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Osborne T, Lowe TA, Meijering L. Care and rhythmanalysis: Using metastability to understand the routines of dementia care. Soc Sci Med 2023; 331:116099. [PMID: 37478663 DOI: 10.1016/j.socscimed.2023.116099] [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] [Received: 02/06/2023] [Revised: 06/27/2023] [Accepted: 07/14/2023] [Indexed: 07/23/2023]
Abstract
An increasing number of people living with dementia worldwide receive informal care from their family members. A key element of dementia care is maintaining a daily routine and familiarity, making caring an extremely rhythmic practice. To explore the rhythmic nature of informal care, we apply and advance Lefebvre's unfinished rhythmanalysis by developing an original typology of eurhythmia as a metastable equilibrium. Metastability, although appearing macroscopically stable, is a vulnerable state where a slight disturbance can result in deviation to another state (i.e., stable or unstable). Drawing upon interviews with informal caregivers, we discuss the rhythms and (dis)harmonies of caring practice, including the substantial rhythms of caring practice, the relational balance of rhythms between the caregiver and care recipient, and the various rhythmic disruptions that occur. We demonstrate how metastability provides an understanding of the ever-changing rhythms of every day and allows us to move beyond the immediacy of arrhythmic breaks and explore the subtle changes that occur in (poly)rhythms. Thus, eurhythmia as a metastable equilibrium allows us to explore the gradual and subtle development of, and changes to, dementia care and other routine practices in health geography.
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Affiliation(s)
- Tess Osborne
- School of Geography, Geology and the Environment, University of Leicester, UK; Population Research Centre, Faculty of Spatial Sciences, University of Groningen, the Netherlands.
| | - Thomas A Lowe
- Population Research Centre, Faculty of Spatial Sciences, University of Groningen, the Netherlands
| | - Louise Meijering
- Population Research Centre, Faculty of Spatial Sciences, University of Groningen, the Netherlands
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Lowe TA, Meijering L, de Haas B. The role of performativity in informal dementia carers' capability to be mobile. Soc Sci Med 2023; 329:116030. [PMID: 37331284 DOI: 10.1016/j.socscimed.2023.116030] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 05/25/2023] [Accepted: 06/13/2023] [Indexed: 06/20/2023]
Abstract
Informal carers are and will remain a vital part of dementia care. Given the nature of their caring tasks, which focus on enabling the care recipient to engage in meaningful activities, informal dementia carers are affected in their everyday mobility. Expectations manifested by society, loved ones and the carers themselves play a critical role in how carers perform their caring role and how they perceive their opportunity, or capability, to be mobile. This article uses Butler's concept of performativity to understand informal dementia carers' capability to be mobile. In the spring and summer of 2021, we combined remote graphic elicitation with telephone interviews to gather the views of 17 informal dementia carers (aged 50+) living in England. Three key themes emerged from our analysis of the data. Firstly, participants perceived that becoming a carer changed their capability to be mobile. Secondly, the caring role in relation to the capability to be mobile resulted in an emotional toll and perceived loss of autonomy. Thirdly, the performativity of the caring role created feelings of guilt, selfishness and resentment due to the impact caring had on participants' capability to be mobile. Our study enriches the literature on informal dementia carers' mobility, as we suggest that performativity is a key factor in how this population experiences their everyday mobility. The findings suggest that existing ageing-in-place policies should take a more holistic approach by better including those ageing adults who provide the most support: informal dementia carers.
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Affiliation(s)
- Thomas A Lowe
- Demography, Population Research Centre, Faculty of Spatial Sciences, Urban and Regional Studies Institute, University of Groningen, Groningen, The Netherlands.
| | - Louise Meijering
- Demography, Population Research Centre, Faculty of Spatial Sciences, Urban and Regional Studies Institute, University of Groningen, Groningen, The Netherlands
| | - Billie de Haas
- Demography, Population Research Centre, Faculty of Spatial Sciences, Urban and Regional Studies Institute, University of Groningen, Groningen, The Netherlands
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Parsekar SS, Meijering L, Bailey A, Nair S. Perceptions and Experiences of Informal Caregivers of Breast Cancer Patients in South India: A Qualitative Study. Asian Pac J Cancer Prev 2023; 24:1651-1658. [PMID: 37247285 PMCID: PMC10495876 DOI: 10.31557/apjcp.2023.24.5.1651] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 05/15/2023] [Indexed: 05/31/2023] Open
Abstract
BACKGROUND This study was conducted to explore the prevailing perceptions and experiences of caregiving burden among informal caregivers of women living with breast cancer in South India. METHODS In-depth interviews were conducted among breast cancer care-receivers (n=35) and their informal caregivers (n=39) and a thematic analysis was used to analyze the data. Informal caregiver in the context of this study was defined as one who takes up the responsibility of an informal caregiving role, and were either self-identified or acknowledged by the care-receivers. RESULTS Four main inductive themes in the domains of: emotional culpability, financial and workplace liability, psychosocial affliction, physical strain and health system demand were identified, that were associated with caregiver burden. CONCLUSION Informal caregivers form an integral part of the cancer care continuum in India. It is recommended to factor in the identified themes while developing a caregiver needs assessment model in the context of caring for breast cancer patients in the Indian setting.
