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Changing to primary nursing in a nursing home in Finland: experiences of residents, their family members and nurses.

https://arctichealth.org/en/permalink/ahliterature195375
Source
J Adv Nurs. 2001 Feb;33(4):475-83
Publication Type
Article
Date
Feb-2001
Author
S. Laakso
P. Routasalo
Author Affiliation
Clinical Research Associate, Hormos Medical Oy Ltd, Tykistökatu, Turku, Finland.
Source
J Adv Nurs. 2001 Feb;33(4):475-83
Date
Feb-2001
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Attitude of Health Personnel
Attitude to Health
Decision Making, Organizational
Family - psychology
Female
Finland
Humans
Inpatients - psychology
Job Description
Male
Middle Aged
Models, Nursing
Motivation
Nurse-Patient Relations
Nursing Homes - organization & administration
Nursing Methodology Research
Nursing Staff - organization & administration - psychology
Organizational Innovation
Primary Nursing - organization & administration
Professional Autonomy
Professional-Family Relations
Questionnaires
Abstract
The aim of the study was to find out how nursing home residents, their families and nurses experienced the change to primary nursing in the nursing home.
This study was carried out in a nursing home in Finland. Following years of functional nursing, the change to primary nursing had started 18 months prior to data collection. The transition was preceded by staff training, planning for the change to primary nursing and discussions with staff members. Meetings were also arranged with family members to inform them of what was happening and why. Staff implemented the changeover independently with the support of the institution's management.
The data were gathered in focused interviews. There were five interview themes: change in the nursing home, the position of the resident in the nursing home, the relationship between the resident and nurse, the relationship between family member and nurse, and the role of the nurse as provider of nursing care.
Residents reported no major changes in nursing care or in their relationship with nurses. However, family members had noticed changes in the behaviour of the nursing staff. Staff members had become friendlier, spent more time with the residents and showed a strong job motivation. Cooperation between nurses and family members had changed very little. Some nurses in the early stages of the change tended to show signs of resistance. Others said that there had been many changes during the past year, that they acted more independently and could use their own decision-making authority more freely than before. They treated residents as individuals and gave them a greater say in decision-making. They felt responsible for the development of the workplace as a collectivity.
Primary nursing is one way in which nurses and family members can work more closely in the best interests of older residents. The findings of this study speak in favour of making the change from functional to primary nursing and at the same time highlight certain problems and possibilities in this process.
PubMed ID
11251735 View in PubMed
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Characteristics of the Mini-Nutritional Assessment in elderly home-care patients.

https://arctichealth.org/en/permalink/ahliterature182351
Source
Eur J Clin Nutr. 2004 Jan;58(1):64-70
Publication Type
Article
Date
Jan-2004
Author
H. Soini
P. Routasalo
H. Lagström
Author Affiliation
Herttoniemi Health Centre, City of Helsinki, Finland. helena.soini@dlc.fi
Source
Eur J Clin Nutr. 2004 Jan;58(1):64-70
Date
Jan-2004
Language
English
Publication Type
Article
Keywords
Aged
Cross-Sectional Studies
Female
Finland - epidemiology
Geriatric Assessment - methods
Health Status Indicators
Home Care Services
Humans
Male
Malnutrition - epidemiology
Nutrition Assessment
Nutritional Status
Questionnaires
Risk assessment
Risk factors
Rural Health
Weight Loss
Abstract
To assess the risk of malnutrition among elderly people living at home and receiving regular home-care services using the Mini-Nutritional Assessment (MNA) and to study the characteristics of the instrument in this patient group.
A cross-sectional study using the MNA score to assess the nutritional status of elderly home-care patients.
Municipal home-care services in rural Finland.
A total of 178 (65%) out of 272 eligible patients aged 75-94 y agreed to participate. MAJOR OUTCOME METHODS: MNA questionnaire, anthropometrics, structured questionnaire, menu record.
According to MNA, 3% were malnourished (MNA 23.5 points). The mean MNA score was 23.4. Weight loss, psychological stress, nutritional status, decline in food intake, self-perceived health status and mid-arm circumference (MAC) showed the strongest significant correlations (P=0.0001) to total MNA score. MNA questions with the strongest significant intercorrelations (P=0.0001) were body mass index with MAC and calf circumference; and the decline of food intake and self-perceived nutritional status. The number of eating problems correlated significantly to the MNA score (P=0.0011). Those with chewing and swallowing problems (n=64, 36%) had a significantly lower MNA score than others (P=0.0001). Dry mouth together with chewing and swallowing problems (n=40, 22%) reduced the MNA score even further (P=0.0001).
The results suggest that MNA is a useful tool in the identification of elderly home-care patients at risk for malnutrition.
PubMed ID
14679369 View in PubMed
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Malnutrition and associated factors among aged residents in all nursing homes in Helsinki.

