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Milavec Kapun M, Rajkovič V, Šušteršič O, Rajkovič U. A self-care process model for patients with chronic noncommunicable diseases. Health Serv Manage Res 2024; 37:189-197. [PMID: 37699151 DOI: 10.1177/09514848231201405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/14/2023]
Abstract
Self-care of patients with chronic noncommunicable diseases is an essential component of contemporary healthcare. The purpose of this paper is to present a novel self-care process model and place it in the broader context of professional care. The extended Event-driven Process Chain approach to process modelling was used, focusing on a detailed overview of sequences of events, connections and activities and other elements/building blocks. A self-care process model was designed. The model is divided into two parts. The first part represents the self-care process when patients are able to manage their symptoms and be independent. The second part includes the process when patients are unable to perform self-care and/or need professional support. By identifying the essential elements of this process and incorporating them into the patients' care process, we can ensure that professional support for self-care creates a dynamic balance in the patients' ecosystems. Patients with chronic noncommunicable diseases need to make timely decisions about individual aspects of their health and seek professional help. In this way, an optimal level of health and well-being of patients can be achieved. Focusing on the patients' self-care process could also reduce treatment costs and improve the quality of life of patients. The novel designed model of the process of self-care, with all its essential elements, can be supported by digital technology, especially in the decision-making process and needs to become an important part of healthcare and long-term care systems.
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Affiliation(s)
| | - Vladislav Rajkovič
- Faculty of Organizational Sciences, University of Maribor, Kranj, Slovenia
| | - Olga Šušteršič
- Faculty of Health Sciences, University of Ljubljana, Ljubljana, Slovenia
| | - Uroš Rajkovič
- Faculty of Organizational Sciences, University of Maribor, Kranj, Slovenia
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Haimi M, Sergienko R. Adoption and Use of Telemedicine and Digital Health Services Among Older Adults in Light of the COVID-19 Pandemic: Repeated Cross-Sectional Analysis. JMIR Aging 2024; 7:e52317. [PMID: 38656768 PMCID: PMC11079757 DOI: 10.2196/52317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 11/15/2023] [Accepted: 03/20/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND As the population ages and the prevalence of long-term diseases rises, the use of telecare is becoming increasingly frequent to aid older people. OBJECTIVE This study aims to explore the use and adoption of 3 types of telehealth services among the older population in Israel before, during, and after the COVID-19 pandemic. METHODS We explored the use characteristics of older adults (aged ≥65 years) belonging to Clalit Health Services in several aspects in the use of 3 types of telehealth services: the use of digital services for administrative tasks; the use of synchronous working-hours telehealth visits with the patient's personal physician during clinic business hours; and the use of after-hours consultations during evenings, nights, and weekends when the clinics are closed. The data were collected and analyzed throughout 3 distinct periods in Israel: before the COVID-19 pandemic, during the onset of the COVID-19 pandemic, and following the COVID-19 peak. RESULTS Data of 618,850 patients who met the inclusion criteria were extracted. Telehealth services used for administrative purposes were the most popular. The most intriguing finding was that the older population significantly increased their use of all types of telehealth services during the COVID-19 pandemic, and in most types, this use decreased after the COVID-19 peak, but to a level that was higher than the baseline level before the COVID-19 pandemic. Before the COVID-19 pandemic, 23.1% (142,936/618,850) of the study population used working-hours telehealth visits, and 2.2% (13,837/618,850) used after-hours consultations at least once. The percentage of use for these services increased during the COVID-19 pandemic to 59.2% (366,566/618,850) and 5% (30,777/618,850) and then decreased during the third period to 39.5% (244,572/618,850) and 2.4% (14,584/618,850), respectively (P<.001). Multiple patient variables have been found to be associated with the use of the different telehealth services in each period. CONCLUSIONS Despite the limitations and obstacles, the older population uses telehealth services and can increase their use when they are needed. These people can learn how to use digital health services effectively, and they should be given the opportunity to do so by creating suitable and straightforward telehealth solutions tailored to this population and enhancing their usability.
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Affiliation(s)
- Motti Haimi
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
- Health Administration Department, The Max Stern Yezreel Valley College, Emek Yezreel, Israel
- Clalit Research Institute, Tel Aviv, Israel
| | - Ruslan Sergienko
- Department of Health Policy and Management, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
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Batı S, Polat HT, Akkuş H. Determination of the Relationship Between Self-Care Agency and Death Anxiety Among Elderly Individuals. OMEGA-JOURNAL OF DEATH AND DYING 2022:302228221095907. [PMID: 35487266 DOI: 10.1177/00302228221095907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study aimed to determine the relationship between self-care agency and death anxiety among elderly individuals. The study sample consisted of 163 elderly individuals who applied to the internal medicine and chest diseases outpatient clinic of a university hospital. Death anxiety (DAS) and Self-care agency (SCAS) scales were used for data collection. The mean DAS score of the participants was found 6.76 ± 3.25 and low. The mean SCAS scores was 94.35 ± 16.37 and moderate. A positive very weak correlation was found between self-care agency and death anxiety (p = 0.044, r = 0.158). Elderly individuals without regular income had higher levels of death anxiety compared to those with regular income (p < 0.05). A significant difference was found in death anxiety levels with respect to the sex and marital status (p < 0.05). The low-level death anxiety on elderly individuals may have a positive effect on maintaining their self-care agency. Nurses should engage in training activities and interventions to increase the levels of self-care agency and determine the death anxiety among elderly individuals.
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Affiliation(s)
- Serap Batı
- Department of Public Health Nursing, 226846Necmettin Erbakan University, Seydisehir Kamil Akkanat Faculty of Health Sciences, Konya, Turkey
| | - Hilal Türkben Polat
- Department of Fundamentals of Nursing, 226846Necmettin Erbakan University, Seydisehir Kamil Akkanat Faculty of Health Sciences, Konya, Turkey
| | - Hamdi Akkuş
- Physician, 586746Konya Provincial Health Directorate, Konya, Turkey
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Santora L, Byrne D, Klöckner C. Exploring Quality of Life Reported by Norwegian Older Adults Using Classification Tree Approach on Group Profiles. AGEING INTERNATIONAL 2021. [DOI: 10.1007/s12126-021-09454-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
AbstractThis study aims to explore the variation between- and within subgroups of older adults with regard to low, medium, and high levels of self-reported quality of life (QoL) measured by the WHOQOL-BREF scale. The contribution of interacting personal and contextual life conditions to QoL was examined in a sample of 1,910 (sample frame 6,000) Norwegian men and women aged 62 to 99 years. The data collected by a postal questionnaire were analyzed using the Chi-square Automatic Interaction Detection (CHAID) classification method in order to detect unique profiles of groups who shared common characteristics. The CHAID model revealed 15 relatively homogenous groups, but distinct from one another, whose profiles were defined by unique constellations of several interacting variables significantly related to a given QoL level. Mental functioning was predominantly linked to perception of life meaning along with health status, and/or in some cases living arrangement, loneliness, neighborhood quality, and satisfaction with income, and placed an individual at different likelihood levels of reporting low, medium, or high QoL. Socio-demographics had no statistically significant impact on QoL for any subgroup. Through this individual-oriented approach, a periodically ongoing assessment of subjective quality of life (QoL) may be sufficiently powerful to allow detecting and addressing personal concerns and specific needs that detract from quality of life in advancing age.
