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Ernsth-Bravell, MarieORCID iD iconorcid.org/0000-0003-4149-9787
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Publications (10 of 167) Show all publications
Torge, C. J., Allgurin, M., Bülow, P. H., Bulow, P., Jegermalm, M. & Ernsth-Bravell, M. (2025). Experiences of Eldercare Staff Working With Older People With Severe Mental Illness. Health & Social Care in the Community, 2025(1), Article ID 2186889.
Open this publication in new window or tab >>Experiences of Eldercare Staff Working With Older People With Severe Mental Illness
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2025 (English)In: Health & Social Care in the Community, ISSN 0966-0410, E-ISSN 1365-2524, Vol. 2025, no 1, article id 2186889Article in journal (Refereed) Published
Abstract [en]

In Sweden, older persons living with severe mental illnesses (SMI) increasingly live independently in the community with support from informal and formal carers and welfare services. A proportion of this group is older people with SMI who, due to age or disability, receive municipal eldercare services such as home care in their ordinary housing, or in residential care. The situation and needs of this group demand that eldercare staff have an understanding for the older person's situation and the tools to provide appropriate care. The aim of this present study is to explore the experiences of eldercare staff working with older people with SMI. Focus group interviews were conducted with staff from three residential care facilities and two home care teams in one mid-sized Swedish municipality. To analyse the interviews, qualitative content analysis was used. The overarching theme from the analysis was "Doing the best they can," which was unpacked in two categories: "Working with fragmentary knowledge" and "Finding the right approach." We could also see differences between the experiences of staff in residential care and in home care. The eldercare staff in our interviews faced lack of formal training, insufficient information and skills concerning mental illness and its treatment. Nevertheless, they tried to make the situation of the older people with SMI as good as possible using experiential and tacit knowledge. Our results also point to system level barriers that hinder effective care for older people with SMI.

Place, publisher, year, edition, pages
John Wiley & Sons, 2025
Keywords
assisted living, eldercare, mental illness, qualitative methods, social and welfare services
National Category
Nursing Geriatrics
Identifiers
urn:nbn:se:hj:diva-67210 (URN)10.1155/hsc/2186889 (DOI)001401209500001 ()HOA;;997937 (Local ID)HOA;;997937 (Archive number)HOA;;997937 (OAI)
Funder
Swedish Research Council
Available from: 2025-02-03 Created: 2025-02-03 Last updated: 2025-02-03Bibliographically approved
Östlund, L., Sandberg, J., Skillmark, M., Ernsth-Bravell, M. & Johansson, L. (2024). A Swedish study about how staff reason and act when they suspect domestic abuse perpetrated by relatives of persons with dementia. European Journal of Social Work, 27(2), 387-400
Open this publication in new window or tab >>A Swedish study about how staff reason and act when they suspect domestic abuse perpetrated by relatives of persons with dementia
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2024 (English)In: European Journal of Social Work, ISSN 1369-1457, E-ISSN 1468-2664, Vol. 27, no 2, p. 387-400Article in journal (Refereed) Published
Abstract [en]

Older persons with dementia have several risk factors for being exposed to domestic abuse, for example dependency on others to manage daily life. The purpose of the study was to explore how staff act and reason when suspecting domestic abuse perpetrated by informal caregivers of persons with dementia. Eight semi-structured group interviews were conducted with staff (n = 39) working with persons with dementia living in their ordinary homes. A thematic analysis generated two themes; Missing a map for guidance and Being left to one’s own inner compass for direction indicating that staff experienced a lack of guidelines and protocols to work from when suspecting abuse. This resulted in staff taking actions based on their own norms, values, and experiences when suspecting domestic abuse. Not knowing how to act risks leading to staff ending up doing nothing or being unable to identify effective interventions, accompanied by feelings of guilt and ethical stress. The results highlight the necessity of providing staff with tools for how to act when they suspect domestic abuse, such as collaboration with others, colleagues, and other organisations where different options for interventions can emerge.

Abstract [sv]

Svensk titel: En svensk studie om hur personal resonerar och agerar när demisstänker våld i nära relationer som begås av anhöriga tillpersoner med demenssjukdom.

