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  • 1.
    Angleman, Sara B
    et al.
    Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Sweden / Stockholm Gerontology Research Center, Sweden.
    Santoni, Giola
    Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Sweden.
    Von Strauss, Eva
    The Swedish Red Cross University College. Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Sweden.
    Fratiglioni, Laura
    The Swedish Red Cross University College. Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Sweden.
    Temporal Trends of Functional Dependence and Survival Among Older Adults From 1991 to 2010 in Sweden: Toward a Healthier Aging2015In: The journals of gerontology. Series A, Biological sciences and medical sciences, ISSN 1079-5006, E-ISSN 1758-535X, Vol. 70, no 6, p. 746-752Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Declines in functional dependence among older adults were observed before the 1990s, but there is uncertainty about subsequent trends. Our study aimed to verify the temporal trends in disability during 1991-2010 in an older Swedish population and to estimate the associated changes in survival.

    METHODS: Functional status in octogenarians and nonagenarians was assessed at seven occasions with intervals of 2-3 years. Sample size varied at each assessment with an average of 646 (range 212-1096). Disability was defined as difficulty in one or more of personal activities of daily living. We compared prevalence and incidence, as well as mortality, and survival associated with disability over the 20-year period.

    RESULTS: Sex-standardized prevalence of disability remained steady over time with a tendency toward a gradual decline, and a statistically significant decrease was present among nonagenarians. Sex-standardized cumulative incidence also remained steady. The proportion of people with prevalent disability who died <3 years remained stable, as did the survival time of people with incident disability. In contrast, among nondisabled persons, 3-year mortality decreased significantly, and for octogenarians median survival time was 1.3 years longer at the more recent assessment than a decade earlier.

    CONCLUSIONS: Both prevalence and incidence of disability remained stable over the last two decades in this urban Swedish population, with a trend toward a slow decline. Mortality remained steady among disabled persons but decreased among persons without disability, suggesting that increased life expectancy during the last two decades may be essentially driven by longer lives of functionally independent people.

  • 2.
    Emami, Azita
    et al.
    Department of Nursing, Karolinska Institutet; Stockholms Sjukhem Foundation .
    Mazaheri, Monir
    Department of Nursing, Karolinska Institutet; Nursing and Midwifery, Tehran University of Medical Science, Iran .
    Difficulties in recruiting participants for a research study on immigrant dementia caregivers: Challenges in conducting research with a culturally diverse population.2007In: Journal of Immigrant & Refugee Studies, ISSN 1556-2948, E-ISSN 1556-2956, Vol. 5, no 4, p. 103-108Article in journal (Refereed)
  • 3.
    Grundberg, Åke
    et al.
    Sophiahemmet Högskola.
    Hansson, Anna
    Sophiahemmet Högskola.
    Hillerås, Pernilla
    Sophiahemmet Högskola / Karolinska Institutet.
    Religa, Dorota
    Karolinska Institutet.
    District nurses' perspectives on detecting mental health problems and promoting mental health among community-dwelling seniors with multimorbidity2016In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 25, no 17-18, p. 2590-2599Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES:

    To describe district nurses' perspectives on detecting mental health problems and promoting mental health among homebound older people with multimorbidity.

    BACKGROUND:

    Mental health problems among older people with multiple chronic conditions, that is, multimorbidity, are challenging issues. These patients' homes often serve as arenas in which district nurses can promote health. Mental health promotion must be studied in greater depth within primary care because older people with multimorbidity are particularly prone to developing poor mental health, which can go undetected and untreated.

    DESIGN:

    A descriptive, qualitative study using semi-structured interviews and content analysis.

    METHODS:

    Twenty-five district nurses completed individual or focus group interviews. Data were analysed using qualitative content analysis.

    RESULTS:

    Most district nurses stated that detecting mental health problems and promoting mental health were important tasks but that they typically focused on more practical home health care tasks. The findings revealed that district nurses focused on assessment, collaboration and social support as means of detecting mental health problems and promoting mental health.