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Affiliation(s)
- Shradha S. Parsekar
- Department of Community Medicine, Kasturba Medical College (KMC), Manipal Academy of Higher Education (MAHE), Manipal, India.
| | - Louise Meijering
- Department of Demography, Faculty of Spatial Sciences, University of Groningen, Netherlands.
| | - Ajay Bailey
- International Development Studies, Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, the Netherlands.
- Transdisciplinary Centre for Qualitative Methods, Prasanna School of Public Health, MAHE, Manipal, India.
| | - Suma Nair
- Department of Community Medicine, Kasturba Medical College (KMC), Manipal Academy of Higher Education (MAHE), Manipal, India.
- Centre for Community Oncology, KMC, MAHE, Manipal, India.
- DYPU School of Public Health, DY Patil Deemed to be University, Nerul, Navi Mumbai, India.
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Eysenbach G, Leung T, Plourde KV, Gadio S, Elf M, Jones CA, Meijering L, Giguère A, Légaré F. Canadian Older Adults' Intention to Use an Electronic Decision Aid for Housing Decisions: Cross-sectional Web-Based Survey. JMIR Aging 2023; 6:e43106. [PMID: 36566499 PMCID: PMC9947828 DOI: 10.2196/43106] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 12/05/2022] [Accepted: 12/25/2022] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Older adults with disabilities such as loss of autonomy face the decision of whether to stay at home or move to a health care facility such as a nursing home. Therefore, they may need support for this difficult decision. OBJECTIVE We assessed the intention of Canadian older adults to use an electronic decision aid (eDA) to make housing decisions and identified the factors that influenced their intention. METHODS We conducted a cross-sectional study using a web-based survey targeting older adults across 10 Canadian provinces and 3 territories. We included respondents from a web-based panel who were aged ≥65 years, understood English or French, had access to an electronic device with an internet connection, and had made a housing decision over the past few months or were planning to make a decision in the coming year. We based the web-based survey on the Unified Theory of Acceptance and Use of Technology (UTAUT). We adapted 17 UTAUT items to measure respondents' intention to use the eDA for housing decisions, as well as items measuring 4 intention constructs (performance expectancy, effort expectancy, social influence, and facilitating conditions). We also assessed eHealth literacy using both subjective and objective scales. We used descriptive statistics and multivariable linear regression analyses to identify the factors influencing the intention to use the eDA. RESULTS Of the 11,972 invited panelists, 1176 (9.82%) met the eligibility criteria, and 1000 (85.03%) respondents completed the survey. The mean age was 72.5 (SD 5.59) years. Most respondents were male (548/1000, 54.8%), White (906/1000, 90.6%), English speakers (629/1000, 62.9%), and lived in Ontario or Quebec (628/1000, 62.8%) and in urban areas (850/1000, 85%). The mean scores were 27.8 (SD 5.88) out of 40 for subjective eHealth literacy and 3.00 (SD 0.97) out of 5 for objective eHealth literacy. In our sample, the intention score was 4.74 (SD 1.7) out of 7. The mean scores of intention constructs out of 7 were 5.63 (SD 1.28) for facilitating conditions, 4.94 (SD 1.48) for performance expectancy, 5.61 (SD 1.35) for effort expectancy, and 4.76 (SD 1.59) for social influence. In the final model, the factors associated with intention included mother tongue (β=.30; P<.001), objective eHealth literacy (β=-.06; P=.03), performance expectancy (β=.55; P<.001), social influence (β=.37; P<.001), and facilitating conditions (β=.15; P<.001). CONCLUSIONS Findings from this pan-Canadian web-based survey on Canadian older adults suggest that their intention to use the eDA to make housing decisions is similar to the findings in other studies using UTAUT. The factors identified as influencing intention were mother tongue, objective eHealth literacy, performance expectancy, social influence, and facilitating conditions. These will guide future strategies for the implementation of the eDA.
