1
|
Yadav A, Kylberg M, Granbom M, Malmgren Fänge A, Iwarsson S. Support Needs Among Older Tenants Living in Public Housing in Sweden: Perspectives of Janitors and Maintenance Staff. J Appl Gerontol 2023:7334648231169130. [PMID: 37098132 PMCID: PMC10394964 DOI: 10.1177/07334648231169130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023] Open
Abstract
Neighborhood support can improve aging in place for older adults, but research on the role of public housing staff in supporting older tenants is lacking. Twenty-nine participants (janitors, n = 11; maintenance staff, n = 18) collected data about critical situations among older tenants residing in apartments in Sweden. Modifying the Critical Incident Technique (CIT) and applying a mixed-methods design, quantitative and qualitative data were collected and analyzed with descriptive statistics and thematic analysis, integrated through narrative. We found that older tenants asked staff for help with daily tasks. The staff identified CI management dilemmas in meeting older tenants' support needs while following the housing company's regulations, maintaining professional responsibilities, respecting individual work attitudes and preferences, and experienced a lack of competencies in some situations. Staff members were responsive to offering support in simple, practical, and emotional situations and in addressing matters they perceived as deficits in social and health services.
Collapse
Affiliation(s)
- Agata Yadav
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Marianne Kylberg
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Marianne Granbom
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | | | - Susanne Iwarsson
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| |
Collapse
|
2
|
Howell DF, Malmgren Fänge A, Rogmark C, Ekvall Hansson E. Rehabilitation Outcomes Following Hip Fracture of Home-Based Exercise Interventions Using a Wearable Device-A Randomized Controlled Pilot and Feasibility Study. Int J Environ Res Public Health 2023; 20:3107. [PMID: 36833801 PMCID: PMC9967499 DOI: 10.3390/ijerph20043107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 02/07/2023] [Accepted: 02/09/2023] [Indexed: 06/18/2023]
Abstract
Although hip fractures are common and severe, there is insufficient evidence concerning which type of rehabilitation is most beneficial. The primary aim of this three-armed pilot study was to investigate any difference in outcome after hip fractures between and within groups in terms of balance, everyday activities, and health-related quality of life (HRQoL) following different home rehabilitation interventions. Further aims were to study feasibility and to suggest, if necessary, adjustments to the protocol for a future full randomized controlled trial (RCT). In total, 32 persons were included in this study. The intervention groups underwent the HIFE program with or without an inertial measurement unit, while the control group underwent standard rehabilitation. Within- and between-groups differences in outcomes and feasibility outcomes in terms of recruitment and retention rates were analyzed, and the ability to collect primary and secondary outcomes was assessed. Balance, measured as postural sway, showed no significant improvement in any group. All three groups improved in functional balance (p = 0.011-0.028), activity of daily living (p = 0.012-0.027), and in HRQoL (p = 0.017-0.028). There were no other significant changes within or between the groups. The recruitment rate was 46%, the retention rate was 75%, and the ability to collect outcome measures was 80% at baseline and 64% at follow-up. Based on the results, it is possible to, after adjusting the protocol, conduct a full RCT.
Collapse
Affiliation(s)
| | - Agneta Malmgren Fänge
- Department of Health Sciences, Faculty of Medicine, Lund University, P.O. Box 157, 22100 Lund, Sweden
| | - Cecilia Rogmark
- Department of Orthopedics, Skane University Hospital, Lund University, 21428 Malmö, Sweden
| | - Eva Ekvall Hansson
- Department of Health Sciences, Faculty of Medicine, Lund University, P.O. Box 157, 22100 Lund, Sweden
| |
Collapse
|
3
|
Ekstrand E, Brogårdh C, Axen I, Fänge AM, Stigmar K, Hansson EE. Perceived Consequences of Post-COVID-19 and Factors Associated with Low Life Satisfaction. Int J Environ Res Public Health 2022; 19:15309. [PMID: 36430026 PMCID: PMC9690380 DOI: 10.3390/ijerph192215309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/15/2022] [Accepted: 11/17/2022] [Indexed: 06/16/2023]
Abstract
A significant number of individuals experience post-COVID-19 symptoms, but knowledge of perceived consequences and life satisfaction is lacking. Here, we investigate perceived consequences regarding everyday life, health, physical activity and work post-COVID-19 and factors associated with low life satisfaction. A total of 766 people (mean age 48; 672 women) experiencing post-COVID-19 symptoms at least two months after infection (mean 13 months) responded to an online survey. A majority (≥77%) perceived physical fatigue, mental fatigue, dizziness, reduced work ability, low life satisfaction and a reduced level of aerobic capacity. In the final logistic regression model (Nagelkerke R Square 0.296, p < 0.001), poor work ability was the most important factor for perceiving low satisfaction with life (Odds ratio 3.369, 95% CI 2.040-5.565, p < 0.001, Nagelkerke R Square 0.177). Reduced aerobic capacity, fatigue and living in a city also increased the odds of low life satisfaction. As people with post-COVID-19 report several long-term consequences, this suggests that there is a need for targeted care for this group. The results of this study can serve as guidance for healthcare authorities regarding important long-term consequences that should be considered in rehabilitation programs directed toward post-COVID-19.
