with staff and family than the patients in the original unit. The reconstruction involved a change from a primarily multi-bed room design to single-room accommodations. In the new unit, the patients' lounge was located in a far corner of the unit with a smaller entrance than the patients' lounge in the old unit, which was located at the end of a corridor with a noticeable entrance. Changes in the design of the stroke unit may have influenced the patients' activities and interactions. This study raises the question of how the physical environment should be designed in the future to facilitate the delivery of health care and improve outcomes for stroke patients. This research is based on a case study, and although the results should be interpreted with caution, we strongly recommend that environmental considerations be included in future stroke guidelines.
Notes
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PubMed ID
28727727 View in PubMed
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Questioning context: a set of interdisciplinary questions for investigating contextual factors affecting health decision making.

https://arctichealth.org/en/permalink/ahliterature139765
Source
Health Expect. 2011 Jun;14(2):115-32
Publication Type
Article
Date
Jun-2011
Author
Andrea Charise
Holly Witteman
Sarah Whyte
Erica J Sutton
Jacqueline L Bender
Michael Massimi
Lindsay Stephens
Joshua Evans
Carmen Logie
Raza M Mirza
Marie Elf
Author Affiliation
Health Care, Technology and Place CIHR Strategic Training Program, University of Toronto, Toronto, Canada. andrea.charise@utoronto.ca
Source
Health Expect. 2011 Jun;14(2):115-32
Date
Jun-2011
Language
English
Publication Type
Article
Keywords
Canada
Cooperative Behavior
Decision Making
Health Knowledge, Attitudes, Practice
Health Promotion - methods
Health Services Research
Humans
Internet
Questionnaires
Abstract
To combine insights from multiple disciplines into a set of questions that can be used to investigate contextual factors affecting health decision making.
Decision-making processes and outcomes may be shaped by a range of non-medical or 'contextual' factors particular to an individual including social, economic, political, geographical and institutional conditions. Research concerning contextual factors occurs across many disciplines and theoretical domains, but few conceptual tools have attempted to integrate and translate this wide-ranging research for health decision-making purposes.
To formulate this tool we employed an iterative, collaborative process of scenario development and question generation. Five hypothetical health decision-making scenarios (preventative, screening, curative, supportive and palliative) were developed and used to generate a set of exploratory questions that aim to highlight potential contextual factors across a range of health decisions.
We present an exploratory tool consisting of questions organized into four thematic domains - Bodies, Technologies, Place and Work (BTPW) - articulating wide-ranging contextual factors relevant to health decision making. The BTPW tool encompasses health-related scholarship and research from a range of disciplines pertinent to health decision making, and identifies concrete points of intersection between its four thematic domains. Examples of the practical application of the questions are also provided.
These exploratory questions provide an interdisciplinary toolkit for identifying the complex contextual factors affecting decision making. The set of questions comprised by the BTPW tool may be applied wholly or partially in the context of clinical practice, policy development and health-related research.
PubMed ID
21029277 View in PubMed
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6 records – page 1 of 1.