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Lämås, Kristina
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Publications (10 of 29) Show all publications
Gustafsson, M., Lämås, K., Isaksson, U., Sandman, P.-O. & Lövheim, H. (2019). Constipation and laxative use among people living in nursing homes in 2007 and 2013. BMC Geriatrics, 19, Article ID 38.
Open this publication in new window or tab >>Constipation and laxative use among people living in nursing homes in 2007 and 2013
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2019 (English)In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 19, article id 38Article in journal (Refereed) Published
Abstract [en]

Background: Constipation is a common condition among older people, particularly among people living in nursing homes, and the use of drugs such as opioids is one of many factors that contribute to its high prevalence. The aim of this study was to compare the prevalence of constipation and the use of laxatives between 2007 and 2013, to analyze constipation and laxative use among people who are prescribed opioids, and to identify factors associated with constipation. Methods: In 2007 and 2013, two surveys were performed in the county of Vasterbotten in Northern Sweden, comprising all those living in nursing homes. The Multi-Dimensional Dementia Assessment Scale was used to collect data regarding laxative, opioid and anticholinergic drug use, functioning in activities of daily living (ADL), cognition and symptoms of constipation. A comparison was made between 2820 people from 2007 and 1902 people from 2013. Results: The prevalence of symptoms of constipation among people living in nursing homes increased from 36% in 2007 to 40% in 2013. After controlling for age, sex, ADL, cognitive impairment and use of opioid and anticholinergic drugs, this difference was found to be statistically significant. When controlled for demographic changes, there was a statistically significant difference in the regular use of laxatives between the respective years, from 46% in 2007 to 59% in 2013. People prescribed opioids and anticholinergic drugs were at increased risk of constipation, while people with a higher ADL score were at decreased risk. Further, among people prescribed opioids and rated as constipated, 35% in 2007 and 20% in 2013 were not prescribed laxatives for regular use, a difference that was found to be statistically significant. Conclusions: The prevalence of symptoms of constipation increased between 2007 and 2013. Although there was a decrease between the years, there were still a number of people being prescribed with opioids and rated as constipated who were not treated with laxatives. This study therefore indicates that constipation remains a significant problem among people in nursing homes and also indicates that those prescribed opioids could benefit from an increased awareness of the risk of constipation and treatment, if required.

Place, publisher, year, edition, pages
BMC, 2019
Keywords
Constipation, Laxatives, Dementia, Nursing homes
National Category
Gerontology, specialising in Medical and Health Sciences Geriatrics
Identifiers
urn:nbn:se:umu:diva-162507 (URN)10.1186/s12877-019-1054-x (DOI)000458136800002 ()30736737 (PubMedID)
Available from: 2019-08-21 Created: 2019-08-21 Last updated: 2019-08-21Bibliographically approved
Bay, A., Lämås, K., Berghammer, M., Sandberg, C. & Johansson, B. (2019). Enablers and barriers for physical activity in adults with congenital heart disease. In: : . Paper presented at Berzelius symposium 99, The Cardiac Patient from Birth to Adulthood, Stockholm, Sweden, 21-22 February 2019..
Open this publication in new window or tab >>Enablers and barriers for physical activity in adults with congenital heart disease
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2019 (English)Conference paper, Oral presentation only (Refereed)
National Category
Cardiac and Cardiovascular Systems Nursing Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Caring Sciences
Identifiers
urn:nbn:se:umu:diva-156923 (URN)
Conference
Berzelius symposium 99, The Cardiac Patient from Birth to Adulthood, Stockholm, Sweden, 21-22 February 2019.
Available from: 2019-03-01 Created: 2019-03-01 Last updated: 2019-03-07Bibliographically approved
Bölenius, K., Lämås, K., Sandman, P.-O., Lindkvist, M. & Edvardsson, D. (2019). Perceptions of self-determination and quality of life among Swedish home care recipients - across-sectional study. BMC Geriatrics, 19, Article ID 142.
Open this publication in new window or tab >>Perceptions of self-determination and quality of life among Swedish home care recipients - across-sectional study
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2019 (English)In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 19, article id 142Article in journal (Refereed) Published
Abstract [en]

Background: It is acknowledged that preservation of self-determination is very important in order for older adults to experience good quality of life, but to what degree and in what areas people receiving help from home care service experience self-determination is unknown. Few studies have examined the perception of self-determination in relation to quality of life among older adults living at home with help from home care services. Thus, the aim of this study was to explore perceptions of self-determination among older adults living at home with the support of home care services, and to test whether older adults who perceive a higher degree of self-determination also feel they have a better quality of life.