https://arctichealth.org/en/permalink/ahliterature175929
Source
Eur J Clin Nutr. 2005 Apr;59(4):578-83
Publication Type
Article
Date
Apr-2005
Author
M. Suominen
S. Muurinen
P. Routasalo
H. Soini
I. Suur-Uski
A. Peiponen
H. Finne-Soveri
K H Pitkala
Author Affiliation
The Central Union for the Welfare of the Aged, Malmin kauppatie 26, FIN-00700 Helsinki, Finland.
Source
Eur J Clin Nutr. 2005 Apr;59(4):578-83
Date
Apr-2005
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Aged, 80 and over
Aging - physiology
Comorbidity
Constipation - epidemiology
Cross-Sectional Studies
Deglutition Disorders - epidemiology
Dementia - epidemiology
Feeding Behavior - physiology
Female
Finland - epidemiology
Humans
Length of Stay - statistics & numerical data
Male
Malnutrition - epidemiology
Nursing Homes
Nutrition Surveys
Nutritional Status - physiology
Risk factors
Sex Factors
Abstract
To acquire information about nutritional problems and factors associated with them in all nursing homes in Helsinki, Finland.
Descriptive, cross-sectional study. The residents were assessed by the Mini Nutritional Assessment test (MNA) and information was gathered about residents' backgrounds, functional status, diseases and about daily routines in institutions providing nutritional care.
All nursing homes in Helsinki community, the capital of Finland.
Of 2424 eligible subjects, 2114 (87%) aged residents, mean age 82 y, were examined.
One-third (29%) of the studied residents suffered from malnutrition (MNA
PubMed ID
15744328 View in PubMed
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Nutrient content of served food, nutrient intake and nutritional status of residents with dementia in a finnish nursing home.

https://arctichealth.org/en/permalink/ahliterature178791
Source
J Nutr Health Aging. 2004;8(4):234-8
Publication Type
Article
Date
2004
Author
M. Suominem
T. Laine
P. Routasalo
K H Pitkala
L. Rasanen
Author Affiliation
The Central Union for the Welfare of the Aged, Malmin kauppatie 26, FIN-00700 Helsinki, Finland. merja.suominen@vanhustyonkeskusliitto.fi
Source
J Nutr Health Aging. 2004;8(4):234-8
Date
2004
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Dementia - complications - physiopathology
Eating - physiology
Energy intake
Female
Finland
Food analysis
Food Services - standards
Geriatric Assessment
Homes for the Aged
Humans
Male
Nursing Homes
Nutrition Assessment
Nutrition Disorders - epidemiology - etiology
Nutrition Surveys
Nutritional Requirements
Nutritional Status
Nutritive Value
Abstract
The aim of this study was to determine the energy and nutrient content of the served food, the actual energy and nutrient intake and the nutritional status of elderly residents in a nursing home.
The nutritional status of 23 individuals aged 69 to 89 years with dementia were assessed by Mini Nutrition Assessment -test (MNA). The nutrient content of the served food was calculated from all meals during a 14-day period. Food consumption was determined by precise weighing method.
Of 23 residents, 20 were at risk of malnutrition and three were malnourished according to MNA. The mean energy content of the served food was 1665 kcal (7.4 MJ) per day. The amount of vitamin D in served food was too little and the amounts of vitamin E, folic acid, and fibre were somewhat lower than the recommended level. The amounts of other nutrients were sufficient or substantial. However, the true mean intake of energy in the whole group was only 1205 kcal (5.4 MJ) per day. The mean protein intake was 59 g. Intakes of vitamin D, E, and folic acid were clearly less than recommended whereas intakes of calcium, magnesium and zinc were as recommended.
It may be possible to get enough energy and most nutrients from the served food, but many elderly nursing home residents did not eat enough. It may be helpful to individually assess, assist and monitor those residents who eat very little in a variety of ways to promote their quality of life.
PubMed ID
15316587 View in PubMed
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Oral and nutritional status--Is the MNA a useful tool for dental clinics.

https://arctichealth.org/en/permalink/ahliterature165984
Source
J Nutr Health Aging. 2006 Nov-Dec;10(6):495-499; discussion 500-501
Publication Type
Article
Author
H. Soini
S. Muurinen
P. Routasalo
E. Sandelin
N. Savikko
M. Suominen
A. Ainamo
K H Pitkala
Author Affiliation
Section of Social and Health Services / Elderly Care, PO Box 2700, FI-02070 City of Espoo, Finland. helena.soini@espoo.fi
Source
J Nutr Health Aging. 2006 Nov-Dec;10(6):495-499; discussion 500-501
Language
English
Publication Type
Article
Keywords
Aged
Cross-Sectional Studies
Dental Care for Aged - standards
Female
Finland - epidemiology
Geriatric Assessment - methods
Homes for the Aged
Humans
Institutionalization
Long-Term Care
Male
Nursing Homes
Nutrition Assessment
Nutrition Disorders - diagnosis - epidemiology
Nutritional Status
Oral Health
Risk factors
Abstract
To determine the oral status of elderly residents in nursing homes (NH) and long term care wards (LT) and to describe associations between oral status and nutritional status among institutionalized elderly residents.
Descriptive, cross-sectional study.
All elderly residents in all NH and LT in Helsinki, the capital of Finland.
The study included 2036 out of 2424 (84 %) eligible subjects in NH, 1052 out of 1444 (73%) eligible subjects in LT, and all wards in NH (N = 92) and LT (N = 53).
A structured questionnaire, oral examination, and Mini Nutritional Assessment (MNA) were completed by ward nurses for all participating residents. The structured questionnaire included information on oral status and oral health problems, demographic characteristics, functional status, diseases and medication. One questionnaire for each ward was used to evaluate the daily ward routines related to nutritional care and meal management.
11 % of the NH residents and 3 % of LH patients were well nourished. Of NH residents 60 % were at risk of malnutrition and 29 % were malnourished. The respective figures for LT patients were 40 % and 57 %. Nutritional status was significantly associated with oral status and with the number of oral health problems. Those with mixed dentition or complete dentures tended to have better nutritional status than those totally edentulous without prosthesis. Malnutrition increased consistently with the increasing number of oral health problems (including chewing problems, swallowing difficulties, pain in mouth and xerostomia).
In the population of institutionalized frail elderly, malnutrition was related to both poor oral status and oral health problems.
PubMed ID
17183421 View in PubMed
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Predictors and subjective causes of loneliness in an aged population.

