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  • 1.
    Afram, Basema
    et al.
    Department of Health Services Research, CAPHRI, Maastricht University, Maastricht, the Netherlands.
    Verbeek, Hilde
    Department of Health Services Research, CAPHRI, Maastricht University, Maastricht, the Netherlands.
    Bleijlevens, Michel
    Department of Health Services Research, CAPHRI, Maastricht University, Maastricht, the Netherlands.
    Challis, David
    University of Manchester, Manchester, England UK.
    Leino-Kilpi, Helena
    University of Turku, Turku, Finland/Turku University Hospital, Turku, Finland.
    Karlsson, Staffan
    Department of Health Sciences, Faculty of Medicine, Lund University, Sweden.
    Soto, Maria
    Department of Geriatric Medicine, CHU Toulouse University Hospital, France.
    Renom-Guiteras, Anna
    School of Nursing Science, Faculty of Health, University of Witten/Herdecke, Germany.
    Saks, Kai
    Department of Internal Medicine, University of Tartu, Estonia.
    Zabalegui, Adelaida
    Nursing Hospital Clinic of Barcelona, Spain.
    Hamers, Jan
    Department of Health Services Research, CAPHRI, Maastricht University, Maastricht, the Netherlands.
    Predicting institutional long-term care admission in dementia: a mixed-methods study of informal caregivers’ reports2015In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 71, no 6, p. 1351-1362Article in journal (Refereed)
    Abstract [en]

    Aim: To investigate agreement between: (1) expected reasons and actual reasons for admission of people with dementia according to informal caregivers; (2) scores on measurement instruments prior to admission and the actual reasons for admission according to informal caregivers.

    Background: Timely admission of people with dementia is a crucial issue. Information is highly warranted on whether informal caregivers are capable of prior identification of causes of admission and, can thus be considered a reliable prospective source on causes of admission.

    Design: A cohort study among informal caregivers of people with dementia who made a transition to institutional long-term care.

    Methods: Qualitative data on the expected and actual reasons for admission were collected via open-ended questions at baseline and follow-up. Furthermore, at baseline, data were collected using measurement instruments to measure pre-admission characteristics. Interviews took place between November 2010-April 2012. After categorizing the answers, the agreement between the expected and actual reasons was calculated. Furthermore, bivariate associations were calculated between the actual reasons for admission and scores on corresponding measurement instruments.

    Results/Findings: For most informal caregivers, there was agreement between their statements on the expected reason and the actual reason for admission. A third of the caregivers showed no conformity. Bivariate associations showed that there is also agreement between the actual reasons for admission and scores on corresponding measurement instruments.

    Conclusion: Informal caregivers can be considered reliable sources of information regarding what causes the admission of a person with dementia. Professional care should anticipate informal caregivers' statements and collaborate with them to strive for timely and appropriate admission. © 2014 John Wiley & Sons Ltd.

  • 2.
    Bökberg, Christina
    et al.
    Department of Health Sciences, Faculty of medicine, Lund University, Sweden.
    Ahlström, Gerd
    Department of Health Sciences, Faculty of medicine, Lund University, Sweden.
    Hallberg, Ingalill R
    Department of Health Sciences, Faculty of medicine, Lund University, Sweden.
    Karlsson, Staffan
    Department of Health Sciences, Faculty of medicine, Lund University, Sweden.
    Janlöv, Ann-Christin
    School of Health and Society, Kristianstad University, Sweden.
    Professional care providers and stakeholders’ views of best practice in the care for persons with dementia in Sweden2013In: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 17, no Suppl. 1, p. S369-S370Article in journal (Refereed)
    Abstract [en]

    Introduction: Dementia implies progressive loss of mental and physical functions during the trajectory of the disease (Porter & Kaplan, 2012). Persons with dementia need involvement of various and several care providers throughout the stages of dementia, and more knowledge is needed about best practice strategies in this complexity of care (Gurner, 2001). The aim of the study was to explore professional care providers and stakeholders’ views of best practice in concepts of information, collaboration and communication in the care for persons with dementia in Sweden.

    Method: The study had a qualitative approach based on three focus group interviews with a variation among participants regarding professions and workplaces to represent different types of care for persons with dementia from diagnosis to end of life care. The transcribed verbatim was analyzed with qualitative content analysis.

    Preliminary results: In early stages primary health care specialized in dementia had close collaboration, training and mentoring, with memory clinic and home care. In the later stages the person with dementia had less frequent contacts with primary health care. Day care played an important role in information delivery of the disease, in collaboration with home and institutional care. In the latest stage the family had an important role as a proxy for the person with dementia about desires in the care.

    Conclusion: A well-functioning network in professional care seems to have an impact on persons with dementia to remain at home despite loss of mental and physical functions.

    On the behalf of RightTimePlaceCare consortium. http://www.righttimeplacecare.eu.

  • 3.
    Bökberg, Christina
    et al.
    Lund University, Lund, Sweden.
    Ahlström, Gerd
    Lund University, Lund, Sweden.
    Karlsson, Staffan
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing. Lund University, Lund, Sweden.
    Significance of quality of care for quality of life in persons with dementia at risk of nursing home admission: a cross-sectional study2017In: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 16, no 1, article id 39Article in journal (Refereed)
    Abstract [en]

    Background

    Quality of life in persons with dementia is, in large part, dependent on the quality of care they receive. Investigating both subjective and objective aspects of quality of care may reveal areas for improvement regarding their care, which information may ultimately enable persons with dementia to remain living in their own homes while maintaining quality of life. The aim of this study was to 1) describe self-reported quality of life in persons with dementia at risk of nursing home admission. 2) describe subjective and objective aspects of quality of care, 3) investigate the significance of quality of care for quality of life.

    Methods

    A cross-sectional interview study design was used, based on questionnaires about quality of life (QoL-AD) and different aspects of quality of care (CLINT and quality indicators). The sample consisted of 177 persons with dementia living in urban and rural areas in Skåne County, Sweden. Descriptive and comparative statistics (Mann-Whitney U-test) were used to analyse the data.

    Results

    Based upon Lawton’s conceptual framework for QoL in older people, persons with pain showed significantly lower quality of life in the dimensions behavioural competence (p = 0.026) and psychological wellbeing (p = 0.006) compared with those without pain. Satisfaction with care seemed to have a positive effect on quality of life. The overall quality of life was perceived high even though one-third of the persons with dementia had daily pain and had had a weight loss of ≥4% during the preceding year. Furthermore, 23% of the persons with dementia had fallen during the last month and 40% of them had sustained an injury when falling.

    Conclusion

    This study indicates need for improvements in home care and services for persons with dementia at risk for nursing home admission. Registered nurses are responsible for nursing interventions related to pain, patient safety, skin care, prevention of accidents, and malnutrition. Therefore, it is of great importance for nurses to have knowledge about areas that can be improved to be able to tailor interventions and thereby improve quality of care outcomes such as quality of life in persons with dementia living at home. © 2017 The Author(s).

  • 4.
    Bökberg, Christina
    et al.
    Lund University, Lund, Sweden.
    Ahlström, Gerd
    Lund University, Lund, Sweden.
    Karlsson, Staffan
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI). Lund University, Lund, Sweden.
    Utilisation of formal and informal care and services at home among persons with dementia: a cross-sectional study2018In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 32, no 2, p. 843-851Article in journal (Refereed)
    Abstract [en]

    Background

    The progression of dementia disease implies increasing needs for both informal and formal care and services but also risk of institutionalisation. To better adjust care and services in the phase preceding institutionalisation it is important to find out whether utilisation of formal and informal care and services is determined by increased needs and by who meets the needs.Aim

    The aim was to compare persons with dementia (65+) with different levels of cognitive impairment, regarding utilisation of formal and informal care and service at home.Methods

    The participants consisted of 177 persons with dementia ≥65 years old and at risk of nursing home admission, divided into groups according to their cognitive function. Structured interviews were conducted based on questionnaires about type and amount of formal and informal care utilised, as well as questions regarding cognitive impairment, dependency in activities of daily living (ADLs) and neuropsychiatric symptoms. To analyse the data, descriptive and comparative statistics were used.Results

    The findings revealed that the group with severe dementia used significantly more help with ADLs and supervision in terms of time (number of hours and days) provided by the informal caregiver, compared with the group with moderate dementia. Utilisation of formal care and services was highest in the group with the most severe cognitive impairments (Standardized Mini-Mental State Examination score of <9). The group with severe dementia were more dependent in ADLs and had more neuropsychiatric symptoms (hallucinations and motor disturbances). They were younger and more often cohabitated with the informal caregiver, compared with the group with moderate dementia.Conclusion

    This study shows that in the phase preceding institutionalisation the ADL and supervision needs due to progression of dementia appear to tend to be met first and foremost by the informal caregivers. © 2017 Nordic College of Caring Science.

  • 5.
    Bökberg, Christina
    et al.
    Department of Health Sciences, Faculty of medicine, Lund University, Lund, Sweden.
    Ahlström, Gerd
    Department of Health Sciences, Faculty of medicine, Lund University, Lund, Sweden.
    Karlsson, Staffan
    Department of Health Sciences, Faculty of medicine, Lund University, Lund, Sweden.
    Hallberg, Ingalill R.
    Department of Health Sciences, Faculty of medicine, Lund University, Lund, Sweden.
    Janlöv, Ann-Christin
    School of Health and Society, Kristianstad University, Kristianstad, Sweden.
    Professional care providers and stakeholders’ views of best practice in the chain of care for persons with dementia in Sweden2013In: Nordic Advances in Health Care Sciences Research: Abstract Book, 2013, p. 98-98Conference paper (Refereed)
    Abstract [en]

    Background: To meet the increasing needs for persons with dementia and their relatives a well-functioning health care system in which resources are used optimally is needed. For this to be achieved requires strategy and planning of synergies between the different cares providers. This study will explore professional caregivers’ and stakeholders’ views of best practice in terms of information, collaboration and communication in dementia care.

    Aim: The aim of the study was to explore professional care providers’ and stakeholders' views of best practice in concepts of information, collaboration and communication throughout the trajectory of care from diagnosis to end of life care for persons with dementia in Sweden.