Äldre personer med demenssjukdom har flera riskfaktorer för att utsättas för våld i nära relationer, till exempel att vara beroende av andra för att klara det dagliga livet. Syftet med studien var att undersöka hur personal agerar och resonerar vid misstanke om våld i nära relationer som begås av anhöriga till personer med demenssjukdom. Åtta semistrukturerade gruppintervjuer genomfördes med personal (n = 39) som arbetar med personer med demenssjukdom som bor i ordinärt boenden. En tematisk analys genererade två teman; karta saknas för att ge guidning och vara utlämnad till en inre kompass för att finna riktning, vilket tyder på att personalen upplevde en brist på rutiner och riktlinjer att utgå ifrån vid misstanke om våld i nära relation. Detta resulterade i att personalen vidtog åtgärder utifrån sina egna normer, värderingar och erfarenheter vid misstanke om våld i nära relationer. Att inte veta hur man ska agera riskerar att leda till att personalen inte gör något eller har svårighter att hitta effektiva insatser, vilket kan leda till skuldkänslor och etisk stress. Resultatet belyser behovet av att ge personalen verktyg för hur de ska agera vid misstanke om våld i nära relationer, såsom samarbete med andra, kollegor och andra verksamheter där olika alternativ för insatser kan växa fram.

Place, publisher, year, edition, pages
Taylor & Francis, 2024
Keywords
Elder abuse, old age care, group interviews, dilemmas, dementia, demenssjukdom, dilemman, gruppintervjuer, våld mot äldre, äldreomsorg
National Category
Gerontology, specialising in Medical and Health Sciences Social Work
Identifiers
urn:nbn:se:hj:diva-62566 (URN)10.1080/13691457.2023.2276653 (DOI)001100045000001 ()2-s2.0-85176309944 (Scopus ID)HOA;;1801546 (Local ID)HOA;;1801546 (Archive number)HOA;;1801546 (OAI)
Funder
Konung Gustaf V:s och Drottning Victorias Frimurarestiftelse
Note

Included in licentiate thesis in manuscript form (submitted to journal).

Available from: 2023-10-02 Created: 2023-10-02 Last updated: 2024-05-28Bibliographically approved
Johansson, L., Sandberg, J., Ernsth-Bravell, M. & Östlund, L. (2024). Health and social care staff's recognition of elder abuse perpetrated by family members of persons with dementia: a mixed-method study. Scandinavian Journal of Public Health
Open this publication in new window or tab >>Health and social care staff's recognition of elder abuse perpetrated by family members of persons with dementia: a mixed-method study
2024 (English)In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905Article in journal (Refereed) Epub ahead of print
Abstract [en]

BACKGROUND: Health and social care staff play a significant role in detecting and reporting abuse among persons with dementia. However, they are often left to their own judgements which can lead to elder abuse not being detected or acted on. The aim was to explore what healthcare and social care staff consider elder abuse, and their experience of elder abuse perpetrated by family members of persons with dementia.

METHODS: This mixed-method vignette study was conducted in Sweden during the year 2021. In total 39 staff working in dementia care were included. They first answered the Caregiver Scenario Questionnaire and then participated in a group interview.

RESULTS: An inconsistency was revealed regarding whether a management strategy for behavioural difficulties included in the Caregiver Scenario Questionnaire should be considered an abusive act or not. No participants were able to identify all five abusive behaviour management strategies. Participants described witnessing 101 abusive acts including different types of abuse of a person with dementia, with emotional/psychological abuse and neglect being most common.

CONCLUSIONS: Health and social care staff who work close to older persons are able to detect abuse perpetrated by family members. However, inconsistency in defining abusive acts demonstrates the uncertainty in identifying abuse. This may lead to abuse not being identified, but it also creates feelings of inadequacy among staff.

Place, publisher, year, edition, pages
Sage Publications, 2024
Keywords
Dementia, Sweden, dental care, domestic violence, elder abuse, health personnel, intimate partner violence, prevention
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-65960 (URN)10.1177/14034948241261724 (DOI)001287935200001 ()39126210 (PubMedID)2-s2.0-8520097524 (Scopus ID)HOA;;966082 (Local ID)HOA;;966082 (Archive number)HOA;;966082 (OAI)
Funder
Konung Gustaf V:s och Drottning Victorias Frimurarestiftelse
Available from: 2024-08-16 Created: 2024-08-16 Last updated: 2024-08-19
Ernsth-Bravell, M. & Fristedt, S. (2024). Information, training and support for staff is essential for a successful implementation of welfare technology-but don't forget the end-users!. Evidence-Based Nursing, Article ID 04130.
Open this publication in new window or tab >>Information, training and support for staff is essential for a successful implementation of welfare technology-but don't forget the end-users!
2024 (English)In: Evidence-Based Nursing, ISSN 1367-6539, E-ISSN 1468-9618, article id 04130Article in journal (Other academic) Epub ahead of print
Abstract [en]