Collapse
Affiliation(s)
- Elisabeth Ekstrand
- Department of Health Sciences, Lund University, 221 85 Lund, Sweden
- Department of Hand Surgery, Skåne University Hospital, 205 02 Malmö, Sweden
| | - Christina Brogårdh
- Department of Health Sciences, Lund University, 221 85 Lund, Sweden
- Department of Neurology, Rehabilitation Medicine, Memory Disorders and Geriatrics, Skåne University Hospital, 221 40 Lund, Sweden
| | - Iben Axen
- Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Nobels v. 13, 171 77 Stockholm, Sweden
| | | | - Kjerstin Stigmar
- Department of Health Sciences, Lund University, 221 85 Lund, Sweden
| | - Eva Ekvall Hansson
- Department of Health Sciences, Lund University, 221 85 Lund, Sweden
- Ear-Nose- and Throat Department, Skåne University Hospital, 221 40 Lund, Sweden
| |
Collapse
|
4
|
Mattisson K, Axmon A, Carlsson G, Malmgren Fänge A, Lethin C, Stroh E. Sociodemographic Variations in the Availability of Urban Green Spaces in an Older Swedish Population. Int J Environ Res Public Health 2022; 19:12651. [PMID: 36231951 PMCID: PMC9566372 DOI: 10.3390/ijerph191912651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 09/29/2022] [Accepted: 09/30/2022] [Indexed: 06/16/2023]
Abstract
Urban green spaces (UGS) can have a positive impact on health and thereby potentially ease the strain on the health care system. However, the availability and benefits seem to vary between different sociodemographic groups. The aim of this study was to investigate associations between sociodemographic factors and availability to UGS among people aged 65 years or older. Data on sociodemographic variables and residential coordinates were obtained for three cross-sectional cohorts in two cities (Malmö and Kristianstad) and three years (2010, 2015, and 2019). Three measures of urban green spaces; total (UGS), public (PGS) and quiet (QGS), within 300 m were used to determine availability. The results indicated higher availability to both total and publicly available urban green spaces for groups with lower socioeconomic status (SES) is positive from a health perspective. However, availability to high qualitative publicly available urban green spaces, from a noise perspective, was lower, indicating the opposite.
Collapse
Affiliation(s)
- Kristoffer Mattisson
- Division of Occupational & Environmental Medicine, Lund University, 223 62 Lund, Sweden
| | - Anna Axmon
- EPI@LUND (Epidemiology, Population Studies, and Infrastructures at Lund University), Lund University, 223 62 Lund, Sweden
| | - Gunilla Carlsson
- Department of Health Science, Lund University, 222 40 Lund, Sweden
| | | | - Connie Lethin
- Department of Health Science, Lund University, 222 40 Lund, Sweden
| | - Emilie Stroh
- Division of Occupational & Environmental Medicine, Lund University, 223 62 Lund, Sweden
| |
Collapse
|
5
|
Stroh E, Axmon A, Lethin C, Carlsson G, Malmgren Fänge A, Mattisson K. Impact of Sociodemographic Factors on Use of Formal Social Services in an Older Swedish Population. Int J Environ Res Public Health 2022; 19:12526. [PMID: 36231825 PMCID: PMC9566083 DOI: 10.3390/ijerph191912526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/27/2022] [Accepted: 09/28/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND In Sweden, societal support for older people is the responsibility of the municipalities. However, due to Sweden's current aging-in-place policy for older people, there is a need to assess how the use of such services varies based on sociodemographic factors. The aim of this study was to describe the use of different forms of social services and institutional long-term care (ILTC) in an older population and to evaluate the impact of sociodemographic factors. METHODS This was a cross-sectional register-based study, including all individuals aged 65 years and older in two Swedish municipalities in 2010, 2015, and 2019. The study analyzed the use of social services and ILTC in relation to sex, place of birth, cohabitation status, and type of housing. RESULTS Women, those born in Sweden, and those living in an apartment were more likely to receive assistance than men, those born abroad, or living in single family houses, respectively. People living alone were consistently more likely to have assistance, as well as ILTC. CONCLUSIONS There may be a discrepancy between the individual's need and the assistance provided from the municipality in certain sociodemographic groups in the older population in Sweden.
Collapse
Affiliation(s)
- Emilie Stroh
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Environment, Society & Health, Lund University, SE-221 00 Lund, Sweden
| | - Anna Axmon
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Environment, Society & Health, Lund University, SE-221 00 Lund, Sweden
- EPI@LUND (Epidemiology, Population Studies, and Infrastructures), Lund University, SE-221 00 Lund, Sweden
| | - Connie Lethin
- Department of Health Sciences, Lund University, SE-221 00 Lund, Sweden
| | - Gunilla Carlsson
- Department of Health Sciences, Lund University, SE-221 00 Lund, Sweden
| | | | - Kristoffer Mattisson
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Environment, Society & Health, Lund University, SE-221 00 Lund, Sweden
| |
Collapse
|
6
|
Ekvall Hansson E, Akar Y, Liu T, Wang C, Malmgren Fänge A. Gait parameters when walking with or without rollator on different surface characteristics: a pilot study among healthy individuals. BMC Res Notes 2022; 15:308. [PMID: 36153568 PMCID: PMC9509549 DOI: 10.1186/s13104-022-06196-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 09/07/2022] [Indexed: 11/24/2022] Open
Abstract
Objectives Gait parameters can measure risks of falling and mortality and identify early stages of frailty. The use of walking aid changes gait parameters. The aim of this study was to describe differences in gait parameters among healthy adults when walking on different surfaces and under different conditions, with and without a rollator. Results Ten healthy participants walked first without and then with a rollator upslope, downslope and on flat surface, on bitumen and gravel respectively. Step length, walking speed and sideway deviation was measured using an inertial measurement unit. Walking up a slope using a rollator generated the longest step length and walking down a slope using a rollator the shortest. Fastest walking speed was used when walking up a slope with rollator and slowest when walking down a slope with rollator. Sideway deviation was highest when walking down a slope and lowest when walking on gravel, both without rollator. Highest walk ratio was found when walk up a slope without rollator and lowest when walking down a slope with rollator. Data from this study provides valuable knowledge regarding gait parameters among healthy individuals, useful for future clinical research relevant for rehabilitation and public health.