    Method: The study had a qualitative approach based on three focus group interviews with a variation among participants regarding professions and workplaces to represent different types of care for persons with dementia from diagnosis to end of life care. The transcribed verbatim was analyzed with qualitative content analysis.

    Preliminary results: In early stages primary health care specialized in dementia had close collaboration, training and mentoring, with memory clinic and home care. In the later stages the person with dementia had less frequent contacts with primary health care. Day care played an important role in information delivery of the disease, in collaboration with home and institutional care. In the latest stage the family had an important role as a proxy for the person with dementia about desires in the care.

    Conclusion: A well-functioning network in professional care seems to have an impact on persons with dementia to remain at home despite loss of mental and physical functions.

  • 6.
    Bökberg, Christina
    et al.
    Health Sciences, Faculty of Medicine, Lund Univiersity, Lund, Sweden.
    Ahlström, Gerd
    Health Sciences, Faculty of Medicine, Lund Univiersity, Lund, Sweden.
    Karlsson, Staffan
    Health Sciences, Faculty of Medicine, Lund Univiersity, Lund, Sweden.
    Hallberg, Ingalill Rahm
    Health Sciences, Faculty of Medicine, Lund Univiersity, Lund, Sweden.
    Janlöv, Ann-Christin
    School of Health and Society, Kristianstad University, Kristianstad, Sweden.
    Best practice and needs for improvement in the chain of care for persons with dementia in Sweden: a qualitative study based on focus group interviews2014In: BMC Health Services Research, ISSN 1472-6963, E-ISSN 1472-6963, Vol. 14, no 1, article id 596Article in journal (Refereed)
    Abstract [en]

    Background: Persons with dementia receive health care and social services from a wide range of professional care providers during the disease trajectory, presenting risks of miscommunication, duplication and/or missed nursing interventions. Accordingly, the aim of this study was to investigate professional care providers' views on conditions for best practice in terms of collaboration and improvement needs in the chain of care from early to end-of-life stage for persons with dementia in Sweden.

    Methods: The study had a qualitative design based on three focus group interviews. A strategic sample of 23 professional care providers was included. Data were subjected to content analysis based on the three stages of dementia (early, moderate, end-of-life).

    Results: The results were divided into five categories: Diagnosis is a prerequisite for specialized dementia care, Creating routines in the chain of care, Competent staff a prerequisite for high-quality care, Day care facilitates transition in the chain of care and Next-of-kin participation is a prerequisite for continuity in the chain of care. It was clear that, according to the participants, best practice in dementia care in Sweden is not achieved in every respect. It appeared that transitions of care between different organizations are critical events which need to be improved. The further the disease progresses, the less collaboration there seems to be among professional care providers, which is when the next of kin are usually called upon to maintain continuity in the chain of care.

    Conclusions: The results indicate that, according to the care providers, best practice in terms of collaboration is achieved to a higher degree during the early stage of dementia compared with the moderate and end-of-life stages. Lack of best practice strategies during these stages makes it difficult to meet the needs of persons with dementia and reduce the burden for next of kin. These are experiences to be taken into account to improve the quality of dementia care. Implementation research is needed to develop strategies for best practice on the basis of national knowledge-based guidelines and to apply these strategies in the moderate and end-of-life stages. ©  Bökberg et al.; licensee BioMed Central Ltd. 2014

  • 7.
    Bökberg, Christina
    et al.
    Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
    Ahlström, Gerd
    Older People's Health and Person-centred Care & Swedish National Graduate School for Competitive Science on Ageing and Health (SWEAH), Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
    Leino-Kilpi, Helena
    University of Turku, Finland & Turku University Hospital, Finland.
    Soto-Martin, Maria
    Gerontopôle Alzheimer´s Disease Research and Clinical Center, Toulouse University Hospital, France.
    Cabrera, Esther
    School of Health Sciences, TecnoCampus, University Pompeu Fabra, Mataró (Barcelona), Spain.
    Verbeek, Hilde
    Department of Health Services Research, Maastricht University, The Netherlands.
    Saks, Kai
    Department of Internal Medicine, University of Tartu, Estonia.
    Stephan, Astrid
    School of Nursing Science, Witten/Herdecke University, Germany.
    Sutcliffe, Caroline
    Personal Social Services Research Unit, School of Nursing, Midwifery, and Social Work, University of Manchester, England.
    Karlsson, Staffan
    Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
    Care and Service at Home for Persons With Dementia in Europe2015In: Journal of Nursing Scholarship, ISSN 1527-6546, E-ISSN 1547-5069, Vol. 47, no 5, p. 407-416Article in journal (Refereed)
    Abstract [en]

    Purpose: To describe available and utilized formal care and service at home for persons with dementia, from diagnosis to end-of-life stage, in eight European countries.

    Design: A descriptive cross-country design concerning eight European countries as a part of the European research project RightTimePlaceCare.

    Methods: The research team in each country used a mapping system to collect country-specific information concerning dementia care and service system. The mapping system consists of 50 types of care and service activities. Sixteen of the 50 predefined activities concerning care and service at home were selected for this study and subdivided into three categories, following the stages of dementia.

    Findings: Availability was reported to be higher than utilization, and the findings indicated more similarities than differences among the eight countries involved. Even though there were several available activities of "basic care and services" and "healthcare interventions," they were utilized by few in most countries. Furthermore, "specialized dementia care and services" were sparsely available and even more sparsely utilized in the participating countries.

    Conclusions: The findings indicated that persons with dementia in Europe received formal care and service on a general, basic level but seldom adjusted to their specific needs.

    Clinical Relevance: This study describes the gap between service provision and utilization enabling nurses to develop individually adjusted care plans for persons with dementia during the progress of the disease. The findings do not include matters of quality of care or how to best organize effective care and services. However, the activities of care and services presented here should shed light on what room there is for improvement when it comes to enabling persons with dementia to go on living at home. © 2015 Sigma Theta Tau International.

  • 8.
    Bökberg, Christina
    et al.
    Lund University, Lund, Sweden.
    Ahlström, Gerd
    Leino-Kilpi, Helena
    Soto-Martin, Maria E.
    Cabrera, Esther
    Verbeek, Hilde
    Saks, Kai
    Stephan, Astrid
    Sutcliffe, Caroline
    Karlsson, Staffan
    Care and Service at Home for People With Dementia in Europe2015In: Abstractbook Nordic Conference on Advances in Health Care Sciences Research, 2015, p. 22-22Conference paper (Refereed)
    Abstract [en]

    Purpose: To describe available and utilized professional care and service at home for people with dementia, from diagnosis to end-of-life stage, in eight European countries. Design: A descriptive cross-country design concerning eight European countries as a part of the European research project, RightTimePlaceCare (RTPC).

    Methods: The research team in each country used a mapping system to collect countryspecific information on a general level concerning dementia care and service system. The mapping system consisted of fifty types of care and service activities. Sixteen of the fifty predefined activities concerning professional care and service at home were selected for this study and subdivided into three categories, following the stages of dementia.

    Results: Availability was reported to be higher than utilization and the results indicated more similarities than differences among the eight countries involved. Even though there were several available activities of Basic care and services and Health care interventions they were utilized by few in most countries. Furthermore, Specialized care and services for people with dementia were sparsely available and even more sparsely utilized in the participating countries.

    Conclusions: The results indicated that people with dementia in Europe received professional care and service on a general, basic level but seldom received care and service adjusted to their specific needs.

    Clinical Relevance: This study highlights available and utilized types of care and service activities enabling nurses to develop individually adjusted care plans for people with dementia during the progress of the disease. Knowledge of care and services in other countries provides nurses with an important tool for the improvement of dementia care. However assessing the quality of care requires an indication of informal care provision in different countries.

  • 9.
    Cabrera, Esther
    et al.
    School of Health Sciences TecnoCampus, University Pompeu Fabra, Barcelona, Spain.
    Sutcliffe, Caroline
    Personal Social Services Research Unit, University of Manchester, Manchester, UK.
    Verbeek, Hilde
    Department of Health Services Research, CAPHRI, Maastricht University, Maastricht, the Netherlands.
    Saks, Kai
    Department of Internal Medicine, University of Tartu, Estonia.
    Soto-Martin, Maria
    Department of Geriatric Medicine, Gerontopole, INSERM 1027, University Hospital de Toulouse, Toulouse, France.
    Meyer, Gabriele
    Medical Faculty, Institute for Health and Nursing Science, Martin-Luther-University Halle-Wittenberg, Germany.
    Leino-Kilpi, Helena
    University of Turku, Turku, Finland/Turku University Hospital, Turku, Finland.
    Karlsson, Staffan
    Department of Health Sciences, Faculty of Medicine, Lund University, Sweden.
    Zabalegui, Adelaida
    Nursing Hospital Clinic of Barcelona, Spain.
    Non-pharmacological interventions as a best practice strategy in people with dementia living in nursing homes: A systematic review2015In: European Geriatric Medicine, ISSN 1878-7649, E-ISSN 1878-7657, Vol. 6, no 2, p. 134-150Article in journal (Refereed)
    Abstract [en]

    Background: Two-thirds of nursing home residents suffer from dementia and there is a need for effective and efficient interventions with meaningful outcomes for these individuals. This study aims to identify current best practices in non-pharmacological interventions in nursing homes.

    Methods: A systematic literature review was conducted, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) declaration guideline. Studies and Randomized Controlled Trials (RCT) evaluating non-pharmacological interventions focused on improving the Quality of Care (QoC) and/or Quality of Life (QoL) of people with dementia (PwD) living in nursing homes were included. For individual study evaluation, the Cochrane Collaboration risk of bias assessment tool was used.

    Results: A total of 31 articles were included and five main categories emerged: psychosocial and educational, physical activity, sensorial therapies, staff-focused interventions and complex interventions. Psychosocial interventions were the most exhaustively studied and evaluated interventions. Few studies related to physical therapy were identified and they did not provide enough evidence of their effectiveness. Therapeutic touch was revealed to have positive effects on residents with dementia.

