Nutritional status among patients in nursing homes and primary care assessed by the nutrition jou... more Nutritional status among patients in nursing homes and primary care assessed by the nutrition journal ➤ Background: Malnutrition amongst the elderly may lead to serious consequences for the person and for the community in terms of need for public support. Assessment of the nutritional status is the first step regarding treatment and follow-up. Purpose: To use the Norwegian Directorate of Health Nutrition Assessment Tool to gain knowledge about the risks of malnutrition. Method: A descriptive study was performed among 532 patients ≥67 years admitted to nursing homes or receiving home care nursing. Data included assessment of the patients' height, weight, Body Mass Index (BMI), and clinical data relevant for nutrition status. Results: BMI lower than recommended (BMI<24 kg/m 2) was found among 50% of the patients, and 30% were reported in the category undernourished (BMI<22 kg/m2). Patients with lack of appetite and reduced ability to chew and/or swallow had significantly lower BMI than patients not suffering from these problems. Conclusion: Systematic use of the nutrition journal seems appropriate to assess the nutrition status among elderly in order to offer adequate treatment and systematic follow-up.
ABSTRACT The article reflects on and explores a daughter's experience of being the relative t... more ABSTRACT The article reflects on and explores a daughter's experience of being the relative to a frail, sick elderly mother in Norway. Recent reforms of the Norwegian healthcare services have had a major impact on the relationship between patients, their families and healthcare workers. The daughter's experiences elucidate the failure of the primary healthcare service to interact with the specialist health service and the patients’ family. The article has a qualitative design and is based on one of the authors’ autoethnographic accounts. The researchers are inspired by collaborative autoethnography (CAE). The co-authors reflect on and explore the daughter's experiences in order to increase the understanding of the interplay between personal and experiential aspects on the one hand and the social, cultural and political context on the other. The article is evocative and analytical, and investigates critically the ways in which system routines, procedures and practices restrict the opportunities for real user involvement and partnership. We address frail older people in transition between various levels of the health service and explore the opportunities of the relative to voice their expectations for user participation in nursing care.
This study was a part of a municipal research and development programme in home healthcare (HHC).... more This study was a part of a municipal research and development programme in home healthcare (HHC). The Oulu Patient Classification instrument (OPCq), part of the RAFAELA Nursing Intensity and Staffing system, was used to measure nursing intensity (NI) for the first time in HHC in Norway. The aim was to describe nurses’ work experiences and perceptions of the usability of the OPCq instrument when classifying NI in HHC. Twenty-two members of staff participated in four focus-group interviews. Content analyses were used to analyze and interpret the data. Three themes emerged: 1) Classifying the modified OPCq levels correctly; 2) Technological problems hinder use of the instrument; 3) Classifying NI when time pressure dominates. The OPCq instrument is useful in classifying NI, although some minor adjustments might be needed for its use in HHC. The nurses considered the OPCq instrument useful in illuminating the actual work situation in HHC and the time pressure they experience.
Building trustworthy relationships that promote equal participation is a fundamental feature of d... more Building trustworthy relationships that promote equal participation is a fundamental feature of daily living in dementia care. Creating a social community is thus a key component of quality of life for residents in dementia special care units. The aim of this study was to explore healthcare personnel’s experiences of enhancing social community in common spaces in dementia special care units. A qualitative descriptive design consisted of four focus-group interviews with 15 healthcare personnel. The transcribed interviews were analyzed inductively using qualitative content analysis. The findings revealed that healthcare personnel’s experiences of enhancing social community in common spaces were related to three main themes, expressed as dilemmas between knowing versus not knowing each other, safety versus unsafety and presence versus absence . Our analysis indicates that to enhance social community, it is essential for healthcare personnel to be able to create different forms of proxi...
