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Baxter, R., Björk, S. & Edvardsson, D. (2019). Commentary on: Sullivan and Willis (2018). Towards Changing the Long-Term Care (LTC) Paradigm: Explicating the Concept of Thriving in Older Adults Living in LTC [Letter to the editor]. Issues in Mental Health Nursing, 40(7), 639-640
Open this publication in new window or tab >>Commentary on: Sullivan and Willis (2018). Towards Changing the Long-Term Care (LTC) Paradigm: Explicating the Concept of Thriving in Older Adults Living in LTC
2019 (English)In: Issues in Mental Health Nursing, ISSN 0161-2840, E-ISSN 1096-4673, Vol. 40, no 7, p. 639-640Article in journal, Letter (Refereed) Published
Place, publisher, year, edition, pages
TAYLOR & FRANCIS INC, 2019
National Category
Psychiatry Nursing
Identifiers
urn:nbn:se:umu:diva-162335 (URN)10.1080/01612840.2019.1590486 (DOI)000477964200014 ()31135240 (PubMedID)
Available from: 2019-08-20 Created: 2019-08-20 Last updated: 2019-12-11Bibliographically approved
Baxter, R., Sandman, P.-O., Björk, S. & Lood, Q. (2019). lluminating Meanings of Thriving for Persons Living in Nursing Homes. The Gerontologist
Open this publication in new window or tab >>lluminating Meanings of Thriving for Persons Living in Nursing Homes
2019 (English)In: The Gerontologist, ISSN 0016-9013, E-ISSN 1758-5341Article in journal (Refereed) Epub ahead of print
Abstract [en]

Background and Objectives: Thriving has been described as a multidimensional concept that can be used to explore place-related well-being; however, there has been limited research into the meaning of thriving in aged care. This study aimed to illuminate meanings of thriving as narrated by persons living in nursing homes.

Research Design and Methods: Narrative interviews were conducted with 21 persons residing in a rural Australian nursing home. The interviews were audio-recorded, transcribed, and interpreted using a phenomenological hermeneutic approach.

Results: Meanings of thriving could be understood as: Striving toward acceptance of being in a nursing home while maintaining a positive outlook; Feeling supported and cared for while maintaining a sense of independence; Balancing opportunities for solitude and company while living with others; and, Feeling a sense of home while residing in an institutional environment. The meanings of thriving, as presented through the interpretive lens of Gaston Bachelard’s “Poetics of Space,” encompassed having access to literal, metaphorical, and symbolic doors, as well as having the freedom to open, close, and use these doors however the person wishes.

Discussion: Exploring meanings of thriving in nursing homes could contribute towards understanding and implementing positive life-world constructs in research and practice. These findings could be used to inform and enhance person-centered care practices by maximizing opportunities for persons residing in nursing homes to have options and choices, and the agency to make decisions where possible, in relation to their everyday care and living environment.

Place, publisher, year, edition, pages
Oxford University Press, 2019
Keywords
Nursing, Phenomenology, Hermeneutics, Thriving, Well-being, Nursing home, Long-term care, Bachelard
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-165627 (URN)10.1093/geront/gnz142 (DOI)
Available from: 2019-12-02 Created: 2019-12-02 Last updated: 2019-12-11
Sköldunger, A., Wimo, A., Sjögren, K., Björk, S., Backman, A. C., Sandman, P.-O. & Edvardsson, D. (2019). Resource use and its association to cognitive impairment, ADL functions, and behavior in residents of Swedish nursing homes: Results from the U-Age program (SWENIS study). International Journal of Geriatric Psychiatry, 34(1), 130-136
Open this publication in new window or tab >>Resource use and its association to cognitive impairment, ADL functions, and behavior in residents of Swedish nursing homes: Results from the U-Age program (SWENIS study)
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2019 (English)In: International Journal of Geriatric Psychiatry, ISSN 0885-6230, E-ISSN 1099-1166, Vol. 34, no 1, p. 130-136Article in journal (Refereed) Published
Abstract [en]

Objectives: We aimed to investigate resource use and its association to cognitive impairment, activities of daily living, and neuropsychiatric symptoms in residents of Swedish nursing homes.