Collapse
|
7
|
Malmgren Fänge A, Christensen J, Backhouse T, Kenkmann A, Killett A, Fisher O, Chiatti C, Lethin C. Care Home and Home Care Staff’s Learning during the COVID-19 Pandemic and Beliefs about Subsequent Changes in the Future: A Survey Study in Sweden, Italy, Germany and the United Kingdom. Healthcare (Basel) 2022; 10:healthcare10020306. [PMID: 35206920 PMCID: PMC8872186 DOI: 10.3390/healthcare10020306] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 01/27/2022] [Accepted: 02/02/2022] [Indexed: 02/04/2023] Open
Abstract
The aim of this study was to compare perceptions of learning from the COVID-19 pandemic and beliefs in subsequent changes for the future, among care home and home care staff, in four European countries. A 29-item on-line questionnaire was designed in English and later translated into Swedish, Italian, and German on the impact of the pandemic on stress and anxiety. Anonymous data from care staff respondents was collected in four countries between 7 October 2020 and 17 December 2010: Sweden (n = 212), Italy (n = 103), Germany (n = 120), and the United Kingdom (n = 167). While care staff in all countries reported learning in multiple areas of care practice, Italy reported the highest levels of learning and the most agreement that changes will occur in the future due to the pandemic. Conversely, care staff in Germany reported low levels of learning and reported the least agreement for change in the future. While the pandemic has strained care home and home care staff practices, our study indicates that much learning of new skills and knowledge has taken place within the workforce. Our study has demonstrated the potential of cross-border collaborations and experiences for enhancing knowledge acquisition in relation to societal challenges and needs. The results could be built upon to improve future health care and care service practices.
Collapse
Affiliation(s)
- Agneta Malmgren Fänge
- Department of Health Sciences, Lund University, 221 00 Lund, Sweden; (A.M.F.); (C.L.)
| | - Jonas Christensen
- Department of Social Work, Faculty of Health and Society, Malmö University, 205 06 Malmö, Sweden
- Correspondence:
| | - Tamara Backhouse
- School of Health Sciences, University of East Anglia, Norwich NR4 7TJ, UK; (T.B.); (A.K.)
| | - Andrea Kenkmann
- Center for Aging, Catholic University of Applied Sciences Munich, 836 71 Benediktbeuern, Germany;
| | - Anne Killett
- School of Health Sciences, University of East Anglia, Norwich NR4 7TJ, UK; (T.B.); (A.K.)
| | - Oliver Fisher
- Department of Economics and Social Sciences, Università Politecnica delle Marche, 60121 Ancona, Italy;
- Centre for Socio-Economic Research on Ageing, IRCCS INRCA—National Institute of Health and Science on Ageing, 60124 Ancona, Italy
| | | | - Connie Lethin
- Department of Health Sciences, Lund University, 221 00 Lund, Sweden; (A.M.F.); (C.L.)
| |
Collapse
|
8
|
Lethin C, Kenkmann A, Chiatti C, Christensen J, Backhouse T, Killett A, Fisher O, Malmgren Fänge A. Organizational Support Experiences of Care Home and Home Care Staff in Sweden, Italy, Germany and the United Kingdom during the COVID-19 Pandemic. Healthcare (Basel) 2021; 9:767. [PMID: 34205430 PMCID: PMC8233956 DOI: 10.3390/healthcare9060767] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2021] [Revised: 06/06/2021] [Accepted: 06/17/2021] [Indexed: 01/21/2023] Open
Abstract
The COVID-19 pandemic has affected care workers all over the globe, as older and more vulnerable people face a high risk of developing severe symptoms and dying from the virus infection. The aim of this study was to compare staff experiences of stress and anxiety as well as internal and external organizational support in Sweden, Italy, Germany, and the United Kingdom (UK) in order to determine how care staff were affected by the pandemic. A 29-item online questionnaire was used to collect data from care staff respondents: management (n = 136), nurses (n = 132), nursing assistants (n = 195), and other healthcare staff working in these organizations (n = 132). Stress and anxiety levels were highest in the UK and Germany, with Swedish staff showing the least stress. Internal and external support only partially explain the outcomes. Striking discrepancies between different staff groups' assessment of organizational support as well as a lack of staff voice in the UK and Germany could be key factors in understanding staff's stress levels during the pandemic. Structural, political, cultural, and economic factors play a significant role, not only factors within the care organization or in the immediate context.
Collapse
Affiliation(s)
- Connie Lethin
- Department of Health Sciences, Faculty of Medicine, Lund University, 221 00 Lund, Sweden;
- Clinical Memory Research Unit, Department of Clinical Sciences, Faculty of Medicine, Lund University, 221 00 Lund, Sweden
| | - Andrea Kenkmann
- Center for Aging, Katholische Stiftungshochschule, 81667 München, Germany;
| | | | - Jonas Christensen
- Department of Social work, Faculty of Health and Society, Malmö University, 21119 Malmö, Sweden;
| | - Tamara Backhouse
- School of Health Sciences, University of East Anglia, Norwich NR4 7TJ, UK; (T.B.); (A.K.)
| | - Anne Killett
- School of Health Sciences, University of East Anglia, Norwich NR4 7TJ, UK; (T.B.); (A.K.)
