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Sköldunger, Anders
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Publications (8 of 8) Show all publications
Corneliusson, L., Sköldunger, A., Sjögren, K., Lövheim, H., Lindkvist, M., Wimo, A., . . . Edvardsson, D. (2020). Well‐being and Thriving in Sheltered Housing versus Ageing in Place: Results from the U‐Age Sheltered Housing Study. Journal of Advanced Nursing, 73(3), 856-866
Open this publication in new window or tab >>Well‐being and Thriving in Sheltered Housing versus Ageing in Place: Results from the U‐Age Sheltered Housing Study
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2020 (English)In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 73, no 3, p. 856-866Article in journal (Refereed) Published
Abstract [en]

Aims: To explore to what extent type of residence (sheltered housing or ageing in place) contributes to thriving and well-being in older adults, when controlling for age, sex, living alone, being a widow and adjusting for functional status, self-rated health, and depressive mood.

Design: A matched cohort study.Methods A self-report survey was sent out to a total population of residents in all sheltered housings in Sweden and a matched control group ageing in place (N = 3,805). The data collection took place between October 2016-January 2017.

Results: The interaction analyses related to thriving showed that with increasing level of depressive mood and decreasing levels of self-rated health and functional status, those residing in sheltered housing generally reported higher levels of thriving, as compared with those ageing in place. Well-being was not found to be significantly associated with type of accommodation.

Conclusion: There may be features in sheltered housing that are associated with resident thriving especially among individuals with impairments of function, health or mood, although further studies are required to identify these specific features.

Impact: This study informs staff and policymakers about thriving and well-being in sheltered housing accommodations. These findings may be used to further the development of sheltered housing accommodations.

Place, publisher, year, edition, pages
John Wiley & Sons, 2020
Keywords
aged, cohort study, housing for the elderly, nursing, older people, quality of life, residence characteristics, social participation, thriving, well-being
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-166130 (URN)10.1111/jan.14285 (DOI)000512486200010 ()31814145 (PubMedID)
Available from: 2019-12-12 Created: 2019-12-12 Last updated: 2020-03-26Bibliographically approved
Wilberforce, M., Sköldunger, A. & Edvardsson, D. (2019). A Rasch analysis of the Person-Centred Climate Questionnaire - staff version. BMC Health Services Research, 19(1), 1-9, Article ID 996.
Open this publication in new window or tab >>A Rasch analysis of the Person-Centred Climate Questionnaire - staff version
2019 (English)In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 19, no 1, p. 1-9, article id 996Article in journal (Refereed) Published
Abstract [en]

Background: Person-centred care is the bedrock of modern dementia services, yet the evidence-base to support its implementation is not firmly established. Research is hindered by a need for more robust measurement instruments. The 14-item Person-Centred Climate Questionnaire - Staff version (PCQ-S) is one of the most established scales and has promising measurement properties. However, its construction under classical test theory methods leaves question marks over its rigour and the need for evaluation under more modern testing procedures. Methods: The PCQ-S was self-completed by nurses and other care staff working across nursing homes in 35 Swedish municipalities in 2013/14. A Rasch analysis was undertaken in RUMM2030 using a partial credit model suited to the Likert-type items. Three subscales of the PCQ-S were evaluated against common thresholds for overall fit to the Rasch model; ordering of category thresholds; unidimensionality; local dependency; targeting; and Differential Item Functioning. Three subscales were evaluated separately as unidimensional models and then combined as subtests into a single measure. Due to large number of respondents (n = 4381), two random sub-samples were drawn, with a satisfactory model established in the first ('evaluation') and confirmed in the second ('validation'). Final item locations and a table converting raw scores to Rasch-transformed values were created using the full sample. Results: All three subscales had disordered thresholds for some items, which were resolved by collapsing categories. The three subscales fit the assumptions of the Rasch model after the removal of two items, except for subscale 3, where there was evidence of local dependence between two items. By forming subtests, the 3 subscales were combined into a single Rasch model which had satisfactory fit statistics. The Rasch form of the instrument (PCQ-S-R) had an adequate but modest Person Separation Index (< 0.80) and some evidence of mistargeting due to a low number of `difficult-to-endorse' items. Conclusions: The PCQ-S-R has 12 items and can be used as a unidimensional scale with interval level properties, using the nomogram presented within this paper. The scale is reliable but has some inefficiencies due to too few high-end thresholds inhibiting discrimination amongst populations who already perceive that person-centred care is very good in their environment.

