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Case managers for frail older people: a randomised controlled pilot study.

https://arctichealth.org/en/permalink/ahliterature144071
Source
Scand J Caring Sci. 2010 Dec;24(4):755-63
Publication Type
Article
Date
Dec-2010
Author
Jimmie Kristensson
Anna K Ekwall
Ulf Jakobsson
Patrik Midlöv
Ingalill R Hallberg
Author Affiliation
Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden. Jimmie.Kristensson@med.lu.se
Source
Scand J Caring Sci. 2010 Dec;24(4):755-63
Date
Dec-2010
Language
English
Publication Type
Article
Keywords
Aged
Case Management
Frail Elderly
Humans
Pilot Projects
Sweden
Abstract
The aim was to test sampling and explore sample characteristics in a pilot study using a case management intervention for older people with functional dependency and repeated contact with the healthcare services as well as to investigate the effects of the intervention on perceived health and depressed mood after 3 months. The aim was also to explore internal consistency in the life satisfaction index Z, activities of daily living-staircase and Geriatric Depression Scale-20.
This pilot study was carried out in a randomised controlled design with repeated follow-ups. In all, 46 people were consecutively and randomly assigned to either an intervention (n = 23) or a control (n = 23) group. Two nurses worked as case managers and carried out the intervention, which consisted of four parts.
No differences were found between the groups at baseline. The results showed the participants had low life satisfaction (median 14 vs. 12), several health complaints (median 11) and a high score on the Geriatric Depression Scale (median 6) at baseline, indicating the risk of depression. No significant effects were observed regarding depressed mood or perceived health between or within groups at follow-up after 3 months. Cronbach's alpha showed satisfactory internal consistency for group comparisons.
The sampling procedure led to similar groups. The life satisfaction, functional dependency and symptoms of depression measures were reliable to use. No changes in perceived health and symptoms of depression were found after 3 months, indicating that it may be too early to expect effects. The low depression score is noteworthy and requires further research.
PubMed ID
20409057 View in PubMed
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Comparison of oral health status on admission and at discharge in a group of geriatric rehabilitation patients.

https://arctichealth.org/en/permalink/ahliterature62773
Source
Oral Health Prev Dent. 2003;1(3):221-8
Publication Type
Article
Date
2003
Author
Pia Andersson
Ingalill R Hallberg
Stefan Renvert
Author Affiliation
Kristianstad University, Department of Health Sciences, Kristianstad, Sweden. Pia.Andersson@hv.hkr.se
Source
Oral Health Prev Dent. 2003;1(3):221-8
Date
2003
Language
English
Publication Type
Article
Keywords
Aged
Cerebrovascular Accident - nursing - rehabilitation
Chi-Square Distribution
Comparative Study
Dental Care for Aged
Geriatric Assessment
Geriatric Nursing
Humans
Observer Variation
Oral Health
Patient Admission
Patient Discharge
Rehabilitation Centers
Rehabilitation Nursing
Research Support, Non-U.S. Gov't
Sweden
Abstract
PURPOSE: The aim of this study was to compare oral health status on a geriatric rehabilitation ward among patients who were assessed using the Revised Oral Assessment Guide (ROAG) on admission and at discharge; and to investigate in what respect the oral health procedures (OHP) suggested in ROAG were applied when oral health problems were detected. MATERIALS AND METHODS: Registered nurses on the ward performed oral health assessments using ROAG with 107 patients on admission and at discharge. When oral health problems were detected measures to be taken were suggested using ROAG. RESULTS: Oral health problems were common among the patients on admission (86%), as well as at discharge (51%). The frequency of the problems was significantly lower at discharge compared to admission. The OHP that were recommended in ROAG were completely followed when saliva flow-related problems were detected. Regarding other oral health problems, measures other than the recommended ones were often performed. CONCLUSION: This study demonstrated that the oral health was better at the end of the hospital stay compared to admission.
PubMed ID
15641500 View in PubMed
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Determinants and characteristics of help provision for elderly people living at home and in relation to quality of life.