| | - Oliver Fisher
- Centre for Socio-Economic Research on Ageing, IRCCS INRCA-National Institute of Health and Science on Ageing, 60124 Ancona, Italy;
- Department of Economics and Social Sciences, Università Politecnica delle Marche, 60121 Ancona, Italy
| | - Agneta Malmgren Fänge
- Department of Health Sciences, Faculty of Medicine, Lund University, 221 00 Lund, Sweden;
| |
Collapse
|
9
|
Taheri-Kharameh Z, Malmgren Fänge A, Ekvall Hansson E, Bashirian S, Heidarimoghadam R, Poorolajal J, Barati M. Development of a mobile application to screen and manage fall risks in older people. Disabil Rehabil Assist Technol 2020; 17:362-367. [PMID: 32608287 DOI: 10.1080/17483107.2020.1785562] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objective: Falls and related injuries are known to be the major health problem leading to disability and mortality among older adults. Identification and management of fall risks aimed to prevent falling is considered to be essential. The aim of this study was to develop a mobile application for screening and management of fall risks based for older adults.Method and materials: First, we determined product features based on literature reviews. Then we asked 10 experts to assess the importance of capabilities. The application was designed in Android environment based on the STEADI toolkit. Finally, the usability and satisfaction of the application were assessed among 30 older adults by means of a usability questionnaire, and the final version was modified.Results: The experts rated the majority of feasibility features to be important. The application consisted of falls risk self-assessment, and the Timed Up and Go (TUG) test to measure individual fall risks, fall prevention education, and suggestions for training based on the individuals' level of fall risk among older adults. The results of the usability assessment showed that the users were satisfied with the application, 8.83 out of 10.Conclusion: The mobile application can be used to screen and manage fall risks in older adults. It may help health providers to identify older adults at low, moderate, and high risks of falls provide education and training to minimise falls and fall-related injuries.Implications for rehabilitationFalls are a major health problem in older people. A great proportion of falls and falls related injuries are preventable.Given the availability and accessibility of various mobile health application and the increasing mobile device usage among older adults, mobile application can be used as a platform for delivering fall prevention programmes such as education and exercise training.The mobile application may be a valuable tool in the fall prevention and their consequences either in old adult.
Collapse
Affiliation(s)
- Zahra Taheri-Kharameh
- Spiritual Health Research Center, School of Paramedical Sciences, Qom University of Medical Sciences, Qom, Iran
| | | | | | - Saeed Bashirian
- Department of Public Health, School of Health, Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Rashid Heidarimoghadam
- Department of Ergonomics, School of Health, Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Jalal Poorolajal
- Research Center for Health Sciences, Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Majid Barati
- Department of Public Health, School of Health, Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| |
Collapse
|
10
|
Affiliation(s)
- Björg Thordardottir
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | | | - Carlos Chiatti
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Lisa Ekstam
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| |
Collapse
|
11
|
Malmgren Fänge A, Carlsson G, Chiatti C, Lethin C. Using sensor-based technology for safety and independence - the experiences of people with dementia and their families. Scand J Caring Sci 2019; 34:648-657. [PMID: 31614031 DOI: 10.1111/scs.12766] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 09/01/2019] [Indexed: 12/28/2022]
Abstract
BACKGROUND The majority of people with dementia prefer to live independently and safely in their own home cared for by their family members. Much effort has been invested in the development of technology, such as sensor-based networks. Many challenges remain, in particular gaining more knowledge about their experiences and perceived benefits. This study aimed to explore experiences, needs and benefits with using sensor-based technology for safety and independence in the homes of people with dementia and their family members. METHODS This study is part of the TECH@HOME project, aiming to evaluate the effects of sensor-based technology on independence among people with dementia and caregiver stress among their family members. This study applied an inductive, qualitative approach with semi-structured interviews of people with dementia (n = 9) and family members (n = 21). The participants were interviewed between June and September 2018 after using the technology for at least 6 months. The interviews were analysed with manifest content analysis. RESULTS Our findings highlighted that technology was considered as a precaution and a safety measure that could provide a sense of having control of the everyday life of the person with dementia. Understanding and acceptance of the technology were as important, together with the reliability of the technology. Ethical dilemmas related to the monitoring of the person with dementia in the home were also raised. CONCLUSION This study provides insights into how people with dementia and family members experience and benefit from using sensor-based technology in their own homes. The knowledge generated is essential for healthcare professionals and policymakers developing and implementing care and service systems including technology, as well as for the industry.
Collapse
Affiliation(s)
| | - Gunilla Carlsson
- Faculty of Medicine, Department of Health Sciences, Lund University, Lund, Sweden
| | - Carlos Chiatti
- Faculty of Medicine, Department of Health Sciences, Lund University, Lund, Sweden
| | - Connie Lethin
- Faculty of Medicine, Department of Health Sciences, Lund University, Lund, Sweden.,Department of Clinical Sciences, Clinical Memory Research Unit, Lund University, Lund, Sweden
| |
Collapse
|
12
|
Axmon A, Ekstam L, Slaug B, Schmidt SM, Fänge AM. Detecting longitudinal changes in activities of daily living (ADL) dependence: Optimizing ADL staircase response choices. Br J Occup Ther 2019. [DOI: 10.1177/0308022619853513] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Anna Axmon
- Epidemiology, Population studies, and Infrastructures at Lund University, Division of Occupational and Environmental Medicine, Lund University, Sweden
| | - Lisa Ekstam
- Department of Health Sciences, Lund University, Sweden
| | - Björn Slaug
- Department of Health Sciences, Lund University, Sweden
| | | | | |
Collapse
|
13
|
Nakajima Y, Schmidt SM, Malmgren Fänge A, Ono M, Ikaga T. Relationship between Perceived Indoor Temperature and Self-Reported Risk for Frailty among Community-Dwelling Older People. Int J Environ Res Public Health 2019; 16:ijerph16040613. [PMID: 30791516 PMCID: PMC6406492 DOI: 10.3390/ijerph16040613] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 02/17/2019] [Accepted: 02/18/2019] [Indexed: 12/12/2022]
Abstract
This study investigated the relationship between perceived indoor temperature in winter and frailty among community-dwelling older people. This cross-sectional study included 342 people 65 years and older in Japan. Participants answered questions about demographics, frailty, housing, and perceived indoor temperature in winter. Participants were grouped based on perceived indoor temperature (Cold or Warm) and economic satisfaction (Unsatisfied or Satisfied). Differences in the frailty index between perceived indoor temperature groups and economic satisfaction groups were tested by using ANCOVA and MANCOVA. An interaction effect showed that people in the Cold Group and unsatisfied with their economic status had significantly higher frailty index scores (F(1, 336) = 5.95, p = 0.015). Furthermore, the frailty index subscale of fall risk was the specific indicator of frailty that accounted for this significant relationship. While previous research has shown the risks related to cold indoor temperature in homes, interestingly among those who reported cold homes, only those who were not satisfied with their economic situation reported being at increased risk for frailty. This highlights the potential importance of preventing fuel poverty to prevent frailty.