Methods: Data were collected in 2014 from a Swedish national sample of nursing home residents (n = 4831) and were collected by staff in the facility. The sample consists of all nursing homes in 35 of 60 randomly selected Swedish municipalities. Demographic data and data on resource use, cognitive and physical function as well as neuropsychiatric symptoms were collected through proxies. Descriptive statistics and regression modeling were used to investigate this association.

Results: We found that cognitive impairment, activities of daily living, and neuropsychiatric symptoms were associated with 23 hours per week increase in total resource use versus cognitively intact persons. This was also the case for being dependent in activities of daily living. Being totally dependent increased the amount of resource use by 25 hours per week. The sex of a resident did not influence the resource use. Annual costs of resource use with no functional dependency were 359 685 SEK, and in severely cognitive impaired resident, the cost was 825 081 SEK.

Conclusion: Being cognitively impaired as well as functionally dependent increases the resource use significantly in nursing homes. This has implications for differentiation of costs in institutional settings in health economic evaluations.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
ADL, care time, cognitive impairment, neuropsychiatric symptoms, nursing home, resource use, RUD
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-155089 (URN)10.1002/gps.5000 (DOI)000453797600017 ()30246433 (PubMedID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, dnr 2014-4016
Available from: 2019-01-10 Created: 2019-01-10 Last updated: 2019-01-10Bibliographically approved
Baxter, R., Lövheim, H., Björk, S., Sköldunger, A., Lindkvist, M., Sjögren, K., . . . Edvardsson, D. (2019). The thriving of older people assessment scale: Psychometric evaluation and short‐form development. Journal of Advanced Nursing
Open this publication in new window or tab >>The thriving of older people assessment scale: Psychometric evaluation and short‐form development
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2019 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648Article in journal (Refereed) Epub ahead of print
Abstract [en]

Aim: To evaluate the psychometric properties and performance of the 32‐item Thriving of Older People Assessment Scale (TOPAS) and to explore reduction into a short‐form.

Background: The 32‐item TOPAS has been used in studies of place‐related well‐being as a positive measure in long‐term care to assess nursing home resident thriving; however, item redundancy has not previously been explored.

Design: Cross‐sectional.

Method: Staff members completed the 32‐item TOPAS as proxy‐raters for a random sample of Swedish nursing home residents (N = 4,831) between November 2013 and September 2014. Reliability analysis, exploratory factor analysis and item response theory‐based analysis were undertaken. Items were systematically identified for reduction using statistical and theoretical analysis. Correlation testing, means comparison and model fit evaluation confirmed scale equivalence.

Results: Psychometric properties of the 32‐item TOPAS were satisfactory and several items were identified for scale reduction. The proposed short‐form TOPAS exhibited a high level of internal consistency (α=0.90) and strong correlation (r=0.98) to the original scale, while also retaining diversity among items in terms of factor structure and item difficulties.

Conclusion: The 32‐item and short‐form TOPAS' indicated sound validity and reliability to measure resident thriving in the nursing home context.

Impact: There is a lack of positive life‐world measures for use in nursing homes. The short‐form TOPAS indicated sound validity and reliability to measure resident thriving, providing a feasible measure with enhanced functionality for use in aged care research, assessments and care planning for health promoting purposes in nursing homes.

Keywords
instrument development, scale reduction, psychometrics, thriving, TOPAS, place‐related well‐being, nursing home residents, long‐term care, nursing
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-162729 (URN)10.1111/jan.14180 (DOI)000485117600001 ()31441533 (PubMedID)2-s2.0-85071953661 (Scopus ID)
Available from: 2019-08-27 Created: 2019-08-27 Last updated: 2019-12-11
Björk, S., Lindkvist, M., Lövheim, H., Bergland, Å., Wimo, A. & Edvardsson, D. (2018). Exploring resident thriving in relation to the nursing home environment: A cross‐sectional study. Journal of Advanced Nursing, 74(12), 2820-2830
Open this publication in new window or tab >>Exploring resident thriving in relation to the nursing home environment: A cross‐sectional study
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2018 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 74, no 12, p. 2820-2830Article in journal (Refereed) Published
Abstract [en]