    Conclusion: Psychosocial interventions have been shown to have the potential to improve the QoL and QoC of people with dementia in nursing homes. Before implementation of the intervention, it is recommended that activities are adjusted according to residents' characteristics and external factors controlled to achieve effectiveness and to structure a well-designed intervention. However, there is not enough evidence to support the effectiveness of non-pharmacological interventions in general. Further well-designed research is needed on non-pharmacological interventions in nursing facilities. (C) 2014 Elsevier Masson SAS and European Union Geriatric Medicine Society. All rights reserved.

  • 10.
    Condelius, Anna
    et al.
    Lund University, Lund, Sweden.
    Jakobsson, Ulf
    Lund University, Malmö, Sweden.
    Karlsson, Staffan
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing. Lund University, Lund, Sweden.
    Exploring the Implementation of Individual Care Plans in Relation to Characteristics of Staff2016In: Open Journal of Nursing, ISSN 2162-5336, E-ISSN 2162-5344, Vol. 6, no 8, p. 582-590Article in journal (Refereed)
    Abstract [en]

    The aim was to explore the implementation of individual care plans in municipal elderly care in relation to characteristics of staff. Data regarding characteristics of staff were derived through a questionnaire distributed to all staff working in the care for older people, (N = 908, n = 245) in four municipalities in Sweden. The number of care plans established during a one-year period was collected through a contact person in each municipality. In total 47 individual care plans were es-tablished during the study year. Significantly more staff in the municipality that had the most number of established individual care plans agreed that there had been sufficient education (p = 0.017), sufficient time (p = 0.002) and routines established regarding individual care plans (p = 0.014) and had a significantly better job satisfaction (p = 0.001), compared to staff in the other municipalities. Implementation leaders may need to take the working conditions and the percep-tion of available resources among staff into consideration in the on-going process of implementing individual care plans.

  • 11.
    de Mauleon, Adelaide
    et al.
    Department of Geriatric Medicine, Gerontopole, Toulouse University Hospital, INSERM 1027, Toulouse, France.
    Sourdet, Sandrine
    Department of Geriatric Medicine, Gerontopole, Toulouse University Hospital, INSERM 1027, Toulouse, France.
    Renom-Guiteras, Anna
    Institut fuer Allgemeinmedizin und Familienmedizin, Universitaet Witten/Herdecke, Witten, Germany.
    Gillette-Guyonnet, Sophie
    Department of Geriatric Medicine, Gerontopole, Toulouse University Hospital, INSERM 1027, Toulouse, France.
    Leino-Kilpi, Helena
    Department of Nursing Science, University of Turku, Turku, Finland.
    Karlsson, Staffan
    Department of Health Sciences, Lund University, Lund, Sweden.
    Bleijlevens, Michel
    Department of Health Services Research, Maastricht University, Maastricht, The Netherlands.
    Zabalegui, Adelaida
    Hospital Clinic de Barcelona, Barcelona, Spain.
    Saks, Kai
    Department of Internal Medicine, University of Tartu, Tartu, Estonia.
    Vellas, Bruno
    Department of Geriatric Medicine, Gerontopole, Toulouse University Hospital, INSERM 1027, Toulouse, France.
    Jolley, David
    Personal Social Services Research Unit, University of Manchester, Manchester, UK.
    Soto, Maria
    Department of Geriatric Medicine, Gerontopole, Toulouse University Hospital, INSERM 1027, Toulouse, France.
    Associated Factors With Antipsychotic Use in Long-Term Institutional Care in Eight European Countries: Results From the RightTimePlaceCare Study2014In: Journal of the American Medical Directors Association, ISSN 1525-8610, E-ISSN 1538-9375, Vol. 15, no 11, p. 812-818Article in journal (Refereed)
    Abstract [en]

    Objectives: To determine factors associated with the antipsychotic (AP) prescription for people with dementia (PwD) recently admitted to institutional long-term carefacilities (LTCFs) and to ascertain differences in the use of this medication in 8 European countries.

    Design: An exploratory cross-sectional study.

    Setting: LTCFs from 8 European countries (Estonia, Finland, France, Germany, The Netherlands, Spain, Sweden, and England).

    Participants: A total of 791 PwD recently admitted to an LTCF and their caregivers.

    Measurements: Baseline data from RightTimePlaceCare survey was used. Patients' medical conditions, neuropsychiatric symptoms, physical and cognitive status, and medications were recorded. Multiple logistic regression models were used to assess associations with the AP use. 

    Results: A group of 296 patients (37.4%) of 791 patients recently admitted received AP medication. The prevalence of the use of 1 or more APs varied between study countries, ranging from 12% in Sweden to 54% inSpain. Factors independently associated with the AP use were living in Sweden [odds ratio (OR) 0.12, 95% confidence interval (CI) 0.05-0.30], Finland (OR 0.26, 95% CI 0.14-0.48), Germany (OR 2.75, 95% CI 1.55-4.86) and Estonia (OR 6.79, 95% CI 3.84-12.0). The odds of AP use decreased with the presence of a dementia specific unit inthe LTCF (OR 0.60, 95% CI 0.39-0.92), but was higher among residents with a hyperactivity behavior (OR 2.12, 95% CI 1.41-3.18).

    Conclusion: The current study shows that more than one-third of the residents recently admitted received APs and that prescription frequency across countries varied significantly. This study raises the possibility that the presence of a dementia-specific unit might play a role in the AP use. Further studies should investigate this association and seek better understanding of what will achieve optimal quality of AP use among newly admitted residents in LTCF. © 2014 AMDA - The Society for Post-Acute and Long-Term Care Medicine.

  • 12.
    Edberg, Anna-Karin
    et al.
    Lund University, Lund, Sweden.
    Karlsson, Staffan
    Lund University, Lund, Sweden.
    Westergren, Albert
    Lund University, Lund, Sweden.
    Difficulties in nursing care for older peoplereceiving public care at home or in sheltered accommodation2005In: 18th World Congress of Gerontology and Geriatrics, Rio de Janeiro, Brazil, June 26-30, 2005: Abstracts / [ed] Elizabete Viana de Freitas & Carlos André Oighenstein, Basel: S. Karger, 2005, p. 488-489Conference paper (Refereed)
  • 13.
    Elmståhl, Sölve
    et al.
    Samhällsmedicinska institutionen och Institutionen för omvårdnad, Lunds universitet, Lund, Sverige.
    Karlsson, Staffan
    Samhällsmedicinska institutionen och Institutionen för omvårdnad, Lunds universitet, Lund, Sverige.
    Lithman, Thor
    Samhällsmedicinska institutionen och Institutionen för omvårdnad, Lunds universitet, Lund, Sverige.
    Hallberg, Ingalill Rahm
    Samhällsmedicinska institutionen och Institutionen för omvårdnad, Lunds universitet, Lund, Sverige.
    Use of public service among elderly. Preliminary results from a population based study2002In: 16 Nordiske Kongres i Gerontologi, 25 - 28 maj 2002: program og abstracts, Aarhus: Nordisk Gerontologisk Forening , 2002, p. 239-239Conference paper (Refereed)
  • 14.
    Forsberg, Elenita
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Bäcklund, Berit
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Hjort-Telhede, Eva
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Karlsson, Staffan
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Virtual patient cases for active student participation in nursing education2018In: Journal of Nursing & Care, ISSN 2167-1168, Vol. 7, p. 63-63Article in journal (Refereed)
    Abstract [en]

    A didactive method which promote a more active student participation (ASP), Virtual Patient (VP) cases  may be a valuable intervention. VP cases are defined as interactive computer simulations of real-life clinical scenarios for healthcare education. VP cases are excellent for training clinical reasoning skills.

    The aim of the study was to investigate utilization of VP cases for ASP in nursing education, regarding student’s learning experience.

    The design was an intervention study, 58 students in the third semester of six in the nursing program were included in the study. In 2016-2017, interventions have been conducted in the Human Biomedicine course with the purpose to develop a course concept that included didactic methods that promoted ASP. The students performed four VP cases individually at home. Before solving  the VP cases, the students had lectures in medicine science for example concerning chest organs diseases. In order to be a complement to that lecture the VP case was about chronic obstructive pulmonary disease. The lectures were followed up with seminars where the students were able to ask questions regarding conducted VP cases. After each performed VP case, the student answered a self -evaluation form with open ended questions.  Data was conducted using content analysis.

    The result showed that the students found the VP cases challenging and motivational. The VPs taught them to think wide and stimulated to search for more knowledge. Finally they thought it was a good way to test themselves and appreciated the direct feedback, lack of knowledge became visible at once. © 2018 OMICS International

  • 15.
    Giebel, Clarissa
    et al.
    School of Psychological Sciences, University of Manchester, Manchester, UK & Personal Social Services Research Unit, University of Manchester, Manchester, UK.
    Sutcliffe, Caroline
    Personal Social Services Research Unit, University of Manchester, Manchester, UK.
    Stolt, Minna
    Department of Nursing Science, University of Turku, Turku, Finland.
    Karlsson, Staffan
    Department of Health Sciences, Lund University, Lund, Sweden.
    Renom-Guiteras, Anna
    School of Nursing Science, Faculty of Health, University of Witten/Herdecke, Witten, Germany.
    Sotos, Maria
    Department of Geriatric Medicine, Gerontopole, INSERM 1027, University Hospital de Toulouse, Toulouse, France.
    Verbeek, Hilde
    Department of Health Services Research, Maastricht University, Maastricht, the Netherlands.
    Zabalegui, Adelaida
    Hospital Clinic de Barcelona, Barcelona, Spain.
    Challis, David
    Personal Social Services Research Unit, University of Manchester, Manchester, UK.
    Deterioration of basic activities of daily living and their impact on quality of life across different cognitive stages of dementia: a European study2014In: International psychogeriatrics, ISSN 1041-6102, E-ISSN 1741-203X, Vol. 26, no 8, p. 1283-1293Article in journal (Refereed)
    Abstract [en]

    Background: Performing basic activities of daily living (ADLs) is one of the major difficulties encountered in dementia, which can have considerable negative impacts on the quality of life (QoL) of people with dementia (PwD). However, the extent to which basic ADL performance deteriorates across mild, moderate, and severe dementia is little examined and its impact, together with depression and neuropsychiatric behavior, upon QoL, is of considerable relevance across European countries.