https://arctichealth.org/en/permalink/ahliterature29994
Source
Scand J Caring Sci. 2004 Dec;18(4):387-95
Publication Type
Article
Date
Dec-2004
Author
Ylva Hellström
Ingalill R Hallberg
Author Affiliation
School of Health Science, Blekinge Institute of Technology, Karlskrona, Sweden. ylva.hellstrom@bth.se
Source
Scand J Caring Sci. 2004 Dec;18(4):387-95
Date
Dec-2004
Language
English
Publication Type
Article
Keywords
Aged - psychology
Aged, 80 and over
Analysis of Variance
Caregivers
Female
Frail Elderly - psychology
Home Care Services
Humans
Male
Quality of Life
Regression Analysis
Research Support, Non-U.S. Gov't
Sweden
Abstract
The aim of this study was to investigate determinants of help from informal or formal caregivers or a combination of both among people aged 75 or more and living at home, and the characteristics of the recipients, the help they received and their quality of life (QoL). The sample for this study was 448 elderly people, 75-99 years of age, living at home and receiving help with activities for daily living, instrumental or both instrumental and personal. Regression analysis showed high QoL not to be significantly related to who was providing the help, whilst it was related to higher age, living with someone, lower number of complaints and managing to be alone at home. Multinomial regression analysis showed age, number of children, number of complaints, the ability to stay alone at home and living alone to predict receiving help from different kinds of caregivers. Recipients receiving help from informal caregivers were younger, more often married and living together with someone, whilst those receiving help from both informal and formal caregivers had more help with instrumental and personal activities for daily living and were not able to stay alone at home as much as those receiving help from other kinds of caregivers. Those receiving help from formal caregivers had fewer children, were single and were living alone more often than the other recipients. Thus the responsibility for help for elderly people rests heavily on informal caregivers, whom it seems essential to support. As public service at home is preferably given to those living alone or able to stay alone at home, those without relatives may not be able to remain at home when their need of help increases.
PubMed ID
15598246 View in PubMed
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Determinants of feeling hindered by health problems in daily living at 60 years and above.

https://arctichealth.org/en/permalink/ahliterature154846
Source
Scand J Caring Sci. 2008 Sep;22(3):410-21
Publication Type
Article
Date
Sep-2008
Author
Cecilia Fagerström
Helen Persson
Göran Holst
Ingalill R Hallberg
Author Affiliation
Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden. cecilia.fagerstrom@bth.se
Source
Scand J Caring Sci. 2008 Sep;22(3):410-21
Date
Sep-2008
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Aged, 80 and over
Cohort Studies
Health status
Humans
Longitudinal Studies
Middle Aged
Sweden
Abstract
Although the ability to perform activities of daily living (ADL) is frequently used to identify the impact on daily living caused by health problems such as diseases, impaired eyesight or hearing, it is still not well known what makes people feel hindered in daily living with more or less inability to perform ADL. The aim of this study was to investigate feeling hindered by health problems in daily living among people (n = 958, 60-96 years) in relation to ADL capacity, health problems as well as social and financial resources, sense of coherence and life satisfaction. The data are taken from a baseline survey in one of the four included centres (Blekinge) of the longitudinal multicentre cohort study, The Swedish National Study on Aging and Care. The result showed that people felt hindered by their health problems despite no impairment in ADL capacity. Feeling greatly hindered by health problems was associated with factors linked to mobility but also to fatigue, no help when needed, and avoiding being outdoors due to fear of falling. Factors associated with feeling greatly hindered differed depending on whether people were impaired in ADL capacity or not. In people with excellent ADL capacity feeling hindered was associated with picking up things from the floor and rising from a chair and fatigue, whereas avoiding being outdoors, no help when needed and rising from a chair were found to be associated with feeling hindered by health problems among people with impaired ADL capacity. Combining people's ADL capacity with questions about feeling hindered may provide knowledge of determinant factors of feeling hindered in relation to ADL capacity, impaired or not, to identify people in need of rehabilitation or other interventions.
PubMed ID
18840225 View in PubMed
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Health status and functional profile at admission of nursing home residents in Iceland over 11-year period.