    CONCLUSIONS:

    The district nurses described various factors and actions that appeared to be important prerequisites for their involvement in primary mental health care. Nevertheless, there were no established goals for mental health promotion, and district nurses often seemed to depend on their collaboration with other actors. Our findings indicated that district nurses cannot bear the primary responsibility for the early detection of mental health problems and early interventions to promote mental health within this population.

    RELEVANCE TO CLINICAL PRACTICE:

    The findings of this study indicated that workforce training and collaboration between different care providers are important elements in the future development of this field. Early detection and early treatment of mental health-related issues should also be stated as explicit objectives in the provision of care to community-dwelling older people with multimorbidity.

  • 4.
    Grundberg, Åke
    et al.
    Karolinska Institutet / Sophiahemmet Högskola.
    Hansson, Anna
    Sophiahemmet Högskola.
    Religa, Dorota
    Karolinska Institutet.
    Hillerås, Pernilla
    Karolinska Institutet / Sophiahemmet Högskola.
    Home care assistants' perspectives on detecting mental health problems and promoting mental health among community-dwelling seniors with multimorbidity2016In: Journal of Multidisciplinary Healthcare, ISSN 1178-2390, E-ISSN 1178-2390, Vol. 9, p. 83-95Article in journal (Refereed)
    Abstract [en]

    Introduction: Elderly people with multiple chronic conditions, or multimorbidity, are at risk of developing poor mental health. These seniors often remain in their homes with support from home care assistants (HCAs). Mental health promotion by HCAs needs to be studied further because they may be among the first to observe changes in clients’ mental health status.

    Aim: To describe HCAs’ perspectives on detecting mental health problems and promoting mental health among homebound seniors with multimorbidity.

    Methods: We applied a descriptive qualitative study design using semi-structured interviews. Content analyses were performed on five focus group interviews conducted in 2014 with 26 HCAs.

    Results: Most HCAs stated that they were experienced in caring for clients with mental health problems such as anxiety, depression, sleep problems, and high alcohol consumption. The HCAs mentioned as causes, or risk factors, multiple chronic conditions, feelings of loneliness, and social isolation. The findings reveal that continuity of care and seniors’ own thoughts and perceptions were essential to detecting mental health problems. Observation, collaboration, and social support emerged as important means of detecting mental health problems and promoting mental health. Conclusion: The HCAs had knowledge of risk factors, but they seemed insecure about which health professionals had the primary responsibility for mental health. They also seemed to have detected early signs of mental health problems, even though good personal knowledge of the client and continuity in home visits were crucial to do so. When it came to mental health promotion, the suggestions related to the aim of ending social isolation, decreasing feelings of loneliness, and increasing physical activity. The results indicate that the HCAs seemed dependent on supervision by district nurses and on care managers’ decisions to support the needed care, to schedule assignments related to the detection of mental health problems, and to promote mental health.

  • 5.
    Lindvall, Agneta
    et al.
    Blekinge Tekniska Högskola.
    Kristensson, Jimmie
    Lund Univeristy.
    Willman, Ania
    Blekinge Tekniska Högskola.
    Holst, Göran
    Lund University.
    Informal Care Provided by Family Caregivers Experiences of Older Adults With Multimorbidity2016In: Journal of Gerontological Nursing, ISSN 0098-9134, E-ISSN 1938-243X, Vol. 42, no 8, p. 24-31Article in journal (Refereed)
    Abstract [en]

    Informal care given by family caregivers is an important part of the total care provided to older adults with multimorbidity. The current study aimed to describe how older adults with multimorbidity experienced care from family caregivers. Interviews were conducted with 24 participants (mean age = 86 years). Older adults with multimorbidity felt gratitude toward family caregivers for their willingness to help with everyday life and for representing their interests in contacts with health care providers. Family caregivers also had a significant impact on older adults' psychological well-being. However, the results also showed that older adults often felt they were a burden to their family caregivers and that their independence might be reduced. Older adults with multimorbidity should have the opportunity to be more involved in and have more influence over their health care so that they do not have to depend on representation by family caregivers.