    Methods: Data were drawn from people living in the community who were participants in a large-scale European study on transition from community living to care homes of PwD. PwD completed measures on cognitive functioning and QoL, and informal carers reported upon QoL, depressive symptomatology, psychopathology, and functional ability of the PwD.

    Results: ADL performance deteriorated differently for each activity. In particular, toileting, transfer, and feeding remained relatively intact throughout, whereas performance on bathing and dressing deteriorated to a greater extent from mild to severe dementia. It appears that continence was not affected by the stage of dementia with similar levels of impairment. Basic ADL performance impacted to different degrees on QoL across dementia stages and countries.

    Conclusions: Interventions aimed at maintaining independence or QoL need to target different ADLs across different dementia stages and perhaps also tailor interventions to the context of different countries. Findings contribute to the development of non-pharmaceutical interventions and governmental pledges to promote independence in dementia. © International Psychogeriatric Association 2014

  • 16.
    Hallberg, Ingalill R
    et al.
    The Pufendorf Institute of Advanced Studies, Lund University, Sweden.
    Challis, David
    Personal Social Services Research Unit, University of Manchester, United Kingdom.
    Hamers, Jan
    Health Services Research, Maastricht University, Netherlands.
    Leino-Kilpi, Helena
    Department of Nursing Science, University of Turku, Finland.
    Meyer, Gabriele
    School of Nursing Science, Witten/Herdecke University, Germany.
    Saks, Kai
    Department of Internal Medicine, University of Tartu, Estonia.
    Soto, Maria
    Department of Geriatric Medicine, Toulouse University Hospital, France.
    Zabalegui, Adela
    Fundacio Privada Clinic per la Recerca Biomedica, Hospital Clinic of Barcelona, Spain.
    Karlsson, Staffan
    Department of Health Sciences, Lund University, Sweden.
    The dementia care system in the eight RTPC European countries2013In: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 17, no Suppl. 1, p. S212-S212Article in journal (Refereed)
    Abstract [en]

    Introduction: Exploring the care and service activities offered throughout the trajectory of dementia is an opportunity for countries to learn from each other. As part of the RightTimePlaceCare project’s general objective to develop best practice strategies this presentation describes development, content and application of a template to explore the dementia health, social care and welfare systems from early sign, diagnosis, intermediate and moderate stage and to the late stage of the disease. It also describes some of the findings with regard to the chain of care and service for people with dementia.

    Method: A step-wise consensus procedure was applied to identify, define and develop a template covering care and service throughout the disease trajectory. In addition the professionals involved were identified and defined as for their educational level.

    Results: In total 50 care and service activities compiled in seven groups were identified: 1) Screening, diagnostic procedure, treatment of dementia and complications; 2) Outpatient care facilities; 3) Care at home; 4) Institutional care; 5) Palliative care; 6) Informal caregiving and support; 7) Civic activities. The largest differences in terms of availability were found for care activities specifically for people with dementia. Non-pharmacological treatment was not commonly utilized in whilst pharmacological treatment for BPSD was common. Also education and social support to family caregivers was sparsely utilized.

    Conclusion: The care and service offered to people with dementia and family caregivers covers a wide range of activities. Facilities specifically for dementia varies among countries.There are more similarities among countries than differences.

  • 17.
    Hallberg, Ingalill R
    et al.
    Lund University, Lund, Sweden.
    Karlsson, Staffan
    Lund University, Lund, Sweden.
    Structure of long-term home and institutional care available to people with dementia in eight European countries2011In: International psychogeriatrics, ISSN 1041-6102, E-ISSN 1741-203X, Vol. 23, no Suppl. 1, p. S31-S31Article in journal (Refereed)
    Abstract [en]

    The RTPC project also concerns the structure of long-term home and institutional care throughout the trajectory of dementia. To describe and analyse the European health, social care and welfare systems, advocacy and informal caregiver support systems for patients/consumers with dementia a template has been developed for the use of homogenous terminology, covering possible care and service interventions from diagnosis to end of life. The structure of the national health care and social service system was described as related to elderly in general and to people with dementia specifically. The system differs between the eight countries in particular in terms of the demands on informal caregivers, financially, the distribution and the emphasis on home care versus nursing home care. Resembling findings throughout the 8 countries were that few had a diagnosis at early disease stage, support to family caregivers still can be improved and palliative care concepts are sparsely applied.

  • 18.
    Hallberg, Ingalill R
    et al.
    Lund University, Lund, Sweden.
    Karlsson, Staffan
    Lund University, Lund, Sweden.
    Lethin, Connie
    Lund University, Lund, Sweden.
    Emilsson, Ulla M
    Lund University, Lund, Sweden.
    Structure of long term home and institutional care systems in Europe2011Report (Other academic)
    Abstract [en]

    The aim of this part of the RightTimePlaceCare study (WP2) was to describe and analyse the European health, social care and welfare systems, advocacy and informal caregiver support systems for patients with dementia. The description and analyses covers the continuum of care from diagnosis, informal care, contributions from civic society, public home care and the intermediate forms of care, to the long-term institutionalised care, and end of life care. In a first step, the terminology was developed and meanings of different terms used in relation to dementia care were collected, analysed, defined and categorised. Thereafter the terminology was used to develop a template organised on the Y-axis as being the course of the dementia disease as described by the OECD in 2004, and on the X-axis as being the type of care provided, organised in accordance with the process of the disease from dementia screening to end of life care. In addition each country was asked to provide an overall description of the care system they offered with regard to the national directives and financing of their dementia care system. The primary source of information was written reports from different sources. Official documents, epidemiological studies and descriptions of the care system, in particular dementia care system offered in their country. In addition interviews with responsible managers, providers or the equivalent in relevant care and service organisations, with persons in consumer/user organisations, with staff, professional employees and purchasers in a municipality or another representative for a civic administrative area were recommended.

  • 19.
    Hallberg, Ingalill R.
    et al.
    Lund University, Lund, Sweden.
    Karlsson, Staffan
    Lund University, Lund, Sweden.
    Lethin, Connie
    Lund University, Lund, Sweden.
    Emilsson, Ulla M.
    Lund University, Lund, Sweden.
    Bökberg, Christina
    Lund University, Lund, Sweden.
    Exploration of intersectorial communication2012Report (Other academic)
  • 20.
    Hallberg, Ingalill R
    et al.
    Institutionen för omvårdnad, Lunds Universitet, Lund, Sverige.
    Karlsson, Staffan
    Institutionen för omvårdnad, Lunds Universitet, Lund, Sverige.
    Westergren, Albert
    Institutionen för omvårdnad, Lunds Universitet, Lund, Sverige.
    Dozet, Alexander
    Region Skåne, Kristianstad, Sverige.
    Lithman, Tor
    Region Skåne, Kristianstad, Sverige.
    Elmståhl, Sölve
    Samhällsmedicinska institutionen, UMAS, Lunds Universitet, Lund, Sverige.
    Ekström, Henrik
    Samhällsmedicinska institutionen, UMAS, Lunds Universitet, Lund, Sverige.
    Edberg, Anna-Karin
    Institutionen för omvårdnad, Lunds Universitet, Lund, Sverige.
    Kommunal och regional vård till äldre: Vård och omsorg i Eslöv, Hässleholm, Malmö, Osby och Ystad till personer 65 och däröver, våren 2001: En delstudie i SNAC. Rapport 12002Report (Other academic)
  • 21.
    Hallberg, Ingalill Rahm
    et al.
    The Pufendorf Institute, Lund University, Lund, Sweden.
    Cabrera, Esther
    Tecnocampus, Barcelona, Spain.
    Jolley, David
    University of Manchester, Manchester, United Kingdom.
    Raamat, Katrin
    University of Tartu, Tartu, Estonia.
    Renom-Guiteras, Anna
    University of Witten/Herdecke, Witten/Herdecke, Germany.
    Verbeek, Hilde
    Maastricht University, Maastricht, Netherlands.
    Soto, Maria
    University of Toulouse, Toulouse, France.
    Stolt, Minna
    University of Turku, Turku, Finland.
    Karlsson, Staffan
    Lund University, Lund, Sweden.
    Professional care providers in dementia care in eight European countries; their training and involvement in early dementia stage and in home care2016In: Dementia, ISSN 1471-3012, E-ISSN 1741-2684, Vol. 15, no 5, p. 931-957Article in journal (Refereed)
    Abstract [en]

    Knowledge concerning professionals involved in dementia care throughout its trajectory is sparse; the focus has mainly been on nursing-homecare and less on home care, diagnosis and treatment of the disease and its complications despite the fact that home care is the most prominent type of care. The aim of this study was to explore and describe professional care providers involved in dementia care and their educational level applying the International Standard Classification of Education (ISCED) and further to investigate practice in the RightTimePlaceCare-countrieswith regard to screening, diagnostic procedures and treatment of dementia and home care. The findings demonstrate more similarities than differences in terms of type of professionals involved among the countries although untrained staff were more common in some countries. Findings also show that many types of professionals are involved, who to turn to may not be clear, for instance in terms of medical specialities and it may be unclear who bears the ultimate responsibility. The professionals involved in diagnosis, treatment and care are educated to bachelor's level or above whilst everyday care is provided by people trained at a lower ISCED level or with no formal training. Registered nurses as well as occupational therapists have bachelor's degrees in most countries, but not in Germany or Estonia. Professionals specifically trained in dementia care are not so common. Further research is needed to reveal not only who provides the diagnostics and treatment, but also how home care is organised and quality assured. Many different types of professionals serve as providers along the trajectory of the disease which may be difficult for the patient and the informal caregiver to cope with. © The Author(s) 2014