https://arctichealth.org/en/permalink/ahliterature101358
Source
Int J Older People Nurs. 2011 Aug 1;
Publication Type
Article
Date
Aug-1-2011
Author
Ingibjörg Hjaltadóttir
Ingalill R Hallberg
Anna K Ekwall
Per Nyberg
Author Affiliation
Doctoral Student, Department of Health Sciences, Lund University, Lund, Sweden and Faculty of Nursing, University of Iceland, Reykjavik, Iceland and The National University Hospital of Iceland, Reykjavik, Iceland Professor, Department of Health Sciences, Lund University, Lund, Sweden and The Swedish Institute for Health Sciences, Lund, Sweden Lecturer, Department of Health Sciences, Lund University, Lund, Sweden Senior Lecturer, Department of Health Sciences, Lund University, Lund, Sweden.
Source
Int J Older People Nurs. 2011 Aug 1;
Date
Aug-1-2011
Language
English
Publication Type
Article
Abstract
hjaltadóttir i., hallberg i.r., ekwall a.k. & nyberg p. (2011) Health status and functional profile at admission of nursing home residents in Iceland over 11-year period. International Journal of Older People Nursing doi: 10.1111/j.1748-3743.2011.00287.x Background. The knowledge over time of the health status and changes in care needs of newly admitted nursing home residents is limited. Objectives. To investigate trends in residents' health status and functional profile at admission to nursing homes and compare rural and capital areas in Iceland over an 11-year period. Design. Retrospective analysis of nursing home data over 11 years (1996-2006). Participants. Residents, who had been assessed with the Minimum Data Set assessment within 90 days from admittance (n = 2206). Method. Non-parametric tests for descriptive statistics and linear regressions were used to analyse time trends. Results. The mean age ranged from 80.1 to 82.8, and women accounted for 52.7% to 67.1%. The level of independency indicated intact cognitive performance in 28.6-61.4% and in 42.5-68% in activities of daily living performance. A weak, but significant, linear trend was seen in residents' health becoming less stable, their cognitive performance improving, more pain being reported and greater participation in social activities over the 11 years. Conclusion. Some residents might have stayed at home longer had they been given appropriate home care and the opportunity of rehabilitation. Pain management and social activities are areas where more staff knowledge seems to be needed. Implications for practice. Resources to enable old people to remain at home need to be explored before their entry into nursing homes. Whereas providing services at the appropriate level is important for society as well as older people.
PubMed ID
21801320 View in PubMed
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Hospital and outpatient clinic utilization among older people in the 3-5 years following the initiation of continuing care: a longitudinal cohort study.

https://arctichealth.org/en/permalink/ahliterature134051
Source
BMC Health Serv Res. 2011;11:136
Publication Type
Article
Date
2011
Author
Anna Condelius
Ingalill R Hallberg
Ulf Jakobsson
Author Affiliation
Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden. anna.condelius@med.lu.se
Source
BMC Health Serv Res. 2011;11:136
Date
2011
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Aged, 80 and over
Analysis of Variance
Cohort Studies
Continuity of Patient Care - statistics & numerical data
Female
Health Services Needs and Demand - statistics & numerical data
Health Services for the Aged - statistics & numerical data - utilization
Hospitalization - statistics & numerical data
Humans
Male
Outpatients - statistics & numerical data
Pilot Projects
Risk Assessment - methods
Sweden
Abstract
Few studies have investigated the subsequent rate of hospital and outpatient clinic utilization in those who receive continuing care and have documented frequent usage over one year. Such knowledge may be helpful in identifying those who would benefit from preventive interventions. The aim of this study was to investigate and compare the subsequent rate of hospital and outpatient clinic utilization among older people with 0, 1, 2, 3 or more hospital stays in the first year following the initiation of continuing care. A further aim was to compare these groups regarding demographic data, health complaints, functional and cognitive ability, informal care and mortality.
A total of 1079 people, aged 65 years or older, who received a decision regarding the initiation of continuing care during the years 2001, 2002 or 2003 were investigated. Four groups were created based on whether they had 0, 1, 2 or = 3 hospital stays in the first year following the initiation of continuing care and were investigated regarding the rate of hospital and outpatient clinic utilization in the subsequent 3-5 years.
Fifty seven percent of the sample had no hospital stay during the first year following the initiation of continuing care, 20% had 1 stay, 10% had 2 stays and 13% had three or more hospital stays (range: 3-13). Those with = 3 hospital stays in the first year continued to have the significantly highest rate of hospital and outpatient care utilization in the subsequent years. This group accounted for 57% of hospital stays in the first year, 27% in the second year and 18% in the third year. In this group the risk of having = 3 hospital stays in the second year was 27% and 12% in the third year.
There is a clear need for interventions targeted on prevention of frequent hospital and outpatient clinic utilization among those who are high users of hospital care in the first year after the initiation of continuing care. Perhaps an increased availability of medically skilled staff in the day to day care of these people in the municipalities could prevent frequent hospital and outpatient clinic utilization, especially hospital readmissions.
Notes
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PubMed ID
21627791 View in PubMed
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Loneliness as a predictor of quality of life among older caregivers.