Place, publisher, year, edition, pages
BMC, 2019
Keywords
Person-centred care, Psychometrics, Dementia, Care quality, Rasch analysis
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-167963 (URN)10.1186/s12913-019-4803-9 (DOI)000506204300002 ()31878914 (PubMedID)
Available from: 2020-02-25 Created: 2020-02-25 Last updated: 2020-02-25Bibliographically approved
Corneliusson, L., Sköldunger, A., Sjögren, K., Lövheim, H., Wimo, A., Winblad, B., . . . Edvardsson, D. (2019). Residing in sheltered housing versus ageing in place: population characteristics, health status and social participation. Health & Social Care in the Community, 27(4), E313-E322
Open this publication in new window or tab >>Residing in sheltered housing versus ageing in place: population characteristics, health status and social participation
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2019 (English)In: Health & Social Care in the Community, ISSN 0966-0410, E-ISSN 1365-2524, Vol. 27, no 4, p. E313-E322Article in journal (Refereed) Published
Abstract [en]

Sheltered housing is a housing model that provides accessible apartments with elevated social possibilities for older people, which is expected to increase resident health and independence, reducing the need for care. As previous research on sheltered housing is scarce, the aim of this study was to explore the characteristics, health status and social participation of older people living in sheltered housing, compared to ageing in place. The study utilised baseline data from a matched cohort study survey on a nationally representative total population of residents in all sheltered housings in Sweden, and a matched control group (n = 3,805). The data collection took place between October 2016 and January 2017. The survey assessed functional capability using the Katz ADL and Lawton IADL scale, self-rated health using the EQ5D scale, and depressive mood using the GDS-4 scale. Descriptive statistics, frequencies, mean scores, independent t tests, p-values and effect sizes were utilised to compare the two groups. The results of the study show that older people living in sheltered housing, compared to ageing in place, had lower self-reported health (M = 64.68/70.08, p = <0.001), lower self-reported quality of life (M = 0.73/0.81, p = <0.001), lower functional status concerning activities of daily living (M = 5.19/5.40, p = <0.001), lower functional status concerning instrumental activities of daily living (M = 4.98/5.42 p = <0.001,), and higher probability of depressive mood (M = 0.80/0.58, p = <0.001). The results imply that residents in sheltered housing may have more care needs than those ageing in place. Further longitudinal comparative studies are needed to explore the impact residence in sheltered housing has on resident health and well-being.

Place, publisher, year, edition, pages
John Wiley & Sons, 2019
Keywords
geriatric assessment, health status, housing for the elderly, population characteristics, social participation
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-157108 (URN)10.1111/hsc.12734 (DOI)000471832800013 ()30821865 (PubMedID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2014-4016Swedish Research Council, 521-2014-2715
Available from: 2019-03-11 Created: 2019-03-11 Last updated: 2019-07-12Bibliographically approved
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, 75(12), 3831-3843
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 1365-2648, Vol. 75, no 12, p. 3831-3843Article in journal (Refereed) Published
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: 2020-01-09Bibliographically 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
Sköldunger, A. B., Wimo, A., Sandman, P.-O., Backman, A. & Edvardsson, D. (2016). Cognitive impairment and resource use in Swedish nursing homes: results from the Svenis study. Paper presented at 2016 GSA Annual Scientific Meeting, New Orleans, Louisiana, November 16-20, 2016. The Gerontologist, 56, 389-389
Open this publication in new window or tab >>Cognitive impairment and resource use in Swedish nursing homes: results from the Svenis study
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2016 (English)In: The Gerontologist, ISSN 0016-9013, E-ISSN 1758-5341, Vol. 56, p. 389-389Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
Oxford University Press, 2016
National Category
Gerontology, specialising in Medical and Health Sciences Geriatrics
Identifiers
urn:nbn:se:umu:diva-129733 (URN)000388585001709 ()
Conference
2016 GSA Annual Scientific Meeting, New Orleans, Louisiana, November 16-20, 2016
Note

Supplement: 3

Available from: 2017-01-11 Created: 2017-01-09 Last updated: 2018-06-09Bibliographically approved
Edvardsson, D., Backman, A., Bergland, Å., Björk, S., Bölenius, K., Kirkevold, M., . . . Winblad, B. (2016). The Umeå Ageing and health research programme (U-age): exploring person-centred care and health promoting living conditions for an ageing population. Nordic journal of nursing research, 36(3), 168-174
Open this publication in new window or tab >>The Umeå Ageing and health research programme (U-age): exploring person-centred care and health promoting living conditions for an ageing population
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2016 (English)In: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 36, no 3, p. 168-174Article in journal (Refereed) Published
Abstract [en]

The aim of this article is to describe the Umeå ageing and health research programme that explores person-centred care and health-promoting living conditions for an ageing population in Sweden, and to place this research programme in a national and international context of available research evidence and trends in aged care policy and practice. Contemporary trends in aged care policy includes facilitating ageing in place and providing person-centred care across home and aged care settings, despite limited evidence on how person-centred care can be operationalised in home care services and sheltered housing accommodation for older people. The Umeå ageing and health research programme consists of four research projects employing controlled, cross-sectional and longitudinal designs across ageing in place, sheltered housing, and nursing homes. The research programme is expected to provide translational knowledge on the structure, content and outcomes of person-centred care and health-promoting living conditions in home care, sheltered housing models, and nursing homes for older people and people with dementia.

Place, publisher, year, edition, pages
Sage Publications, 2016
Keywords
health, home care services, housing for the elderly, nursing homes, residential facilities, sheltered housing
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-122764 (URN)10.1177/2057158516645705 (DOI)
Available from: 2016-06-22 Created: 2016-06-22 Last updated: 2018-06-07Bibliographically approved
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