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Özkeskin M, Özden F, Şahin S. Translation, Cross-cultural Adaptation, and Psychometric Properties of the Turkish Version of the Self-care Ability Scale for the Elderly. Ann Geriatr Med Res 2021; 25:122-128. [DOI: https:/doi.org/10.4235/agmr.21.0046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 06/09/2021] [Indexed: 08/30/2023] Open
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Özkeskin M, Özden F, Şahin S. Translation, Cross-cultural Adaptation, and Psychometric Properties of the Turkish Version of the Self-care Ability Scale for the Elderly. Ann Geriatr Med Res 2021; 25:122-128. [PMID: 34120435 PMCID: PMC8273004 DOI: 10.4235/agmr.21.0046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 06/09/2021] [Indexed: 11/29/2022] Open
Abstract
Purpose The Self-care Ability Scale for the Elderly (SASE) is a frequently used scale that was created in Sweden according to Orem’s self-care deficit theory and later modified according to Pörn’s theory of environment and purpose. This study translated and cross-culturally adapted the Turkish version of the SASE (T-SASE) and demonstrated its psychometric properties, including its reliability and construct validity. Methods This study recruited a total of 122 participants and applied international guidelines for the translation and adaptation of the scale. The test-retest reliability of the SASE was calculated at 1-week intervals. Internal consistency was analyzed using Cronbach’s alpha. For construct validity, we compared the T-SASE to the Nottingham Extended Activities of Daily Living Scale (NEADLS) and the Exercise of Self-Care Agency Scale (ESCAS). Results The mean age of the participants was 68.6±5.7 years. The test-retest reliability of the T-SASE was excellent (intraclass correlation coefficient=0.914; 95% confidence interval, 0.81–0.95). The internal consistency of the total T-SASE score was also excellent (Cronbach’s α=0.912), as were the Cronbach’s alpha scores for the individual items, ranging from 0.901 to 0.915. The items were also highly consistent with each other (Cronbach’s α>0.80). The construct validity of the T-SASE was acceptable (0.35<r<0.50) in a convergent manner. The T-SASE was also strongly correlated with the NEADLS and ESCAS (r1=0.405, r2=0.437, p<0.01). Conclusions The T-SASE was a reliable and valid tool for assessing the self-care ability of community-dwelling older adults. Owing to its multidimensional structure, the T-SASE is an essential tool for evaluating self-care in older adults.
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Affiliation(s)
- Mehmet Özkeskin
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Ege University, Izmir, Turkey
| | - Fatih Özden
- Department of Elderly Care, Koycegiz Vocational School of Health Services, Mugla Sitki Kocman University, Mugla, Turkey
| | - Sevnaz Şahin
- Division of Geriatrics, Department of Internal Medicine, Faculty of Medicine, Ege University, Izmir, Turkey
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Al Gilani S, Tingö L, Kihlgren A, Schröder A. Mental health as a prerequisite for functioning as optimally as possible in old age: A phenomenological approach. Nurs Open 2021; 8:2025-2034. [PMID: 33423387 PMCID: PMC8363343 DOI: 10.1002/nop2.698] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 09/15/2020] [Accepted: 10/22/2020] [Indexed: 01/07/2023] Open
Abstract
Aim To describe the impact of mental health on the ability to function optimally among older adults experiencing mental health issues. Design This study had a descriptive qualitative design. Methods Six older females with a Hospital Anxiety and Depression Scale (HADS) score of ≥8 on either of the subscales (depression or anxiety) participated in individual interviews. All data were analysed using a phenomenological approach influenced by Giorgi. Results The phenomenological analysis led to a structured synthesis comprising the following three themes: (a) life situations affecting mental health, (b) consequences of mental health in everyday life and (c) strategies for maintaining mental health.
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Affiliation(s)
- Samal Al Gilani
- Nutrition and Physical Activity Research CentreFaculty of Medicine and HealthÖrebro UniversityÖrebroSweden
- School of Health and SciencesFaculty of Medicine and HealthUniversity Health Care Research CentreÖrebro UniversityÖrebroSweden
| | - Lina Tingö
- Nutrition and Physical Activity Research CentreFaculty of Medicine and HealthÖrebro UniversityÖrebroSweden
- Nutrition Gut Brain Interactions Research CentreFaculty of Medicine and HealthÖrebro UniversityÖrebroSweden
| | - Annica Kihlgren
- Nutrition and Physical Activity Research CentreFaculty of Medicine and HealthÖrebro UniversityÖrebroSweden
- School of Health and SciencesFaculty of Medicine and HealthUniversity Health Care Research CentreÖrebro UniversityÖrebroSweden
| | - Agneta Schröder
- Faculty of Medicine and HealthÖrebro UniversityÖrebroSweden
- Department of Health SciencesFaculty of Medicine and Health ScienceNTNU – Norwegian University of Science and TechnologyGjøvikNorway
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Yoshimura J, Tanimura C, Matsumoto H, Tokushima Y, Inoue K, Park D, Hagino H. Relationship of Physical Activity to Self-Care Agency and Physical Condition Among Older Adults in a Rural Area. Yonago Acta Med 2021; 64:18-29. [PMID: 33642900 DOI: 10.33160/yam.2021.02.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 12/03/2020] [Indexed: 11/05/2022]
Abstract
Background Maintaining physical activity is important for older adults. "Self-care agency" is the ability to perform self-care, which is defined as people following their own will, managing themselves, and maintaining activities. We investigated the relationship among physical activity and self-care agency, demographic factors and physical condition in older adults. Methods Self-care agency was assessed by using the Self-Care Agency Questionnaire developed for Japanese patients with chronic diseases. Among 175 older adults aged 65 years or older living in a rural area, responses from 83 who performed physical activities were analyzed. Correspondence analysis was conducted to characterize demographic factors and self-care agency. Results A higher proportion of women than men were engaged in physical activity. Irrespective of age and sex, many of the participants performed stretching exercises, walking, radio exercises, TV exercises, and participated in community circles. Participants who engaged in physical activities had significantly higher self-care agency scores than inactive participants. Among the active participants, the self-care agency score was significantly higher for women than men (P = .04) and was also significantly higher for participants aged ≥ 75 years compared to those aged < 75 years. Individuals with a high self-care agency tended to participate in local programs and perform brief physical activities at home. Conclusion Physically active older adults demonstrated high self-care agency. Their activities were easily carried out in their daily lives, with activities varying by age and sex. Support from community health experts is needed to promote suitable physical activity among older adults tailored for age and sex, especially among older adults who have low self-care agency.
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Affiliation(s)
- Junko Yoshimura
- Department of Adult and Elderly Nursing, School of Health Science, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan
| | - Chika Tanimura
- Department of Adult and Elderly Nursing, School of Health Science, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan
| | - Hiromi Matsumoto
- Department of Physical Therapy, Faculty of Rehabilitation, Kawasaki University of Medical Welfare, Kurashiki 701-0193, Japan
| | - Yasuko Tokushima
- Department of Nursing Care Environment and Mental Health, School of Health Science, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan
| | - Kazuoki Inoue
- Department of Community-based Family Medicine, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan
| | - Daeho Park
- Daisen Clinic, Daisen-cho, 689-3314, Japan
| | - Hiroshi Hagino
- Department of Fundamental Nursing, School of Health Science, Faculty of Medicine, Tottori University, Yonago 683-8503, Japan
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Amir-Behghadami M, Tabrizi JS, Saadati M, Gholizadeh M. Psychometric properties of the Iranian version of self-care ability scale for the elderly. BMC Geriatr 2020; 20:364. [PMID: 32962635 PMCID: PMC7510275 DOI: 10.1186/s12877-020-01775-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 09/16/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Measuring self-care ability in elderly people needs specific instruments. The Self-care Ability Scale for Elderly (SASE) is one of the common instruments used for assessing self-care ability. The aim of this study was to assess the psychometric properties of the SASE among Iranian elderly population. METHODS This cross-cultural adaptation study was carried out at Shahid Chamran and Shadpour Health Complex in Tabriz, Iran. The forward-backward procedure was applied to translate the SASE from English into Persian. Then, it was completed to 220 elderly people. A systematic random sampling method was used for sampling. Content validity was calculated through modified Kappa coefficient (modified CVI) based on clarity and relevance criteria. Reliability was measured by internal consistency and test-retest analysis. The construct validity also was assessed using Exploratory Factor Analysis (EFA). All the statistical analyses were performed using SPSS 21 statistical software package. RESULTS The mean of self-care ability was 61.14 ± 21.08. The CVI and modified kappa were 0.91 and 0.92 for relevance and clarity, respectively. The Cronbach's alpha coefficient was 0.73 and Intra-class correlation coefficient was 0.97. The results of EFA revealed a three-factor solution ('ability to take care of personal responsibility', 'ability to take care for the goals', and 'ability to take care of the health') that jointly explained for 64.61% of the total variance. CONCLUSION Results of the study showed that the Iranian version of the SASE has good psychometric properties and can be used in assessing the self-care ability of elderly people.