https://arctichealth.org/en/permalink/ahliterature51925
Source
J Adv Nurs. 2005 Jan;49(1):23-32
Publication Type
Article
Date
Jan-2005
Author
Anna K Ekwall
Bengt Sivberg
Ingalill R Hallberg
Author Affiliation
Department of Nursing, Faculty of Medicine, Lund University, Lund, Sweden. anna.ekwall@omv.lu.se
Source
J Adv Nurs. 2005 Jan;49(1):23-32
Date
Jan-2005
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Caregivers - psychology
Female
Health Services for the Aged
Health status
Humans
Loneliness - psychology
Male
Quality of Life
Questionnaires
Research Support, Non-U.S. Gov't
Residence Characteristics
Sex Factors
Social Support
Sweden - epidemiology
Abstract
AIM: This paper reports a study investigating quality of life in relation to loneliness, caregiving, social network, gender, age and economic status among caregiving men and women in a population-based sample aged 75 years or older. BACKGROUND: Because of demographic changes, in the future more care for older people will be given by informal caregivers who are themselves older. Being old and caring for another older person may affect various aspects of life, such as physical and emotional health and decreased time for respite, which may affect social life and quality of life. METHOD: A postal questionnaire including the Short Form Health Survey was used. The sample consisted of 4278 people, aged 75 years and over, living in Sweden. Of these, 783 (18%) were caregivers. FINDINGS: Caregivers had a larger social network and reported feelings of loneliness less often than non-caregivers. Forty per cent of caregivers helped every day. There were gender differences in experiences of loneliness during the last year, with the frequency of intense feelings of loneliness being higher among women. Loneliness and a small or non-existent network were significantly associated with low quality of life among caregivers, as well as in the total sample. The results showed significant association between loneliness, weak social network and low mental quality of life. CONCLUSIONS: The fact that loneliness was the most important factor predicting low quality of life among caregivers, as well as older people in general, indicates that it is crucial in the care of older people. From a nursing perspective, the findings indicate the advantage of helping older people to keep up and develop their social networks. Nursing care should involve steps to maintain the social network before an older person becomes too weak, since decreased health status makes social contacts more difficult.
PubMed ID
15610378 View in PubMed
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Managing pain in older persons who receive home-help for their daily living. Perceptions by older persons and care providers.

https://arctichealth.org/en/permalink/ahliterature188881
Source
Scand J Caring Sci. 2002 Sep;16(3):319-28
Publication Type
Article
Date
Sep-2002
Author
Kerstin Blomqvist
Ingalill R Hallberg
Author Affiliation
Department of Nursing, University of Lund, Lund, Sweden. Kerstin.Blomqvist@bth.se
Source
Scand J Caring Sci. 2002 Sep;16(3):319-28
Date
Sep-2002
Language
English
Publication Type
Article
Keywords
Activities of Daily Living
Aged
Aged, 80 and over
Female
Geriatric Nursing
Home Care Services
Humans
Male
Pain - drug therapy
Pain Management
Physical Therapy Specialty - statistics & numerical data
Sweden
Abstract
Pain is a common problem for older persons who need professional help for their daily living. In this study 94 older persons (75+) in persistent pain were compared with 52 care providers concerning the pain management methods they had used/administered during the previous week and how helpful they perceived these methods to be. Interviews were based on 16 items from the original version of the pain management inventory (PMI). Both groups perceived prescribed medication, rest and distraction as the most frequently utilized methods. Specific methods such as transcutaneous electrical nerve stimulation (TENS) or bracing/splinting or bandaging the affected body part were seldom employed, although most users perceived these methods as helpful. Care providers perceived most methods for managing pain as more effective than older persons did. The results imply that care providers need skills in a variety of pharmacological and nonpharmacological methods to manage pain and a need to evaluate effectiveness of the methods in a systematic way.
PubMed ID
12191045 View in PubMed
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Medical healthcare utilization as related to long-term care at home or in special accommodation.