Aim: To test the content validity of a modified Oulu Patient Classification instrument (OPCq), pa... more Aim: To test the content validity of a modified Oulu Patient Classification instrument (OPCq), part of the RAFAELA Nursing Intensity and Staffing system in home health care (HHC) in Norway. Background: Due to the growing number of patients in HHC, a Patient Classification System (PCS) whereby the systematic registration of patients' care needs, nursing intensity (NI) and the allocation of nursing staff can occur is needed. The validity and reliability of the OPCq instrument have been tested with good outcomes in hospital settings, but only once in an HHC setting. In this study, the OPCq is tested for the first time in HHC in Norway. Methods: A pilot study with a descriptive design. The data were collected through a questionnaire (n = 44). Both qualitative and quantitative analyses were used. Results: The OPCq fulfills the requirements for validity in HHC, but the manual may need some minor adjustments. Discussion: The OPCq seems to be useful for measuring nursing intensity in HHC. Staff training and guidance, high-quality technological solutions and that all technology works satisfactorily are important when implementing a new PCS. Further research is needed in regard to NI and the optimal allocation of nursing staff in an HHC setting.
The objective of this study was to examine the nature of pain and persistence of pain in nursing ... more The objective of this study was to examine the nature of pain and persistence of pain in nursing home residents. The study was carried out with 201 participants drawn from six nursing homes in Norway. The participants rated their pain on 5 different days within a 14-day period on the modified McGill Pain Questionnaire regarding the intensity and location of pain. Four patterns in the persistence of pain were extracted, with the results showing approximately 50% of the participants experiencing persistent pain of a moderate to intense level. Pain ratings and persistent pain were significantly associated with number of body areas with pain, sleeping problems, number of medical diagnoses, and number of medications. The findings of this study suggest that both persistence and fluctuation of pain within short time periods may be related to inadequacy in pain management in nursing home residents, and fill the gap in the literature regarding patterns of persistent pain in nursing home resi...
Most Western countries aim to enable dementia sufferers to live at home for as long as possible. ... more Most Western countries aim to enable dementia sufferers to live at home for as long as possible. Person centeredness, continuity of care, and competence level are all important for the quality of home health care (HHC). The aim of this qualitative study is to describe staff’s experiences of providing care to home-dwelling dementia clients through HHC services. The study used a phenomenological-hermeneutic interpretation of focus group interviews. This study supports the value of continuous interpersonal relationships in HHC services. The findings show that specialized teams facilitate continuity and person-centered care, and that after training, staff become more holistically oriented, involve clients in daily care, and experience greater job confidence.
The number of people suffering from dementia will increase dramatically in the future, and this w... more The number of people suffering from dementia will increase dramatically in the future, and this will be a great challenge and concern for health care services. It is assumed that volunteers will strengthen community health care services more in the future than they do today. Aim: The aim of this study was to elucidate lived experiences of working as a volunteer in an activity center with adapted activities for home-dwelling people with early stage dementia. Methods: Qualitative interviews were implemented in a group of nine female volunteers from an activity center in southern Norway. The interviews were recorded, transcribed verbatim, and analyzed with a descriptive phenomenological method. Results: Volunteering in an activity center for home-dwelling people with early stage dementia was reported to provide experiences of being useful and feeling satisfied with performing a good job. It was an advantage for the volunteers to have had experiences from life in general, but also as a health professional or as being the next of kin of a dementia sufferer. It was important for the volunteers to focus on the dementia sufferer and show caring behavior, and interaction with and the appreciation of the health care professionals were also important. The volunteers were motivated by being able to have influence and participate in the planning of the work, to be a part of the social setting, and to learn. However, for some volunteers it was difficult to adjust to an appropriate role. Conclusion: In order to promote volunteering in a caring context, mutual trust and freedom should be emphasized. Being conscious of important volunteer characteristics like their experiences, knowledge, and caring behavior, as well as a focus on the staff showing appreciation and providing feedback, may be the difference between success and failure.