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Affiliation(s)
- Mehrdad Amir-Behghadami
- Student Research Committee (SRC), Tabriz University of Medical Sciences, Tabriz, Iran. .,Iranian Center of Excellence in Health Management (IceHM), Department of Health Service Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, University Rd, Golbad, EAZN, Tabriz, 5165665811, Iran.
| | - Jafar Sadegh Tabrizi
- Iranian Center of Excellence in Health Management (IceHM), Department of Health Service Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, University Rd, Golbad, EAZN, Tabriz, 5165665811, Iran.,Tabriz Health Service Management Research Centre, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Saadati
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Masoumeh Gholizadeh
- Iranian Center of Excellence in Health Management (IceHM), Department of Health Service Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, University Rd, Golbad, EAZN, Tabriz, 5165665811, Iran
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Terp R, Kayser L, Lindhardt T. "It is not rocket science.." - Older peoples' understanding of nutrition - A qualitative study. Appetite 2020; 156:104854. [PMID: 32871203 DOI: 10.1016/j.appet.2020.104854] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 08/28/2020] [Accepted: 08/28/2020] [Indexed: 12/31/2022]
Abstract
OBJECTIVE The aim of this study was to: 1) explore older patients' knowledge, skills and behavior in relation to nutrition and 2) achieve an understanding of older patients' experiences, understanding and attitudes towards management of nutritional needs. DESIGN Semi-structured interviews were conducted and analyzed using content analysis. The Readiness and Enablement Index for Health Technology (READHY) instrument was used as a framework. SETTING Two hospital units specialized in internal medicine located at two university hospitals in Copenhagen. PARTICIPANTS Patients (N = 25) age 65 ≥ years and admitted to hospital for medical treatment. FINDINGS The informants' knowledge, behavior and attitude towards nutrition was influenced by their experience of food as an everyday phenomenon but less so by the experience of nutrition as important for their well-being and health. Three themes were identified: 1) Food - an everyday phenomenon; 2) Habits and preferences and 3) When food becomes nutrition. CONCLUSION Older, ill patients have limited knowledge about specific needs for energy and protein and the importance of nutrition for their physical functioning. They have potential resources and competencies which can positively impact and be utilized in nutritional interventions. Social interaction, the pleasurable experience of eating well-prepared food, and daily routines facilitate their nutritional intake.
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Affiliation(s)
- Rikke Terp
- Department of Internal Medicine, Copenhagen University Hospital, Herlev and Gentofte, Hospitalsvej 1, 2900, Hellerup, Denmark.
| | - Lars Kayser
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014, København K, Denmark.
| | - Tove Lindhardt
- Department of Internal Medicine, Copenhagen University Hospital, Herlev and Gentofte, Hospitalsvej 1, 2900, Hellerup, Denmark.
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Ng TKS, Matchar DB, Sultana R, Chan A. Effects of Self-Care for Older PErsons (SCOPE) on Functional and Physiological Measures: A Cluster Randomized Controlled Trial. J Clin Med 2020; 9:jcm9030885. [PMID: 32213860 PMCID: PMC7141527 DOI: 10.3390/jcm9030885] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 02/21/2020] [Accepted: 03/03/2020] [Indexed: 11/16/2022] Open
Abstract
Background: Population aging poses unprecedented demands on the healthcare system. There is also a scarcity of evidence on self-care intervention to improve objective measures of morbidity and aging-associated functional and physiological measures in a low-income multi-ethnic population setting. Methods: We conducted a cluster randomized controlled trial (ClinicalTrials.gov Identifier: NCT01672177) to examine the effects of the Self-Care for Older PErsons (SCOPE) program. We randomized 14 Senior Activity Centers and randomly selected older adults within these centers. Functional and physiological measurements were performed at baseline, 10-month, and 18-month periods. The primary outcome was a composite of three morbidity-specific measures, which include hemoglobin A1c (HbA1C), peak expiratory flow, and systolic blood pressure. Aging-associated functional and physiological measures were examined as secondary outcomes. Repeated-measure mixed models were employed to examine the effects of SCOPE on these measures. Results: 378 community-dwelling older adults participated in either the treatment (n= 164) or the control arm (n = 214). The primary outcome was not significantly improved. For the secondary outcomes, SCOPE participants demonstrated slower oxygen desaturation at an 18-month period (p = 0.001), improved time to complete the chair-stand test (p < 0.001) at a 10-month period with the effect persisting at the 18-month period (p < 0.001). SCOPE participants also had significantly improved vitamin B12 levels at the 18-month period (p < 0.001), increased hemoglobin concentration (p < 0.001), decreased mean corpuscular volume (p = 0.001), and decreased creatinine (p = 0.002) at the 10-month period. Conclusions: SCOPE did not improve morbidity-specific measures. However, it improved several aging-associated measures implicated in geriatric syndromes. This study highlights the potential of a self-care program in the prevention of geriatric syndromes in community-dwelling older adults, while emphasizing self-management to manage existing morbidities.
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Affiliation(s)
- Ted Kheng Siang Ng
- Center for Aging, Research and Education, Duke-National University of Singapore Medical School, Singapore 169857, Singapore;
| | - David Bruce Matchar
- Program in Health Services and Systems Research, Duke-National University of Singapore Medical School, Singapore 169857, Singapore;
- Department of Medicine (General Internal Medicine), Duke University School of Medicine, Durham, NC 27710, USA
| | - Rehena Sultana
- Center for Quantitative Medicine, Duke-National University of Singapore Medical School, Singapore 169857, Singapore;
| | - Angelique Chan
- Center for Aging, Research and Education, Duke-National University of Singapore Medical School, Singapore 169857, Singapore;
- Program in Health Services and Systems Research, Duke-National University of Singapore Medical School, Singapore 169857, Singapore;
- Department of Sociology, Faculty of Arts and Social Sciences, National University of Singapore, Singapore 117570, Singapore
- Correspondence:
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Falkenberg HK, Kvikstad TM, Eilertsen G. Improved indoor lighting improved healthy aging at home - an intervention study in 77-year-old Norwegians. J Multidiscip Healthc 2019; 12:315-324. [PMID: 31190854 PMCID: PMC6526775 DOI: 10.2147/jmdh.s198763] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 03/29/2019] [Indexed: 11/23/2022] Open
Abstract
Introduction: Healthy aging and good quality of life is important to allow older people to live at home. Lighting is a significant environmental attribute promoting visual, physical, and mental health. Due to normal visual age changes, older people need more light, but improving indoor lighting levels receives little attention. Objective: To investigate the impact of improved home lighting on abilities to perform activities of daily living (ADLs) and quality of life in healthy older people. Methods: Sixty healthy 77 years old living at home participated during the 4-month dark winter period. In the intervention group (IG, n=30), the living room lighting was optimized by providing lamps and a basic control system with three preset levels (normal, medium, low). Participants chose the light level and kept a diary. No change was implemented for the control group (CG, n=30). A questionnaire measured self-reported visual and general health and ability to perform ADL in regards to lighting before and after the intervention in both groups. Results: In the IG, lighting levels significantly improved self-assessed lighting levels, abilities to perform ADLs, and read and write in the living room (all p<0.03). In the CG the only change was a deterioration in performing ADLs ( p<0.05). The difference in change was significant between the IG and CG (all p<0.02). "Normal" lighting was the preferred level and increased comfort and well-being. The IG also resumed visually demanding tasks, and acknowledged that avoiding these tasks were mainly due to poor lighting. Conclusions: Good vision is essential in promoting healthy aging at home and require adequate lighting. This can easily be achieved using a basic light system. Adopting to higher lighting levels evolves quickly. Our results suggest that improved quality of light could improve quality of life, and lighting should be included as a factor promoting healthy aging at home.