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Affiliation(s)
| | | | - Karine V Plourde
- VITAM - Centre de recherche en santé durable, Centre intégré universitaire de santé et services sociaux de la Capitale-Nationale, Quebec City, QC, Canada
| | - Souleymane Gadio
- VITAM - Centre de recherche en santé durable, Centre intégré universitaire de santé et services sociaux de la Capitale-Nationale, Quebec City, QC, Canada
| | - Marie Elf
- School of Health and Welfare, Dalarna University, Falun, Dalarna, Sweden
| | - C Allyson Jones
- Faculty of Rehabilitation Medicine, University of Alberta, Edmondon, AB, Canada
| | - Louise Meijering
- Population Research Centre, Faculty of Spatial Sciences, University of Groningen, Groningen, Netherlands
| | - Anik Giguère
- VITAM - Centre de recherche en santé durable, Centre intégré universitaire de santé et services sociaux de la Capitale-Nationale, Quebec City, QC, Canada.,Department of Family Medicine and Emergency Medicine, Université Laval, Quebec City, QC, Canada
| | - France Légaré
- VITAM - Centre de recherche en santé durable, Centre intégré universitaire de santé et services sociaux de la Capitale-Nationale, Quebec City, QC, Canada.,Department of Family Medicine and Emergency Medicine, Université Laval, Quebec City, QC, Canada
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Nordin S, Sturge J, Ayoub M, Jones A, McKee K, Dahlberg L, Meijering L, Elf M. The Role of Information and Communication Technology (ICT) for Older Adults' Decision-Making Related to Health, and Health and Social Care Services in Daily Life-A Scoping Review. Int J Environ Res Public Health 2021; 19:ijerph19010151. [PMID: 35010408 PMCID: PMC8750227 DOI: 10.3390/ijerph19010151] [Citation(s) in RCA: 6] [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] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/15/2021] [Accepted: 12/17/2021] [Indexed: 05/08/2023]
Abstract
Information and communication technology (ICT) can potentially support older adults in making decisions and increase their involvement in decision-making processes. Although the range of technical products has expanded in various areas of society, knowledge is lacking on the influence that ICT has on older adults' decision-making in everyday situations. Based on the literature, we aimed to provide an overview of the role of ICT in home-dwelling older adults' decision-making in relation to health, and health and social care services. A scoping review of articles published between 2010 and 2020 was undertaken by searching five electronic databases. Finally, 12 articles using qualitative, quantitative, and mixed-method designs were included. The articles were published in journals representing biology and medicine, nursing, informatics, and computer science. A majority of the articles were published in the last five years, and most articles came from European countries. The results are presented in three categories: (i) form and function of ICT for decision-making, (ii) perceived value and effect of ICT for decision-making, and (iii) factors influencing ICT use for decision-making. According to our findings, ICT for decision-making in relation to health, and health and social care services was more implicitly described than explicitly described, and we conclude that more research on this topic is needed. Future research should engage older adults and health professionals in developing technology based on their needs. Further, factors that influence older adults' use of ICT should be evaluated to ensure that it is successfully integrated into their daily lives.
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Affiliation(s)
- Susanna Nordin
- School of Health and Welfare, Dalarna University, 791 88 Falun, Sweden; (M.A.); (K.M.); (L.D.); (M.E.)
- Correspondence:
| | - Jodi Sturge
- Population Research Center, Urban and Regional Studies Institute, Faculty of Spatial Sciences, University of Groningen, P.O. Box 800, 9700 AV Groningen, The Netherlands; (J.S.); (L.M.)
| | - Maria Ayoub
- School of Health and Welfare, Dalarna University, 791 88 Falun, Sweden; (M.A.); (K.M.); (L.D.); (M.E.)
| | - Allyson Jones
- Department of Physical Therapy, University of Alberta, Edmonton, AB T6G 2G4, Canada;
| | - Kevin McKee
- School of Health and Welfare, Dalarna University, 791 88 Falun, Sweden; (M.A.); (K.M.); (L.D.); (M.E.)
| | - Lena Dahlberg
- School of Health and Welfare, Dalarna University, 791 88 Falun, Sweden; (M.A.); (K.M.); (L.D.); (M.E.)
- Aging Research Center, Karolinska Institutet & Stockholm University, 171 77 Stockholm, Sweden
| | - Louise Meijering
- Population Research Center, Urban and Regional Studies Institute, Faculty of Spatial Sciences, University of Groningen, P.O. Box 800, 9700 AV Groningen, The Netherlands; (J.S.); (L.M.)
| | - Marie Elf
- School of Health and Welfare, Dalarna University, 791 88 Falun, Sweden; (M.A.); (K.M.); (L.D.); (M.E.)
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Meijering L, Lettinga A. Hopeful adaptation after acquired brain injury: The case of late referrals in the Netherlands. Soc Sci Med 2021; 293:114651. [PMID: 34915241 DOI: 10.1016/j.socscimed.2021.114651] [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] [Received: 11/30/2020] [Revised: 11/03/2021] [Accepted: 12/09/2021] [Indexed: 11/28/2022]
Abstract
A substantial number of people with 'mild' acquired brain injury (ABI) suffer from cognitive impairments that are not immediately acknowledged as such. Some are eventually referred to multidisciplinary rehabilitation care after months or years of suffering, which is why we have labelled them 'late referrals'. The aim of this paper is to add to the discussion on hopeful adaptation by focussing on the diverse adaptive strategies of late referrals. Hope is typically discussed as a positive emotion that can contribute to transformative processes, but that is also mirrored by despair. We conducted in-depth interviews with ten late referrals in the Netherlands. Our findings demonstrate that the trajectories of late referrals are characterised by wandering and navigating. Wandering is predominantly associated with feeling lost, and not knowing where one is going. While navigating is more purposeful, we found that our participants sometimes navigated in directions that turned out to be dead-end streets. We conclude that hopeful adaptation encompasses a circuitous way of trying and adapting and trying again. As a key recommendation for practice, we suggest that people with cognitive problems due to mild ABI should be supported in reducing the complexities of their everyday lives by taking up challenges one place at a time.
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Affiliation(s)
- Louise Meijering
- Population Research Centre (PRC), Faculty of Spatial Sciences, University of Groningen, the Netherlands.
| | - Ant Lettinga
- University Medical Center Groningen, Department of Epidemiology, the Netherlands.