International journal of older people nursing, 2010
Nursing home residents often have pain as their everyday experiences and experience pain in silen... more Nursing home residents often have pain as their everyday experiences and experience pain in silence. The aim of this study was to gain an understanding of how nursing home residents experienced pain and how it influenced their lives and daily living. The present study applied a descriptive design. Fifteen residents from nursing homes were recruited among the participants in a larger quantitative study who reported having pain. A qualitative method using in-depth interviews was used. The data were analysed applying Kvale's method of interpretive analysis. Two dimensions of pain were identified: physical pain and pain as suffering. These are described in relation to factors that influence the intensity and the consequences of pain experiences. Physical pain may be relieved by various means of pain management. The residents experienced pain as suffering because pain management was not timely, inappropriate, or insufficient and also because of the nature of their social situation in...
Background: Reablement, also known as restorative care, supports older adults in regaining or mai... more Background: Reablement, also known as restorative care, supports older adults in regaining or maintaining their independence in daily life through the optimization of functional ability. Users' goals and healthcare professionals' use of a "hands-off" approach are key, thus user involvement is central to reablement logic. The aim of this study was to explore user involvement in reablement from users' perspectives from the beginning of an intervention. Methods: The study has an explorative qualitative design and includes thematic content analysis of data from repeat, individual semi-structured interviews with ten users accepting reablement intervention services in an urban Norwegian municipality. Findings: Control emerged as a core component. Users handed control over their time and body to professionals, balanced by drawing on an inner strength to control own limits, retain the right to make own judgements and decisions, and dream. Five themes were seen: Positive, but with a "wait and see" attitude; Professionals have goals, users have dreams; Desire to control schedule and activity; Regaining faith in one's own capacity and strengthening one's dreams; and Keep going, hold on to your dreams. Conclusion: User involvement interpreted as user-set goals may be overemphasized. Users possess the information that professionals need to set goals, consider these the goals important for professionals, and seek to facilitate professionals in their work. Based on a belief in own competence and a trust in professional's expertise, users invite professionals into a co-creation process. User involvement has previously been defined as a willingness and positive attitude toward reablement activities, but we find it can be expressed in different ways. Reablement logic does not always match users' understanding or desires, and it may be time to rethink user involvement in reablement. The reablement concept should be developed further, so that it better suits the individuals it should serve.
Studies in health technology and informatics, 2015
The aim of the study is to generate knowledge on the use of Global Positioning Systems (GPS) to s... more The aim of the study is to generate knowledge on the use of Global Positioning Systems (GPS) to support autonomy and independence for persons with dementia. By studying a larger cohort of persons with dementia (n=208) and their caregivers, this study provides essential knowledge for planning and implementing GPS technology as a part of public health care services. Commercially available GPS technology was provided to the cohort of 208 persons with dementia from nineteen different Norwegian municipalities. The participants used GPS when performing outdoor activities as part of their daily life during a period of time between 2012 and 2014. Their family caregivers were instructed on how to use the GPS technology for locating the participants. The study documents that using GPS for locating persons with dementia provide increased safety for the person with dementia, their family caregivers and their professional caregivers. Furthermore the results confirm that by using GPS, persons wit...
How do preventive home visits affect older peoples’ health and possibility for a good life in the... more How do preventive home visits affect older peoples’ health and possibility for a good life in their own home? Older peoples’ experiences with preventive home visits in a Norwegian municipality. Background: The main aim of preventive home visits (PHV) is to uphold home dwelling older people’s health and wellbeing, and to prevent or postpone functional decline and need for comprehensive health care. The interest in PHV is increasing due to expected demographic changes. The potential of PHV to improve older peoples’ health is well documented, but studies that shed light on experiences and perceptions of recipients of PHV are missing. Aim: The aim of this study was to explore and describe older persons’ experiences with and perceptions of PHV. The knowledge gained may contribute to further development of the PHV service. Methods: The study presented here was part of a evaluation study of PHV in a Norwegian municipality, with an explorative case study design. The present study was based ...