Methods: This cross-sectional study was conducted in one municipality in northern Sweden. A total of 134 older adults (≥ 65 years) were included. Data were collected by means of a survey including questionnaires about background characteristics, self-determination, and health-related quality of life. Descriptive statistics regarding background characteristics for groups with high and low self-determination respectively were presented and the differences between the groups were analyzed using the Chi-square test and the Mann-Whitney U test.

Results: Our main finding shows that the majority of older adults with support from home care services experience self-determination in the dimensions use of time, and self-care. However, a wide variation was found in self-reported self-determination in all dimensions. Results also show that the group with higher self-reported self-determination also reported a greater degree of experienced quality of life in comparison with the group with lower self-reported self-determination.

Conclusions: In line with earlier research, our results found a positive relation between self-determination and quality of life. The results are relevant for the care of older adults and indicate a need of further research. The results presented in this paper could serve as a guide when planning for improved self-determination among older adults in home care service.

Place, publisher, year, edition, pages
BioMed Central, 2019
Keywords
Aged care, Health, Home care services, Nursing care, Older adults, Older people, Self-determination, Quality of life
National Category
Geriatrics
Identifiers
urn:nbn:se:umu:diva-160298 (URN)10.1186/s12877-019-1145-8 (DOI)000468889900006 ()31126243 (PubMedID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare
Available from: 2019-06-17 Created: 2019-06-17 Last updated: 2019-06-17Bibliographically approved
Norberg, C., Santamäki Fischer, R., Isaksson, U. & Lämås, K. (2019). Something wonderful and incomprehensible: Expressions and experiences of spirituality among very old people.
Open this publication in new window or tab >>Something wonderful and incomprehensible: Expressions and experiences of spirituality among very old people
2019 (English)In: Article in journal (Refereed) Epub ahead of print
Abstract [en]

This study aimed to illuminate very old people’s experiences and expressions of spirituality and is a part of the Umeå 85+/Gerontological Regional Database (GERDA). The participants (n = 12) had declared an interest in spirituality, were 86–99 years of age, and were interviewed in their own homes. The interviews were analyzed using qualitative content analysis. The findings revealed that spirituality was experienced as being in communion, transcending life’s circumstances, and living in a spiritual reality. Spirituality was expressed as an inner sense of communion with God and with other people, and as a spiritual reality. The participants expressed a desire to talk about spiritual experiences and personal beliefs but regarded spirituality as an uncommon topic. Nurses and other professionals need to be aware of spiritual needs and prepared to give spiritual care.

Keywords
Personal beliefs, spiritual needs, transcendence, Umeå 85+/GERDA, nursing, experiences
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-163507 (URN)10.1080/20440243.2019.1658265 (DOI)2-s2.0-85072014668 (Scopus ID)
Available from: 2019-09-24 Created: 2019-09-24 Last updated: 2019-10-03
Bay, A., Berghammer, M., Lämås, K., Sandberg, C. & Johansson, B. (2018). Facilitators and barriers for physical activity in adults with congenital heart disease. In: European Heart Journal: ESC Congress 2018 25 - 29 August Munich, Germany. Paper presented at European Society of Cardiology (ESC), Munich, Germany, 25-29 August 2018.. Oxford University Press, 39, Article ID P5433.
Open this publication in new window or tab >>Facilitators and barriers for physical activity in adults with congenital heart disease
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2018 (English)In: European Heart Journal: ESC Congress 2018 25 - 29 August Munich, Germany, Oxford University Press, 2018, Vol. 39, article id P5433Conference paper, Poster (with or without abstract) (Refereed)
Place, publisher, year, edition, pages
Oxford University Press, 2018
Series
European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645
National Category
Cardiac and Cardiovascular Systems Nursing Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Caring Sciences
Identifiers
urn:nbn:se:umu:diva-156922 (URN)10.1093/eurheartj/ehy566.P5433 (DOI)
Conference
European Society of Cardiology (ESC), Munich, Germany, 25-29 August 2018.
Note