  • 22.
    Hallberg, Ingalill Rahm
    et al.
    Institutionen för omvårdnad, Lunds universitet, Lund, Sverige.
    Karlsson, Staffan
    Institutionen för omvårdnad, Lunds universitet, Lund, Sverige.
    Edberg, Anna-Karin
    Institutionen för omvårdnad, Lunds universitet, Lund, Sverige.
    Westergren, Albert
    Institutionen för omvårdnad, Lunds universitet, Lund, Sverige.
    Funktionsbedömning och vårdinsatser. Utveckling av ett index för klassificering av vårdbehov2002In: 16 Nordiske Kongres i Gerontologi, 25 - 28 maj 2002: program og abstracts, Aarhus: Nordisk Gerontologisk Forening , 2002, p. 238-238Conference paper (Refereed)
  • 23.
    Hallberg, Ingalill Rahm
    et al.
    Lund University, Lund, Sweden.
    Leino-Kilpi, Helena
    University of Turku, Turku, Finland & Hospital District of Southwest Finland, Turku, Finland.
    Meyer, Gabriele
    Witten/Herdecke University, Witten, Germany.
    Raamat, Katrin
    University of Tartu, Tartu, Estonia.
    Martin Soto, Maria
    Gerontopôle, Alzheimer's disease Research and Clinical Center, Toulouse University Hospital, Toulouse, France.
    Sutcliffe, Caroline
    University of Manchester, Manchester, United Kingdom.
    Zabalegui,, Adelaida
    Hospital Clinic of Barcelona, Barcelona, Spain.
    Zwakhalen, Sandra
    Maastricht University, Department of Health Services Research, CAPHRI School for Public Health and Primary Care, Maastricht, Netherlands.
    Karlsson, Staffan
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing. Lund University, Lund, Sweden.
    Dementia care in eight European Countries: developing a mapping system to explore systems2013In: Image - the Journal of Nursing Scholarship, ISSN 0743-5150, Vol. 45, no 4, p. 412-424Article in journal (Refereed)
    Abstract [en]

    Purpose: There is a knowledge gap with regard to the structure of the care and service system available to persons with dementia. This is very much a concern for nurses who are the main providers in the care of dementia. The study, a part of the "RightTimePlaceCare" project, describes the development and content of a mapping system aimed at exploring the content of care and service for persons with dementia and their informal caregiver throughout the disease trajectory. The usefulness of the mapping system is illustrated in describing the availability of care and service at the diagnostic stage, and at the institutional and palliative stages.

    Design: A descriptive cross-country design concerning eight European countries differing in demographic composition and terms of long-term care provided is employed.

    Methods: A modified consensus strategy was used to develop the mapping system and define the terminology. Thereafter, each country ' s mapping systemwas completed by its research group collecting country-specific information and using expert groups either as consultants or for completing the system.

    Findings: The consensus procedure worked satisfactorily with regard to content and definitions, whereas assessing the availability and utilization of care and service was problematic. Some 50 types care and service activities were identified and defined and were categorized as follows: (a) screening, diagnostic procedures, and treatment of dementia; (b) outpatient care facilities; (c) care at home; (d) institutional care; (e) palliative care; (f) informal caregiving and supportive actions; and (g) civic activities. Care at home included the broadest range of activities; palliative care, informal caregiving, and supportive actions were the smallest range.

    Conclusions: The dementia care systems were found to be comprehensive and to emphasize home care. Activities aimed at transferring knowledge to informal caregivers, though highly important for home care, seemed less extensive. The mapping system appears useful from a nurse manager's standpoint for exploring the dementia care pathway. Comparisons between countries appear useful for developing the care system and for sharing information of how toperfect it. Further testing and development are needed regarding information on the availability and utilization of care and service activities.

    Clinical Relevance: The mapping system can be useful in clarifying the dementia care system for those concerned, in helping nurse researchers and managers review and initiate evaluation and communicate with policy makers, as well as to ensure that providers use appropriate parts of the system. It can also be useful in national and international comparative studies. © 2013 Sigma Theta Tau International.

  • 24.
    Helldén, Josefin
    et al.
    Department of Health Sciences, Lund University, Lund, Sweden & Geriatric and rehabilitation clinic, Kungälv Hospital, Kungälv, Sweden.
    Bergström, Liza
    Department of Speech and Language Pathology, University of Gothenburg, Gothenburg, Sweden.
    Karlsson, Staffan
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing. Department of Health Sciences, Lund University, Lund, Sweden.
    Experiences of living with persisting post-stroke dysphagia and of dysphagia management – a qualitative study2018In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 13, no sup1, article id 1522194Article in journal (Refereed)
    Abstract [en]

    Purpose: The aim of this study was to investigate people’s experiences of living with dysphagia after stroke, and their experiences of dysphagia management.

    Methods: The study design was qualitative, and an open-ended approach to data collection was used, with follow-up probing questions to gain more information as needed. Personal interviews were conducted with five persons who had persisting moderate to severe dysphagia after stroke, living in the south-west part of Sweden. The data were analysed with qualitative content analysis.

    Results: When analysing the data, the following theme emerged; “Dysphagia impacts life situations negatively and requires individually adapted, long term support from skilled health care professionals”. The theme consists of three categories: “Learning to manage dysphagia and its complications”, “Professional support with dysphagia varies” and “Finding small moments of joy despite large restrictions in life situations”.

    Conclusions: Findings indicated that people with dysphagia experienced a lack of support from health care professionals. Better health care support following discharge from hospital is required to ensure an optimal quality of life. Actions to achieve this may include developing national guidelines for adequate dysphagia follow-up and establishing multidisciplinary dysphagia teams in hospitals and long-term care facilities.

  • 25.
    Jakobsson, Ulf
    et al.
    Department of Clinical Sciences, Centre for Primary Health Care Research, Faculty of Medicine, Lund University, Malmö, Sweden.
    Karlsson, Staffan
    Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
    Predicting Mortality With the ADL-Staircase in Frail Elderly2011In: Physical & Occupational Therapy in Geriatrics, ISSN 0270-3181, E-ISSN 1541-3152, Vol. 29, no 2, p. 136-147Article in journal (Refereed)
    Abstract [en]

    Objectives: To investigate the ability of the ADL-staircase to predict mortality among older people receiving long-term formal health care and service.

    Method: This study comprises 626 respondents. Data were collected for 2 cohorts.

    Results: Crude mortality rate ranged between 9% and 23%. Higher scores on the ADL-staircase significantly increased the risk of mortality (RR = 1.253). For the total sample, Youden's index suggested a cutoff value of 6 for mortality on the ADL-staircase. A cutoff value of 4 was suggested for those living at home and 7 for those in special accommodation. Regression analysis, using these cutoff values, showed a significant association with mortality.

    Conclusion: Knowledge of how to use the ADL-staircase as a mortality predictor is limited. This study not only found a cutoff point for the total sample but also when grouped by type of housing. The findings may be useful when allocating care and service and when providing preventive interventions and palliative care. © 2011 Informa Healthcare USA, Inc.

  • 26.
    Johansson, Annika
    et al.
    Institutionen för hälsa, vård och samhälle, Avdelningen för omvårdnad, Medicinska fakulteten, Lunds universitet, Lund, Sverige.
    Selan, Denis
    Institutionen för hälsa, vård och samhälle, Avdelningen för omvårdnad, Medicinska fakulteten, Lunds universitet, Lund, Sverige.
    Karlsson, Staffan
    Vårdalinstitutet, Lunds universitet, Lund, Sverige.
    Distriktssköterskors erfarenhet av informationen kring pandemin A(H1N1), 2009 = District nurses experiences of the information concerning the pandemic a(HINI), 20092012In: Vård i Norden, ISSN 0107-4083, E-ISSN 1890-4238, Vol. 32, no 3, p. 4-8Article in journal (Refereed)
    Abstract [en]

    Aim: To explore district nurses' experiences of information received from the employer and communicated to patients in the context of the pandemic A(H1N1).

    Background: Dissemination of oral and written information in pandemics is essential to limit the spread of infection and public concern. Information is channeled via various authorities and health care centers, where district nurses often provide information directly to patients.

    Method: Transcribed semi structured interviews with 21 district nurses in Region Skåne were analyzed using qualitative content analysis.

    Results: The district nurses experienced shortfalls in the information communicated from the employer and that the relevant information was often preceded by public media. This made it problematic to provide information concerning pandemic A(H1N1) in a professional manner, as well as to mediate safety and credibility. During the pandemic the district nurses simultaneously sought information from websites, popular science magazines and other public media. The nurses did however express an understanding of the difficulty in this unique situation and have a positive outlook on the use of the intranet for dissemination of information.

    Conclusion: It is important that district nurses receive prompt and precise information from their employer in a pandemic to facilitate the patients' information needs in credible manner. 

  • 27.
    Karlsson, Staffan
    Lund University, Lund, Sweden.
    Dementia care in European countries, from the perspective of people with dementia and their caregivers2014Conference paper (Refereed)
    Abstract [en]

    Aim To investigate persons with dementia and their informal caregivers’ views of inter-sectoral information, communication and collaboration throughout the trajectory of dementia care, in eight European countries.

    Background: Living with dementia and being next of kin to a person with dementia means having to live through stages that have different characteristics, needs, challenges and requirements.

    Design Qualitative research. Focus groups were conducted in England, Estonia, Finland, France, Germany, The Netherlands, Spain and Sweden.

    Methods Persons with dementia (N=137) and their informal caregivers participated in focus group interviews during 2011. Content analysis generated a tentative model of information, communication and collaboration for people with dementia and their caregivers, which was then tested.

    Results The core finding was that information, communication and collaboration were to be focused on the persons with dementia and the informal caregivers. Entering into the trajectory of the disease and its consequences was addressed as an important point of departure. The relation to professional care required establishing a trusting relationship, tailor-made intervention and a single person or organisation to contact. Professional knowledge and commitment, variation in service and care adapted to needs were important.

    Conclusion As focus of care is on the person with dementia and their informal caregivers, a dyadic approach seems most suitable for dementia care. A trusting relationship and a specific person or organisation to contact seem to be indicators of best practice, as does adaptation to the needs of the person with dementia and their informal caregiver.