Objectives: To identify the patient classification systems used to classify nursing intensity in ... more Objectives: To identify the patient classification systems used to classify nursing intensity in the assessment of nursing staffing resources currently used in home health care, with a special emphasis on validity, reliability and staff allocation. Design: Scoping review of internationally published and grey literature, based on a methodological framework by Arksey and O'Malley. 3 were considered to have benefits and to be appropriate for the measurement of patients' needs, workload and allocation of staff, although specific information was not always given. Conclusion: Little has been published on validity or reliability tested patient classification systems linked to staffing allocation in home health care in the past decade. Limited research was seen where a patient classification system was considered to be fully operational in home health care.
This is an open access article under the terms of the Creative Commons Attribution License, which... more This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Introduction: The municipal health services have been given greater responsibility for an increas... more Introduction: The municipal health services have been given greater responsibility for an increasing number of younger patients with neurological diseases. This has created new challenges regarding the use of resources and skills, in addition to coordination and organization of health services. Amyotrophic Lateral Sclerosis (ALS) leads to considerable loss of function. These patients are in need of care from interprofessional health teams; from municipal health services and specialists in hospital service. Aim: To investigate how health professionals from municipal and specialist health services experience interprofessional cooperation when caring for home-dwelling patients with ALS in the palliative phase. Methods: Design: An exploratory design with a qualitative approach, theoretically inspired by perspectives on interprofessional cooperation and person-centered care, was used. Material and methods: Data collection was carried out during four focus group interviews, consisting of twenty-three participants. Analyses were performed using Malterud's and Kvale and Brinkmann's approaches. Results: Team building and cooperative fellowship were important preconditions for the provision of interprofessional services to meet patients with ALS' individual needs and desires. Throughout the disease trajectory patients with ALS present a diversity of problems. In order to provide relevant services during the palliative phase, staff changes should be avoided, the coordinator role should be clarified, and palliative skills must be developed. Co-creation and flexibility are essential to provide unique, person-centered services for patients with ALS and their families. Conclusions: Health personnel face challenges related to cooperating across health system borders. Addressing pitfalls of responsibility, the interprofessional team highlights co-creation and flexibility. Successful cooperation occurs when personcenteredness and flexibility are jointly used to co-create in clinical practice.
Systematisk smertekartlegging er en forutsetning for å lindre pasientens smerte. Resultater av sm... more Systematisk smertekartlegging er en forutsetning for å lindre pasientens smerte. Resultater av smertekartleggingen må dokumenteres i pasientens tiltaksplan og følges opp i form av en individuell tilrettelagt behandling. Kunnskap om smerter, hvordan og hvorfor smerter bør kartlegges er viktig, men ikke tilstrekkelig for å optimalisere smertelindringen. For å få til endringer i praksis knyttet til smerter, er det behov for stabilitet i lederskap og en bevisstgjøring av personalets holdninger til eldre og smerter. Legen har en sentral rolle i å etterspørre resultater av kartlegging og bidra i en tverrfaglig vurdering for å lindre pasientens smerte. ESAS er et velegnet instrument for å kartellegge smerter hos eldre i sykehjem forutsatt at en benytter et kroppskart i tillegg.
In Norway, there is a focus on home-dwelling people with dementia receiving the opportunity to pa... more In Norway, there is a focus on home-dwelling people with dementia receiving the opportunity to participate in organized meaningful activities. The aim of this study was to elucidate the experiences of home-dwelling persons with early-stage dementia who attend an activity center and participate in adapted physical and social activities delivered by nurses and volunteers. The study adopted a qualitative approach, with individual interviews conducted among eight people diagnosed with early-stage dementia. The interview texts were analyzed using manifest and latent content analysis. Four categories, ie, "appreciated activities", "praised nurses and volunteers", "being more active", and "being included in a fellowship", as well as the overall theme "participation in appreciated activities and a sense of feeling included in a fellowship may have a positive influence on health and well-being" emerged in the analysis. The informants apprecia...
