1
|
Davy CP, Windle A, Harvey G. Fostering an aged care organizational culture that supports innovation. JBI Evid Implement 2024:02205615-990000000-00131. [PMID: 39291719 DOI: 10.1097/xeb.0000000000000465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/19/2024]
Abstract
AIM This study aimed to identify how aged care organizations can foster a culture that supports the implementation of innovation. INTRODUCTION The aged care sector must innovate to meet clients' evolving needs and increased regulatory requirements. Given the need to account for the values, beliefs, expectations, and assumptions held by a diverse range of stakeholders, implementing innovations within aged care can be exceptionally complex. Fostering a supportive organizational culture can facilitate the implementation of these critical innovations. METHODS Papers from a large scoping review that identified organizational culture as a barrier and/or enabler to implementing innovations in aged care were imported into NVivo. Data relating to how organizations fostered (or could foster) a culture that supported the implementation of innovations were then extracted, inductively coded, interpreted, and grouped into approaches. RESULTS Of the 193 papers from the original scoping review, 109 were included in this secondary analysis. From these 109 papers, we identified six key approaches: cultivating collaboration; valuing contributions; ensuring alignment between the organizational vision, culture, and innovation; demonstrating organizational commitment; developing and communicating the implementation plan; and accounting for stability. CONCLUSIONS Our study outlines effective approaches that can be used by aged care organizations to cultivate a culture that supports the implementation of innovations. However, these approaches should not be viewed in isolation; rather, they are interconnected and mutually reinforcing. Together, these insights offer practical guidance for aged care entities seeking to adapt and evolve through innovation implementation. SPANISH ABSTRACT http://links.lww.com/IJEBH/A264.
Collapse
Affiliation(s)
- Carol Patricia Davy
- Aged Care Research and Industry Innovation Australia, Adelaide, SA, Australia
- Caring Futures Institute, Flinders University, Adelaide, SA, Australia
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Alice Windle
- Aged Care Research and Industry Innovation Australia, Adelaide, SA, Australia
- Caring Futures Institute, Flinders University, Adelaide, SA, Australia
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Gillian Harvey
- Aged Care Research and Industry Innovation Australia, Adelaide, SA, Australia
- Caring Futures Institute, Flinders University, Adelaide, SA, Australia
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| |
Collapse
|
2
|
Bergström A, Mondaca M, Nilsson I, Guidetti S, Rosenberg L. Phronesis: Recognising a neglected dimension of knowledge within occupational therapy research. Scand J Occup Ther 2024; 31:2341782. [PMID: 38630858 DOI: 10.1080/11038128.2024.2341782] [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: 10/24/2022] [Accepted: 04/07/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND Phronesis is a way of knowing, implying wisdom, experiences, and reflections that guide our judgements. Phronesis, important for learning, is a neglected form of knowledge when applied to research. AIM To examine how phronesis is conceptualised and practiced in three research projects. METHOD Data from eight interviews with researchers involved in three research projects was generated. The interview material was analysed. A theoretical matrix of contemporary understanding of phronesis was applied to the material. RESULT Examples of phronesis from three research projects in occupational therapy are presented according to categories of contemporary phronesis; acknowledging embodiment, embracing humility, using perceptiveness, and practicing reflexivity. SIGNIFICANCE This unique approach of analysing research projects contributes to the understanding of phronesis and its implications for research, providing valuable insights into the researchers' praxis in their respective projects. CONCLUSION There is a need for a greater recognition of phronesis as a dimension of knowledge within all types of research, and within the discipline. By not recognising phronesis as a legitimate form of knowledge, the discipline perpetuates a superiority of knowledge from episteme that dominates our ways of learning about the world around us and where the type of knowledge gleaned from phronesis is consequently marginalised.