The interest of using digital technologies, robots etc in supporting old age care is growing, due to the fact that the technological possibilities are also increasing. The fact that older populations are growing while working populations are decreasing in proportion represents yet a driving force. Implementation of welfare technology for older people and persons with disabilities requires awareness of that necessary evidence and guidance may not always be available, even though it is necessary for a successful implementation of the same.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2024
Keywords
Evidence-Based Nursing, Nursing
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-66901 (URN)10.1136/ebnurs-2024-104130 (DOI)39721735 (PubMedID)2-s2.0-85214533661 (Scopus ID)
Note

Commentary on: Ren, LH., Wong, KLY., Wong, J., Kleiss, S., Berndt, A., Mann, J., Hussein, A., Hu, G., Wong, L., Khong, R., Fu, J., Ahmed, N., Nolte, J., Hung, L. (2024) Working with a robot in hospital and long-term care homes: staff experience BMC Nursing 23:317 https://doi.org/10.1186/s12912-024-01983-0

Available from: 2025-01-06 Created: 2025-01-06 Last updated: 2025-01-22
Ernsth-Bravell, M. & Johansson, L. (2024). Need and importance of reflections of dignity at the end of life for nursing students. Evidence-Based Nursing, Article ID ebnurs-2024-103972.
Open this publication in new window or tab >>Need and importance of reflections of dignity at the end of life for nursing students
2024 (English)In: Evidence-Based Nursing, ISSN 1367-6539, E-ISSN 1468-9618, article id ebnurs-2024-103972Article in journal (Other academic) Epub ahead of print
Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2024
Keywords
Nursing Education Research
National Category
Nursing Learning
Identifiers
urn:nbn:se:hj:diva-65377 (URN)10.1136/ebnurs-2024-103972 (DOI)38866429 (PubMedID)2-s2.0-85196156911 (Scopus ID)
Note

Commentary on: Farfán- Zúñiga, X abd Jaman- Mewes, P. Reflections of nursing students on the care of the person’s dignity at the end of life: a qualitative study. Nurse Education Today, 2024; 133: 106067.

Available from: 2024-06-25 Created: 2024-06-25 Last updated: 2024-08-13Bibliographically approved
Schaefer, S., Peterson, D., Ernsth-Bravell, M. & Finkel, D. (2024). PREDICTING THE ONSET OF DEMENTIA WITH LONGITUDINAL OBJECTIVE MEASURES OF PHYSICAL FUNCTION. Innovation in Aging, 8(Supplement 1), 1364-1365
Open this publication in new window or tab >>PREDICTING THE ONSET OF DEMENTIA WITH LONGITUDINAL OBJECTIVE MEASURES OF PHYSICAL FUNCTION
2024 (English)In: Innovation in Aging, E-ISSN 2399-5300, Vol. 8, no Supplement 1, p. 1364-1365Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Older adults with dementia have reduced physical function; however, whether physical function decline accelerates prior to dementia onset remains unclear. This study compared changes in three objective physical function measures for up to 26 years in 518 older adults who did or did not develop dementia: Time to complete a three-meter walk (Gait), grip dynamometry (Grip strength), and time to complete five functional tasks (e.g., putting coins into a slot) (Fine motor). Data from three longitudinal Swedish datasets of older adults (OCTO-Twin, GENDER, SATSA) were analyzed. During the studies, 259 participants were diagnosed with dementia (through clinical consensus); only data prior to the age of dementia onset were included. Propensity matching identified 259 participants who did not develop dementia and whose age at last observation matched the age of diagnosis in the dementia group. Linear latent growth curve models captured longitudinal changes in each measure prior to the onset of disability; thus, intercepts reflect an estimate of physical function at dementia onset or the last timepoint in the study. After controlling for sex, the fine motor test declined faster in the dementia onset group, with differences emerging 9 years prior to dementia onset. Gait and grip strength showed no differences between groups in the rate of change. Fine motor decline also occurred at the same rate as cognitive decline (measured with the Mini-mental status exam). These findings suggest that functional fine motor tasks may identify elevated risk for developing dementia, particularly in cases where memory tests may not be reliable.