Nutritional status among patients in nursing homes and primary care assessed by the nutrition jou... more Nutritional status among patients in nursing homes and primary care assessed by the nutrition journal ➤ Background: Malnutrition amongst the elderly may lead to serious consequences for the person and for the community in terms of need for public support. Assessment of the nutritional status is the first step regarding treatment and follow-up. Purpose: To use the Norwegian Directorate of Health Nutrition Assessment Tool to gain knowledge about the risks of malnutrition. Method: A descriptive study was performed among 532 patients ≥67 years admitted to nursing homes or receiving home care nursing. Data included assessment of the patients' height, weight, Body Mass Index (BMI), and clinical data relevant for nutrition status. Results: BMI lower than recommended (BMI<24 kg/m 2) was found among 50% of the patients, and 30% were reported in the category undernourished (BMI<22 kg/m2). Patients with lack of appetite and reduced ability to chew and/or swallow had significantly lower BMI than patients not suffering from these problems. Conclusion: Systematic use of the nutrition journal seems appropriate to assess the nutrition status among elderly in order to offer adequate treatment and systematic follow-up.
ABSTRACT The article reflects on and explores a daughter's experience of being the relative t... more ABSTRACT The article reflects on and explores a daughter's experience of being the relative to a frail, sick elderly mother in Norway. Recent reforms of the Norwegian healthcare services have had a major impact on the relationship between patients, their families and healthcare workers. The daughter's experiences elucidate the failure of the primary healthcare service to interact with the specialist health service and the patients’ family. The article has a qualitative design and is based on one of the authors’ autoethnographic accounts. The researchers are inspired by collaborative autoethnography (CAE). The co-authors reflect on and explore the daughter's experiences in order to increase the understanding of the interplay between personal and experiential aspects on the one hand and the social, cultural and political context on the other. The article is evocative and analytical, and investigates critically the ways in which system routines, procedures and practices restrict the opportunities for real user involvement and partnership. We address frail older people in transition between various levels of the health service and explore the opportunities of the relative to voice their expectations for user participation in nursing care.
This study was a part of a municipal research and development programme in home healthcare (HHC).... more This study was a part of a municipal research and development programme in home healthcare (HHC). The Oulu Patient Classification instrument (OPCq), part of the RAFAELA Nursing Intensity and Staffing system, was used to measure nursing intensity (NI) for the first time in HHC in Norway. The aim was to describe nurses’ work experiences and perceptions of the usability of the OPCq instrument when classifying NI in HHC. Twenty-two members of staff participated in four focus-group interviews. Content analyses were used to analyze and interpret the data. Three themes emerged: 1) Classifying the modified OPCq levels correctly; 2) Technological problems hinder use of the instrument; 3) Classifying NI when time pressure dominates. The OPCq instrument is useful in classifying NI, although some minor adjustments might be needed for its use in HHC. The nurses considered the OPCq instrument useful in illuminating the actual work situation in HHC and the time pressure they experience.
Building trustworthy relationships that promote equal participation is a fundamental feature of d... more Building trustworthy relationships that promote equal participation is a fundamental feature of daily living in dementia care. Creating a social community is thus a key component of quality of life for residents in dementia special care units. The aim of this study was to explore healthcare personnel’s experiences of enhancing social community in common spaces in dementia special care units. A qualitative descriptive design consisted of four focus-group interviews with 15 healthcare personnel. The transcribed interviews were analyzed inductively using qualitative content analysis. The findings revealed that healthcare personnel’s experiences of enhancing social community in common spaces were related to three main themes, expressed as dilemmas between knowing versus not knowing each other, safety versus unsafety and presence versus absence . Our analysis indicates that to enhance social community, it is essential for healthcare personnel to be able to create different forms of proxi...