https://arctichealth.org/en/permalink/ahliterature146726
Source
Arch Gerontol Geriatr. 2010 Nov-Dec;51(3):250-6
Publication Type
Article
Author
Anna Condelius
Ingalill R Hallberg
Ulf Jakobsson
Author Affiliation
Department of Health Sciences, Faculty of Medicine, Lund University, P.O. Box 157, 221 00 Lund, Sweden. anna.condelius@med.lu.se
Source
Arch Gerontol Geriatr. 2010 Nov-Dec;51(3):250-6
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Analysis of Variance
Female
Health Services - utilization
Home Care Services - utilization
Humans
Length of Stay - statistics & numerical data
Long-Term Care - utilization
Male
Sweden
Abstract
This study aimed to investigate medical healthcare utilization 3-5 years following the decision about long-term care at home vs. in special accommodation in older people. A total of 1079 people who were granted long-term care the years 2001, 2002 or 2003 were studied regarding the number of hospital stays and the number of contacts with physicians in outpatient care in the 3-5 subsequent years. Those living at home and those in special accommodation were compared regarding medical healthcare utilization during the 3-5 subsequent years. Data were collected through the study Good Aging in Skåne (GAS) and through the registers, Patient Administrative Support in Skåne (PASiS) and PrivaStat. Utilization of medical healthcare decreased slightly in the years following the decision about long-term care. Despite younger age and less dependency in activities of daily living (ADL), those living at home utilized hospital and outpatient care to a greater extent than those in special accommodation; these differences remained over time. Thus, it seems as long-term care needs to become more effective in the prevention of medical healthcare utilization among those cared for at home. More, older people who are granted long-term care at home may otherwise imply increased utilization of medical healthcare.
PubMed ID
20006391 View in PubMed
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Nurses' experiences of the encounter with elderly patients in acute confusional state in orthopaedic care.

https://arctichealth.org/en/permalink/ahliterature71389
Source
Int J Nurs Stud. 2003 May;40(4):437-48
Publication Type
Article
Date
May-2003
Author
Edith M Andersson
Ingalill R Hallberg
Anna-Karin Edberg
Author Affiliation
Department of Nursing, University of Lund, P.O. Box 157, SE-221 00 Lund, Sweden. edith.andersson@omv.lu.se
Source
Int J Nurs Stud. 2003 May;40(4):437-48
Date
May-2003
Language
English
Publication Type
Article
Keywords
Acute Disease
Adaptation, Psychological
Adult
Aged - psychology
Attitude of Health Personnel
Confusion - etiology - nursing - psychology
Female
Helping Behavior
Humans
Male
Middle Aged
Models, Nursing
Nurse's Role
Nurse-Patient Relations
Nursing Methodology Research
Nursing Staff, Hospital - education - psychology
Orthopedic Nursing - methods
Questionnaires
Research Support, Non-U.S. Gov't
Sweden
Abstract
The aim of this study was to illuminate nurses' experiences of the encounter with elderly patients who developed acute confusional state (ACS) in orthopaedic care. Forty-eight nurses with professional background as registered (n=26) or licensed practical nurses (n=22) who took part in the nursing care of acute confused patients were involved. Open-ended unstructured interviews were conducted with regard to the course of events, experiences and interpretation of what had happened during the ACS as well as the nurses' actions and encounter with the confused patient. The texts were analysed using manifest and latent content analysis, revealing that the nurses had difficulties in reaching the patients and their reality, and thus in understanding their experiences. Interpretation of the nurses' experiences showed that the nurses found it difficult to reach the patients' reality because the patients were in a divided and/or different world. They interpreted the patients as seeking solitude or company, keeping a distance or being suspicious of the nurses. The findings indicated that the interaction in the encounter between the acutely confused patients and the nurses indicated insufficient and/or broken reciprocity. The nurses used various strategies to meet the patients, being a companion and/or being a surrogate. They acted in the encounter based on their view of the patient and their ability to enter into and understand the patients' situation. The strategies were more or less successful, sometimes resulting in contact and calming the patients and in other cases increasing the patients' irritation and anger. The results were more successful when the strategies were derived from the nurses' interpretation of the patients' situation and the nurses paid attention to the patients and confirmed them.
PubMed ID
12667520 View in PubMed
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11 records – page 1 of 2.