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  • 1.
    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.

  • 2.
    Nilsson, Håkan
    et al.
    Department of Stomatognathic Physiology, Faculty of Odontology, Malmö University.
    Samuelsson, Mats
    Department of Neurobiology, Caring Sciences and Society, Karolinska Institutet.
    Ekdahl, Susanne
    Nyckeln Competence Center for Pedagogics in Healthcare, Kalmar County Hospital, Kalmar.
    Halling, Yvonne
    Unit of Stomatognathic Physiology, Specialist Dental Centre, Kalmar County Hospital, Kalmar.
    Öster, Anders
    Unit of Stomatognathic Physiology, Specialist Dental Centre, Kalmar County Hospital, Kalmar.
    Perseius, Kent-Inge
    Department of Neurobiology, Caring Sciences and Society, Karolinska Institutet.
    Experiences by patients and health professionals of a multidisciplinary intervention for long-term orofacial pain2013In: Journal of Multidisciplinary Healthcare, ISSN 1178-2390, E-ISSN 1178-2390, Vol. 6, p. 365-371Article in journal (Refereed)
    Abstract [en]

    The aim of the present study was to describe patients’ and health professionals’ experiences of a multidisciplinary stress-focused clinical evaluation with prolonged engagement as an intervention for patients with long-term orofacial pain. Data in the patient part of this study were collected by free-text questionnaires using open-ended questions. Data were collected by group interview in the part of the study concerning health professionals. All data were analyzed according to qualitative content analysis. Data from patients revealed three categories for the intervention, ie, “helpful for most and crucial for some”, “being listened to, respected and validated”, and “gives important coping strategies”. The results showed that a vast majority of patients described themselves as having been helped by the intervention. Some patients reported that meeting with the orofacial pain consultant team was crucial to the future course of their lives. Most patients described still having residual pain and symptoms, and only a few described their pain as being fully remitted. However, because of the intervention, the patients reported being able to adopt more constructive coping strategies. They also described their perception of the pain as being different, in that it was not so frightening once they had been given a model with which to understand it. Data from the health professionals revealed similar categories. Concordance between the patients' and health professionals' experiences was striking. In their descriptions, the health professionals and patients underscored the same components as being effective, with understanding, respect, and validation being the most important. The multidisciplinary approach was highlighted as being key to success by both the patients and health professionals.

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