Aim: To test the content validity of a modified Oulu Patient Classification instrument (OPCq), pa... more Aim: To test the content validity of a modified Oulu Patient Classification instrument (OPCq), part of the RAFAELA Nursing Intensity and Staffing system in home health care (HHC) in Norway. Background: Due to the growing number of patients in HHC, a Patient Classification System (PCS) whereby the systematic registration of patients' care needs, nursing intensity (NI) and the allocation of nursing staff can occur is needed. The validity and reliability of the OPCq instrument have been tested with good outcomes in hospital settings, but only once in an HHC setting. In this study, the OPCq is tested for the first time in HHC in Norway. Methods: A pilot study with a descriptive design. The data were collected through a questionnaire (n = 44). Both qualitative and quantitative analyses were used. Results: The OPCq fulfills the requirements for validity in HHC, but the manual may need some minor adjustments. Discussion: The OPCq seems to be useful for measuring nursing intensity in HHC. Staff training and guidance, high-quality technological solutions and that all technology works satisfactorily are important when implementing a new PCS. Further research is needed in regard to NI and the optimal allocation of nursing staff in an HHC setting.
The objective of this study was to examine the nature of pain and persistence of pain in nursing ... more The objective of this study was to examine the nature of pain and persistence of pain in nursing home residents. The study was carried out with 201 participants drawn from six nursing homes in Norway. The participants rated their pain on 5 different days within a 14-day period on the modified McGill Pain Questionnaire regarding the intensity and location of pain. Four patterns in the persistence of pain were extracted, with the results showing approximately 50% of the participants experiencing persistent pain of a moderate to intense level. Pain ratings and persistent pain were significantly associated with number of body areas with pain, sleeping problems, number of medical diagnoses, and number of medications. The findings of this study suggest that both persistence and fluctuation of pain within short time periods may be related to inadequacy in pain management in nursing home residents, and fill the gap in the literature regarding patterns of persistent pain in nursing home resi...
Most Western countries aim to enable dementia sufferers to live at home for as long as possible. ... more Most Western countries aim to enable dementia sufferers to live at home for as long as possible. Person centeredness, continuity of care, and competence level are all important for the quality of home health care (HHC). The aim of this qualitative study is to describe staff’s experiences of providing care to home-dwelling dementia clients through HHC services. The study used a phenomenological-hermeneutic interpretation of focus group interviews. This study supports the value of continuous interpersonal relationships in HHC services. The findings show that specialized teams facilitate continuity and person-centered care, and that after training, staff become more holistically oriented, involve clients in daily care, and experience greater job confidence.
The number of people suffering from dementia will increase dramatically in the future, and this w... more The number of people suffering from dementia will increase dramatically in the future, and this will be a great challenge and concern for health care services. It is assumed that volunteers will strengthen community health care services more in the future than they do today. Aim: The aim of this study was to elucidate lived experiences of working as a volunteer in an activity center with adapted activities for home-dwelling people with early stage dementia. Methods: Qualitative interviews were implemented in a group of nine female volunteers from an activity center in southern Norway. The interviews were recorded, transcribed verbatim, and analyzed with a descriptive phenomenological method. Results: Volunteering in an activity center for home-dwelling people with early stage dementia was reported to provide experiences of being useful and feeling satisfied with performing a good job. It was an advantage for the volunteers to have had experiences from life in general, but also as a health professional or as being the next of kin of a dementia sufferer. It was important for the volunteers to focus on the dementia sufferer and show caring behavior, and interaction with and the appreciation of the health care professionals were also important. The volunteers were motivated by being able to have influence and participate in the planning of the work, to be a part of the social setting, and to learn. However, for some volunteers it was difficult to adjust to an appropriate role. Conclusion: In order to promote volunteering in a caring context, mutual trust and freedom should be emphasized. Being conscious of important volunteer characteristics like their experiences, knowledge, and caring behavior, as well as a focus on the staff showing appreciation and providing feedback, may be the difference between success and failure.