Collapse
Affiliation(s)
- Aileen Bergström
- Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institute, Huddinge, Sweden
| | - Margarita Mondaca
- Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institute, Huddinge, Sweden
- Division of Occupational Therapy, Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
| | - Ingeborg Nilsson
- Division of Occupational Therapy, Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
- School of Health and Welfare, Halmstad, Sweden
| | - Susanne Guidetti
- Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institute, Huddinge, Sweden
- Medical Unit Occupational Therapy and Physiotherapy, and Theme Women's Health and Allied Health Professionals, Karolinska University Hospital, Stockholm, Sweden
| | - Lena Rosenberg
- Department of Neurobiology, Care Sciences and Society, Division of Occupational Therapy, Karolinska Institute, Huddinge, Sweden
- Department of Rehabilitation, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| |
Collapse
|
3
|
Windle A, Marshall A, de la Perrelle L, Champion S, Ross PD, Harvey G, Davy C. Factors that influence the implementation of innovation in aged care: a scoping review. JBI Evid Implement 2023; 22:02205615-990000000-00072. [PMID: 38153118 PMCID: PMC11163893 DOI: 10.1097/xeb.0000000000000407] [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: 12/29/2023]
Abstract
OBJECTIVE The objective of this scoping review is to identify factors that influence the implementation of innovation in aged care. INTRODUCTION Aged care is a dynamic sector experiencing rapid change. Implementation of innovations in aged care has received relatively little research attention compared to health care. INCLUSION CRITERIA This review included studies of any design, that examined the implementation of innovations in aged care settings. METHODS Searches were conducted in MEDLINE, CINAHL, AgeLine, and ProQuest Social Sciences Premium Collection for studies published between January 1, 2012 and December 31, 2022. The titles and abstracts of retrieved citations were screened by two independent reviewers. Full-text articles were screened by one reviewer to determine inclusion. Data were extracted in NVivo using a tool developed by the research team. Factors that influenced implementation were inductively coded, interpreted, and grouped into categories in a series of workshops. RESULTS Of the 2530 studies that were screened, 193 were included. Of the included papers, the majority (74%) related to residential aged care, 28% used an implementation theory or framework, and 15% involved consumers. Five key categories of factors influencing implementation were identified: organizational context including resourcing and culture; people's attitudes and capabilities; relationships between people; the intervention and its appropriateness; and implementation actions such as stakeholder engagement and implementation strategies. CONCLUSIONS Our findings can be used to develop practical resources to support implementation efforts, and highlight the importance of resourcing for successful implementation. Attention to community-based aged care, and greater engagement with theory and community is needed to promote research rigor, relevance and applicability.
Collapse
Affiliation(s)
- Alice Windle
- Aged Care Research and Industry Innovation Australia (ARIIA), Adelaide, SA, Australia
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Amy Marshall
- Aged Care Research and Industry Innovation Australia (ARIIA), Adelaide, SA, Australia
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
- Caring Futures Institute, Flinders University, Adelaide, SA, Australia
| | - Lenore de la Perrelle
- Aged Care Research and Industry Innovation Australia (ARIIA), Adelaide, SA, Australia
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Stephanie Champion
- Aged Care Research and Industry Innovation Australia (ARIIA), Adelaide, SA, Australia
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
- Caring Futures Institute, Flinders University, Adelaide, SA, Australia
| | - Paul D.S. Ross
- Aged Care Research and Industry Innovation Australia (ARIIA), Adelaide, SA, Australia
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| | - Gillian Harvey
- Aged Care Research and Industry Innovation Australia (ARIIA), Adelaide, SA, Australia
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
- Caring Futures Institute, Flinders University, Adelaide, SA, Australia
| | - Carol Davy
- Aged Care Research and Industry Innovation Australia (ARIIA), Adelaide, SA, Australia
- College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia
| |
Collapse
|
4
|
Barcheus IM, Ranner M, Nyman A, Månsson Lexell E, Larsson-Lund M. Developing and testing the feasibility of a new internet-based intervention-A case study of people with stroke and occupational therapists. PLoS One 2023; 18:e0296364. [PMID: 38153937 PMCID: PMC10754454 DOI: 10.1371/journal.pone.0296364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 12/10/2023] [Indexed: 12/30/2023] Open
Abstract
INTRODUCTION Internet-based interventions are called for within rehabilitation to meet the limited access to support for self-management after stroke. Therefore, a new intervention program, "Strategies for Empowering activities in Everyday life" (SEE) was developed. The aim of this study was to explore and describe how clients with stroke and their occupational therapists experienced the SEE intervention process and whether SEE has the potential to promote an active everyday life. METHODS A qualitative descriptive case study was designed. Four people with stroke (two of each sex, mean age 66,5 years) and their two occupational therapists (one of each sex) were included. A mix of data collection methods as interviews, assessments, registration forms and fieldnotes was used to uncover the participants' experiences and potential changes. Data were analysed with pattern matching. FINDINGS The analysed data formed three categories: "Not being able to take on the internet-based intervention", "Being facilitated in the change process of everyday life through the internet-based intervention", and "Providing a new internet-based intervention is a transition from ordinary practice". These categories included two to four subcategories that reflected aspects of SEE feasibility and acceptability with a focus on content and delivery. CONCLUSION The first test of the intervention indicates that the content and delivery of SEE can be feasible and acceptable both for clients and occupational therapists. The findings suggest that SEE has the potential to support clients' self-reflections and their adoption of strategies that influence engagement in daily activities and satisfaction with life in various ways. Further research with large-scale studies is needed.