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Affiliation(s)
- Helle K Falkenberg
- National Centre for Optics, Vision and Eye Care, Department of Optometry, Radiography and Lighting Design, University of South-Eastern Norway, Kongsberg, Norway
| | - Tor Martin Kvikstad
- Department of Business, Strategy and Political Sciences, University of South-Eastern Norway, Kongsberg, Norway
| | - Grethe Eilertsen
- USN Eldreforsk Research Group, Department of Nursing- and Health Science, University of South-Eastern Norway, Kongsberg, Norway
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Nursing staff's responses to thematic content of patients' expressed worries: observing communication in home care visits. BMC Health Serv Res 2018; 18:597. [PMID: 30075767 PMCID: PMC6091070 DOI: 10.1186/s12913-018-3390-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 07/13/2018] [Indexed: 02/07/2023] Open
Abstract
Background The aim of the study was to explore the thematic content of older persons’ expressed worries in home care visits, and how nursing staff respond to different thematic contents. Methods The study had a descriptive, observational design, including 195 audio-recorded Norwegian home care visits with 33 nursing staff and 48 older persons. In all, 638 patient cues/concerns (worries) and subsequent nursing staff’s responses were identified using Verona Coding Definitions of Emotional Sequences. A novel thematic coding scheme was used to label the thematic content of the cues/concerns. The nursing staff’s responses were grouped based on communicative function as emotion-focused, content-focused or ignoring/blocking the cue/concern. Group difference was analysed using Pearson’s chi-squared test, Fisher’s exact test, and adjusted residuals. Results The theme of worries was associated with elicitation of the cue/concern, either elicited by the nursing staff or spontaneously expressed by the patient (Chi-square, p< 0.001). “Ageing and bodily impairment” was the most common theme (66%) and was equally elicited by patients and nursing staff. Worries about “Relationships with others” (9%), “Health care-related issues” (15%) and “Life narratives and value issues” (9%) were mainly elicited by nursing staff. The nursing staff response was associated with the theme of worries (p˂0.001). For the sub-themes of “Ageing and bodily impairment”, Coping with existential challenges received more frequently emotion-focused responses (adjusted residuals: 3.2) and Expression of pain felt in the moment were more frequently ignored/blocked (adjusted residuals: 4.0, Fisher’s exact test, p< 0.001). For the sub-themes of “Relationships with others”, Being a burden more frequently received a content-focused response (adjusted residuals: 2.8), while Losing social ties more frequently received an emotion-focused response (adjusted residuals: 3.1, Fisher’s exact test, p = 0.009). Conclusion “Ageing and bodily impairment” was the most common theme and more frequently elicited by the older persons than other themes. Emotionally focused nursing staff responses were most common when addressing existential challenges and fear of losing social ties. Whereas nursing staff showed a tendency to ignore patients’ spontaneous expressions of pain. Further research should explore the influence of nursing staff’s responses on quality of care and patient satisfaction.
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Bergland A, Slettebø Å. Older Women’s Experience Of Everyday Life In Old Age: Past, Present And Future. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2018. [DOI: 10.1080/02703181.2018.1508169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Astrid Bergland
- Faculty of Health Sciences, Department of Physiotherapy, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Åshild Slettebø
- Faculty of Health and Sport Sciences, Department of Health and Nursing Science/Centre of Care Research, University of Agder, Kristiansand, Norway
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Nykänen I, Törrönen R, Schwab U. Dairy-Based and Energy-Enriched Berry-Based Snacks Improve or Maintain Nutritional and Functional Status in Older People in Home Care. J Nutr Health Aging 2018; 22:1205-1210. [PMID: 30498827 DOI: 10.1007/s12603-018-1076-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Consumption of energy- and nutrient-dense snacks are recommended for older people to maintain adequate nutrition. We evaluated the effects of dairy-based and energy-enriched berry products consumed as snacks on nutritional and functional status among vulnerable older people receiving home care services. DESIGN Randomised controlled study. SETTING AND PARTICIPANTS The study sample consisted of 85 home care clients, with mean age of 81.9 (SD 7.1) years in the intervention group (n=50) and 83.7 (SD 8.1) years in the control group (n=35), and 72% women in both groups. INTERVENTION In the intervention group, the participants consumed both high-protein dairy-based products and energy-enriched berry purées for three months. The snack products provided nearly 300 kcal and 14 g protein per day. MEASUREMENTS The Mini Nutritional Assessment (MNA), body mass index (BMI), mid-arm muscular area (MAMA) and concentrations of plasma albumin and prealbumin and blood haemoglobin were used to determine nutritional status, and handgrip strength was used to determine functional status at baseline and after the intervention. RESULTS After adjustment for age and gender, the intervention showed a significant effect on MNA scores (2.1, 95% [CI]: 1.0 to 3.3) (p=0.003), albumin concentration (2.0 g/L, 95% [CI]: 1.1 to 3.2) (p=0.006) and handgrip strength of the right hand in women (2.4 kg, 95% [CI]: 1.2 to 3.3) (p=0.007). The MNA scores improved in the intervention group, while albumin concentration and handgrip strength decreased in the control group. CONCLUSIONS Regular use of dairy- and energy-enriched berry-based snacks may improve or maintain nutritional and functional status among older people in home care.
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Affiliation(s)
- I Nykänen
- Irma Nykänen, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, P.O. Box 1627, FI-70211 Kuopio, Finland Phone: +358 40 355 2991, Fax: +358 17 162 131, E-mail:
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Improved Health Status and Life Satisfaction among Older People following Self-Help Group Intervention in Jakarta. Curr Gerontol Geriatr Res 2017; 2017:3879067. [PMID: 29225621 PMCID: PMC5684573 DOI: 10.1155/2017/3879067] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2017] [Revised: 08/23/2017] [Accepted: 09/06/2017] [Indexed: 11/17/2022] Open
Abstract
Although self-help group for older people gains the effectiveness, the effect of a nursing intervention using a self-help group model as a guideline for self-monitoring and intervention on the health status and life satisfaction among older people still remains. To determine the effectiveness of this nursing intervention, an experimental design using multistage sampling method was used for this study. The self-help intervention included a single 50-70-minute session once a week for 12 weeks done, using the Life Satisfaction Inventory-A (LSI-A) questionnaire, and SF-36 shows a significant difference. Self-help intervention could be implemented by nurses for older people in the community to improve health and well-being.
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Gao H, Söderhamn U, Cliffordson C, Guo L, Guo Q, Liu K. Reliability and validity of the Chinese version of the Self-care Ability Scale for the Elderly. J Clin Nurs 2017; 26:4489-4497. [PMID: 28231632 DOI: 10.1111/jocn.13779] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2017] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To translate the Self-care Ability Scale for the Elderly into Simplified Chinese and to test the Chinese version of the scale regarding its reliability and validity among older people. BACKGROUND Self-care is an important topic in nursing. When assessing older people's self-care ability, it is essential that a reliable and valid instrument is used. DESIGN This study employed across-sectional design. METHODS We translated the English version of the Self-care Ability Scale for the Elderly into Simplified Chinese according to Brislin's translation guidelines and carried out a questionnaire survey among 610 older people, including both community-dwelling people and hospital patients, in Jinzhou City, People's Republic of China. Eighty participants completed the instrument twice for test-retest reliability. Data analyses were performed using spss 17.0 and Mplus, version 5, to assess reliability and validity. RESULTS A Cronbach's alpha coefficient of .89 and statistically significant item-to-total correlations showed evidence of homogeneity. An intraclass correlation coefficient of .99 for the test-retest between total scores and intraclass correlation coefficients between .87-.99 for the test-retest scores of each item explained the almost perfect test-retest reliability noted in this study. Content validity was found to be good, and a three-factor model was obtained in an exploratory factor analysis (explaining a variance of 57%) and modified in a confirmatory factor analysis (χ2 = 261.559, df = 98, root mean square error of approximation = 0.074; standardised root mean square residual = 0.059), which reflected an acceptable construct validity. CONCLUSIONS This study shows that the Chinese version of the Self-care Ability Scale for the Elderly has sufficient psychometric properties for assessing self-care ability among older people in China. RELEVANCE TO CLINICAL PRACTICE A reliable and valid instrument is available to assess the self-care ability of older Chinese people.
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Affiliation(s)
- Han Gao
- College of Nursing, Jinzhou Medical University, Jinzhou City, Liaoning Province, China
| | - Ulrika Söderhamn
- Center for Caring Research-Southern Norway, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | | | - Lina Guo
- College of Nursing, Jinzhou Medical University, Jinzhou City, Liaoning Province, China
| | - Qiyun Guo
- College of Nursing, Jinzhou Medical University, Jinzhou City, Liaoning Province, China
| | - Kun Liu
- College of Nursing, Jinzhou Medical University, Jinzhou City, Liaoning Province, China
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Kalfoss MH, Low G, Halvorsrud L. Identity Processes Among Older Norwegians Living in Urban and Rural Areas. West J Nurs Res 2017; 40:701-724. [PMID: 28322656 DOI: 10.1177/0193945916687514] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Guided by the Identity Process Theory, we examined whether 424 Norwegians 60+ years of age would attribute their physical and mental functioning to their health (identity assimilation), to aging itself (identity accommodation), or to both (identity balance). We were also interested in the effect of these attribution styles upon depressive symptoms. Secondary data from the 2004 World Health Organization Quality of Life OLD Group Norwegian Field Study were analyzed using General Linear Model Regression and subsequent Path Analyses. Attributing physical functioning to health as opposed to aging had a negligible effect on depressive symptoms among both study groups. Attributing mental functioning to aging worsened depressive symptoms among rural participants. Attributing mental functioning to health was associated with more positive perceptions of psychosocial loss among urban participants. Positivity toward psychosocial loss lessened depressive symptoms and factors affecting those perceptions differed among rural versus urban participants. Adapting to functional changes in older age is a complex process affecting depressive symptoms.