Collapse
Affiliation(s)
- Yukie Nakajima
- School of Science for Open and Environmental Systems, Graduate School of Science and Technology, Keio University, Hiyoshi 3 14 1, Kohoku, Yokohama, Kanagawa 2238522, Japan.
- Japan Society for the Promotion of Science, Koujimachi 5 3 1, Chiyoda, Tokyo 1020083, Japan.
| | - Steven M Schmidt
- School of Science for Open and Environmental Systems, Graduate School of Science and Technology, Keio University, Hiyoshi 3 14 1, Kohoku, Yokohama, Kanagawa 2238522, Japan.
- Department of Health Sciences, Faculty of Medicine, Lund University, Box 157, 22100 Lund, Sweden.
| | - Agneta Malmgren Fänge
- Department of Health Sciences, Faculty of Medicine, Lund University, Box 157, 22100 Lund, Sweden.
| | - Mari Ono
- School of Science for Open and Environmental Systems, Graduate School of Science and Technology, Keio University, Hiyoshi 3 14 1, Kohoku, Yokohama, Kanagawa 2238522, Japan.
| | - Toshiharu Ikaga
- Department of System Design Engineering, Faculty of Science and Technology, Keio University, Hiyoshi 3 14 1, Kohoku, Yokohama, Kanagawa 2238522, Japan.
| |
Collapse
|
14
|
Luther A, Chiatti C, Ekstam L, Thordardottir B, Fänge AM. Identifying and validating housing adaptation client profiles - a mixed methods study. Disabil Rehabil 2019; 42:2027-2034. [PMID: 30731046 DOI: 10.1080/09638288.2018.1550530] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Purpose: An increasing number of people will live with disabilities in their homes and consequently, the need for home-based interventions will increase. Housing adaptations (HAs) are modifications to the physical home environment with the purpose to enhance independence for a heterogeneous group of people. Increasing the knowledge of the characteristics of HA clients by exploring their heterogeneity, could facilitate the planning of interventions and allocation of resources. The purpose of this article was to identify and validate HA client profiles.Materials and methods: This cross-sectional study applied a mixed methods design to identify profiles of HA clients through cluster analysis confirmed by qualitative interview data. The sample consists of 241 HA clients in Sweden with a mean age of 75.1 years.Results: A classification into five groups emerged as the one best describing the heterogeneity of characteristics among this sample of clients. Five client profiles were outlined based on their age and level of disability, and the variation between the profiles was confirmed through the qualitative interview data.Conclusions: The identified client profiles are a step towards a better understanding of how home-based interventions could be delivered more effectively to groups of HA clients, based on their different characteristics.Implications for rehabilitationHousing adaptations are structural modifications to the physical home environment with the purpose to enhance independence for people with disabilities.People applying for housing adaptations are a heterogeneous group with different needs.This study outlines five client profiles which can guide professionals on how to differentiate home-based interventions and follow-up processes among housing adaptation clients.
Collapse
Affiliation(s)
- Anna Luther
- Department of Geriatrics, Skåne University Hospital, Malmö, Sweden.,Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Carlos Chiatti
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Lisa Ekstam
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Björg Thordardottir
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden.,Occupational Therapy, Prosthetics and Orthotics, Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | | |
Collapse
|
15
|
Chiatti C, Rodríguez Gatta D, Malmgren Fänge A, Scandali VM, Masera F, Lethin C. Utilization of Formal and Informal Care by Community-Living People with Dementia: A Comparative Study between Sweden and Italy. Int J Environ Res Public Health 2018; 15:ijerph15122679. [PMID: 30487417 PMCID: PMC6313614 DOI: 10.3390/ijerph15122679] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Revised: 11/21/2018] [Accepted: 11/22/2018] [Indexed: 01/19/2023]
Abstract
Background: Dementia is a public health priority with a dramatic social and economic impact on people with dementia (PwD), their caregivers and societies. The aim of this study was to contribute to the knowledge on how utilization of formal and informal care varies between Sweden and Italy. Methods: Data were retrieved from two trials: TECH@HOME (Sweden) and UP-TECH (Italy). The sample consisted of 89 Swedish and 317 Italian dyads (PwD and caregivers). Using bivariate analysis, we compared demographic characteristics and informal resource utilization. Multiple linear regression was performed to analyze factors associated with time spent on care by the informal caregivers. Results: Swedish participants utilized more frequently health care and social services. Informal caregivers in Italy spent more time in caregiving than the Swedish ones (6.3 and 3.7 h per day, respectively). Factors associated with an increased time were country of origin, PwD level of dependency, living situation, use of formal care services and occupation. Conclusions: Care and service utilization significantly varies between Sweden and Italy. The level of formal care support received by the caregivers has a significant impact on time spent on informal care. Knowledge on the factors triggering formal care resources utilization by PwD and their caregivers might further support care services planning and delivery across different countries.