Aim: To explore the extent to which environmental factors are associated with resident thriving. Background: Thriving is a concept that denotes experiences of well-being in relation to the living environment. Although there is a substantial body of research into quality of life in nursing homes, less is known about what contributes to thriving among residents. Recent research on resident thriving has focused mainly on resident characteristics and activities associated with thriving. Less attention has been given to explore associations with the physical and psychosocial environment of the nursing home. This study explores facility- and unit-level factors associated with resident thriving. Design: A cross-sectional national survey. Methods: Data on 4,205 residents, 3,509 staff, and environment of 147 nursing home facilities collected in 2013–2014 were analysed using descriptive statistics, multilevel simple, and multiple linear regression to explore resident thriving in relation to environmental factors. Results: Multilevel analysis revealed that residents’ thriving varied significantly across nursing home units. Several environmental factors were associated with thriving in univariate analyses. However, a positive psychosocial climate of units, having access to newspapers, living in a special care unit, and living in an unlocked facility showed significant positive associations with resident thriving when controlling for resident characteristics. The psychosocial climate showed the strongest association of the environment variables with resident thriving. Conclusions: Nursing home environments may have an impact on residents’ thriving. A positive psychosocial climate of units seems to have an important role in facilitating thriving in nursing home residents.

Place, publisher, year, edition, pages
John Wiley & Sons, 2018
Keywords
cross-sectional study, older people, environment, nursing, nursing homes, proxy, psychosocial environment, thriving
National Category
Nursing
Research subject
Caring Sciences
Identifiers
urn:nbn:se:umu:diva-139061 (URN)10.1111/jan.13812 (DOI)000452529800014 ()30043451 (PubMedID)2-s2.0-85053192917 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2014-4016Swedish Research Council, 521-2014-2715
Note

Originally included in thesis in manuscript form.

Available from: 2017-09-06 Created: 2017-09-06 Last updated: 2019-01-23Bibliographically approved
Björk, S., Lövheim, H., Lindkvist, M., Wimo, A. & Edvardsson, D. (2018). Thriving in relation to cognitive impairment and neuropsychiatric symptoms in Swedish nursing home residents. International Journal of Geriatric Psychiatry, 33(1), E49-E57
Open this publication in new window or tab >>Thriving in relation to cognitive impairment and neuropsychiatric symptoms in Swedish nursing home residents
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2018 (English)In: International Journal of Geriatric Psychiatry, ISSN 0885-6230, E-ISSN 1099-1166, Vol. 33, no 1, p. E49-E57Article in journal (Refereed) Published
Abstract [en]

Objectives: The purpose of this study was to explore relations among thriving, cognitive function, and neuropsychiatric symptoms (NPS) in nursing home residents.

Methods: A national, cross-sectional, randomized study of Swedish nursing home residents (N = 4831) was conducted between November 2013 and September 2014. Activities of daily life functioning, cognitive functioning, NPS, and thriving were assessed with the Katz activities of daily living, Gottfries' Cognitive Scale, Nursing Home version of the Neuropsychiatric Inventory, and Thriving of Older People Scale, respectively. Individual NPS were explored in relation to cognitive function. Simple linear and multiple regression models were used to explore thriving in relation to resident characteristics.

Results: Aggression and depressive symptoms were identified as negatively associated with thriving regardless of resident cognitive functioning. At higher levels of cognitive functioning, several factors showed associations with thriving; however, at lower levels of cognitive functioning, only the degree of cognitive impairment and the NPS was associated with thriving. Most of the individual NPS formed nonlinear relationships with cognitive functioning with higher symptom scores in the middle stages of cognitive functioning. Exceptions were elation/euphoria and apathy, which increased linearly with severity of cognitive impairment.

Conclusions: The lower the cognitive functioning was, the fewer factors were associated with thriving. Aggression and depressive symptoms may indicate lower levels of thriving; thus, targeting these symptoms should be a priority in nursing homes.