  • 28.
    Karlsson, Staffan
    Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
    Elderly Care Consumption in Municipalities, County Council and Informal Care2005Conference paper (Refereed)
    Abstract [en]

    The aim was to investigate care consumption in County Council, municipalities and informal care for people 65+, make comparisons between age groups and housing. Data was drawn from elderly in the southern part of Sweden (n=1958). Data were collected regarding demography, extent of professional care in municipalities and County Council, and informal care.

    49 % got care in special accommodation (SA) and the remaining at home (AH). More (p<0.006) of the oldest had help in PADL from home service care than the youngest elderly, 66 % and 34 % respectively. Less (p<0.007) home nursing care could be seen by the oldest (9.6 visits/month) compared to the youngest elderly (15.7 visits/month). In out-patient care by physician had 65 % of the youngest elderly contact with primary health care (PHC) compared to 74 % for the age groups 75 and above (p<0.004). The oldest had less number of contacts with psychiatry (1 %) and specialist care (SC) (55 %) compared to age group 75-84, 3 % and 62 % respectively (p<0.001 and p<0.006 respectively). More (p<0.001) elderly in SA (81 %) had contact with PHC by physician, compared to elderly AH (66 %). Outpatient SC (p<0.001) and hospital care (number of episodes p<0.001 and days p<0.002) were more frequent among elderly living AH in contrast to SA.

    Elderly is not a homogenous group with regard to care consumption. The youngest elderly and those living AH consumed more of specialised care while the oldest and those living in SA consumed more of PHC.

  • 29.
    Karlsson, Staffan
    Lund University, Lund, Sweden.
    Institutional care for older people with dementia in an European perspective2011Conference paper (Refereed)
    Abstract [en]

  • 30.
    Karlsson, Staffan
    Lund University, Lund, Sweden.
    Older people´s care and services in Sweden and Europe2011Conference paper (Other academic)
  • 31.
    Karlsson, Staffan
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Older people´s health and well-being in the Nordic countries2018Conference paper (Other academic)
    Abstract [en]

    Keynote speak

  • 32.
    Karlsson, Staffan
    Lund University, Lund, Sweden.
    Older people`s public health care and social services: Functional ability, health complaints, agreement in needs assessment and care satisfaction2008Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The overall aim was to describe and compare functional ability and health complaints of older people receiving municipal care in relation to housing and informal care, and factors associated with medical health care, municipal care and informal care. Further, the aim was to investigate agreement in needs assessments between personnel and older people and to investigate care satisfaction and health-related quality of life among older people receiving municipal care and services. Study I and II included 1958 persons aged 65 years and above, who were assessed for functional ability, health complaints, and level of informal and municipal care and service. Study II in addition included data from a register including medical health care. In study III (n=152), standardised needs assessments were performed by the staff. Later, the older person’s view was collected in a personal interview concerning functional ability, health complaints, public and informal care. In addition (Study IV, n=166), SF-12 was used for measuring health-related quality of life and for measuring care satisfaction. Cohabitation was a predictor of a combination of municipal and informal care at home (OR: 5.935), while assistance with Instrumental Activities of Daily Living (IADL) provided by municipal home care and services predicted municipal care only (OR: 0.344). Care in special accommodation was predicted by advanced age (OR: 1.051), dependency in IADL (OR: 19.883), Personal Activities of Daily Living (PADL) (OR: 02.695), and impaired cognitive ability (OR: 3.849) with receiving municipal care only as a reference. Living alone (OR: 0.106), dependency in IADL (OR: 11.348) and PADL (OR: 2.506), impaired cognitive ability (OR: 3.448), impaired vision or blindness (OR: 1.812) and the absence of slowly healing wounds (OR: 0.407) were predictors of special accommodation with a combination of informal and municipal care at home as a reference. 35% of those with public care at home were admitted to hospital and 76% had contact with outpatient care by physician compared to 26% and 87% respectively of those in special accommodation. Living in special accommodation was associated with more contacts with primary health care (B=0.643) and fewer contacts with specialist care (B=-0.722). Informal care was associated with more contacts with primary health care (B=0.413), specialist care (B=0.787), admissions to (B=0.265) and days in hospital (B=1.573). Agreement for dependency in IADL and PADL varied between good (κ=0.78) and moderate (κ=0.43). Poor agreement was found for dizziness (κw=0.17) and fair agreement for impaired hearing, urinary incontinence, pain, anxiety and depressed mood (κw between 0.21 and 0.37). Older persons reported more health complaints than were found in the personnel’s assessments, although significantly lower estimation was found only for incontinence and vision. Agreement for provided public care at home was poor, while for informal care it varied between very good and moderate. Low care satisfaction was associated with dependency in IADL (B=-1.338 and B=-1.630), impaired mobility (B=-12.579), blindness (B=-26.143), faeces incontinence (B=-11.898 and B=-17.529) and anxiety (B=-6.105 and B=-27.197), while high care satisfaction was associated with dependency in PADL (B=2.109) and receiving informal care with IADL from spouse (B=8.738). In special accommodation, low care satisfaction had to do with continuity, timing, the staff’s personal characteristics and with their ability to give service. At home, the older people were the least satisfied with the staff’s ability to do housework and to give medical care, with the staff’s amount of time and with their own influence over their care.

  • 33.
    Karlsson, Staffan
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Promotion of health with digital learning for older persons with dementia and their cohabitee at home2017Conference paper (Other academic)
  • 34.
    Karlsson, Staffan
    Lund University, Lund, Sweden.
    RightTimePlaceCare: Improving health service for European citizens with dementia2011In: Conference on Ageing Societies - a Japanese-Swedish Research Cooperation: Abstracts and CVs, 2011Conference paper (Refereed)
  • 35.
    Karlsson, Staffan
    Lund University, Lund, Sweden.
    Swedish health care and elderly care2013In: 2013 International Symposium on Healthcare for the Elderly: Program Book, 2013, p. 99-103Conference paper (Other academic)
  • 36.
    Karlsson, Staffan
    et al.
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Arvidsson, Susann
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Cuesta, Marta
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI).
    Millberg German, Lena
    Halmstad University, School of Health and Welfare, Centre of Research on Welfare, Health and Sport (CVHI), Health and Nursing.
    Nilsson, Caroline
    Varbergs kommun, Varberg, Sverige.
    HICube Kompetenta vården, Delrapport: Välfärdsteknik ur ett etiskt perspektiv, Varbergs kommun2018Report (Other academic)
  • 37.
    Karlsson, Staffan
    et al.
    Health Sciences, Lund University, Lund, Sweden.
    Bleijlevens, Michel
    Department of Health Services Research, Maastricht University, Maastricht, Netherlands.
    Roe, Brenda
    Evidence-based Practice Research Centre, Edge Hill University, Lancashire & Personal Social Services Research Unit, University of Manchester, Manchester, United Kingdom.
    Saks, Kai
    Department of Internal Medicine , University of Tartu, Tartu, Estonia.
    Soto Martin, Maria
    Alzheimer’s disease Research and Clinical Center, Toulouse University Hospital, Toulouse, France.
    Stephan, Astrid
    Department of Nursing Science, Witten/Herdecke University, Witten/Herdecke , Germany.
    Suhonen, Riita
    Department of Nursing Science, University of Turku, Turku, Finland.
    Zabalegui, Adelaida
    Nursing, Hospital Clinic of Barcelona, Barcelona, Spain.
    Hallberg, Ingalill R
    Pufendorf Institute, Lund University, Lund, Sweden.
    Dementia care in eight European countries from the perspective of recipients and their caregivers2015In: Abstract Booklet: Care, Cure and the Dementia Experience - A Global Challenge, 2015, p. 318-318Conference paper (Refereed)
    Abstract [en]

    Objectives: To investigate persons with dementia and their informal caregivers’ views of inter-sectoral information, communication and collaboration throughout the trajectory of dementia care, in eight European countries

    Methods: 137 persons with dementia and their informal caregivers participated in focus group interviews. Content analysis generated a tentative model of information, communication and collaboration for people with dementia and their caregivers.

    Results: The core nding was that information, communication and collaboration were to be focused on the persons with dementia and the informal caregivers. Entering into the trajectory of the disease and its consequences was addressed as an important point of departure. The relation to professional care required establishing a trusting relationship, tailor-made intervention and a single person or organisation to contact. Professional knowledge and commitment, variation in service, and care adapted to needs were important.

    Conclusion: As focus of care is on the person with dementia and their informal caregivers, a dyadic approach seems most suitable for dementia care. A trusting relationship and a speci c person or organisation to contact seem to be indicators of best practice, as does adaptation to the needs of the person with dementia and their informal caregiver. 

  • 38.
    Karlsson, Staffan
    et al.
    Department of Health Sciences, Faculty of Medicine, Lund University, Sweden.
    Bleijlevens, Michel
    Maastricht University, The Netherlands.
    Roe, Brenda
    Edge Hill University/University of Manchester, UK.
    Saks, Kai
    University of Tartu, Estonia.
    Soto Martin, Maria
    Alzheimer's Disease Research and Clinical Center in Toulouse University Hospital, France.
    Stephan, Astrid
    Witten/Herdecke University, Germany.
    Suhonen, Riita
    University of Turku, Finland.
    Zabalegui, Adelaida
    Hospital Clinic of Barcelona, Spain.
    Hallberg, Ingalill Rahm
    Lund University, Sweden.
    Dementia care in European countries, from the perspective of people with dementia and their caregivers2015In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 71, no 6, p. 1405-1416Article in journal (Refereed)
    Abstract [en]

    Aim: To investigate persons with dementia and their informal caregivers' views of inter-sectoral information, communication and collaboration throughout the trajectory of dementia care, in eight European countries.

    Background: Living with dementia and being next of kin to a person with dementia means having to live through stages that have different characteristics, needs, challenges and requirements.

    Design: Qualitative research. Focus groups were conducted in England, Estonia, Finland, France, Germany, The Netherlands, Spain and Sweden.

    Methods: Persons with dementia and their informal caregivers (N = 137) participated in focus group interviews during 2011. Content analysis generated a tentative model of information, communication and collaboration for people with dementia and their caregivers, which was then tested.