Collapse
Affiliation(s)
- Ida-Maria Barcheus
- Department of Health, Education and Technology, Division of Health, Medicine and Rehabilitation, Luleå University of Technology, Luleå, Sweden
| | - Maria Ranner
- Department of Health, Education and Technology, Division of Health, Medicine and Rehabilitation, Luleå University of Technology, Luleå, Sweden
| | - Anneli Nyman
- Department of Health, Education and Technology, Division of Health, Medicine and Rehabilitation, Luleå University of Technology, Luleå, Sweden
| | - Eva Månsson Lexell
- Department of Health Sciences, Lund University, Lund, Sweden
- Department of Neurology, Rehabilitation Medicine, Memory Clinic and Geriatrics, Skåne University Hospital, Lund-Malmö, Sweden
| | - Maria Larsson-Lund
- Department of Health, Education and Technology, Division of Health, Medicine and Rehabilitation, Luleå University of Technology, Luleå, Sweden
| |
Collapse
|
5
|
Mouchaers I, Verbeek H, Kempen GIJM, van Haastregt JCM, Vlaeyen E, Goderis G, Metzelthin SF. Development and content of a community-based reablement programme (I-MANAGE): a co-creation study. BMJ Open 2023; 13:e070890. [PMID: 37648386 PMCID: PMC10471872 DOI: 10.1136/bmjopen-2022-070890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 07/19/2023] [Indexed: 09/01/2023] Open
Abstract
OBJECTIVES As age increases, people generally start experiencing problems related to independent living, resulting in an increased need for long-term care services. Investing in sustainable solutions to promote independent living is therefore essential. Subsequently, reablement is a concept attracting growing interest. Reablement is a person-centred, holistic approach promoting older adults' active participation through daily, social, leisure and physical activities. The aim of this paper is to describe the development and content of I-MANAGE, a model for a reablement programme for community-dwelling older adults. DESIGN The development of the programme was performed according to the Medical Research Council framework as part of the TRANS-SENIOR international training and research network. A co-creation design was used, including literature research, observations, interviews, and working group sessions with stakeholders. SETTING AND PARTICIPANTS The interviews and working group sessions took place in the Dutch long-term home care context. Stakeholders invited to the individual interviews and working group sessions included care professionals, policymakers, client representatives, informal caregiver representatives, informal caregivers, and scientific experts. RESULTS The co-creation process resulted in a 5-phase interdisciplinary primary care programme, called I-MANAGE. The programme focuses on improving the self-management and well-being of older adults by working towards their meaningful goals. During the programme, the person's physical and social environment will be put to optimal use, and sufficient support will be provided to informal caregivers to reduce their burden. Lastly, the programme aims for continuity of care and better communication and coordination. CONCLUSION The I-MANAGE programme can be tailored to the local practices and resources and is therefore suitable for the use in different settings, nationally and internationally. If the programme is implemented as described, it is important to closely monitor the process and results.