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Osborne T, Meijering L. 'We may be long in the tooth, but it makes us tough': exploring stillness for older adults during the COVID-19 lockdowns. Soc Cult Geogr 2021; 24:447-466. [PMID: 37025930 PMCID: PMC10069370 DOI: 10.1080/14649365.2021.2000019] [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] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 09/13/2021] [Indexed: 06/07/2023]
Abstract
Following the outbreak of the SARS-CoV-2 across the world in 2020, millions of people were reduced in their mobility to hinder the spread of the disease. The lockdown was particularly difficult for older adults, who were deemed 'vulnerable' because many felt unsafe leaving the house and often forced to self-isolate. In this paper, we interpret the lockdowns as a period of prolonged stillness: breaks from everyday practices, including withdrawnness, inefficiency, and retreat. We extend ideas of stillness by integrating the capability approach, which shows how the opportunities and challenges that arise from moments of stillness are dependent on a combination of individual agency and the role of structural or contextual factors. Using the accounts of thirty-eight older adults in the Netherlands and England, we show how the COVID-19 lockdowns established and encouraged different types of stillness which had differing impacts upon the older adults' lives. The effect of the prolonged stillness on these different areas of everyday life is based on individual agency and contextual factors, such as choosing to volunteer or having an adequate internet connection. Thus, our findings contribute to discussions around active ageing and demonstrate that slowing down, and spending more time at home, can provide respite from an otherwise active everyday life.
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Abstract
Geographical life-space is an important factor to consider when studying subjective wellbeing of older adults. The purpose of this article is twofold: to provide an in-depth understanding of 1) the geographical life-spaces in which the lives of older adults take place and 2) the relation between life-space and experienced levels of subjective wellbeing. Seventy-six older adults (aged 65 and older) participated in our qualitative study. We applied a qualitative research approach, through combining indepth-interviews with visual life-space diagrams. Our findings show that most older adults continue to experience a high level of subjective wellbeing, regardless of the extent of their life-space. We conclude that the possibility to fulfill one's needs, even in a restricted life-space, is more conducive to maintaining subjective wellbeing than the extent of life-space itself.
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Affiliation(s)
- Linden Douma
- Population Research Centre, Urban and Regional Studies Institute (URSI), Faculty of Spatial Sciences, University of Groningen, Landleven 1, 9747 AD Groningen, PO Box 800, 9700 AV, Groningen, the Netherlands.
| | - Nardi Steverink
- Department of Sociology, Faculty of Behavioural and Social Sciences, University of Groningen, Grote Rozenstraat 38, 97112, TJ, the Netherlands; Department of Health Sciences, University Medical Center Groningen, University of Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, the Netherlands.
| | - Louise Meijering
- Population Research Centre, Urban and Regional Studies Institute (URSI), Faculty of Spatial Sciences, University of Groningen, Landleven 1, 9747 AD Groningen, PO Box 800, 9700 AV, Groningen, the Netherlands.
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Klaassens M, Meijering L. ['I went for a short walk, so I'll run into people again'. Qualitative research on the participation of older adults with memory problems]. Tijdschr Gerontol Geriatr 2021; 52. [PMID: 34057359 DOI: 10.36613/tgg.1875-6832/2021.01.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Many older adults who live at home face memory problems, which creates challenges for their participation in society. This may lead to social isolation and a lower wellbeing. In this qualitative study, we studied the physical and social participation of seven older adults with memory problems who live at home, to identify obstacles and coping strategies. Different research methods were adopted: 1) walking interviews, 2) travel diaries, and 3) in-depth interviews. Physical and social participation take place independently and in the immediate living environment. Participants experience several obstacles, which are highly impacted by the mode of transportation that they use: walking versus cycling. The results provide new insights on the strategies that participants develop to continue to participate. Fixed routes help them navigate, orientate and anticipate to traffic situations. Participating in activities for a short period of time is a strategy to make social participation less demanding. It is not the duration, but the experience of the activity that is important. The article concludes that older adults with memory problems exercise control in shaping their activities according to their personal needs, possibilities and surroundings. It is important that they are not only supported in avoiding risks, but also in developing suitable coping strategies.
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Briones S, Meijering L. Using Everyday Technology Independently When Living with Forgetfulness: Experiences of Older Adults in Barcelona. Gerontol Geriatr Med 2021; 7:2333721421993754. [PMID: 33623810 PMCID: PMC7876746 DOI: 10.1177/2333721421993754] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 06/22/2020] [Revised: 12/06/2020] [Accepted: 01/11/2021] [Indexed: 11/16/2022] Open
Abstract
Older adults living with forgetfulness encounter difficulties when
engaging with changing and dynamic everyday technology (ET). The
capability to use ET is important for independence in later life and
is affected by the contextual and individual characteristics of older
adults. Using the capability approach as a theoretical lens, this
phenomenological study aims to explore the experiences of older adults
living with forgetfulness, in order to identify contextual and
individual factors that facilitate the use of ET in everyday life. A
qualitative methodology was used to interview 16 community-dwelling
older adults participating in memory and technology workshops at local
community centres in Barcelona. Findings show that motivation and
openness to learning played a facilitating role in our participants’
use of ET. The presence of social support in the form of “technology
experts” and community centres offering learning opportunities were
also enhancing factors that encourage independence when engaging with
ET. In conclusion, our study demonstrates the importance of expanding
intergenerational ET learning opportunities, through the creation of
age-friendly spaces.