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Affiliation(s)
| | - Gail Low
- 2 University of Alberta, Edmonton, Canada
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Khorsandi M, Fekrizadeh Z, Roozbahani N. Investigation of the effect of education based on the health belief model on the adoption of hypertension-controlling behaviors in the elderly. Clin Interv Aging 2017; 12:233-240. [PMID: 28184154 PMCID: PMC5291452 DOI: 10.2147/cia.s117142] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Purpose Hypertension is one of the risk factors for cardiovascular diseases and stroke, and has a direct relationship with aging. The aim of this study was to investigate the effect of education based on the health belief model (HBM) on the adoption of hypertension-controlling behaviors in the elderly. Methods The present quasiexperimental study was conducted on 100 hypertensive elderly persons from Qom, Iran. The questionnaire was completed by the participants before, immediately after, and 3 months after the intervention. Results The results of repeated measure analysis of variance showed a significant difference in the scores of the constructs in the intervention and nonintervention groups before, immediately after, and 3 months after the intervention (P<0.001). Conclusion Education based on the HBM increases the performance and enhances the health beliefs regarding hypertension in the elderly population with hypertension. Therefore, it is recommended to consider the HBM to enhance self-care behaviors in the elderly.
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Srikan P, Callen B, Phillips K, Tavakoli A, Brockett R, Hanucharurnkul S, Beebe L. Testing a Model of Sodium Reduction in Hypertensive Older Thai Adults. J Nutr Gerontol Geriatr 2017; 36:48-62. [PMID: 28107108 DOI: 10.1080/21551197.2016.1274278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Hypertensive older adults will benefit if there is a clear understanding of the factors related to sodium reduction. That would raise awareness of the causes, consequently reducing many health risks, lowering health care costs, and diminishing economic and social burden from high blood pressure. This study explored predictors of urinary sodium excretion. A cross-sectional, correlational study was conducted in 312 hypertensive older Thai adults. Questionnaires related to knowledge, self-care agency, self-care behavior of sodium reduction, and 24-hour urinary sodium analyses were used, followed by the application of structural equation modeling and the Analysis of Moment Structures program. Self-care agency, knowledge, self-care behavior, rural/urban location, and education accounted for 61% of urinary sodium excretion. Self-care agency, knowledge, and self-care behavior were the main predictors in the urinary sodium excretion model. This study suggests establishing supportive educative sodium reduction-related programs that improve knowledge and enhance self-care agency, as well as a comparison of the changes of sodium reduction self-care behavior and urinary sodium excretion over time after the intervention.
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Affiliation(s)
| | - Bonnie Callen
- b College of Nursing , University of Tennessee , Knoxville , Tennessee , USA
| | - Kenneth Phillips
- b College of Nursing , University of Tennessee , Knoxville , Tennessee , USA
| | - Abbas Tavakoli
- c College of Nursing , University of South Carolina , Columbia , North Carolina , USA
| | - Ralph Brockett
- d College of Education , University of Tennessee , Knoxville , Tennessee , USA
| | | | - Lora Beebe
- b College of Nursing , University of Tennessee , Knoxville , Tennessee , USA
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Mohammadi M, Alavi M, Bahrami M, Zandieh Z. Assessment of the Relationship between Spiritual and Social Health and the Self-Care Ability of Elderly People Referred to Community Health Centers. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2017; 22:471-475. [PMID: 29184587 PMCID: PMC5684796 DOI: 10.4103/ijnmr.ijnmr_171_16] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Background: Promotion of self-care ability among older people is an essential means to help maintain and improve their health. However, the role of spiritual and social health has not yet been considered in detail in the context of self-care ability among elderly. The aim of this study was to assess the relationship between spiritual and social health and self-care ability of older people referred to community health centers in Isfahan. Materials and Methods: In this cross-sectional correlation study, 200 people, aged 60 years and older, referred to healthcare centers in 2016 were recruited through convenience sampling method. Data were collected by four-part tool comprising of: (a) demographics, (b) Ellison and Palotzin's spiritual well-being scale, (c) Kees's “social health” scale, and (d) self-care ability scale for the elderly by Soderhamn's; data were analyzed by descriptive and inferential (independent t-test, analysis of variance – ANOVA, Pearson's coefficient tests, and multiple regression analysis) statistics by SPSS16 software. Results: Findings showed that the entered predictor variables were accounted for 41% of total variance (R2) of the two self-care ability in the model (p < 0.001, F3, 199 = 46.02). Two out of the three predictor variables including religious well-being and social health, significantly predicted the self-care ability of older people. Conclusions: The results of this study emphasized on the relationship between spiritual and social health of the elderly people and their ability to self-care. Therefore, it would be recommended to keep the focus of the service resources towards improving social and spiritual health to improve self-care ability in elderly people.
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Affiliation(s)
- Mahboobeh Mohammadi
- Student Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mousa Alavi
- Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Masoud Bahrami
- Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Zandieh
- Student Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
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Multidimensional factors affecting medication adherence among community-dwelling older adults: a structural-equation-modeling approach. J Public Health (Oxf) 2016. [DOI: 10.1007/s10389-016-0764-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Hamirudin AH, Charlton K, Walton K. Outcomes related to nutrition screening in community living older adults: A systematic literature review. Arch Gerontol Geriatr 2016; 62:9-25. [DOI: 10.1016/j.archger.2015.09.007] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Revised: 09/18/2015] [Accepted: 09/20/2015] [Indexed: 01/04/2023]
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Tan KK, Chan SWC, Wang W, Vehviläinen-Julkunen K. A salutogenic program to enhance sense of coherence and quality of life for older people in the community: A feasibility randomized controlled trial and process evaluation. PATIENT EDUCATION AND COUNSELING 2016; 99:108-116. [PMID: 26293542 DOI: 10.1016/j.pec.2015.08.003] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2015] [Revised: 07/01/2015] [Accepted: 08/02/2015] [Indexed: 06/04/2023]
Abstract
OBJECTIVE To determine the feasibility of a salutogenesis-based self-care program on quality of life, sense of coherence, activation and resilience among older community dwellers. METHODS This is a feasibility randomized controlled trial. Sixty-four older community-dwellers were recruited from a Singapore senior activity center and randomly assigned to intervention and control groups. The intervention group attended a 12-week Resource Enhancement and Activation Program. The outcomes were assessed with the Chinese versions of World Health Organization Quality of Life Scale, Sense of Coherence, Patient Activation Measure, and Connor-Davidson Resilience Scale. Process evaluation was conducted using focus groups with the intervention group. RESULTS At the end of the program, the intervention group showed significant improvement in the Sense of Coherence scale and the psychological subscale of the WHO Quality of Life scale compared with the control group. Three themes emerged from the process evaluation: participation in the program, reflection on the experience, and improving the experience. CONCLUSION A salutogenic self-care approach could be a potential health promotion strategy for older people. PRACTICE IMPLICATIONS With improved sense of coherence and psychological aspect of quality of life, older people's self-care ability may improve, leading to better health and better quality of life.
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Affiliation(s)
- Khoon Kiat Tan
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.
| | - Sally Wai-Chi Chan
- School of Nursing and Midwifery, Faculty of Health and Medicine, University of Newcastle, Australia.
| | - Wenru Wang
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Katri Vehviläinen-Julkunen
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland.
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Pedersen JL, Pedersen PU, Damsgaard EM. Early Nutritional Follow-Up after Discharge Prevents Deterioration of ADL Functions in Malnourished, Independent, Geriatric Patients Who Live Alone - A Randomized Clinical Trial. J Nutr Health Aging 2016; 20:845-853. [PMID: 27709234 DOI: 10.1007/s12603-015-0629-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVES To compare the effects of two nutritional follow-up interventions with regard to preventing short-term deterioration in ADL, and to compare their effects on physical function, emotional health, and health-related quality of life. DESIGN Randomized clinical trial with two intervention groups and one control group, and a follow-up period of eight weeks. SETTING Intervention in the participants' homes after discharge from hospital. PARTICIPANTS Inclusion: Malnourished geriatric patients and patients at risk of malnutrition (MNA<24), aged 75 years and older, living at home and alone. Exclusion: Nursing home residents and patients with terminal illnesses or cognitive impairment. Randomization: At discharge, the patients were assigned to one of three groups: 'home visit', 'telephone consultation', or 'control' group. INTERVENTION Individually tailored nutritional counselling of the patient and the patient's daily home carer by a clinical dietician one, two, and four weeks after discharge from hospital. The counselling was either in-person at the patients' homes, or by telephone. The control group received no follow-up after discharge. MEASUREMENTS Primary outcome: Change in ADL (Barthel-100 score) at discharge and eight weeks later. SECONDARY OUTCOMES Change in physical performance (handgrip strength, 30-sec. chair stand test, CAS), quality of life and depression measurements (SF-36, Depression List, Geriatric Depression Score), and Avlund mobility-tiredness score (Mob-T). RESULTS Two-hundred and eight participants were randomized, 73 to home visits and 68 to telephone consultations. The control group comprised 67 patients. The mean age of the participants was 86.1 years. At eight weeks after discharge, 157 completed the follow-up (home visit 52, telephone consultation 51, and control group 54). The mean age of these patients was 85.8 years. More patients in the home visit group improved or maintained their ADL (96%), compared to the telephone (75%) and control groups (72%), p<0.01. No difference was detected among the groups with regard to physical measurements, health-related quality of life, and emotional health. CONCLUSION Early nutritional follow-up after discharge, performed as home visits, prevents deterioration of ADL in malnourished, independent, geriatric patients who live alone and thereby preserves their independence.