Place, publisher, year, edition, pages
John Wiley & Sons, 2018
Keywords
neuropsychiatric symptoms, dementia, nursing homes, frail elderly, thriving, quality of life, cross-sectional study
National Category
Nursing Geriatrics Gerontology, specialising in Medical and Health Sciences
Identifiers
urn:nbn:se:umu:diva-133431 (URN)10.1002/gps.4714 (DOI)000418408100006 ()28370353 (PubMedID)
Available from: 2017-04-10 Created: 2017-04-10 Last updated: 2018-06-09Bibliographically approved
Björk, S. (2017). Exploring resident thriving in Swedish nursing homes: the Umeå Ageing and Health Research Programme (U-Age) Thesis I. (Doctoral dissertation). Umeå: Umeå universitet
Open this publication in new window or tab >>Exploring resident thriving in Swedish nursing homes: the Umeå Ageing and Health Research Programme (U-Age) Thesis I
2017 (English)Doctoral thesis, comprehensive summary (Other academic)
Alternative title[sv]
Trivsel i svenska särskilda boenden för äldre
Abstract [en]

Background

The population living in nursing homes is generally characterized by high age and female sex, as well as by physical and cognitive impairments. Also, negative symptoms such as pain and neuropsychiatric symptoms are reportedly common. Care in Swedish nursing homes is regulated by law and national guidelines implying that care is to be tailored to resident preferences and needs in order to facilitate their well-being. However, there is no national data source on the characteristics of nursing home residents or on measures of their well-being. Thriving and not merely surviving in nursing homes has been described as a subjective experience of place-related well-being resulting from interaction between residents and the nursing home environment in terms of the quality of care and caregivers, as well as from the physical and psychosocial environment. However, there is a gap in knowledge of whether and, if so, to what extent resident characteristics and factors in the nursing home environment are associated with resident thriving in nursing homes.

Aim

The overall aim of this thesis is to explore resident thriving in Swedish nursing homes, and the extent to which resident characteristics, neuropsychiatric symptoms, activities, and environmental factors are associated with resident thriving.

Methods

This thesis is based on cross-sectional baseline data from a national inventory of health and care in Swedish nursing homes collected in 2013–2014. The resident sample covered 4831 residents in 548 units from 172 nursing homes in 35 Swedish municipalities. The data were explored using descriptive statistics, as well as simple and multiple linear regression analyses and multilevel linear regression analyses. Resident characteristics and symptom prevalence as well as their associations with thriving; and engagement in everyday activities and their associations with thriving were explored in a sample comprising 4831 nursing home residents from 172 nursing homes. Associations between resident thriving and resident living conditions, nursing home facility and unit characteristics, and the psychosocial climate of units were explored in a sample comprising 4205 residents from 147 nursing homes.

Results

Engagement in everyday activities was positively associated with resident thriving, the strongest associations being found for engagement in an activity programme, dressing nicely, and spending time with someone the resident likes. 

Environmental factors associated with thriving were a positive psychosocial climate at the unit, having access to newspapers, residing in a special care unit, and residing in a facility that was unlocked during the day. Cognitive functioning was strongly associated with resident thriving. Aggressive and depressive symptoms were found to be negatively associated with resident thriving regardless of levels of cognitive functioning.

Conclusions

Engagement in everyday activities can support thriving and can be conceptualized and implemented as nursing interventions to facilitate thriving in nursing homes. Factors in the nursing home environment can support resident thriving; in particular, the psychosocial climate of units seems to have a great influence. Aggressive and depressive symptoms were associated with lower levels of thriving. Targeting these symptoms would therefore seem to be a priority in nursing homes. The population living in Swedish nursing homes has a high prevalence of neuropsychiatric symptoms and cognitive impairment. Residents with cognitive impairment also commonly resided in general units. As all data were cross-sectional, longitudinal studies would be valuable to further explore causality. As resident data were based on proxy ratings, future research exploring residents’ perspectives on thriving would be valuable. The present findings contribute to our understanding of nursing home residents’ complex care needs and identify factors that could have an impact on their well-being. These findings can provide benchmark estimates for further research, quality assessment activities, as well as further clinical development work. 