International journal of older people nursing, 2010
Nursing home residents often have pain as their everyday experiences and experience pain in silen... more Nursing home residents often have pain as their everyday experiences and experience pain in silence. The aim of this study was to gain an understanding of how nursing home residents experienced pain and how it influenced their lives and daily living. The present study applied a descriptive design. Fifteen residents from nursing homes were recruited among the participants in a larger quantitative study who reported having pain. A qualitative method using in-depth interviews was used. The data were analysed applying Kvale's method of interpretive analysis. Two dimensions of pain were identified: physical pain and pain as suffering. These are described in relation to factors that influence the intensity and the consequences of pain experiences. Physical pain may be relieved by various means of pain management. The residents experienced pain as suffering because pain management was not timely, inappropriate, or insufficient and also because of the nature of their social situation in...
Background: Reablement, also known as restorative care, supports older adults in regaining or mai... more Background: Reablement, also known as restorative care, supports older adults in regaining or maintaining their independence in daily life through the optimization of functional ability. Users' goals and healthcare professionals' use of a "hands-off" approach are key, thus user involvement is central to reablement logic. The aim of this study was to explore user involvement in reablement from users' perspectives from the beginning of an intervention. Methods: The study has an explorative qualitative design and includes thematic content analysis of data from repeat, individual semi-structured interviews with ten users accepting reablement intervention services in an urban Norwegian municipality. Findings: Control emerged as a core component. Users handed control over their time and body to professionals, balanced by drawing on an inner strength to control own limits, retain the right to make own judgements and decisions, and dream. Five themes were seen: Positive, but with a "wait and see" attitude; Professionals have goals, users have dreams; Desire to control schedule and activity; Regaining faith in one's own capacity and strengthening one's dreams; and Keep going, hold on to your dreams. Conclusion: User involvement interpreted as user-set goals may be overemphasized. Users possess the information that professionals need to set goals, consider these the goals important for professionals, and seek to facilitate professionals in their work. Based on a belief in own competence and a trust in professional's expertise, users invite professionals into a co-creation process. User involvement has previously been defined as a willingness and positive attitude toward reablement activities, but we find it can be expressed in different ways. Reablement logic does not always match users' understanding or desires, and it may be time to rethink user involvement in reablement. The reablement concept should be developed further, so that it better suits the individuals it should serve.
Studies in health technology and informatics, 2015
The aim of the study is to generate knowledge on the use of Global Positioning Systems (GPS) to s... more The aim of the study is to generate knowledge on the use of Global Positioning Systems (GPS) to support autonomy and independence for persons with dementia. By studying a larger cohort of persons with dementia (n=208) and their caregivers, this study provides essential knowledge for planning and implementing GPS technology as a part of public health care services. Commercially available GPS technology was provided to the cohort of 208 persons with dementia from nineteen different Norwegian municipalities. The participants used GPS when performing outdoor activities as part of their daily life during a period of time between 2012 and 2014. Their family caregivers were instructed on how to use the GPS technology for locating the participants. The study documents that using GPS for locating persons with dementia provide increased safety for the person with dementia, their family caregivers and their professional caregivers. Furthermore the results confirm that by using GPS, persons wit...
How do preventive home visits affect older peoples’ health and possibility for a good life in the... more How do preventive home visits affect older peoples’ health and possibility for a good life in their own home? Older peoples’ experiences with preventive home visits in a Norwegian municipality. Background: The main aim of preventive home visits (PHV) is to uphold home dwelling older people’s health and wellbeing, and to prevent or postpone functional decline and need for comprehensive health care. The interest in PHV is increasing due to expected demographic changes. The potential of PHV to improve older peoples’ health is well documented, but studies that shed light on experiences and perceptions of recipients of PHV are missing. Aim: The aim of this study was to explore and describe older persons’ experiences with and perceptions of PHV. The knowledge gained may contribute to further development of the PHV service. Methods: The study presented here was part of a evaluation study of PHV in a Norwegian municipality, with an explorative case study design. The present study was based ...