Collapse
Affiliation(s)
- Ines Mouchaers
- Department of Health Services Research, Faculty of Health Medicine and Life Sciences, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
- Department of Public Health and Primary Care, Academic Centre for General Practice, KU Leuven, Leuven, Belgium
| | - Hilde Verbeek
- Department of Health Services Research, Faculty of Health Medicine and Life Sciences, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
| | - Gertrudis I J M Kempen
- Department of Health Services Research, Faculty of Health Medicine and Life Sciences, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
| | - Jolanda C M van Haastregt
- Department of Health Services Research, Faculty of Health Medicine and Life Sciences, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
| | - Ellen Vlaeyen
- Department of Public Health and Primary Care, Academic Centre for Nursing and Midwifery, KU Leuven, Leuven, Belgium
- Faculty of Medicine and Life Sciences, UHasselt, Hasselt, Belgium
| | - Geert Goderis
- Department of Public Health and Primary Care, Academic Centre for General Practice, KU Leuven, Leuven, Belgium
| | - Silke F Metzelthin
- Department of Health Services Research, Faculty of Health Medicine and Life Sciences, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
- Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands
| |
Collapse
|
6
|
Guadaña J, Oyeneyin B, Moe CF, Tuntland H. Publication Trends in Reablement - A Scoping Review. J Multidiscip Healthc 2023; 16:1641-1660. [PMID: 37333025 PMCID: PMC10276570 DOI: 10.2147/jmdh.s407802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 05/18/2023] [Indexed: 06/20/2023] Open
Abstract
Background Reablement is a holistic and multidisciplinary intervention that can facilitate achievement of service users' goals related to their independence in everyday activities. Reablement has been the subject of increasing scientific activity in recent years. Currently, no review has provided a broad overview of the extent and breadth of international publications in reablement. Objective The objectives were 1) to map the volume of reablement publications, how the publications had increased over time, and their geographical distribution, 2) to identify the publication types and designs, 3) to identify publication trends, and 4) to identify knowledge gaps in the current peer-reviewed literature. Methods The scoping review approach designed by Arksey and O'Malley was used to identify peer-reviewed articles on reablement. Information was obtained on scientific activity on reablement over a period of more than two decades from five electronic databases and without language restrictions. Data was extracted from the eligible articles and both descriptive analysis and thematic analysis of the data was performed. Results A total of 198 articles published from 1999 to August 2022 from 14 countries were identified. There is a continuous interest in the field from countries where reablement has been implemented. An international and historical overview among countries with peer-reviewed publications on reablement is presented, which also partly reflects the countries that have implemented reablement. Most of the research derives from Western countries, in particular from Norway. Varied approaches to publications in reablement were noted with the majority being empirical and quantitative in nature. Conclusion The scoping review confirms the continued expansion of the breadth of reablement-focused publications in terms of originating countries, target populations, and research designs. In addition, the scoping review contributes to the knowledge base regarding reablement's research front.
Collapse
Affiliation(s)
- Jean Guadaña
- Department for Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway
| | - Babatunde Oyeneyin
- Victoria Ward, Farnham Road Hospital, Surrey and Borders Partnership NHS Foundation Trust, Guildford, UK
| | | | - Hanne Tuntland
- Department for Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway
| |
Collapse
|
7
|
Chen C, Beresford B. Factors Impacting User Engagement in Reablement: A Qualitative Study of User, Family Member and Practitioners' Views. J Multidiscip Healthc 2023; 16:1349-1365. [PMID: 37205000 PMCID: PMC10187647 DOI: 10.2147/jmdh.s407211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 04/18/2023] [Indexed: 05/21/2023] Open
Abstract
Background The challenges of population aging have fostered the adoption of reablement as a core pillar of older people's care in many developed economies. Aligning with wider literature on the association between "patient" engagement and outcomes, emerging evidence points to the impact user engagement may have on reablement outcomes. To date, existing research on the factors implicated in engagement with reablement is rather limited. Objective To identify and describe factors which impact user engagement in reablement from the perspectives of reablement staff, staff in interfacing services, service users and family members. Sample and Methods A total of 78 staff were recruited from five sites across England and Wales. Twelve service users and five family members were recruited from three of these sites. Data were collected via focus groups with staff and interviews with service users and families, and subject to thematic analysis. Results The data revealed a complex picture of factors potentially impacting user engagement, ranging from user-, family-, and staff-centered factors, the nature of the relationship between staff and users, and aspects of service organization and delivery across referral and intervention pathways. Many are amenable to intervention. As well as offering a more fine-grained understanding of factors reported by previous research, new factors impacting engagement were identified. These included staff morale, equipment provision systems, assessment and reviewing processes, and attention to social reablement needs. Aspects of the wider service context (eg, degree of integration of health and social care) played a role in determining which factors were pertinent. Conclusion Findings highlight the complexity of factors influencing engagement with reablement, and the need to ensure features of the wider service context (eg delivery models, referral pathways) do not work against securing and sustaining older people's engagement with reablement.