Abstract [sv]

Populationen som bor i särskilda boenden kännetecknas allmänt av hög ålder, förekomst av fysiska och kognitiva funktionsnedsättningar och majoriteten är kvinnor. Smärta och neuropsykiatriska symtom har också rapporterats vara vanliga. Vård och omsorg i svenska särskilda boenden regleras av lag och nationella riktlinjer som gör gällande att äldre personer har rätt till en aktiv och meningsfull tillvaro tillsammans med andra och det bör vara möjligt för äldre människor att leva självständigt och under trygga förhållanden. Den vård och omsorg som ges bör vara personcentrerad och därigenom anpassad till de äldre personernas behov för att underlätta deras välbefinnande. Dock saknas det nationell data om de äldre personernas fysiska och kognitiva förmåga. Det är även okänt i vilken grad personer i svenska särskilda boenden för äldre deltar i vardagliga aktiviteter. Att trivas i särskilda boenden har beskrivits som ett resultat av en optimal interaktion mellan personen själv och kvaliteter i miljön så som omsorgen och personalens kvalitet samt fysisk- och psykosocial miljö. Det finns emellertid en kunskapslucka när det gäller om, samt i vilken utsträckning personernas egen karaktäristika, deltagande i vardagliga aktiviteter och enskilda faktorer i boendemiljön är associerade med deras trivsel. Denna avhandling undersöker faktorer av betydelse för trivsel i svenska särskilda boenden för äldre med fokus på karaktäristika, deltagande i aktiviteter samt faktorer i den fysiska och psykosociala miljön.

Avhandlingens fyra delstudier baseras på tvärsnittsdata från enkätundersökningen Svensk nationell inventering av vård och hälsa inom särskilda boenden (SWENIS) som genomfördes 2013 – 2014 i 172 särskilda boenden i 35 kommuner. Insamlade data omfattar uppgifter om de äldre, personalen samt boendet. I de tre första delstudierna (I-III) användes ett urval som omfattade 4831 äldre. Proxyskattningar av de äldre personernas trivsel, karaktäristika (ålder, kön, kognitiv förmåga, ADL förmåga), samt förekomst av symtom (smärta och neuropsykiatriska symptom) och skattningar av deltagande i vardagliga aktiviteter utfördes av personalen. I delstudie IV användes ett matchat dataset innehållande proxyskattningar av de äldre personernas trivsel och karaktäristika (n=4205); personalens självskattningar av psykosociala klimatet på avdelningen (n=3509); samt karaktäristika på 147 särskilda boenden. Datat analyserades med beskrivande statistik, enkla och multipla linjära regressionsanalyser och flernivåsmodeller.

Huvudresultatet visade att ett deltagande i vardagliga aktiviteter var positivt associerat med trivsel. Deltagande i ett aktivitetsprogram, att klä sig fint samt att spendera tid med någon som personen tycker om uppvisade de starkaste associationerna med trivsel. De faktorer i boendemiljön som var positivt associerade med de äldre personernas trivsel var ett positivt psykosocialt klimat på avdelningen, tillgång till dagstidningar, att bo på demensenhet samt att bo på ett särskilt boende där entrédörren var upplåst under dagtid. Aggressiva och depressiva symptom visade sig vara negativt associerade med trivsel oavsett grad av kognitiv funktion. Vidare var den kognitiva förmågan var starkt associerad med personernas trivsel. Resultatet visade också att de som bor i svenska särskilda boenden för äldre har en hög förekomst av neuropsykiatriska symtom och kognitiv svikt. Personer med kognitiv svikt bodde också i hög utsträckning på vanliga avdelningar.

Sammantaget visar avhandlingen att deltagande i vardagliga aktiviteter kan stödja trivsel. Vardagliga aktiviteter skulle därmed kunna användas som omvårdnadsåtgärder i syfte att främja trivsel i särskilda boenden. Även faktorer i det särskilda boendets miljö kan stödja personernas trivsel, varav det psykosociala klimatet på avdelningen verkar kunna ha ett stort inflytande. Aggressiva och depressiva symtom kan indikera lägre nivåer av trivsel. Att inrikta omvårdnaden på att förebygga och lindra dessa symptom borde därmed prioriteras. Fortsatta studier, i synnerhet longitudinella kvalitativa och kvantitativa studier för att avgöra vilka faktorer som är relaterade till en förändring av trivsel skulle vara värdefulla. Intervjustudier där äldre personer med kognitiv svikt får ge sin syn på faktorer av betydelse för trivsel i särskilda boenden skulle vara värdefullt.