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Affiliation(s)
- Samuel Briones
- University of Groningen, The Netherlands.,Utrecht University, The Netherlands
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Sturge J, Meijering L, Jones CA, Garvelink M, Caron D, Nordin S, Elf M, Légaré F. Technology to Improve Autonomy and Inform Housing Decisions for Older Adults With Memory Problems Who Live at Home in Canada, Sweden, and the Netherlands: Protocol for a Multipronged Mixed Methods Study. JMIR Res Protoc 2021; 10:e19244. [PMID: 33475512 PMCID: PMC7861998 DOI: 10.2196/19244] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 04/09/2020] [Revised: 10/20/2020] [Accepted: 12/08/2020] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Understanding the mobility patterns and experiences of older adults with memory problems living at home has the potential to improve autonomy and inform shared decision making (SDM) about their housing options. OBJECTIVE We aim to (1) assess the mobility patterns and experiences of older adults with memory problems, (2) co-design an electronic decision support intervention (e-DSI) that integrates users' mobility patterns and experiences, (3) explore their intention to use an e-DSI to support autonomy at home, and (4) inform future SDM processes about housing options. METHODS Informed by the Good Reporting of A Mixed Methods Study (GRAMMS) reporting guidelines, we will conduct a 3-year, multipronged mixed methods study in Canada, Sweden, and the Netherlands. For Phase 1, we will recruit a convenience sample of 20 older adults living at home with memory problems from clinical and community settings in each country, for a total of 60 participants. We will ask participants to record their mobility patterns outside their home for 14 days using a GPS tracker and a travel diary; in addition, we will conduct a walking interview and a final debrief interview after 14 days. For Phase 2, referring to results from the first phase, we will conduct one user-centered co-design process per country with older adults with memory issues, caregivers, health care professionals, and information technology representatives informed by the Double Diamond method. We will ask participants how personalized information about mobility patterns and experiences could be added to an existing e-DSI and how this information could inform SDM about housing options. For Phase 3, using online web-based surveys, we will invite 210 older adults with memory problems and/or their caregivers, split equally across the three countries, to use the e-DSI and provide feedback on its strengths and limitations. Finally, in Phase 4, we will triangulate and compare data from all phases and countries to inform a stakeholder meeting where an action plan will be developed. RESULTS The study opened for recruitment in the Netherlands in November 2018 and in Canada and Sweden in December 2019. Data collection will be completed by April 2021. CONCLUSIONS This project will explore how e-DSIs can integrate the mobility patterns and mobility experiences of older adults with memory problems in three countries, improve older adults' autonomy, and, ultimately, inform SDM about housing options. TRIAL REGISTRATION ClinicalTrials.gov NCT04267484; https://clinicaltrials.gov/ct2/show/NCT04267484. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/19244.
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Affiliation(s)
- Jodi Sturge
- Population Research Centre, Faculty of Spatial Sciences, University of Groningen, Groningen, Netherlands
| | - Louise Meijering
- Population Research Centre, Faculty of Spatial Sciences, University of Groningen, Groningen, Netherlands
| | - C Allyson Jones
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB, Canada
| | - Mirjam Garvelink
- VITAM - Centre de recherche en santé durable, Quebec, QC, Canada
| | - Danielle Caron
- VITAM - Centre de recherche en santé durable, Quebec, QC, Canada
| | - Susanna Nordin
- School of Education, Health and Social Studies, Dalarna University, Falun, Sweden
| | - Marie Elf
- School of Education, Health and Social Studies, Dalarna University, Falun, Sweden
| | - France Légaré
- VITAM - Centre de recherche en santé durable, CIUSSS de la Capitale-Nationale, Department of Family Medicine and Emergency Medicine, Université Laval, Quebec City, QC, Canada
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Sturge J, Nordin S, Sussana Patil D, Jones A, Légaré F, Elf M, Meijering L. Features of the social and built environment that contribute to the well-being of people with dementia who live at home: A scoping review. Health Place 2020; 67:102483. [PMID: 33254054 DOI: 10.1016/j.healthplace.2020.102483] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 11/11/2020] [Accepted: 11/12/2020] [Indexed: 10/22/2022]
Abstract
This scoping review summarizes findings from 23 qualitative articles on how social and built environments contribute to the well-being of people with dementia who live at home. Through thematic analysis, two themes were identified: i) connection to society and supportive relationships and ii) interaction with natural environments and public space. Features of the social and built environment contribute to well-being both positively and negatively. Future research should explore how these features intersect in an urban-rural context as a basis to inform the development of dementia-friendly initiatives. Moreover, involving people with dementia in the design of features of built environments, such as infrastructure, will result in more inclusive communities.