Issue supplement 1, August 2018

Available from: 2019-03-01 Created: 2019-03-01 Last updated: 2019-03-07Bibliographically approved
Bay, A., Berghammer, M., Lämås, K., Sandberg, C. & Johansson, B. (2018). Facilitators and barriers for physical activity in adults with congenital heart disease. Paper presented at European-Society-of-Cardiology Congress, AUG 25-29, 2018, Munich, GERMANY. European Heart Journal, 39, 1120-1121
Open this publication in new window or tab >>Facilitators and barriers for physical activity in adults with congenital heart disease
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2018 (English)In: European Heart Journal, ISSN 0195-668X, E-ISSN 1522-9645, Vol. 39, p. 1120-1121Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Background: A majority of adults with congenital heart disease (CHD) have reduced exercise capacity and do not reach the recommended level of physical activity. A physically active lifestyle is essential to maintain health and counteract acquired cardiovascular disease. This study illuminates aspects that may be relevant for performing physical activity.

Purpose: To describe facilitators and barriers for physical activity in adults with CHD.

Methods: Semi-structured interviews were performed individually with fourteen adults (age 19–68 years, women=7) with complex CHD. The interviews were analyzed using qualitative content analysis.

Results: Aspects that may enable or inhibit physical activity were found in two domains; Facilitators and Barriers, which both consisted of four categories physical, psychological, psychosocial and environmental aspects (Table 1).

This can be exemplified by the category physical aspects; where persons expressed being limited by the CHD to perform physical activity, but also that improved aerobic fitness allows for being more active, and in the category psychosocial aspects; the person's previous negative experiences and lack of support constituted barriers while encouragement from others and being active as a child facilitated an active lifestyle in adult age.

Conclusion: The present study identifies barriers and facilitators for being physically active in adults living with CHD. It is essential to identify prerequisites for supporting and promoting physical activity and thereby hopefully prevent long-term adverse outcomes. Barriers can potentially be transformed to facilitators through increased knowledge in both the adult with CHD and the healthcare provider.

Place, publisher, year, edition, pages
Oxford University Press, 2018
National Category
Cardiac and Cardiovascular Systems Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-157621 (URN)10.1093/eurheartj/ehy566.P5433 (DOI)000459824003524 ()
Conference
European-Society-of-Cardiology Congress, AUG 25-29, 2018, Munich, GERMANY
Note

Supplement: 1

Meeting Abstract: P5433

Available from: 2019-03-26 Created: 2019-03-26 Last updated: 2019-03-26Bibliographically approved
Bay, A., Lämås, K., Berghammer, M., Sandberg, C. & Johansson, B. (2018). It ́s like balancing on a slackline: A description from adults living with congenital heart disease. Paper presented at 52nd Annual Meeting of the Association for European Paediatric and Congenital Cardiology (AEPC), Athens, May 9-12, 2018. Cardiology in the Young, 28(Suppl. S1), S37-S37
Open this publication in new window or tab >>It ́s like balancing on a slackline: A description from adults living with congenital heart disease
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2018 (English)In: Cardiology in the Young, ISSN 1047-9511, E-ISSN 1467-1107, Vol. 28, no Suppl. S1, p. S37-S37Article in journal, Meeting abstract (Refereed) Published
Abstract [en]

Introduction: Several studies have shown that adults with congenital heart disease have reduced exercise capacity and do not reach the recommended daily level of physical activity. With this in view, it is of great importance to investigate how this population experiences physical activity. The aim of the study is to illuminate how adults with congenital heart disease describes themselves in relation to physical activity.

Methods: Semi-structured interviews with fourteen adults with complex congenital heart disease were performed. Patients were recruited from the clinic waiting list, based on their scheduled follow up and diagnosis. Interviews were analysed by qualitative content analysis.

Results: The overall theme It´s like balancing on a slackline illustrates how adults with congenital heart disease described themselves in relation to physical activity. The overall theme consists of four themes: Being an adventurer- enjoying the challenges of physical activity, Being a realist- adapting to physical ability, Beinga non-doer- lacking prerequisites for physical activity and Being an outsider- feeling excluded depending on physical ability.