Resultaten i denna avhandling bidrar med en ökad förståelse för de komplexa omvårdnadsbehov som personer i särskilda boenden för äldre har, samt om faktorer som har betydelse för deras trivsel. Avhandlingen tillhandahåller även riktvärden som skulle kunna användas vid ytterligare forskning, kvalitetsbedömning samt vid kliniskt utvecklingsarbete.

Place, publisher, year, edition, pages
Umeå: Umeå universitet, 2017. p. 63
Series
Umeå University medical dissertations, ISSN 0346-6612 ; 1907
Keywords
Thriving, everyday activities, environment, cognitive impairment, neuropsychiatric symptoms, nursing homes, nursing, Trivsel, vardagliga aktiviteter, miljö, kognitiv svikt, neuropsykiatriska symptom, särskilda boenden, omvårdnad
National Category
Nursing
Research subject
Caring Sciences
Identifiers
urn:nbn:se:umu:diva-139057 (URN)978-91-7601-752-4 (ISBN)
Public defence
2017-09-29, Vårdvetarhuset Aula, Umeå, 09:00 (Swedish)
Opponent
Supervisors
Projects
U-Age
Funder
Vårdal FoundationThe Kempe FoundationsForte, Swedish Research Council for Health, Working Life and WelfareSwedish Research Council
Available from: 2017-09-08 Created: 2017-09-06 Last updated: 2018-06-09Bibliographically approved
Björk, S., Lindkvist, M., Wimo, A., Juthberg, C., Bergland, Å. & Edvardsson, D. (2017). Residents' engagement in everyday activities and its association with thriving in nursing homes. Journal of Advanced Nursing, 73(8), 1884-1895
Open this publication in new window or tab >>Residents' engagement in everyday activities and its association with thriving in nursing homes
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2017 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 73, no 8, p. 1884-1895Article in journal (Refereed) Published
Abstract [en]

Aim: To describe the prevalence of everyday activity engagement for older people in nursing homes and the extent to which engagement in everyday activities is associated with thriving.

Background: Research into residents’ engagement in everyday activities in nursing homes has focused primarily on associations with quality of life and prevention and management of neuropsychiatric symptoms. However, the mere absence of symptoms does not necessarily guarantee experiences of well-being. The concept of thriving encapsulates and explores experiences of well-being in relation to the place where a person lives.

Design: A cross-sectional survey.

Method: A national survey of 172 Swedish nursing homes (2013–2014). Resident (= 4831) symptoms, activities and thriving were assessed by staff using a study survey based on established questionnaires. Descriptive statistics, simple and multiple linear regression, and linear stepwise multiple regression were performed.

Results: The most commonly occurring everyday activities were receiving hugs and physical touch, talking to relatives/friends and receiving visitors, having conversation with staff not related to care and grooming. The least commonly occurring everyday activities were going to the cinema, participating in an educational program, visiting a restaurant and doing everyday chores. Positive associations were found between activity engagement and thriving, where engagement in an activity program, dressing nicely and spending time with someone the resident likes had the strongest positive association with resident thriving.

Conclusions: Engagement in everyday activities can support personhood and thriving and can be conceptualized and implemented as nursing interventions to enable residents to thrive in nursing homes.

Place, publisher, year, edition, pages
John Wiley & Sons, 2017
Keywords
cross-sectional study, frail elderly, leisure activities, nursing, nursing homes, thriving
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-133484 (URN)10.1111/jan.13275 (DOI)000405289800011 ()
Available from: 2017-04-10 Created: 2017-04-10 Last updated: 2018-06-09Bibliographically approved
Lood, Q., Björk, S., Sköldunger, A., Backman, A., Sjögren, K. & Edvardsson, D. (2017). The relative impact of symptoms, resident characteristics and features of nursing homes on residents’ participation in social occupations: cross-sectional findings from U-Age Swenis. Journal of Occupational Science, 24(3), 327-337
Open this publication in new window or tab >>The relative impact of symptoms, resident characteristics and features of nursing homes on residents’ participation in social occupations: cross-sectional findings from U-Age Swenis
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2017 (English)In: Journal of Occupational Science, ISSN 1442-7591, E-ISSN 2158-1576, Vol. 24, no 3, p. 327-337Article in journal (Refereed) Published
Abstract [en]