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Affiliation(s)
- Jodi Sturge
- Population Research Centre, Faculty of Spatial Sciences, University of Groningen, Netherlands.
| | - Susanna Nordin
- School of Education, Health and Social Studies, Dalarna University, Falun, Sweden
| | - Divya Sussana Patil
- Transdisciplinary Centre for Qualitative Methods, Department of Health Information, Prasanna School of Public Health (PSPH), Manipal Academy of Higher Education (MAHE), Manipal, India
| | - Allyson Jones
- Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Canada
| | - France Légaré
- Centre De Recherche Sur Les soins et Les Services de Première Ligne de S'Université Laval (CERSSPL-UL), Department of Family Medicine and Emergency Medicine, Université Laval, Canada
| | - Marie Elf
- School of Education, Health and Social Studies, Dalarna University, Falun, Sweden
| | - Louise Meijering
- Population Research Centre, Faculty of Spatial Sciences, University of Groningen, Netherlands
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Meij E, Haartsen T, Meijering L. Enduring rural poverty: Stigma, class practices and social networks in a town in the Groninger Veenkoloniën. J Rural Stud 2020; 79:226-234. [PMID: 32868964 PMCID: PMC7448954 DOI: 10.1016/j.jrurstud.2020.08.031] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 06/09/2020] [Accepted: 08/11/2020] [Indexed: 06/11/2023]
Abstract
In the Groninger Veenkoloniën, a former peat region in the northeast of the Netherlands, persistent poverty is more prevalent compared to other rural regions in the country. Grounded in participant observations and supplemented by in-depth interviews capturing the social life history of 21 participants, this paper paints a detailed picture of the social networks and class practices of those experiencing persisting poverty in the examined town and surrounding region. In addition, we explore the relations between the rural context and lived experiences of class and poverty. Our findings highlight the complex experience as well as spatial embeddedness of persisting poverty. We find that, although the specific circumstances to which the participants are exposed vary greatly, the repercussions in terms of the characteristics of their social networks and practices are very similar. In general, the social networks of participants are fragmented and small, tightly knit, and characterized by clear power imbalances. The most formative experiences that result in the isolation of networks of poor are found to occur in the home and family situation during childhood years. We argue that poverty and the region's history are intricately interwoven resulting in a socio-spatial stigma which in turn contributes to the persistent and intergenerational character of poverty in the rural context of our study. Due to the long history of stigmatization, dismantling the socio-spatial stigma attached to the Groninger Veenkoloniën will presumably take multiple generations.
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Affiliation(s)
- Erik Meij
- University of Groningen, Faculty of Spatial Sciences, the Netherlands
| | - Tialda Haartsen
- University of Groningen, Faculty of Spatial Sciences, the Netherlands
| | - Louise Meijering
- University of Groningen, Faculty of Spatial Sciences, the Netherlands
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Abstract
This editorial is based on Towards meaningful mobility: a research agenda for movement within and between places in later life.
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Affiliation(s)
- Louise Meijering
- Basiseenheid Demografie, Faculteit Ruimtelijke Wetenschappen, Rijksuniversiteit Groningen, Groningen, Nederland
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Kaper M, Sixsmith J, Meijering L, Vervoordeldonk J, Doyle P, Barry MM, de Winter AF, Reijneveld SA. Implementation and Long-Term Outcomes of Organisational Health Literacy Interventions in Ireland and The Netherlands: A Longitudinal Mixed-Methods Study. Int J Environ Res Public Health 2019; 16:ijerph16234812. [PMID: 31795504 PMCID: PMC6926611 DOI: 10.3390/ijerph16234812] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [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: 09/12/2019] [Revised: 11/14/2019] [Accepted: 11/26/2019] [Indexed: 11/16/2022]
Abstract
Organisational Health Literacy (OHL)-interventions are needed to overcome health inequality. OHL-interventions have successfully identified communication barriers at the organisational level, but evidence is limited on the extent to which this leads to sustainable organisational change. This study aims to assess the implementation fidelity, moderators (barriers and facilitators), and long-term impact of OHL-interventions in hospitals in Ireland and The Netherlands. We used a longitudinal mixed-methods approach to assess two similar OHL-interventions in one Irish and three Dutch hospitals. The OHL-interventions concerned the improvement of navigation and implementation of health literacy-friendly communication throughout organisations. Participants were 24 hospital employees and 40 older adults who use hospital services. At six, eight, and eighteen months, we assessed the level of implementation, barriers and facilitators, and impact through questionnaires and in-depth semi-structured interviews. After older adults and professionals had identified a number of communication problems, we found that professionals had successfully implemented OHL-interventions to promote navigation and comprehensible communication. Limited resources and variation in organisational structures and procedures were perceived as barriers to implementation. The participation of service users, leadership support, and a stepwise implementation of interventions were perceived to facilitate implementation. In the long term, the OHL-interventions led to system-wide improvements, as shown by better embedding of health literacy policies, enhanced patient engagement, provision of plain language training and comprehensible information. Findings were similar for the two countries. Embedded OHL-interventions resulted in sustainable and system-wide health literacy changes in all four hospitals. Following implementation, OHL-interventions have the potential to promote health equity and empowerment among health service users.
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Affiliation(s)
- Marise Kaper
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30.001, FA10, 9700 RB Groningen, The Netherlands; (A.F.d.W.); (S.A.R.)