Collapse
Affiliation(s)
- Carlos Chiatti
- Department of Health Sciences, Faculty of medicine, Lund University, Box 157, SE-221 00 Lund, Sweden.
| | - Danae Rodríguez Gatta
- Department of Health Sciences, Faculty of medicine, Lund University, Box 157, SE-221 00 Lund, Sweden.
| | - Agneta Malmgren Fänge
- Department of Health Sciences, Faculty of medicine, Lund University, Box 157, SE-221 00 Lund, Sweden.
| | | | - Filippo Masera
- Department of Health Care Planning, Regional Health Agency of Marche Region, 60015 Ancona, Italy.
| | - Connie Lethin
- Department of Health Sciences, Faculty of medicine, Lund University, Box 157, SE-221 00 Lund, Sweden.
- Department of Clinical Sciences, Clinical Memory Research Unit, Faculty of Medicine, Lund University, SE-214 28 Malmö, Sweden.
| |
Collapse
|
16
|
Boström L, Chiatti C, Thordardottir B, Ekstam L, Malmgren Fänge A. Health-Related Quality of Life among People Applying for Housing Adaptations: Associated Factors. Int J Environ Res Public Health 2018; 15:ijerph15102130. [PMID: 30262784 PMCID: PMC6211042 DOI: 10.3390/ijerph15102130] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 09/24/2018] [Accepted: 09/25/2018] [Indexed: 12/03/2022]
Abstract
Housing adaptations (HA) clients are a heterogeneous group of people with disabilities experiencing restricted performance and participation in everyday life. While health-related quality of life is a common and relevant outcome in health care research, associated factors among HA clients are largely unknown. Thus, the aim of this study was to investigate which factors are associated with health-related quality of life among HA clients in Sweden. The study has a cross-sectional design, using baseline data collected among 224 participants in three municipalities in Sweden. The main outcome was health-related quality of life measured by the EQ-5D. Factors investigated as potentially associated were age, sex, living conditions, cognitive impairment, usability of the home, activities of daily living (ADL) dependence, participation, and fear of falling. The associations were explored using multiple linear regression analysis. Younger age and higher dependence in ADL were associated with lower scores on the EQ-5D. The social aspect of usability in the home had a positive association with the EQ VAS. Results suggest that certain groups of HA clients might be at risk for low health-related quality of life. Knowledge of their characteristics can potentially improve development and implementation of tailored interventions aiming at increasing their health-related quality of life.
Collapse
Affiliation(s)
- Lovisa Boström
- Department of Health Sciences, Faculty of Medicine, Lund University, P.O. Box 157, 221 00 Lund, Sweden.
| | - Carlos Chiatti
- Department of Health Sciences, Faculty of Medicine, Lund University, P.O. Box 157, 221 00 Lund, Sweden.
| | - Björg Thordardottir
- Department of Occupational Therapy, Prosthetics and Orthotics, Faculty of Health Sciences, OsloMet-Oslo Metropolitan University, P.O. Box 4 St. Olavs Plass, 0130 Oslo, Norway.
| | - Lisa Ekstam
- Department of Health Sciences, Faculty of Medicine, Lund University, P.O. Box 157, 221 00 Lund, Sweden.
| | - Agneta Malmgren Fänge
- Department of Health Sciences, Faculty of Medicine, Lund University, P.O. Box 157, 221 00 Lund, Sweden.
| |
Collapse
|
17
|
Abstract
Background: Today people can live a long time with a chronic cancer diagnosis, and it affects the entire family. Family members to patients in palliative care often have to leave valued occupations due to lack of time and energy, while new roles are forced upon them, potentially affecting their health.Objective: To explore occupational balance, needs and roles among family members to persons in palliative care.Methods: Six semi-structured interviews were conducted with family members to terminally ill persons enrolled to specialized palliative care. A qualitative content analysis guided the data collection and analysis.Result: An overarching theme Striving for control while being in the disease, and two categories Changing roles and occupations in the family; and Handling emotions in the end of life emerged from the data.Conclusion: The findings suggest that family members could benefit from strategies to maintain valued roles and occupations, and that palliative care provision need to develop new ways to take family members needs into consideration.
Collapse
Affiliation(s)
- Sofia Nissmark
- Neurology and Rehabilitation Medicine, Lund University Hospital, Lund, Sweden
| | | |
Collapse
|
18
|
Malmgren Fänge A, Schmidt SM, Nilsson MH, Carlsson G, Liwander A, Dahlgren Bergström C, Olivetti P, Johansson P, Chiatti C. The TECH@HOME study, a technological intervention to reduce caregiver burden for informal caregivers of people with dementia: study protocol for a randomized controlled trial. Trials 2017; 18:63. [PMID: 28183323 PMCID: PMC5301412 DOI: 10.1186/s13063-017-1796-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2016] [Accepted: 01/11/2017] [Indexed: 12/18/2022] Open
Abstract
Background It is estimated that global dementia rates will more than triple by 2050 and result in a staggering economic burden on families and societies. Dementia carries significant physical, psychological and social challenges for individuals and caregivers. Informal caregiving is common and increasing as more people with dementia are being cared for at home instead of in nursing homes. Caregiver burden is associated with lower perceived health, lower social coherence, and increased risk of morbidity and mortality. The aim of this trial is to evaluate the effects of information and communication technology (ICT) on caregiver burden among informal caregivers of people with dementia by reducing the need for supervision. Methods/design This randomized controlled trial aims to recruit 320 dyads composed of people with dementia living in community settings and their primary informal caregivers. In the intervention group, people with dementia will have a home monitoring kit installed in their home while dyads in the control group will receive usual care. The ICT kit includes home-leaving sensors, smoke and water leak sensors, bed sensors, and automatic lights that monitor the individual’s behavior. Alerts (text message and/or phone call) will be sent to the caregiver if anything unusual occurs. All study dyads will receive three home visits by project administrators who have received project-specific training in order to harmonize data collection. Home visits will take place at enrollment and 3 and 12 months following installation of the ICT kit. At every home visit, a standardized questionnaire will be administered to all dyads to assess their health, quality of life and resource utilization. The primary outcome of this trial is the amount of informal care support provided by primary informal caregivers to people with dementia. Discussion This is the first randomized controlled trial exploring the implementation of ICT for people with dementia in a large sample in Sweden and one of the first at the international level. Results hold the potential to inform regional and national policy-makers in Sweden and beyond about the cost-effectiveness of ICT and its impact on caregiver burden. Trial Registration ClinicalTrials.gov, NCT02733939. Registered on 10 March 2016. Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-1796-8) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Agneta Malmgren Fänge
- Department of Health Sciences, Health Sciences Centre (HSC), Lund University, Baravägen 3, 222 41, Lund, Sweden.
