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  • 1.
    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.

  • 2.
    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.

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