Conclusions: The descriptions on themselves as a physically active were not constant or one-dimensional and the descriptions varied during the interviews, related to different time periods in life. It meant that they could described themselves as being an adventurer liking tough challenges, but at the same time describing themselves as being a non-doer with uncertainty over their physical strength. The findings point out specific factors for adults with CHD that might constitute as obstacles, but also possibilities for being physically active.

Place, publisher, year, edition, pages
Cambridge University Press, 2018
National Category
Nursing
Research subject
Caring Sciences
Identifiers
urn:nbn:se:umu:diva-156921 (URN)10.1017/S1047951118000318 (DOI)
Conference
52nd Annual Meeting of the Association for European Paediatric and Congenital Cardiology (AEPC), Athens, May 9-12, 2018
Available from: 2019-03-01 Created: 2019-03-01 Last updated: 2019-03-20Bibliographically approved
Bay, A., Lämås, K., Berghammer, M., Sandberg, C. & Johansson, B. (2018). It's like balancing on a slackline: a description of how adults with congenital heart disease describe themselves in relation to physical activity. Journal of Clinical Nursing, 27(15-16), 3131-3138
Open this publication in new window or tab >>It's like balancing on a slackline: a description of how adults with congenital heart disease describe themselves in relation to physical activity
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2018 (English)In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 15-16, p. 3131-3138Article in journal (Refereed) Published
Abstract [en]

AIMS AND OBJECTIVES: To illuminate how adults with CHD describe themselves in relation to physical activity.

BACKGROUND: Several studies have shown that adults with congenital heart disease (CHD) have reduced exercise capacity and do not reach the recommended daily level of physical activity. With this in view, it is of immense importance to investigate how this population experiences physical activity.

DESIGN: Qualitative study with semi-structured interviews analysed with qualitative content analysis.

METHODS: Semi-structured interviews were individually performed with fourteen adults (women=7, age 19-68 years) with complex CHD. Patients were purposively recruited from the clinic waiting list, based on a scheduled follow-up and diagnosis.

RESULTS: The overall theme, It's like balancing on a slackline, illustrates how adults with CHD described themselves in relation to physical activity. This overall theme consisted of four subthemes: (1) Being an adventurer- enjoying the challenges of physical activity; (2) Being a realist- adapting to physical ability; (3) Being a non-doer- lacking prerequisites for physical activity; and (4) Being an outsider- feeling excluded depending on physical ability.

CONCLUSIONS: Adults with CHD seem to have a diverse relationship to physical activity and it involves various aspects throughout the lifespan. The findings point out factors that might constitute as obstacles for being physically active, specific for people with chronic conditions like CHD. This highlights the importance of further exploring the hindering and facilitating factors for being physically active in order to get a deeper understanding of how to support adults with CHD to be physically active.

RELEVANCE TO CLINICAL PRACTICE: Given the diverse relationship to physical activity, nurses have to further investigate the patients' relationship to physical activity, in order to support a healthy lifestyle. Nurses and allied health professionals should offer individualized exercise prescriptions and education about suitable physical activities in relation to physical ability. This article is protected by copyright. All rights reserved.

Keywords
Congenital heart disease, content analysis, interviews, nursing, physical activity, prevention
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-148097 (URN)10.1111/jocn.14507 (DOI)000439796600022 ()29752846 (PubMedID)2-s2.0-85050400287 (Scopus ID)
Available from: 2018-05-28 Created: 2018-05-28 Last updated: 2019-05-16Bibliographically approved
Bölenius, K., Lämås, K., Sandman, P.-O. & Edvardsson, D. (2017). Effects and meanings of a person-centred and health-promoting intervention in homecare services: a study protocol of a non-randomised controlled trial. BMC Geriatrics, 17, Article ID 57.
Open this publication in new window or tab >>Effects and meanings of a person-centred and health-promoting intervention in homecare services: a study protocol of a non-randomised controlled trial
2017 (English)In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 17, article id 57Article in journal (Refereed) Published
Abstract [en]