- Correspondence:
| | - Jane Sixsmith
- Health Promotion Research Centre, National University of Ireland Galway, University Road, H91 TK33 Galway, Ireland; (J.S.); (P.D.); (M.M.B.)
| | - Louise Meijering
- Population Research Center, Urban and Regional Studies Institute, University of Groningen, Landleven 1, P.O. Box 800, 9700 AV Groningen, The Netherlands;
| | - Janine Vervoordeldonk
- Health Impact Gezondheid & Zorg, Blinkertlaan 7, Dishoek, 4371 PV Veere, The Netherlands;
| | - Priscilla Doyle
- Health Promotion Research Centre, National University of Ireland Galway, University Road, H91 TK33 Galway, Ireland; (J.S.); (P.D.); (M.M.B.)
| | - Margaret M. Barry
- Health Promotion Research Centre, National University of Ireland Galway, University Road, H91 TK33 Galway, Ireland; (J.S.); (P.D.); (M.M.B.)
| | - Andrea F. de Winter
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30.001, FA10, 9700 RB Groningen, The Netherlands; (A.F.d.W.); (S.A.R.)
| | - Sijmen A. Reijneveld
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Hanzeplein 1, P.O. Box 30.001, FA10, 9700 RB Groningen, The Netherlands; (A.F.d.W.); (S.A.R.)
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Meijering L, Van Hoven B, Yousefzadeh S. “I think I'm better at it myself”: the Capability Approach and Being Independent in Later Life. RASP 2019. [DOI: 10.17583/rasp.2019.3678] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Current policies on ageing in the global north emphasize that ‘ageing well’ is an individual responsibility, and tend to undervalue the social, economic and cultural context of ageing. The capability approach is well-suited to address the interplay between context and individual in later life. In this article, we therefore use the capability approach to explore how individual capabilities and contextual opportunities and restrictions contribute to being independent in later life. A qualitative methodology was adopted and we conducted in-depth interviews with 32 adults aged 65 and older, who lived independently and in sheltered housing. The study was carried out in two urban neighborhoods in the North of the Netherlands. Our findings underline that different pathways to independence are shaped by individual resources and capabilities, as well as by social and physical characteristics of the living environment. The three key capabilities that lead to being independent that we found were 1) to be comfortable at home and in the neighborhood; 2) to enjoy fulfilling social relations, and 3) to be mobile. The generated insights could be linked to policy initiatives with regard to age-friendly environments.
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de Wit L, Fenenga C, Giammarchi C, di Furia L, Hutter I, de Winter A, Meijering L. Community-based initiatives improving critical health literacy: a systematic review and meta-synthesis of qualitative evidence. BMC Public Health 2017; 18:40. [PMID: 28728547 PMCID: PMC5520348 DOI: 10.1186/s12889-017-4570-7] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 07/05/2017] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Critical health literacy enables older adults to make informed health decisions and take actions for the health and wellbeing of themselves and their community, within their own social and cultural context. A community-based approach has the potential to improve the critical health literacy of older adults and their communities. However, it is not clear how such initiatives consider critical health literacy. Therefore, this study explored how community-based initiatives address the critical health literacy of older adults and their communities. METHODS A systematic literature search was conducted. Two reviewers independently screened titles and abstracts, as well as the quality of the methodological and community-based elements of the studies. In addition, a meta-synthesis was carried out, consisting of a qualitative text analysis of the results sections of the 23 included studies. RESULTS We identified two main themes, which are practices that contribute to the critical health literacy of older adults as well as their communities: 1) collaborative learning, and 2) social support. In these practices we identified reciprocity as a key characteristic of both co-learning and social support. CONCLUSIONS This study provides the first overview of community-based initiatives that implicitly address the critical health literacy of older adults and their community. Our results demonstrate that in the context of one's own life collaborative learning and social support could contribute to people's understanding and ability to judge, sift and use health information. We therefore suggest to add these two practices to the definition of critical health literacy.