Objectives: To identify the patient classification systems used to classify nursing intensity in ... more Objectives: To identify the patient classification systems used to classify nursing intensity in the assessment of nursing staffing resources currently used in home health care, with a special emphasis on validity, reliability and staff allocation. Design: Scoping review of internationally published and grey literature, based on a methodological framework by Arksey and O'Malley. 3 were considered to have benefits and to be appropriate for the measurement of patients' needs, workload and allocation of staff, although specific information was not always given. Conclusion: Little has been published on validity or reliability tested patient classification systems linked to staffing allocation in home health care in the past decade. Limited research was seen where a patient classification system was considered to be fully operational in home health care.
This is an open access article under the terms of the Creative Commons Attribution License, which... more This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Introduction: The municipal health services have been given greater responsibility for an increas... more Introduction: The municipal health services have been given greater responsibility for an increasing number of younger patients with neurological diseases. This has created new challenges regarding the use of resources and skills, in addition to coordination and organization of health services. Amyotrophic Lateral Sclerosis (ALS) leads to considerable loss of function. These patients are in need of care from interprofessional health teams; from municipal health services and specialists in hospital service. Aim: To investigate how health professionals from municipal and specialist health services experience interprofessional cooperation when caring for home-dwelling patients with ALS in the palliative phase. Methods: Design: An exploratory design with a qualitative approach, theoretically inspired by perspectives on interprofessional cooperation and person-centered care, was used. Material and methods: Data collection was carried out during four focus group interviews, consisting of twenty-three participants. Analyses were performed using Malterud's and Kvale and Brinkmann's approaches. Results: Team building and cooperative fellowship were important preconditions for the provision of interprofessional services to meet patients with ALS' individual needs and desires. Throughout the disease trajectory patients with ALS present a diversity of problems. In order to provide relevant services during the palliative phase, staff changes should be avoided, the coordinator role should be clarified, and palliative skills must be developed. Co-creation and flexibility are essential to provide unique, person-centered services for patients with ALS and their families. Conclusions: Health personnel face challenges related to cooperating across health system borders. Addressing pitfalls of responsibility, the interprofessional team highlights co-creation and flexibility. Successful cooperation occurs when personcenteredness and flexibility are jointly used to co-create in clinical practice.
Systematisk smertekartlegging er en forutsetning for å lindre pasientens smerte. Resultater av sm... more Systematisk smertekartlegging er en forutsetning for å lindre pasientens smerte. Resultater av smertekartleggingen må dokumenteres i pasientens tiltaksplan og følges opp i form av en individuell tilrettelagt behandling. Kunnskap om smerter, hvordan og hvorfor smerter bør kartlegges er viktig, men ikke tilstrekkelig for å optimalisere smertelindringen. For å få til endringer i praksis knyttet til smerter, er det behov for stabilitet i lederskap og en bevisstgjøring av personalets holdninger til eldre og smerter. Legen har en sentral rolle i å etterspørre resultater av kartlegging og bidra i en tverrfaglig vurdering for å lindre pasientens smerte. ESAS er et velegnet instrument for å kartellegge smerter hos eldre i sykehjem forutsatt at en benytter et kroppskart i tillegg.
In Norway, there is a focus on home-dwelling people with dementia receiving the opportunity to pa... more In Norway, there is a focus on home-dwelling people with dementia receiving the opportunity to participate in organized meaningful activities. The aim of this study was to elucidate the experiences of home-dwelling persons with early-stage dementia who attend an activity center and participate in adapted physical and social activities delivered by nurses and volunteers. The study adopted a qualitative approach, with individual interviews conducted among eight people diagnosed with early-stage dementia. The interview texts were analyzed using manifest and latent content analysis. Four categories, ie, "appreciated activities", "praised nurses and volunteers", "being more active", and "being included in a fellowship", as well as the overall theme "participation in appreciated activities and a sense of feeling included in a fellowship may have a positive influence on health and well-being" emerged in the analysis. The informants apprecia...
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