Collapse
Affiliation(s)
- Chunhua Chen
- Social Policy Research Unit, University of York, York, UK
| | - Bryony Beresford
- Social Policy Research Unit, University of York, York, UK
- Correspondence: Bryony Beresford, Social Policy Research Unit, School for Business and Society, University of York, York, YO10 5ZF, UK, Tel/Fax +44 1904 321960, Email
| |
Collapse
|
8
|
Susanne A, Aileen B, Helen O, Susanne G, Anne-Marie B. Individual and organisational factors in the psychosocial work environment are associated with home care staffs' job strain: a Swedish cross-sectional study. BMC Health Serv Res 2022; 22:1418. [PMID: 36434716 PMCID: PMC9701045 DOI: 10.1186/s12913-022-08699-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 10/18/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Home care staff (HCS) provide essential service to enable older adults to age in place. However, unreasonable demands in the work environment to deliver a safe, effective service with high quality has a negative impact on the individual employee's well-being and the care provided to the older adults. The psychosocial work environment is associated with employees´ well-being, although, knowledge regarding which individual and organisational factors that contribute to job strain for HCS is limited. These factors need to be identified to develop targeted interventions and create sustainable work situations for HCS. This study aimed to explore how HCS´s perceived job strain is associated with, and to what extent can be explained by, individual and organisational factors of the psychosocial work environment and psychosomatic health. METHOD An explorative cross-sectional questionnaire survey design was used in a large Swedish county. Five home care agencies with a total of 481 HCS were asked to respond to a questionnaire regarding their perceived level of job strain (Strain in Dementia Care Scale), psychosocial work environment (QPSNordic34+), and psychosomatic health (Satisfaction with Work Questionnaire). Multiple linear regression (MLR) analyses were conducted to explore the association between job strain and individual and organisational factors. RESULTS In total, 226 (46%) HCS responded to the questionnaire. Both individual and organisational factors were significant predictors of job strain and explained a variance ranging between 39 to 51% (p = 0.001). The organisational factor job demand and the individual factor feeling worried and restless was most frequently represented in these MRL models. A higher job strain was also associated with adverse outcomes regarding leadership, organisational culture and climate, and control at work. CONCLUSION This study indicates that there is an intertwined complexity of individual and organisational factors that are associated with the HCS´s perception of job strain. Implementation of new multidimensional work strategies, such as a reablement approach, could support the development of efficient strategies for HCS and reduce the level of job strain. Policy changes for the provision of home care are also needed to support the development of a sustainable and healthy psychosocial work environment.
Collapse
Affiliation(s)
- Assander Susanne
- grid.4714.60000 0004 1937 0626Department of Neurobiology, Caring Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden
| | - Bergström Aileen
- grid.4714.60000 0004 1937 0626Department of Neurobiology, Caring Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden
| | - Olt Helen
- grid.4714.60000 0004 1937 0626Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden
| | - Guidetti Susanne
- grid.4714.60000 0004 1937 0626Department of Neurobiology, Caring Sciences and Society, Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden ,grid.24381.3c0000 0000 9241 5705Theme Women´S Health and Allied Health Professionals, Medical Unit Occupational Therapy and Physiotherapy, Karolinska University Hospital, Stockholm, Sweden
| | - Boström Anne-Marie
- grid.4714.60000 0004 1937 0626Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden ,grid.24381.3c0000 0000 9241 5705Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden ,Research & Development Unit, Stockholms Sjukhem, Stockholm, Sweden
| |
Collapse
|