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Affiliation(s)
- J L Pedersen
- Jette Lindegaard Pedersen, Department of Geriatrics, Aarhus University Hospital, P.P. Oerumsgade 11, 8000 Aarhus C, Denmark,
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Money AG, Barnett J, Kuljis J, Duffin D. Patient perceptions and expectations of an anticoagulation service: a quantitative comparison study of clinic-based testers and patient self-testers. Scand J Caring Sci 2015; 29:662-78. [PMID: 25684404 PMCID: PMC4964929 DOI: 10.1111/scs.12195] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Accepted: 10/17/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND Government initiatives see the provision of technology-assisted self-care as one of the key areas in which there is capacity for improving quality of care whilst reducing costs. However, levels of patient engagement in self-testing and management (STM) remain low. Little emphasis has been placed on understanding the patients' perspectives of the reasons for this limited engagement. Typically, patient engagement in STM is achieved via the provision of patient education programmes, which aim to enable patients to make the changes necessary to become competent self-carers. However, placing the onus to change on the individual patient is unrealistic. If levels of patient engagement are to be improved, patient needs and expectations of clinical services must be better understood and service provision must be adapted accordingly. OBJECTIVE Explore patient perceptions and expectations of clinical service provision and their views of having and making choices about care. METHODS Participants [N = 191, 103 patient self-tester managers (PSTMs) and 87 clinic-based testers (CBTs)] completed the SERVQUAL and ChQ instruments to capture perspectives on service quality and choice, respectively. A comparative statistical analysis explored the similarities and differences between PSTMs' and CBTs' responses. RESULTS Clinic-based testers' perceptions of service quality were significantly more positive than PSTMs', as were their expectations of the 'tangible' aspects of service delivery. PSTMs' expectations of service quality were significantly higher than their perceptions. PSTMs attributed significantly more value to making choices compared with CBTs. CONCLUSIONS AND RECOMMENDATIONS To close the gap between PSTMs expectations and perceptions of service quality and better cater for their choice preferences, service providers may benefit from taking into account the following practice considerations: maintain frequent, timely, personalised and direct interactions with PSTMs; prioritise investment in resources to facilitate patient/practitioner interaction over tangible facilities; ensure that PSTMs are given the opportunity to make choices about their care.
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Affiliation(s)
- Arthur G. Money
- Department of Computer ScienceBrunel University LondonUxbridge, LondonUK, UB8 3PH
| | - Julie Barnett
- Department of Computer ScienceBrunel University LondonUxbridge, LondonUK, UB8 3PH
| | - Jasna Kuljis
- Department of Computer ScienceBrunel University LondonUxbridge, LondonUK, UB8 3PH
| | - Debbie Duffin
- Haemostasis and Thrombosis UnitNottingham University Hospitals NHS TrustQueen's Medical Centre CampusDerby RoadNottinghamNG7 2UH
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Chan A, Matchar DB, Tsao MA, Harding S, Chiu CT, Tay B, Raman P, Pietryla Z, Klein MK, Haldane VE. Self-Care for Older People (SCOPE): A cluster randomized controlled trial of self-care training and health outcomes in low-income elderly in Singapore. Contemp Clin Trials 2015; 41:313-24. [DOI: 10.1016/j.cct.2015.01.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Revised: 12/27/2014] [Accepted: 01/02/2015] [Indexed: 10/24/2022]
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Dale B, Söderhamn U. Nutritional self-care among a group of older home-living people in rural Southern Norway. J Multidiscip Healthc 2015; 8:67-74. [PMID: 25670905 PMCID: PMC4315559 DOI: 10.2147/jmdh.s75521] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Older home-living people are an at-risk group for undernutrition, particularly those who are living alone. Lack of knowledge about healthy dietary habits, altered taste sensation, and declined health status are shown to be some of the factors related to undernutrition. The aims of this study were to explore how a small group of older people in Southern Norway perceived their nutritional self-care. Methods An exploratory qualitative approach, combined with a simple self-report questionnaire, was used. Five persons living in rural areas in Southern Norway, who in a former study were screened and found to be at risk for undernutrition, participated. Qualitative data assessed by means of individual self-care talks in the persons’ own homes were analyzed using directed content analysis. A simple self-report questionnaire containing demographic variables, two health-related questions, and the Nutritional Form For the Elderly (NUFFE-NO) instrument was filled out at baseline and 6 months after the self-care talks. Results The qualitative data showed that the participants had adequate knowledge about healthy and nutritious diets. They were aware of and motivated to adapt their diet to their current state of health and to perform the necessary actions to maintain an optimal nutritional status and nutritional self-care. Conclusion Older people living at home are a diverse group. However, this study showed that they may have sufficient knowledge, willingness, and ability to perform nutritional self-care, even if they live alone and have several chronic illnesses and impaired health.
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Affiliation(s)
- Bjørg Dale
- Centre for Caring Research - Southern Norway, Faculty of Health and Sport Sciences, University of Agder, Grimstad, Norway
| | - Ulrika Söderhamn
- Centre for Caring Research - Southern Norway, Faculty of Health and Sport Sciences, University of Agder, Grimstad, Norway
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Jonsén E, Norberg A, Lundman B. Sense of meaning in life among the oldest old people living in a rural area in northern Sweden. Int J Older People Nurs 2014; 10:221-9. [DOI: 10.1111/opn.12077] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Accepted: 10/10/2014] [Indexed: 11/28/2022]
Affiliation(s)
| | - Astrid Norberg
- Department of Nursing; Umeå University; Umeå Sweden
- Palliative Research Centre; Ersta Sköndal University College; Stockholm Sweden
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Virtual visits in home health care for older adults. ScientificWorldJournal 2014; 2014:689873. [PMID: 25506616 PMCID: PMC4258330 DOI: 10.1155/2014/689873] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2014] [Revised: 10/01/2014] [Accepted: 11/02/2014] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND This review identifies the content of virtual visits in community nursing services to older adults and explores the manner in which service users and the nurses use virtual visits. DESIGN An integrative literature review. METHOD Data collection comprised a literature search in three databases: Cinahl, Medline, and PubMed. In addition, a manual search of reference lists and expert consultation were performed. A total of 12 articles met the inclusion criteria. The articles were reviewed in terms of study characteristics, service content and utilization, and patient and health care provider experience. RESULTS Our review shows that in most studies the service is delivered on a daily basis and in combination with in-person visits. The findings suggest that older home-dwelling patients can benefit from virtual visits in terms of enhanced social inclusion and medication compliance. Service users and their nurses found virtual visits satisfactory and suitable for care delivery in home care to the elderly. Evidence for cost-saving benefits of virtual visits was not found. CONCLUSIONS The findings can inform the planning of virtual visits in home health care as a complementary service to in-person visits, in order to meet the increasingly complex needs of older adults living at home.