| | - Steven M Schmidt
- Department of Health Sciences, Health Sciences Centre (HSC), Lund University, Baravägen 3, 222 41, Lund, Sweden
| | - Maria H Nilsson
- Department of Health Sciences, Health Sciences Centre (HSC), Lund University, Baravägen 3, 222 41, Lund, Sweden.,Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - Gunilla Carlsson
- Department of Health Sciences, Health Sciences Centre (HSC), Lund University, Baravägen 3, 222 41, Lund, Sweden
| | - Anna Liwander
- Department of Health Sciences, Health Sciences Centre (HSC), Lund University, Baravägen 3, 222 41, Lund, Sweden
| | - Caroline Dahlgren Bergström
- Department of Health Sciences, Health Sciences Centre (HSC), Lund University, Baravägen 3, 222 41, Lund, Sweden
| | - Paolo Olivetti
- Scientific Direction, Italian National Institute of Health and Science on Ageing (INRCA), Ancona, Italy
| | - Per Johansson
- Institute of Medicine, The Sahlgrenska Academy University of Gothenburg Department of Internal Medicine (Endocrinology), Gothenburg, Sweden
| | - Carlos Chiatti
- Department of Health Sciences, Health Sciences Centre (HSC), Lund University, Baravägen 3, 222 41, Lund, Sweden.,Scientific Direction, Italian National Institute of Health and Science on Ageing (INRCA), Ancona, Italy
| | | |
Collapse
|
19
|
Affiliation(s)
- Lisa Ekstam
- Department of Health Sciences, Lund University, Lund, Sweden
| | | | | |
Collapse
|
20
|
Thordardottir B, Ekstam L, Chiatti C, Fänge AM. Factors associated with participation frequency and satisfaction among people applying for a housing adaptation grant. Scand J Occup Ther 2016; 23:347-56. [PMID: 26853519 DOI: 10.3109/11038128.2016.1139622] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND People applying for a housing adaptation (HA) grant are at great risk of participation restrictions due to declining capacity and environmental barriers. AIM To investigate the association of person-, environment-, and activity-related factors with participation frequency and satisfaction among people applying for a housing adaptation grant. MATERIAL AND METHODS Baseline cross-sectional data were collected during home visits (n = 128). The association between person-, environment-, and activity-related factors and participation frequency and satisfaction was analysed using logistic regressions. RESULTS The main result is that frequency of participation outside the home is strongly associated with dependence in activities of daily living (ADL) and cognitive impairments, while satisfaction with participation outside the home is strongly associated with self-reported health. Moreover, aspects of usability in the home were associated with frequency of participation outside the home and satisfaction with participation in the home and outside the home alone. CONCLUSION Dependence in ADL, cognitive impairments, self-rated health, and aspects of usability are important factors contributing to participation frequency and satisfaction among people applying for a housing adaptation grant, particularly outside the home. SIGNIFICANCE Our findings indicate that more attention should be directed towards activity-related factors to facilitate participation among HA applicants, inside and outside the home.
Collapse
Affiliation(s)
- Björg Thordardottir
- a Department of Health Sciences, Faculty of Medicine , Lund University , Sweden
| | - Lisa Ekstam
- a Department of Health Sciences, Faculty of Medicine , Lund University , Sweden
| | - Carlos Chiatti
- a Department of Health Sciences, Faculty of Medicine , Lund University , Sweden ;,b Scientific Direction , Italian National Research Centre on Ageing (INRCA) , Italy
| | | |
Collapse
|
21
|
Thordardottir B, Chiatti C, Ekstam L, Malmgren Fänge A. Heterogeneity of Characteristics among Housing Adaptation Clients in Sweden--Relationship to Participation and Self-Rated Health. Int J Environ Res Public Health 2015; 13:ijerph13010091. [PMID: 26729145 PMCID: PMC4730482 DOI: 10.3390/ijerph13010091] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Revised: 12/21/2015] [Accepted: 12/23/2015] [Indexed: 01/14/2023]
Abstract
The aim of the paper was to explore the heterogeneity among housing adaptation clients. Cluster analysis was performed using baseline data from applicants in three Swedish municipalities. The analysis identified six main groups: “adults at risk of disability”, “young old with disabilities”, “well-functioning older adults”, “frail older adults”, “frail older with moderate cognitive impairments” and “resilient oldest old”. The clusters differed significantly in terms of participation frequency and satisfaction in and outside the home as well as in terms of self-rated health. The identification of clusters in a heterogeneous sample served the purpose of finding groups with different characteristics, including participation and self-rated health which could be used to facilitate targeted home-based interventions. The findings indicate that housing adaptions should take person/environment/activity specific characteristics into consideration so that they may fully serve the purpose of facilitating independent living, as well as enhancing participation and health.
Collapse
Affiliation(s)
- Björg Thordardottir
- Department of Health Sciences, Faculty of Medicine, Lund University, Box 157, Lund 221 00, Sweden.
| | - Carlos Chiatti
- Department of Health Sciences, Faculty of Medicine, Lund University, Box 157, Lund 221 00, Sweden.