https://arctichealth.org/en/permalink/ahliterature174697
Source
Arch Gerontol Geriatr. 2005 Nov-Dec;41(3):223-33
Publication Type
Article
Author
N. Savikko
P. Routasalo
R S Tilvis
T E Strandberg
K H Pitkälä
Author Affiliation
The Central Union for the Welfare of the Aged, Malmin Kauppatie 26, 00700 Helsinki, Finland.
Source
Arch Gerontol Geriatr. 2005 Nov-Dec;41(3):223-33
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Female
Finland - epidemiology
Health status
Humans
Loneliness - psychology
Male
Prevalence
Quality of Life
Questionnaires
Retrospective Studies
Social Isolation - psychology
Socioeconomic Factors
Urban Population
Abstract
The aim of the study was to examine the prevalence and self-reported causes of loneliness among Finnish older population. The data were collected with a postal questionnaire from a random sample of 6,786 elderly people (>or=75 years of age). The response rate was 71.8% from community-dwelling sample. Of the respondents, 39% suffered from loneliness, 5% often or always. Loneliness was more common among rural elderly people than those living in cities. It was associated with advancing age, living alone or in a residential home, widowhood, low level of education and poor income. In addition, poor health status, poor functional status, poor vision and loss of hearing increased the prevalence of loneliness. The most common subjective causes for loneliness were illnesses, death of a spouse and lack of friends. Loneliness seems to derive from societal life changes as well as from natural life events and hardships originating from aging.
PubMed ID
15908025 View in PubMed
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Vitamin D and calcium supplementation among aged residents in nursing homes.

https://arctichealth.org/en/permalink/ahliterature162260
Source
J Nutr Health Aging. 2007 Sep-Oct;11(5):433-7
Publication Type
Article
Author
M H Suominen
H M V Hosia-Randell
S. Muurinen
A. Peiponen
P. Routasalo
H. Soini
I. Suur-Uski
K H Pitkala
Author Affiliation
Central Union for the Welfare of the Aged, Helsinki, Finland.
Source
J Nutr Health Aging. 2007 Sep-Oct;11(5):433-7
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Aging - physiology
Calcium, Dietary - administration & dosage
Cross-Sectional Studies
Dietary Supplements
Dose-Response Relationship, Drug
Female
Finland
Fractures, Bone - prevention & control
Homes for the Aged
Humans
Logistic Models
Male
Nursing Homes
Nutrition Assessment
Nutritional Status
Risk factors
Vitamin D - administration & dosage
Abstract
Aged residents in nursing homes are at particularly high risk of fractures. Vitamin D and calcium have a preventative role.
To describe the use of vitamin D and calcium supplementations, and their association with nutritional factors among nursing home residents.
Our study is a cross-sectional assessment of long-term residents in all nursing homes in Helsinki during February 2003. We collected residents' background information, nutritional status (Mini Nutritional Assessment, MNA), and data on daily nursing routines in institutions, including nutritional care. Vitamin D and calcium supplementations were inquired after in the questionnaire and retrieved from residents' medication lists.
2,114 (87%) of all 2,424 eligible residents had available data on the use of vitamin D and calcium supplementation. Their mean age was 83 years, and 80.7% were female. Of all participants, 32.9% received vitamin D supplementation and 27.7% calcium supplementation. Altogether 20.0% received both. However, only 21.3% received vitamin D in the therapeutic dose of 10 mg (400 IU) or more, and 3.6% in the recommended dose of 20 microg (800 IU) or more. In logistic regression analysis, residents who received vitamin D supplementation also had better nutritional status (MNA), ate snacks between meals, did not have constipation and their weight was checked more frequently.
Regardless of the known benefit and recommendation of vitamin D supplementation for the elderly residing mostly indoors, the proportion of nursing home residents receiving vitamin D and calcium was surprisingly low.
PubMed ID
17657365 View in PubMed
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7 records – page 1 of 1.