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Marques A, Martins A, Jácome C, Figueiredo D. Linking the EASY-care standard to the international classification of functioning, disability and health. Disabil Rehabil 2013; 36:593-9. [PMID: 23786348 DOI: 10.3109/09638288.2013.804598] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE This study aimed to document the content of the EASY-Care Standard questionnaire to the International Classification of Functioning, Disability and Health (ICF) and present its ICF Core Set. METHOD The EASY-Care was linked to the ICF by two trained health professionals according to the established linking rules. The agreement between the health professionals was determined using the Cohen's kappa. RESULTS The agreement between the two health professionals was almost perfect for each level of the ICF (Cohen's kappas between 0.91 and 0.97). The 65 items of the EASY-Care were linked to 61 different ICF categories, 16 (26%) from the Body functions component, 3 from the Body structures (5%), 30 from the Activities and participation (49%) and 12 from the Environmental factors (20%). Twelve concepts could not be linked to the ICF at all: 6 were classified as Personal factors, 1 as not defined-general health and 5 were not classified. CONCLUSIONS The integration of the universal language of the ICF in the EASY-Care illustrates the potential of use this instrument in primary care settings at community level. IMPLICATIONS FOR REHABILITATION The integration of the universal language of the ICF in the EASY-Care potentiates the use of this comprehensive instrument in assessing older people needs at primary care settings. The information obtained with the EASY-Care Standard can be worldwide understood and can be used to plan rehabilitation interventions at community settings for older adults.
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Affiliation(s)
- Alda Marques
- School of Health Sciences, University of Aveiro (ESSUA) , Aveiro , Portugal
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Söderhamn U, Dale B, Söderhamn O. The meaning of actualization of self-care resources among a group of older home-dwelling people--a hermeneutic study. Int J Qual Stud Health Well-being 2013; 8:1-9. [PMID: 23601788 PMCID: PMC3631604 DOI: 10.3402/qhw.v8i0.20592] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/25/2013] [Indexed: 11/29/2022] Open
Abstract
Self-care is an activity of mature persons who have developed their abilities to take care of themselves. Individuals can choose to actualize their self-care abilities into self-care activities to maintain, restore, or improve health and well-being. It is of importance to understand the meaning of the actualization of self-care resources among older people. The aim of this study was to investigate the meaning of the actualization of self-care resources, i.e., actions taken to improve, maintain, or restore health and well-being, among a group of older home-dwelling individuals with a high sense of coherence. The design of this study was to reanalyse narratives revealing self-care activities from 11 (five females and six males) Norwegian older home-dwelling people (65 years or older) identified as having a high sense of coherence. In order to reveal the meaning and get an understanding of why these self-care resources were realized or actualized, a Gadamerian-based research method was chosen. The analysis revealed four themes that showed the meaning of actualization of self-care resources in the study group: "Desire to carry on", "Be of use to others", "Self-realization", and "Confidence to manage in the future". The findings showed what older people found meaningful to strive for, and this information can be used as a guide for health professionals when supporting older people in their self-care. Older people with self-care resources can also be an important resource for others in need of social contact and practical help. These resources have to be asked for in voluntary work among older people in need of help and, thereby, can be a valuable supplement to the community health care system.
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Affiliation(s)
- Ulrika Söderhamn
- Centre for Caring Research-Southern Norway, Faculty of Health and Sport Sciences, University of Agder, Grimstad, Norway.
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Abstract
The ageing of European populations presents health, long-term care, and welfare systems with new challenges. Although reports of ageing as a fundamental threat to the welfare state seem exaggerated, societies have to embrace various policy options to improve the robustness of health, long-term care, and welfare systems in Europe and to help people to stay healthy and active in old age. These policy options include prevention and health promotion, better self-care, increased coordination of care, improved management of hospital admissions and discharges, improved systems of long-term care, and new work and pension arrangements. Ageing of the health workforce is another challenge, and policies will need to be pursued that meet the particular needs of older workers (ie, those aged 50 years or older) while recruiting young practitioners.
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Affiliation(s)
- Bernd Rechel
- European Observatory on Health Systems and Policies, London School of Hygiene & Tropical Medicine, London, UK.
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Dale B, Söderhamn U, Söderhamn O. Psychometric properties of the Norwegian version of the General Health Questionnaire (GHQ-30) among older people living at home. Psychol Res Behav Manag 2012; 5:151-7. [PMID: 23152715 PMCID: PMC3496412 DOI: 10.2147/prbm.s37502] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Introduction The incidence and prevalence of mental problems among older people are difficult to map because the causes are often complex and the symptoms manifest in a range of ways. Therefore, there is a need for robust and useful instruments for screening mental problems in this group. One instrument used in Norway and around the world is the 30-item version of the General Health Questionnaire (GHQ-30). Nevertheless, studies testing reliability and validity of the Norwegian version are scarce. Aim The aim of this study was to test the psychometric properties, by means of reliability and construct validity, of the Norwegian version of the GHQ-30 in a sample of older people living at home. Methods A cross-sectional design was used. A postal questionnaire including background variables and a range of health related questions, including the GHQ-30, was mailed to 6033 older people (age 65 years or more) who lived in their own homes in southern Norway. A final sample of 2106 persons (34.9%) responded to and returned the questionnaire. Data were analyzed statistically regarding reliability and construct validity of the GHQ-30. Results The reliability of the instrument, reflecting its homogeneity, was shown in a Cronbach’s alpha coefficient of 0.93 and in significant item-to-total correlations. Construct validity was supported as the GHQ-30 demonstrated robustness in separating groups with known mental problems. Construct validity was also demonstrated in a logical four factor solution, which accounted for 50.0% of the variance in the study group. The factor structure supported previous testing studies of the instrument. Conclusion The GHQ-30 showed satisfactory psychometric properties regarding reliability and construct validity in this study group, which may indicate that the instrument is suitable for use in screening mental problems in older people living at home.
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Affiliation(s)
- Bjørg Dale
- Centre for Caring Research - Southern Norway, Faculty of Health and Sport Sciences, University of Agder, Grimstad, Norway
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Söderhamn U, Dale B, Sundsli K, Söderhamn O. Nutritional screening of older home-dwelling Norwegians: a comparison between two instruments. Clin Interv Aging 2012; 7:383-91. [PMID: 23049250 PMCID: PMC3459573 DOI: 10.2147/cia.s35986] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Background It is important to obtain knowledge about the prevalence of nutritional risk and associated factors among older home-dwelling people in order to be able to meet nutritional challenges in this group in the future and to plan appropriate interventions. The aim of this survey was to investigate the prevalence of home-dwelling older people at nutritional risk and to identify associated factors using two different nutritional screening instruments as self-report instruments. Methods This study had a cross-sectional design. A postal questionnaire, including the Norwegian versions of the Nutritional Form for the Elderly (NUFFE-NO) and Mini Nutritional Assessment – Short Form (MNA-SF), background variables, and health-related questions was sent to a randomized sample of 6033 home-dwelling older people in southern Norway. A total of 2106 (34.9%) subjects were included in the study. Data were analyzed using descriptive statistics and logistic regression analyses. Results When using the NUFFE-NO and MNA-SF, 426 (22.3%) and 258 (13.5%) older persons, respectively, were identified to be at nutritional risk. The risk of undernutrition increased with age. Several predictors for being at risk of undernutrition, including chronic disease/handicap and receiving family help, as well as protective factors, including sufficient food intake and having social contacts, were identified. Conclusion Health professionals must be aware of older people’s vulnerability to risk of undernutrition, perform screening, and have a plan for preventing under-nutrition. For that purpose, MNA-SF and NUFFE-NO can be suggested for screening older people living at home.
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Affiliation(s)
- Ulrika Söderhamn
- Centre for Caring Research-Southern Norway, Faculty of Health and Sport Sciences, University of Agder, Grimstad, Norway.
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Money AG, Barnett J, Kuljis J, Lucas J. Patient perceptions of epinephrine auto-injectors: exploring barriers to use. Scand J Caring Sci 2012; 27:335-44. [DOI: 10.1111/j.1471-6712.2012.01045.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Dale B, Söderhamn U, Söderhamn O. Life situation and identity among single older home-living people: a phenomenological-hermeneutic study. Int J Qual Stud Health Well-being 2012; 7:QHW-7-18456. [PMID: 22848230 PMCID: PMC3406221 DOI: 10.3402/qhw.v7i0.18456] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/13/2012] [Indexed: 11/26/2022] Open
Abstract
Being able to continue living in their own home as long as possible is the general preference for many older people, and this is also in line with the public policy in the Nordic countries. The aim of this study was to elucidate the meaning of self-care and health for perception of life situation and identity among single-living older individuals in rural areas in southern Norway. Eleven older persons with a mean age of 78 years were interviewed and encouraged to narrate their self-care and health experiences. The interviews were audio taped, transcribed verbatim and analysed using a phenomenological–hermeneutic method inspired by the philosophy of Ricoeur. The findings are presented as a naïve reading, an inductive structural analysis characterized by two main themes; i.e., “being able to do” and “being able to be”, and a comprehensive interpretation. The life situation of the interviewed single-living older individuals in rural areas in southern Norway was interpreted as inevitable, appropriate and meaningful. Their identity was constituted by their freedom and self-chosen actions in their personal contexts. The overall impression was that independence and the ability to control and govern their own life in accordance with needs and preferences were ultimate goals for the study participants.
