Nordic responses to covid-19 from a health promotion perspective

On 30 January 2020, the disease covid-19 was declared by the World Health Organization to be an international threat to human health and on 11 March 2020, the outbreak was declared a pandemic. The aim of this study was to analyse policy strategies developed by the five Nordic countries during the first 3 months of the pandemic from a health promotion perspective in order to identify Nordic responses to the crisis. Although the Nordic countries have a long tradition of co-operation as well as similar social welfare policies and legislation, each country developed their own strategies towards the crisis. The strategies identified were analysed from a health promotion perspective emanating from five principles: intersectorality, sustainability, equity, empowerment and a lifecourse perspective. Denmark, Finland and Norway had lockdowns to varying degrees, whereas Sweden and Iceland had no lockdowns. Iceland implemented a test and tracking strategy from the very beginning. All countries based their recommendations and restrictions on appeals to solidarity and trust in institutions and fellow citizens. The analysis showed that the strategies in all countries could be related to health promotion principles with some differences between the countries especially regarding equity and sustainability. The Nordic governments took responsibility for protecting their citizens by developing policy strategies based on restrictions and recommendations congruent with the principles of health promotion. The findings also identified issues that will pose challenges for future pandemic strategies.

Nordiske sundhedsfremmende perspektiver på ældre menneskers deltagelse og tryghed

Nordic Health Promotion Perspectives on Older Adults Participation and Sense og Security Demographic changes and the growing elderly population in Scandinavia provide an incentive to study Health Ageing in the Nordic Countries. The chosen Nordic perspective takes into account commonalities and differences in socio-economic status, welfare systems, gender, history and culture. It also involves focusing on the health of individuals and populations. The Nordic perspective and the authors’ understanding of health and health promotion provide a backdrop for the essay. The authors are part of the Nordic Health Promotion Network (NHPRN), which is grounded in an ethics of health and well-being. This understanding highlights key values such as participation, justice and equality (freedom from discrimination), autonomy (independence). The authors focus mainly on the importance of participation and on the older person’s sense of security in this paper. We seek answers to what prevents and in which way Healthy Ageing can be promoted in the Northern countries. Concepts such as discrimination, retirement, dementia, nursing home residents’ access to nature and the elements, and the importance of relationships are illuminated.

The vulnerability of family caregivers in relation to vulnerability as understood by nurses

In Finland, the care of older persons is shifting from institutional care to family care. Research shows that family caregivers experience their situation much in the same way as professional nurses. The nurses' experiences have been studied in terms of vulnerability, and the same perspective could deepen our understanding of family caregivers' experiences. The aim of this study was to gain knowledge of the vulnerability of older caregivers taking care of an ageing family member. The research questions were as follows: How do family caregivers experience vulnerability? How do their experiences relate to vulnerability as understood by nurses? The study was done as a secondary analysis of focus group interviews on the experiences and daily life of older family caregivers. Four caregivers had taken part in monthly interviews during a period of 10 months. The interviews were analysed by deductive and inductive content analysis. The results showed that the caregivers saw caregiving as part of being human. They experienced a variety of feelings and moral agony and were harmed physically, mentally and socially. They showed courage, protected themselves and recognised that being a caregiver also was a source of maturing and developing. These results corresponded with the nurses' understanding of vulnerability. Shame, the experience of duty as a burden, worry and loneliness were themes that were found only among the family caregivers. The use of a matrix may have restricted the analysis, but using it in an unconstrained way allowed for new themes to be created. The results indicate a common humanness and vulnerability in professional and family caregiving. They also show that family caregivers need more support both from society and professionals.

Home as a health promotion setting for older adults

BACKGROUND

The number and the proportion of older persons is growing in the Nordic Countries. The growth in the older population has a clear impact on the care system for older persons. One trend is to prioritise home care instead of care in institutions. Another trend is to emphasise preventive and health promotion care. As official guidelines in the Nordic countries state that home is the best place to grow old, it is essential that older persons keep their health and functional capacity in order to be able to live at home for as long as possible. As current policy emphasises living at home, home care, preventive work and health promotion it becomes essential to study the home as a health promotion setting.

OBJECTIVE

The aim of this study was to reach a new understanding of home as a health promotion setting for older persons.

STUDY DESIGN

The method used was a literature reflection and analysis with a hermeneutical approach.

RESULTS

The results show that with increasing age the home environment becomes a crucial determinant for independence. The home environment supports the self as people age; it has associations with the past, can provide proximity to family, and a sense of being a part of neighbourhood life.

CONCLUSIONS

Only by taking into consideration the meaning of home and the resources of the individual older person can home function as a true health promoting setting if health personnel focus solely on risk prevention, they can neglect the perspectives of the older person, resulting in dis-empowerment not health promotion.

The meaning of vulnerability to older persons

Background:

Vulnerability is an important concept in nursing and nursing ethics. Vulnerability and ageing have generally been associated with frailty, which gives a limited view of both vulnerability and ageing.

Objective:

The aim of this study was to illuminate the meaning of vulnerability to older persons themselves.

Research design:

A qualitative design based on interpretive description was adopted. The data were collected by interviews that were analysed by qualitative content analysis as interplay between analysis, interpretation and meaning construction.

Participants and research context:

In total, 14 older persons aged 70–96 years were interviewed, 2 men and 12 women. Some of the participants lived in their own homes, some in service houses and some in nursing homes.

Ethical considerations:

The ethical principles of informed consent, confidentiality and non-identification were respected.

Findings:

The core meaning was a deeper sense of vulnerability as you grow old. This was expressed in six themes: Being easily harmed, Becoming an old person, Being an old person in society, Reactions when being violated and hurt, Protection and Vulnerability as strength.

Discussion and conclusion:

The themes include frailty and threats to the dignity of older persons and also capacity to feel and develop. The results showed that although the frailty perspective dominated, vulnerability also had positive meanings for the older persons.

Quality of life in old age described as a sense of well-being, meaning and value

The purpose of the study was to present a model of quality of life and related factors, to study quality of life in a group of elderly subjects, and to do preliminary testing of the model. Quality of life was defined as a sense of well-being, meaning and value. The model includes health, functional capacity, and coping mechanisms as intra-individual conditions for quality of life, while factors in the biophysical and sociocultural environment are described as external conditions. The study sample consisted of 300 subjects, aged 75 or older and living in Finland. Data were gathered by means of structured personal interviews. The participants' quality of life was generally quite good. The correlations among the variables related to quality of life were significant, but the results of the regression analyses showed that the individual aspects of quality of life did not have identical explanatory models. The internal consistency of the instruments was good. The results give preliminary support to the model, but in future studies more attention must be paid to the conceptual and theoretical validity. In order to achieve results that can be applied in gerontological nursing practice, different groups and contexts must be investigated.

Intuition--a problematic form of knowledge in nursing

The purpose of this article is to discuss the concept and phenomenon of intuition in nursing. With an overview of theories of intuition in philosophy and empirical research as the starting point, the authors discuss the conceptualization of intuition in nursing. Concept analyses, intuition as phenomenological nursing knowledge, intuition as clinical knowledge and intuition as spiritual connection are discussed. The authors conclude that the conceptions of intuition in nursing differ with respect to their philosophical underpinnings and that it can be questioned whether 'intuition' is always a proper term for the kind of knowledge investigated. Intuition is seen as an important concept in nursing, but there are still philosophical as well as empirical and practical problems to investigate.