    Results: The core finding was that information, communication and collaboration were to be focused on the persons with dementia and the informal caregivers. Entering into the trajectory of the disease and its consequences was addressed as an important point of departure. The relation to professional care required establishing a trusting relationship, tailor-made intervention and a single person or organization to contact. Professional knowledge and commitment, variation in service and care adapted to needs were important.

    Conclusion: As focus of care is on the person with dementia and their informal caregivers, a dyadic approach seems most suitable for dementia care. A trusting relationship and a specific person or organization to contact seem to be indicators of best practice, as does adaptation to the needs of the person with dementia and their informal caregiver. © 2014 John Wiley & Sons Ltd.

  • 39. Karlsson, Staffan
    et al.
    Bökberg, Christina
    Ahlström, Gerd
    Quality of care significance for Quality of life in persons with dementia at risk of moving into nursing home: a cross-sectional stud2016Conference paper (Refereed)
    Abstract [en]

    Background: Quality of life in persons with dementia is, in large part, dependent on the quality of care they receive. Investigating both subjective and objective aspects of quality of care may reveal areas for improvement regarding their care, which information may ultimately enable persons with dementia to remain living in their own homes while maintaining quality of life. The aim of this study was threefold. Firstly, we wanted to describe self-reported quality of life in persons with dementia at risk of nursing home admission. Secondly, the aim was to describe subjective and objective aspects of quality of care. The third aim was to investigate the significance of quality of care for quality of life in persons with dementia at risk of nursing home admission.

    Methods: A cross-sectional interview study design was used, based on questionnaires about quality of life in persons with dementia and different aspects of quality of care. The participants were 177 persons with dementia at risk of nursing home admission. Descriptive and comparative statistics were used to analyse the data.

    Results: Persons with pain showed significantly lower quality of life in the dimensions behavioural competence (p=0.026) and psychological wellbeing (p=0.006) compared with those without pain. Satisfaction with received care seemed to have a positive effect on quality of life. The overall quality of life was perceived high even though one-third of the persons with dementia had daily pain and had had a weight loss of ≥4% during the preceding year. Furthermore, 23% of the persons with dementia had fallen during the last month and 40% of them had sustained an injury when falling.

    Conclusion: This study indicates need for improvements in home health care and social services for persons with dementia at risk for nursing home admission. Registered nurses are responsible for nursing interventions related to pain, patient safety, skin care, prevention of accidents, and malnutrition. Therefore, it is of great importance for nurses to have knowledge about areas that can be improved to be able to tailor interventions and thereby improve quality of care outcomes such as quality of life in persons with dementia living at home.

  • 40. Karlsson, Staffan
    et al.
    Bökberg, Christina
    Janlöv, Ann-Christin
    Ahlström, Gerd
    Hallberg, Ingalill R
    Best practice and needs of improvement in the chain of care for persons with dementia in Sweden2014Conference paper (Refereed)
    Abstract [en]

    INTRODUCTION: The fragmentation of responsibilities in the chain of care may result in information lost, duplications and discontinuity. This may in turn lead to consequences for the person with dementia dealing with unmet care needs.

    AIM: The aim of the study was to explore professional care providers’ and stakeholders' views of best practice and needs of improvement of information, collaboration and communication in the chain of care for persons with dementia in Sweden.

    METHOD: The study was carried out with an explorative qualitative design based on three focus group interviews. The text was analysed with qualitative content analysis.

    RESULTS: The participants’ views of best practices and needs of improvement resulted in six themes following the trajectory of dementia. “Dementia diagnosis significant for receiving care”, “Day care for person with dementia supportive to home care”, Collaboration between staff important for information delivery, Skilled staff for person-centred care”, “The life story of the person with dementia important source of information”,  and Relatives participation for continuity in the chain of care”.

    CONCLUSION: A well-functioning network between different professional care providers seems to have an impact on best practice in the chain of care for persons with dementia so they could remain at home despite loss of mental and physical functions.

  • 41.
    Karlsson, Staffan
    et al.
    Department of Health Sciences, Faculty of Medicine, Lund University, Sweden.
    Edberg, AK
    Department of Health Sciences, Faculty of Medicine, Lund University, Sweden.
    Hallberg, IR
    Department of Health Sciences, Faculty of Medicine, Lund University, Sweden.
    Functional ability and complaints among elderly receiving informal and formal or formal care only2005In: 18th World Congress of Gerontology and Geriatrics, Rio de Janeiro, Brazil, June 26-30, 2005: Abstracts / [ed] Elizabete Viana de Freitas & Carlos André Oighenstein, Basel: S. Karger, 2005, p. 707-707Conference paper (Refereed)
  • 42.
    Karlsson, Staffan
    et al.
    Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
    Edberg, Anna-Karin
    Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
    Hallberg, Ingalill Rahm
    Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden & The Vårdal Institute, The Swedish Institute for Health Sciences, Lund University, Lund, Sweden.
    Professional’s and older person’s assessments of functional ability, health complaints and received care and service: A descriptive study2010In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 47, no 10, p. 1217-1227Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of the study was to investigate the level of agreement between the needs assessment made by professional on the one hand, and the older person's views on the other. A further aim was to explore if the estimations made by the professional were systematically lower or higher compared to the views of the older person.

    Participants: The study included 152 individuals, 65+, who received public care and services in southern Sweden. The concept public care and services include home help, home nursing care, rehabilitation and special accommodation.

    Methods: Standardised needs assessments were performed by home help officers, registered nurses and one physiotherapist. Subsequently to the needs assessment, the older person's view was collected in a personal interview. Standardised assessment form was used covering items about demographic data, functional ability, health complaints, adaptation in housing, public and informal care. The concept informal care includes care from spouse and children. Cohen's Kappa was used for analysis of level ofagreement. and Chi-square tests for differences in estimation.

    Results: Level of agreement for dependency in instrumental activities of daily living (IADL) and personal activities of daily living (PADL) varied between good (kappa = 0.78) and moderate (kappa = 0.43). Poor agreement was found for occurrence of dizziness (kappa(w) = 0.17) and fair agreement for impaired hearing (kappa(w) = 0.27), urinary incontinence (kappa(w) = 0.38), pain (kappa(w) = 0.21), anxiety (kappa(w) = 0.37) and depressed mood (kappa(w) = 0.37). Older persons reported more health complaints than in the professional's assessments, significantly lower estimation was found for incontinence and vision. Level of agreement for provided public care at home (home help and home nursing care) was poor, for informal care it varied between very good and moderate.

    Conclusions: Needs assessments appeared to focus on older persons ADL, cognition anti informal care, while health complaints and social needs were less in focus. A more comprehensive view including preventive and palliative approach may improve quality of life for older persons receiving care and service. (C) 2010 Elsevier Ltd. All rights reserved.

  • 43.
    Karlsson, Staffan
    et al.
    Lund University, Lund, Sweden.
    Edberg, Anna-Karin
    Jakobsson, Ulf
    Hallberg, Ingalill R
    Care satisfaction among older people receiving public care and service, at home or in special accommodation2012In: 21st Nordic Congress of Gerontology : Dilemmas In Ageing Societies: Abstracts and Program, 2012, p. 136-136Conference paper (Refereed)
    Abstract [en]

    In order to be able to provide care and service of high quality to older people, knowledge about factors influencing their experience of satisfaction with the care is essential.

    Aim: The aim was to explore care satisfaction in relation to health related quality of life, functional dependency, health complaints and place of living among people 65 years or older, receiving formal care and service.

    Methods: 166 people receiving care and service from the municipality were interviewed regarding demography, functional ability, perceived health complaints and care. Health related quality of life was measured with SF-12, and care satisfaction was measured with a questionnaire.

    Results: The people were in mean 84 years old and those at home were more often cohabitating, less dependent in activities of daily living, less cognitively impaired and had fewer health complaints regarding mobility, faeces incontinence and pressure ulcer, compared to those in special accommodation (equivalent to nursing home). Low care satisfaction was associated with IADL dependency, blindness, faeces incontinence and anxiety, while high care satisfaction was associated with PADL dependency. Those at home rated an overall higher care satisfaction and were more satisfied with care continuity, personal relations and that staff have plenty of time, are respectful and quiet, than those in special accommodation.

    Conclusions: Care satisfaction and health related quality of life (HRQoL) among older people was found to be more associated to functional impairment and health complaints than to whether care and service is received at home or in special accommodation.

  • 44.
    Karlsson, Staffan
    et al.
    Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
    Edberg, Anna-Karin
    The Swedish institute for Health Sciences, Lund University, Sweden.
    Jakobsson, Ulf
    Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
    Hallberg, Ingalill R
    The Swedish institute for Health Sciences, Lund University, Sweden.
    Care satisfaction among older people receiving public care and service, at home or in special accommodation2011In: Positioning Nursing for the Future: Advancing Nurses´Role in Community and Home Care: 1st NUS-NUH International Nursing Conference, 2011, p. 100-100Conference paper (Refereed)
    Abstract [en]

    In order to be able to provide care and service of high quality to older people, knowledge about factors influencing their experience of satisfaction with the care is essential.

    Purpose: To explore care satisfaction in relation to health related quality of life, functional dependency, health complaints and place of living among people 65 years or older, receiving formal care and service.

    Methods: 166 people receiving care and service from the municipality were interviewed regarding demography, functional ability, perceived health complaints and care. Health related quality of life was measured with SF-12, and care satisfaction was measured with a questionnaire.

    Results: The people were in mean 84 years old and those at home were more often cohabitating, less dependent in activities of daily living, less cognitively impaired and had fewer health complaints regarding mobility, faeces incontinence and pressure ulcer, compared to those in special accommodation (equivalent to nursing home). Low care satisfaction was associated with IADL dependency, blindness, faeces incontinence and anxiety, while high care satisfaction was associated with PADL dependency. Those at home rated an overall higher care satisfaction and were more satisfied with care continuity, personal relations and that staff have plenty of time, are respectful and quiet, than those in special accommodation.