- Italian National Research Center on Aging, Via S. Margherita 5, Ancona 60124, Italy.
| | - Lisa Ekstam
- Department of Health Sciences, Faculty of Medicine, Lund University, Box 157, Lund 221 00, Sweden.
| | - Agneta Malmgren Fänge
- Department of Health Sciences, Faculty of Medicine, Lund University, Box 157, Lund 221 00, Sweden.
| |
Collapse
|
22
|
Ekstam L, Carlsson G, Chiatti C, Nilsson MH, Malmgren Fänge A. A research-based strategy for managing housing adaptations: study protocol for a quasi-experimental trial. BMC Health Serv Res 2014; 14:602. [PMID: 25432718 PMCID: PMC4256922 DOI: 10.1186/s12913-014-0602-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Accepted: 11/14/2014] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND The primary aim of this paper is to describe the design of a project evaluating the effects of using a research-based strategy for managing housing adaptations (HAs). The evaluation targets clients' perspectives in terms of activity, participation, usability, fear of falling, fall incidence, use of mobility devices, and health-related quality of life, and determines the societal effects of HAs in terms of costs. Additional aims of the project are to explore and describe this strategy in relation to experiences and expectations (a) among clients and cohabitants and (b) occupational therapists in ordinary practice. METHODS/DESIGN This study is a quasi-experimental trial applying a multiphase design, combining quantitative and qualitative data. At the experimental sites, the occupational therapists (OTs) apply the intervention, i.e. a standardized research-based strategy for HA case management. At the control site, the occupational therapists are following their regular routine in relation to HA. Three municipalities in south Sweden will be included based on their population, their geographical dispersion, and their similar organizational structures for HA administration. Identical data on outcomes is being collected at all the sites at the same four time points: before the HA and then 3, 6, and 12 months after the HA. The data-collection methods are semi-structured qualitative interviews, observations, clinical assessments, and certificates related to each client's HA. DISCUSSION The intervention in this study has been developed and tested through many years of research and in collaboration with practitioners. This process includes methodological development and testing research aimed at identifying the most important outcomes and research targeting current HA case-management procedures in Swedish municipalities. When the study is completed, the results will be used for further optimization of the practice strategy for HA, in close collaboration with the data-collecting OTs. TRIAL REGISTRATION No: NCT01960582.
Collapse
|
23
|
Ekvall-Hansson E, Carlsson G, Fänge AM. Implementing evidence based health skills in practice through higher education. BMC Health Serv Res 2014. [PMCID: PMC4123146 DOI: 10.1186/1472-6963-14-s2-p38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
24
|
Abstract
AIM The aim of this study was to investigate how occupational therapists in Sweden administer housing adaptation cases, how they perceive the housing adaptation process, and which improvements they consider necessary. METHODS A total of 1 679 occupational therapists employed by the county councils or the local authorities (and involved in housing adaptations) participated in a web-based survey. The survey targeted issues related to referral and needs identification, assessment, certification, case progress feedback, and evaluation. RESULTS Less than half of the occupational therapists systematized the assessment prior to intervention and very few conducted any evaluation afterwards. Feedback from workmen or grant managers to the occupational therapists on each case's adaptation progress was often asked for but rarely given. The majority of the participants were satisfied with the housing adaptation process in general, while at the same time they indicated a need for further improvements in the process. Differences between occupational therapists related to employer and year of graduation were found on the majority of the targeted issues. CONCLUSIONS To conclude, to a very large extent housing adaptations seem to be based on non-standardized procedures for assessment, and only a few of them are evaluated systematically.
Collapse
|
25
|
Abstract
PURPOSE To explore clients' experience of the housing adaptations (HAs) over time in relation to housing and health. METHOD A multiple longitudinal case study, employing an embedded mixed-method design was used. Four participants were included and data from semi-structured interviews were combined with data from structured survey assessments. RESULTS HA made it possible to maintain valuable roles and activities, to continue to live in the participants' own homes and to take part in the society. The participants strived for autonomy and control, and in order to do so they needed different kinds of support, in terms of HA and mobility devices as well as support from professionals. HA also challenged the participants' routines and habits, as well as their perception about how an appealing HA aesthetically. Thus, the decision to apply for a HA was not always straightforward. Instead, the participants were constantly engaged in negotiations with themselves, concerning benefits and drawbacks of different decisions. CONCLUSIONS HAs involve complex person-environment-activity (P-E-A) transactions, and enhance clients' activity and independence in spite of functional decline. The knowledge generated is important in order to improve individual HA, as well as improving the efficiency and effectiveness of the intervention.
Collapse
|
26
|
Haak M, Malmgren Fänge A, Iwarsson S, Dahlin-Ivanoff S. The importance of successful place integration for perceived health in very old age: a qualitative meta-synthesis. Int J Public Health 2011; 56:589-95. [DOI: 10.1007/s00038-011-0282-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2010] [Revised: 07/18/2011] [Accepted: 07/21/2011] [Indexed: 10/18/2022] Open
|
27
|
Abstract
The ambition underlying this study is to provide a valid and efficient screening tool targeting accessibility problems in the ordinary housing stock. The study aims to test the feasibility and interrater agreement of a screening-tool version of the Housing Enabler in a real estate company practice context. Two rater pairs administer the screening in 35 apartments in a Swedish municipality. The overall agreement for the rater pairs was 83% and 78%. For 29 of the 61 items of the tool, the agreement was >80% for both rater pairs; for 8 items, it was <80%. The findings show that the tool is feasible for use in a real estate practice context but that there is a need for more rater training and an instrument manual. This study contributes to the development of research-based strategies for the identification of accessibility problems in ordinary housing, with the long-term aim to increase accessibility in the housing stock, ultimately supporting activity and participation among senior citizens.
Collapse
|