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Affiliation(s)
- Liesbeth de Wit
- University of Groningen, Population Research Centre / Urban and Regional Studies Institute, Landleven 1, P.O. Box 800, 9700 AV Groningen, The Netherlands
| | - Christine Fenenga
- University of Groningen, Population Research Centre / Urban and Regional Studies Institute, Landleven 1, P.O. Box 800, 9700 AV Groningen, The Netherlands
- Amsterdam Institute for Global Health and Development, Trinity Building C, 3rd Floor Pietersbergweg 17, P.O. Box 22700, 1100 DE Amsterdam, The Netherlands
| | - Cinzia Giammarchi
- Agenzia Regionale Sanitaria (The Regional Agency for Health), Marche Region, Via Gentile da Fabriano n.3 nel palazzo Rossini, 60125 Ancona, Italy
| | - Lucia di Furia
- Agenzia Regionale Sanitaria (The Regional Agency for Health), Marche Region, Via Gentile da Fabriano n.3 nel palazzo Rossini, 60125 Ancona, Italy
| | - Inge Hutter
- International Institute of Social Studies, The Hague, of Erasmus University Rotterdam, The Netherlands, Kortenaerkade 12, 2518 AX The Hague, The Netherlands
| | - Andrea de Winter
- Department of Health Sciences, University of Groningen, University Medical Center Groningen, Postbus 196, 9700 AD, Groningen, The Netherlands
| | - Louise Meijering
- University of Groningen, Population Research Centre / Urban and Regional Studies Institute, Landleven 1, P.O. Box 800, 9700 AV Groningen, The Netherlands
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Nanninga CS, Meijering L, Postema K, Schönherr MC, Lettinga AT. Unpacking community mobility: a preliminary study into the embodied experiences of stroke survivors. Disabil Rehabil 2017; 40:2015-2024. [DOI: 10.1080/09638288.2017.1323031] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Christa S. Nanninga
- Center for Rehabilitation, University Medical Center Groningen, University of Groningen, Haren, The Netherlands
| | - Louise Meijering
- Population Research Centre, Urban and Regional Studies Institute, Faculty of Spatial Sciences, University of Groningen, Groningen, The Netherlands
| | - Klaas Postema
- Department of Rehabilitation Medicine, Center for Rehabilitation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Marleen C. Schönherr
- Department of Rehabilitation Medicine, Center for Rehabilitation, University Medical Center Groningen, University of Groningen, Haren, The Netherlands
| | - Ant T. Lettinga
- Center for Rehabilitation, University Medical Center Groningen, University of Groningen, Haren, The Netherlands
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Douma L, Steverink N, Hutter I, Meijering L. Exploring Subjective Well-being in Older Age by Using Participant-generated Word Clouds. Gerontologist 2017; 57:229-239. [PMID: 26329319 PMCID: PMC5434489 DOI: 10.1093/geront/gnv119] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 06/25/2015] [Indexed: 11/26/2022] Open
Abstract
Purpose of the study Previous research has overlooked the heterogeneity in older adults' personal conceptions of subjective well-being (SWB), by not taking into account intradomain differences in the conceptions of SWB for different groups of older adults. The aim of this article is therefore to explore (a) older adults' own views on which aspects, categorized under domains, are important to their SWB and (b) which domains and aspects are important to older adults in different contexts and with different characteristics: to men and women, of different ages, and in different housing arrangements. Design and methods Sixty-six older adults (aged 65 and older) participated in our study. We asked the participants to freely nominate aspects of SWB that are important to them, using participant-generated word clouds as our exploratory, qualitative data collection method. The data were analyzed using qualitative inductive content analysis. Results We found 15 domains based on our participants' conceptions of SWB. The multidimensional domains of social life, activities, health, and space and place were most important to our participants. The domains and aspects were defined and prioritized differently by different groups of participants. Implications SWB should be studied as a multidimensional, individualized, and contextualized process to generate meaningful empirical information for researchers and policymakers.
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Affiliation(s)
- Linden Douma
- Department of Demography, Faculty of Spatial Sciences, University of Groningen, the Netherlands
- Healthy Ageing, Population and Society, University of Groningen, the Netherlands
| | - Nardi Steverink
- Department of Sociology, Faculty of Behavioural and Social Sciences, University of Groningen, the Netherlands
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, the Netherlands
| | - Inge Hutter
- Department of Demography, Faculty of Spatial Sciences, University of Groningen, the Netherlands
| | - Louise Meijering
- Department of Demography, Faculty of Spatial Sciences, University of Groningen, the Netherlands
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Meijering L, Weitkamp G. Numbers and narratives: Developing a mixed-methods approach to understand mobility in later life. Soc Sci Med 2016; 168:200-206. [DOI: 10.1016/j.socscimed.2016.06.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2016] [Revised: 05/24/2016] [Accepted: 06/07/2016] [Indexed: 11/16/2022]
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Meijering L, Nanninga CS, Lettinga AT. Home-making after stroke. A qualitative study among Dutch stroke survivors. Health Place 2016; 37:35-42. [DOI: 10.1016/j.healthplace.2015.11.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Revised: 11/24/2015] [Accepted: 11/26/2015] [Indexed: 11/16/2022]
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Abstract
<div><p>The aim of this article is to examine how experiences with interpersonal relationships contribute to older adults’ well-being in the residential context of sheltered housing. We draw on data collected from sixteen in-depth interviews with older adults living in sheltered housing in a small town in northern Netherlands. Our participants experienced the interaction with their children as of primary importance among their interpersonal relationships, while interactions with other residents were rather superficial. Their children offered emotional support as well as instrumental support and were found to play essential roles in our participants’ wellbeing. Moreover, participants expressed that the social and physical activities organized by the residential care-facility offered them the opportunity to remain physically and mentally active. The help received from housekeepers and caregivers was found to be another important element of interpersonal relationships and so was the reciprocal nature of support exchanged with other sheltered housing residents. We conclude that the benefits of interpersonal relationships in sheltered housing should be considered when designing policy for the well-being of older adults ageing in place.</p></div>
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Nanninga CS, Meijering L, Schönherr MC, Postema K, Lettinga AT. Place attachment in stroke rehabilitation: a transdisciplinary encounter between cultural geography, environmental psychology and rehabilitation medicine. Disabil Rehabil 2014; 37:1125-34. [DOI: 10.3109/09638288.2014.955136] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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