    Conclusions: Care satisfaction and health related quality of life (HRQoL) among older people was found to be more associated to functional impairment and health complaints than to whether care and service is received at home or in special accommodation.

  • 45.
    Karlsson, Staffan
    et al.
    Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
    Edberg, Anna-Karin
    The Vårdal Institute, The Swedish Institute for Health Sciences, Lund University, Lund, Sweden.
    Jakobsson, Ulf
    Center for Primary Health Care Research, Lund University, Skåne University Hospital, Malmö, Sweden.
    Hallberg, Ingalill Rahm
    The Vårdal Institute, The Swedish Institute for Health Sciences, Lund University, Lund, Sweden.
    Care satisfaction among older people receiving public care and service at home or in special accommodation2013In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 22, no 3-4, p. 318-330Article in journal (Refereed)
    Abstract [en]

    Aims and objectives: To explore care satisfaction in relation to place of living, health-related quality of life, functional dependency and health complaints among people 65 years or older, receiving public care and service. The concept public care and service concerns formal care from the municipality, including home help, home nursing care, rehabilitation and a special accommodation.

    Background: To be able to provide care and service of high quality to older people, knowledge about factors influencing their experience of satisfaction with the care is essential.

    Design: Cross-sectional, including comparison and correlation.

    Methods: One-hundred sixty-six people receiving public care and service from the municipality were interviewed regarding demography, functional ability, perceived health complaints and care. Health-related quality of life was measured with SF-12, and self-rated care satisfaction was measured with a questionnaire.

    Results: Low self-rated care satisfaction was associated with dependency in Instrumental Activities of Daily Living, blindness, faeces incontinence and anxiety, while high self-rated care satisfaction was associated with dependency in Personal Activities of Daily Living. Those at home rated an overall higher care satisfaction and were more satisfied with care continuity and personal relations; they thought that the staff had more time and were more respectful and quiet, than the ratings by those in a special accommodation (equivalent to a nursing home).

    Conclusions: Care satisfaction and health-related quality of life among older people was more associated with functional impairment and health complaints than to whether care and service was received at home or in a special accommodation.

    Relevance to clinical practice: An approach using intervention focused on functional ability and health complaints is important for development of improved care satisfaction for older people receiving public care and service.

  • 46.
    Karlsson, Staffan
    et al.
    Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
    Edberg, Anna-Karin
    The Vårdal Institute. The Swedish Institute for Health Science, Lund University, Lund, Sweden.
    Westergren, Albert
    Research and Development Unit, Central Hospital, Kristianstad, Sweden.
    Halberg, Ingalill Rahm
    Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden & The Vårdal Institute. The Swedish Institute for Health Science, Lund University, Lund, Sweden.
    Older People Receiving Public Long-Term Care in Relation to Consumption of Medical Health Care and Informal Care2008In: The Open Geriatric Medicine Journal, ISSN 1874-8279, Vol. 1, p. 1-9Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to investigate medical health care and informal care consumption among older people receiving public long-term care, and factors associated with medical health care consumption. 1958 persons aged 65 years and over were included. Data were collected from two registers, including demography, functional ability and received long-term, informal and medical health care. 35% of those at home were admitted to hospital and 76% had contact with outpatient care by physician compared to 26% and 87% respectively of those in special accommodation. Living in special accommodation was associated with more contacts with primary health care and fewer contacts with specialist care other than psychiatric care. Informal care was associated with more contacts with primary health care, specialist care, admis- sions to and days in hospital. More elderly people being cared for at home may mean more hospital and outpatient care consumption.

  • 47.
    Karlsson, Staffan
    et al.
    Department of Health Sciences, Faculty of Medicine, Lund University, Sweden.
    Edberg, Anna-Karin
    Department of Health Sciences, Lund University, Lund, Sweden.
    Westergren, Albert
    Lund University, Lund, Sweden.
    Hallberg, Ingalill Rahm
    Lund University, Lund, Sweden.
    Content and predictors for care from municipalities, the County Council and informal care givers2002Conference paper (Refereed)
  • 48. Karlsson, Staffan
    et al.
    Edberg, Anna-Karin
    Westergren, Albert
    Hallberg, Ingalill Rahm
    Elderly receiving informal and formal care or formal care only with regard to functional ability and complaints: Book of Abstracts2004In: 12th Biennial Conference of the Workgroup of European Nurse Researchers – Nursing Research, Nursing's <contribution for Health of European Citizens, 2004, p. 88-88Conference paper (Refereed)
    Abstract [en]

    Besides the professional health and elderly care also provision of informal care is extensive to elderly. The aim was to describe and compare elderly people living at home and in special accommodation receiving informal and formal care or formal care only, with regard to functional ability and health complaints. Data was drawn from elderly people living in the southern part of Sweden (n=1963). Data covered the ”ADL-staircase” (Hulter-Asberg 1989) to measure Activity in Daily Living and cognitive functional ability (Berger 1980).

    Elderly living in special accommodation were older (mean age 85) than those living at home (mean age 82, p <0,001) and more often women (71 % and 66 % respectively, p <0,015). Informal care with regard to PADL and IADL were more common among those living at home than in special accommodation (PADL 24 % and 3 %, p <0,001; concerning IADL 64 % and 11 %, p <0,001). Mostly children gave informal help in IADL and the spouse in PADL, 33 % and 14 % respectively. Elderly at home with informal and formal care had significantly higher extent of walking problems, urinary incontinence and slow healing wounds than those with only formal care (p <0,043 and <0,001). Having informal care at home was associated with dependence for shopping food, transportation, and activities in social life, but also with urinary incontinence. Formal care only at home was associated with dependency in cleaning and bathing as well as faeces incontinence.

  • 49.
    Karlsson, Staffan
    et al.
    Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
    Edberg, Anna-Karin
    Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden & The Vårdal Institute. The Swedish institute for health science, Lund University, Lund, Sweden.
    Westergren, Albert
    Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden.
    Hallberg, Ingalill Rahm
    Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden & The Vårdal Institute. The Swedish institute for health science, Lund University, Lund, Sweden.
    Functional ability and health complaints among older people with a combination of public and informal care versus public care only2007In: Abstract Book: 8th Asia/Oceania Regional Congress of Gerontology and Geriatrics, 2007, p. 161-162Conference paper (Refereed)
    Abstract [en]

    The aim of the study was to investigate functional ability   and health complaints of people, 65+, living in special accommodation and   their counterparts who live at home and receive public care or a combination   of public and informal care. Persons   (n=1958) in receipt of municipal care were assessed in terms of functional   ability, health complaints, and level of informal and municipal care and   services. The results showed that more home care, services and help with IADL   were provided to those receiving only public care at home, while more home   care and services associated with PADL as well as nursing care were provided   to those in receipt of informal care. Cohabitation was a predictor of a   combination of public and informal care in the home (OR 5.935), while   assistance with IADL provided by public home care and services predicted   public care only (OR 0.344). Care in special accommodation was predicted by   advanced age (OR 1.051), dependency in IADL (OR 19.883) and PADL (OR 2.695),   and impaired cognitive ability (OR 3.849) with receipt of public care only as   a reference. Living alone (OR 0.106), dependency in IADL (OR 11.348) and PADL   (OR 2.506), impaired cognitive ability (OR 3.448), impaired vision or   blindness (OR 1.812) and the absence of slowly healing wounds (OR 0.407) were   predictors of special accommodation with a combination of informal and public   care at home as a reference. The distribution of municipal care divided older   people into   three distinct groups. The most frail and elderly people who had   no cohabitants received care in special accommodation, determined by their level of   physical and cognitive dependency. The frailest individuals living at home were cohabiting   and received a combination of public and informal care, while those who were   less dependent mainly had help with IADL from public care only.

     

  • 50.
    Karlsson, Staffan
    et al.
    Department of Health Sciences, Faculty of Medicine, Lund University, Sweden.
    Edberg, Anna-Karin
    Department of Health Sciences, Faculty of Medicine & The Vårdal Institute, The Swedish institute for Health Sciences, Lund University, Sweden.
    Westergren, Albert
    Department of Health Sciences, Faculty of Medicine, Lund University, Sweden.
    Hallberg, Ingalill Rahm
    Department of Health Sciences, Faculty of Medicine & The Vårdal Institute, The Swedish institute for Health Sciences, Lund University, Sweden.
    Functional ability and health complaints among older people with a combination of public and informal care vs. public care only2008In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 22, no 1, p. 136-148Article in journal (Refereed)
    Abstract [en]

    The aim of the study was to investigate functional ability and health complaints of people, 65+, living in special accommodation (equivalent to nursing home) and their counterparts who live at home and receive municipal care or a combination of municipal and informal care. Persons (n = 1958) receiving municipal care were assessed in terms of functional ability, health complaints, and level of informal and municipal care and services. The results showed that more home care, services and help with Instrumental Activities of Daily Living (IADL) were provided to those receiving only municipal care at home, while more home care and services associated with Personal Activities of Daily Living (PADL) as well as nursing care were provided to those receiving informal care in addition to formal care. Cohabitation was a predictor of a combination of municipal and informal care in the home (OR: 5.935), while assistance with IADL provided by municipal home care and services predicted municipal care only (OR: 0.344). Care in special accommodation was predicted by advanced age (OR: 1.051), dependency in IADL (OR: 19.883) and PADL (OR: 2.695), and impaired cognitive ability (OR: 3.849) with receiving municipal care only as a reference. Living alone (OR: 0.106), dependency in IADL (OR: 11.348) and PADL (OR: 2.506), impaired cognitive ability (OR: 3.448), impaired vision or blindness (OR: 1.812) and the absence of slowly healing wounds (OR: 0.407) were predictors of special accommodation with a combination of informal and municipal care at home as a reference. The distribution of municipal care divided older people into three distinct groups. The most frail and elderly people who had no cohabitants received care in special accommodation, determined by their level of physical and cognitive dependency. The frailest individuals living at home were cohabiting and received a combination of municipal and informal care, while those who were less dependent mainly had help with IADL from municipal care only. The results indicate that there is a shift from the substitution to the complementary model and highlights that attention to the family carers is needed. © 2008 Nordic College of Caring Science

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