Social occupations have been described as meaningful occupations, and a determinant of health in old age. With ageing populations, and increased need for nursing home care, it is therefore important to support participation in social occupations in nursing homes. However, the limited evidence on factors that may have an impact on nursing home residents’ participation in social occupations makes it difficult to know how and when to support their participation and who to target. Therefore, the aim of this study was to explore the impact of symptoms, resident characteristics and features of nursing homes on residents’ participation in social occupations. In a sample of 4,451 nursing home residents, the average number of social occupations participated in during the week preceding data collection was 5.8. Additionally, participation in social occupations was positively influenced by fewer symptoms of cognitive impairment, female sex, shorter length of stay, and living in a dementia specific care unit. The study thereby contributes with knowledge on populations at risk for occupational deprivation, and implications for understanding who to target with interventions to promote social occupations and when. However, very little is known about how to design interventions to support nursing home residents’ occupational opportunities, and what occupations they desire and need. Further research is therefore needed to identify nursing home residents’ occupational opportunities, wishes and needs in relation to environmental barriers, individual characteristics, and individual choice.

Place, publisher, year, edition, pages
Taylor & Francis, 2017
Keywords
Residential aged care, elderly, meaningful occupation, cognitive impairment, gender
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-133301 (URN)10.1080/14427591.2017.1306721 (DOI)000414755000007 ()
Available from: 2017-04-03 Created: 2017-04-03 Last updated: 2018-06-09Bibliographically approved
Björk, S., Juthberg, C., Lindkvist, M., Wimo, A., Sandman, P.-O., Winblad, B. & Edvardsson, D. (2016). Exploring the prevalence and variance of cognitive impairment, pain, neuropsychiatric symptoms and ADL dependency among persons living in nursing homes: a cross-sectional study. BMC Geriatrics, 16, Article ID 154.
Open this publication in new window or tab >>Exploring the prevalence and variance of cognitive impairment, pain, neuropsychiatric symptoms and ADL dependency among persons living in nursing homes: a cross-sectional study
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2016 (English)In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 16, article id 154Article in journal (Refereed) Published
Abstract [en]

Background: Earlier studies in nursing homes show a high prevalence of cognitive impairment, dependency in activities of daily living (ADL), pain, and neuropsychiatric symptoms among residents. The aim of this study was to explore the prevalence of the above among residents in a nationally representative sample of Swedish nursing homes, and to investigate whether pain and neuropsychiatric symptoms differ in relation to gender, cognitive function, ADL-capacity, type of nursing-home unit and length of stay. Methods: Cross-sectional data from 188 randomly selected nursing homes were collected. A total of 4831 residents were assessed for cognitive and ADL function, pain and neuropsychiatric symptoms. Data were analysed using descriptive statistics and the chi-square test. Results: The results show the following: the prevalence of cognitive impairment was 67 %, 56 % of residents were ADL-dependent, 48 % exhibited pain and 92 % exhibited neuropsychiatric symptoms. The prevalence of pain did not differ significantly between male and female residents, but pain was more prevalent among cognitively impaired and ADL-dependent residents. Pain prevalence was not significantly different between residents in special care units for people with dementia (SCU) and general units, or between shorter-and longer-stay residents. Furthermore, the prevalence of neuropsychiatric symptoms did not differ significantly between male and female residents, between ADL capacities or in relation to length of stay. However, residents with cognitive impairment and residents in SCUs had a significantly higher prevalence of neuropsychiatric symptoms than residents without cognitive impairment and residents in general units. Conclusions: The prevalence rates ascertained in this study could contribute to a greater understanding of the needs of nursing-home residents, and may provide nursing home staff and managers with trustworthy assessment scales and benchmark values for further quality assessment purposes, clinical development work and initiating future nursing assessments.

Place, publisher, year, edition, pages
BioMed Central, 2016
Keywords
Nursing homes, Frail elderly, Dementia, Pain, Activities of daily living, Neuropsychiatric symptoms, evalence, Cross-sectional study
National Category
Geriatrics Gerontology, specialising in Medical and Health Sciences
Identifiers
urn:nbn:se:umu:diva-125541 (URN)10.1186/s12877-016-0328-9 (DOI)000381732700001 ()27549203 (PubMedID)
Available from: 2016-09-16 Created: 2016-09-13 Last updated: 2018-06-07Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-8107-2860

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