  • 6.
    Mazaheri, Monir
    Mälardalens högskola.
    The status of social and leisure time activities among elderly residing in Iran and Sweden2009In: Iranian Journal of Ageing, Vol. 3, no 8, p. 597-606Article in journal (Refereed)
    Abstract [en]

    Objective: Among social determinants of health, culture and ethnicity play a key role in defining the needs of different population groups. The aim of this study was to consider and compare the social and leisure time activities of the three .elderly groups: Iranian residing in Iran, Iranian residing in Sweden and Swedish residing in Sweden Methods and Materials: Via the cross-sectional design, 825 Iranian elderly who were living in Tehran compared with 305 Swedish elderly and 101 Iranian elderly living in Stockholm on social relations, group activities and leisure time activities. Only, elderly who could communicate properly entered the study. A structured questionnaire designed by the Iranian and Swedish Research Group on the” Assessment of Social Health Status and Needs” implemented for .the subjects. Estimation method and logistic regression used to analyze the gathered data Results: Subjects of all 3 groups were in the age range of 60-77 years old and mostly were married. Results showed despite very common characteristics, there are, also, many differences which can be explained by cultural and environmental factors. Rapid urbanization, limited resources and unawareness of or disregard for healthy life style resulted in lower levels of satisfaction with social and leisure life in the Iranian elderly. On the other hand, level of activities related to the spiritual dimension of health were more in Iranians than Swedish and the difference was significant (p=0.000), whereas the reverse was true for the group activities (p=0.000). Poor attitude toward physicalactivity and exercise in Iranian elderly, especially women, with consequent hazards for health, needs special consid.eration on behalf of the health planners and providers Conclusions: Needs assessment with trance- cultural approach, especially on social determinants of the health of elderly is a necessity. Using valid and reliable instruments, designed to overcome the cultural barriers would help.planners to apply the experience of the aged societies more reasonably, properly and creatively.

  • 7.
    Sjölund, Britt-Marie
    et al.
    Aging Research Center, Karolinska Institutet.
    Nordberg, Gunilla
    Alzheimer Disease Research Center, Karolinska Institutet,.
    Wimo, Anders
    Aging Research Center, Karolinska Institutet.
    von Strauss, Eva
    The Swedish Red Cross University College. Aging Research Center, Karolinska Institutet.
    Morbidity and physical functioning in old age: Differences according to living area2010In: Journal of The American Geriatrics Society, ISSN 0002-8614, E-ISSN 1532-5415, Vol. 58, no 10, p. 1855-1862Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: To describe differences in morbidity and functional status according to living area.

    DESIGN: Community-based survey.

    SETTING: A community-based prospective cohort, the Kungsholmen-Nordanstig Project.

    PARTICIPANTS: Adults aged 75 and older living in an urban area of central Stockholm (n=1,222) and in the rural community of Nordanstig in northern Sweden (n=919).

    MEASUREMENTS: Physicians clinically examined all participants using the same standardized protocols in both living areas; trained nurses directly assessed disability.

    RESULTS: Cardiovascular disease was the most common disorder in both living areas (39.9% in the urban area and 45.2% in the rural area). There were great area differences in the prevalence of stroke (7.4% and 14.0%), diabetes mellitus 6.3% and 16.1%), and Parkinson's disease (1.0% and 3.7%). It was more common to have two or more diseases than no diseases in the rural area than in the urban area (odds ratio=1.9, 95% confidence interval=1.4–2.4). Significant living area differences (urban vs rural) in population attributable risk (PAR) was found for disability due to stroke (5.6 vs 32.2), diabetes mellitus (1.2 vs 6.1), fractures (1.4 vs 10.7), and hearing impairment (8.7 vs 22.0).

    CONCLUSION: Differences were found in disability, morbidity, and disease patterns according to living area. The rural elderly population was more disabled and had more diseases than the urban elderly population, despite being slightly younger than the urban cohort. There were significant area differences in the PAR of how specific chronic conditions influenced the risk of disability.

1 - 7 of 7
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