Background: The literature indicates that current home care service are largely task oriented with limited focus on the involvement of the older people themselves, and studies show that lack of involvement might reduce older people's quality of life. Person-centred care has been shown to improve the satisfaction with care and quality of life in older people cared for in hospitals and nursing homes, with limited published evidence about the effects and meanings of person-centred interventions in home care services for older people. This study protocol outlines a study aiming to evaluate such effects and meanings of a person-centred and health-promoting intervention in home aged care services. Methods/design: The study will take the form of a non-randomised controlled trial with a before/after approach. It will include 270 older people >65 years receiving home care services, 270 relatives and 65 staff, as well as a matched control group of equal size. All participants will be recruited from a municipality in northern Sweden. The intervention is based on the theoretical concepts of person-centredness and health-promotion, and builds on the four pedagogical phases of: theory apprehension, experimental learning, operationalization, and clinical supervision. Outcome assessments will focus on: a) health and quality of life (primary outcomes), thriving and satisfaction with care for older people; b) caregiver strain, informal caregiving engagement and relatives' satisfaction with care: c) job satisfaction and stress of conscience among care staff (secondary outcomes). Evaluation will be conducted by means of self-reported questionnaires and qualitative research interviews. Discussion: Person-centred home care services have the potential to improve the recurrently reported sub-standard experiences of home care services, and the results can point the way to establishing a more person-centred and health-promoting model for home care services for older people.

Place, publisher, year, edition, pages
BioMed Central, 2017
Keywords
Aged care, Decision making, Health, Home care services, Older people, Person-centred, Quality of life
National Category
Nursing Gerontology, specialising in Medical and Health Sciences Geriatrics
Identifiers
urn:nbn:se:umu:diva-132087 (URN)10.1186/s12877-017-0445-0 (DOI)000397451700001 ()28209122 (PubMedID)
Available from: 2017-03-02 Created: 2017-03-02 Last updated: 2018-06-09Bibliographically approved
Lämås, K., Karlsson, S., Nolén, A., Lövheim, H. & Sandman, P.-O. (2017). Prevalence of constipation among persons living in institutional geriatric-care settings - a cross-sectional study. Scandinavian Journal of Caring Sciences, 31(1), 157-163
Open this publication in new window or tab >>Prevalence of constipation among persons living in institutional geriatric-care settings - a cross-sectional study
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2017 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 31, no 1, p. 157-163Article in journal (Refereed) Published
Abstract [en]

RATIONAL: The current state of knowledge about the prevalence of constipation among persons living in institutional geriatric-care settings is limited.

AIM: The aim was to investigate the prevalence of constipation among institutional geriatric-care residents and identify resident characteristics related to constipation.

METHODOLOGICAL DESIGN: In a cross-sectional study of all the institutional geriatric-care settings in a county in northern Sweden, 2970 residents were assessed. The member of staff who knew each resident best used the Multi-Dimensional Dementia Assessment Scale and the resident's records of prescribed medication to monitor cognitive function, activities in daily life, behavioural and psychological symptoms, physical restraints, speech ability, nutrition and pharmacologic agents. The study was approved by the Regional Ethical Review Board.

RESULT: The prevalence of constipation was 67%. The mean age was higher among those with constipation. A significantly higher proportion of the constipated had cognitive and/or physical impairments, physical restraints, impaired speech, problems with nutrition, and higher numbers of drugs for regular use. Of those with constipation, 68% were prescribed laxatives for regular use. Twenty-three per cent of the constipated residents were prescribed opioid analgesics (n = 465), and 29% (n = 134) of these were not prescribed any laxatives.

STUDY LIMITATION: Due to the cross-sectional design, the results should be interpreted with caution in terms of causal reasoning, generalisation and conclusions about risk factors. Another limitation is the use of proxy assessments of constipation.

CONCLUSION: The results show that constipation is common among residents in institutional geriatric-care settings in Sweden, which is in line with previous studies from other Western countries. Despite being constipated when having prescribed opioid analgesics, a large number did not have prescribed laxatives. The results indicate the urgency of finding strategies and implementing suitable interventions to improve bowel management in residents in institutional geriatric-care settings.

Keywords
aged, constipation, nursing homes (residential facilities), prevalence
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-127093 (URN)10.1111/scs.12345 (DOI)000394988700017 ()27327073 (PubMedID)
Available from: 2016-10-28 Created: 2016-10-28 Last updated: 2018-06-09Bibliographically approved
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