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Affiliation(s)
- Bjørg Dale
- Centre for Caring Research, Faculty of Health and Sport Sciences, University of Agder, Grimstad, Norway.
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Söderhamn U, Dale B, Sundsli K, Tomstad ST, Söderhamn O. Psychometric testing of the Norwegian version of the Nutritional Form For the Elderly among older home-dwelling people. J Multidiscip Healthc 2012; 5:121-8. [PMID: 22791993 PMCID: PMC3392698 DOI: 10.2147/jmdh.s32502] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Nutritional screening instruments need to be evaluated in terms of reliability and validity and being able to demonstrate sensitivity and specificity for use in clinical practice and research. The aims of this study were to test the reliability and validity of the Norwegian version of the Nutritional Form For the Elderly (NUFFE-NO) in a sample of older home-dwelling people, and to use the short form of the Mini Nutritional Assessment (MNA-SF) as a standard. Methods A postal questionnaire, including the two instruments, background variables, and health-related questions, was sent to 6033 home-dwelling older people (65+ years) in southern Norway. In total, 2106 persons responded and were included. Data were analyzed statistically regarding homogeneity, concurrent and construct validity, sensitivity, and specificity of NUFFE-NO. Results A Cronbach’s alpha coefficient of 0.71 and significant item-to-total correlations were obtained as measures of homogeneity. Concurrent validity was assessed by a correlation coefficient of −0.37 (P < 0.001) between NUFFE-NO and MNA-SF. NUFFE-NO could separate known nutritional at-risk groups as a measure of construct validity. A cut-off point of ≥4 for identification of older people at nutritional risk was found for NUFFE-NO with MNA-SF as a standard. Conclusion NUFFE-NO shows adequate psychometric properties regarding homogeneity and construct validity. MNA-SF was not found to be the most suitable standard to use, because a low correlation coefficient was obtained as a measure of concurrent validity and a lower cut-off point was found compared with another study using the Mini Nutritional Assessment (MNA®) as a standard for NUFFE-NO. The obtained cut-off point of ≥4 is not recommended for use in practice or research, because many false positive nutritional at-risk persons would then be identified. Further studies with suitable design have to be performed among older home-dwelling people using the MNA as a standard.
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Affiliation(s)
- Ulrika Söderhamn
- Center for Caring Research, Southern Norway, Faculty of Health and Sport Sciences, University of Agder, Grimstad, Norway
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An evaluation of bladder emptying methods and the effect of demographic and clinical factors on spontaneous voiding frequency in stroke patients. Neurol Sci 2012; 34:729-34. [DOI: 10.1007/s10072-012-1123-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2012] [Accepted: 05/21/2012] [Indexed: 11/26/2022]
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Sundsli K, Söderhamn U, Espnes GA, Söderhamn O. Ability for self-care in urban living older people in southern Norway. J Multidiscip Healthc 2012; 5:85-95. [PMID: 22536079 PMCID: PMC3333801 DOI: 10.2147/jmdh.s29388] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background The number of older people living in urban environments throughout the world will increase in the coming years. There is a trend in most European countries towards improved health among older people, and increased life expectancy for both women and men. Norway has experienced less increase in life expectancy than some other European countries, and it is therefore important to investigate older urban Norwegian people’s health and ways of living in a self-care environment, with special regard to health promotion. Aim The aim of this study was to describe self-care ability among home-dwelling older (65+ years) individuals living in urban areas in southern Norway in relation to general living conditions, sense of coherence (SOC), screened nutritional state, physical activity, perceived self-reported health, mental health, and perceived life situation. Methods In 2010, a randomized sample of 1044 men and women aged 65+ years who were living in urban areas in southern Norway answered a postal questionnaire consisting of five instruments, some background variables, and 17 health-related questions. Univariate and multivariate statistical methods were used in the analyses of the data. Results The mean age of the participants was 74.8 years (SD = 7.1). Eighty-three percent of the participants had higher abilities to care for themselves. Self-care agency, perceived good health, being active, being frequently active, good mental health, not being at risk of undernutrition, and satisfaction with life were all positively related to self-care ability. Negative factors were perceived helplessness, receiving home nursing, being anxious, and being at a more advanced age. People aged 85+ years had worse mental health, were less physically active, and more at risk of undernutrition. Conclusion Health professionals should focus on the health-promoting factors that reinforce older people’s ability to care for themselves, and be aware of important symptoms and signs associated with a reduction in a person’s self-care ability. Politicians should assume responsibility for health care with a special regard to senior citizens.
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Affiliation(s)
- Kari Sundsli
- Department of Social Work and Health Science, Faculty of Social Sciences and Technology Management, NTNU, Trondheim, Norway
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Tomstad ST, Söderhamn U, Espnes GA, Söderhamn O. Living alone, receiving help, helplessness, and inactivity are strongly related to risk of undernutrition among older home-dwelling people. Int J Gen Med 2012; 5:231-40. [PMID: 22419884 PMCID: PMC3302765 DOI: 10.2147/ijgm.s28507] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Being at risk of undernutrition is a global problem among older people. Undernutrition can be considered inadequate nutritional status, characterized by insufficient food intake and weight loss. There is a lack of Norwegian studies focusing on being at risk of undernutrition and self-care ability, sense of coherence, and health-related issues among older home-dwelling people. Aim To describe the prevalence of being at risk of undernutrition among a group of older home-dwelling individuals in Norway, and to relate the results to reported self-care ability, sense of coherence, perceived health and other health-related issues. Methods A cross-sectional design was applied. A questionnaire with instruments for nutritional screening, self-care ability, and sense of coherence, and health-related questions was sent to a randomized sample of 450 persons (aged 65+ years) in southern Norway. The study group included 158 (35.1%) participants. Data were analysed using statistical methods. Results The results showed that 19% of the participants were at medium risk of undernutrition and 1.3% at high risk. Due to the low response rate it can be expected that the nonparticipants can be at risk of undernutrition. The nutritional at-risk group had lower self-care ability and weaker sense of coherence. Living alone, receiving help regularly to manage daily life, not being active and perceived helplessness emerged as predictors for being at risk of undernutrition. The results indicate difficulties in identifying people at nutritional risk and supporting self-care activities to maintain a good nutritional status. Conclusion Health care professionals have to be able to identify older home-dwelling people at risk of undernutrition, support self-care activities to enable people at risk to maintain a sufficient nutritional status, and be aware that older people living alone, who receive help, feel helpless, and are inactive are especially vulnerable.
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Affiliation(s)
- Solveig T Tomstad
- Department of Social Work and Health Science, Faculty of Sciences and Technology Management, NTNU, Trondheim, Norway and Centre for Caring Research - Southern Norway, Faculty of Health and Sport Sciences, University of Agder, Grimstad, Norway
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Söderhamn U, Dale B, Söderhamn O. Narrated lived experiences of self-care and health among rural-living older persons with a strong sense of coherence. Psychol Res Behav Manag 2011; 4:151-8. [PMID: 22241954 PMCID: PMC3255462 DOI: 10.2147/prbm.s27228] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Sense of coherence (SOC), with its components comprehensibility, manageability, and meaningfulness, is a major factor in the ability to cope successfully with stressors and is closely related to health. Qualitative studies related to SOC are scarce, and in this phenomenological interview study, self-care is investigated in relation to SOC. The aim of this study was to describe the lived experiences of self-care and features that may influence health and self-care among older home-dwelling individuals living in rural areas and who have a strong SOC. Eleven persons with a mean age of 73.5 years and a SOC value in the range of 153–188, measured by Antonovsky’s 29-item SOC scale, were interviewed. The interviews were recorded, transcribed verbatim, and analyzed with a phenomenological descriptive method. The findings showed that successful self-care involves having, when needed, contact with the health care system, being conscious of a sound lifestyle, being physically and mentally active, being engaged, having social contacts with family and/or others, and being satisfied and positive and looking forward. Formal and informal caregivers should be conscious of the importance of motivating and supporting older individuals with respect to these dimensions of self-care.
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Affiliation(s)
- Ulrika Söderhamn
- Faculty of Health and Sport Sciences, University of Agder, Centre for Caring Research - Southern Norway, Grimstad, Norway
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