Place, publisher, year, edition, pages
Oxford University Press, 2024
National Category
Geriatrics
Identifiers
urn:nbn:se:hj:diva-66999 (URN)10.1093/geroni/igae098.4351 (DOI)001388252100001 ()HOA;intsam;993011 (Local ID)HOA;intsam;993011 (Archive number)HOA;intsam;993011 (OAI)
Available from: 2025-01-13 Created: 2025-01-13 Last updated: 2025-01-13Bibliographically approved
Ernsth-Bravell, M., Johansson, L. & Finkel, D. (2024). PREVENTION OF SEVERE EVENTS IN OLDER PEOPLE IN SWEDEN: POSSIBILITIES AND CHALLENGES. Innovation in Aging, 8(Supplement 1), 1267-1268
Open this publication in new window or tab >>PREVENTION OF SEVERE EVENTS IN OLDER PEOPLE IN SWEDEN: POSSIBILITIES AND CHALLENGES
2024 (English)In: Innovation in Aging, E-ISSN 2399-5300, Vol. 8, no Supplement 1, p. 1267-1268Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Older adults are at high risk of malnutrition, falls, pressure ulcers and poor oral health. In Sweden the quality register Senior Alert is trying to improve the preventive work among older people. This study used data from Senior Alert to understand how the preventive work process functions in different care settings. Data included 2957 persons that were assessed in Senior Alert: 864 in nursing homes, 226 in home care and 1829 in hospital. Descriptive and comparative analyses were performed to understand how many were assessed as having risk, and then the actions planned and follow-ups. The results demonstrated that people who were assessed in hospital had risks of some kind in almost half of the cases (46%), in comparison to nursing homes (29%) and home care (8%). Planned actions differed between the settings: in nursing homes, actions were more often planned to prevent poor oral health (29%) whereas hospital staff more often planned actions to prevent falls (73%), malnutrition (71%) and pressure ulcers (57%). Planned actions were significantly less in home care. Follow-ups follow the same patterns, where follow-up in home care were significantly smaller than in nursing homes and hospitals in all areas. Home care provides good opportunities to provide preventive care, as it is more continuous than, for example, hospital care. Additional analyses identified particular actions planned and performed, for a fine-grained investigation of preventive care in Sweden.

Place, publisher, year, edition, pages
Oxford University Press, 2024
National Category
Geriatrics
Identifiers
urn:nbn:se:hj:diva-67059 (URN)10.1093/geroni/igae098.4053 (DOI)001388971600001 ()
Available from: 2025-01-16 Created: 2025-01-16 Last updated: 2025-01-16Bibliographically approved
Johansson, L., Ernsth-Bravell, M. & Östlund, L. (2023). Erfarenheter och uppfattningar av tvång och begränsningar vid vård och omsorg av personer med kognitiv nedsättning i Jönköpings kommun. Jönköping: Jönköpings kommun
Open this publication in new window or tab >>Erfarenheter och uppfattningar av tvång och begränsningar vid vård och omsorg av personer med kognitiv nedsättning i Jönköpings kommun
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2023 (Swedish)Report (Other academic)
Abstract [sv]

Tvång och begränsningar i vård och omsorg är inte tillåtet, men används trots detta ändå ibland vid vård av personer med kognitiv nedsättning. I många fall med goda intentioner. I Jönköping kommun har olika utbildningsinsatser gjorts för att arbeta mot den nollvision som finns på nationell nivå. Ett samverkansprojekt mellan Jönköping kommun och Jönköping University startades upp för att få en tydligare bild av fortsatta utbildningsbehov. Syftet med studien var att kartlägga personals erfarenheter och uppfattningar om användandet av tvång och begränsningar inom kommunal vård och omsorg av personer med demenssjukdom. Totalt fjorton fokusgruppsintervjuer med vård- och omsorgspersonal som mötte personer med demenssjukdom inom ordinärt eller särskilt boende genomfördes och ligger till grund för studien. Materialet analyserades med tematisk analys och visa ratt användandet av tvång och begränsningar var relaterat till både relationella aspekter och det direkta mötet såväl som till strukturella och organisatoriska aspekter. Skillnader bland vård- och omsorgspersonalens kunskap och arbete med tvång och begränsningar skilde sig åt beroende på var i organisationen de arbetade. Vård- och omsorgspersonal har ofta förmåga att själva hitta alternativa lösningar och på så vis undvika tvång och begränsningar, men för att öka kunskapen ytterligare behövs ökade möjlighet att reflektera med kollegorna i det dagliga arbetet. 

Place, publisher, year, edition, pages
Jönköping: Jönköpings kommun, 2023. p. 24
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-59844 (URN)
Available from: 2023-02-16 Created: 2023-02-16 Last updated: 2023-10-02Bibliographically approved
Östlund, L., Ernsth-Bravell, M. & Johansson, L. (2023). Working in a gray area: Healthcare staff experiences of receiving consent when caring for persons with dementia. Dementia, 22(1), 144-160
Open this publication in new window or tab >>Working in a gray area: Healthcare staff experiences of receiving consent when caring for persons with dementia
2023 (English)In: Dementia, ISSN 1471-3012, E-ISSN 1741-2684, Vol. 22, no 1, p. 144-160Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Every person has the right to autonomy, and to be involved in decisions about their care. When persons with dementia have difficulties in expressing what they want, their autonomy is challenged. Staff should strive to involve the person in care decisions, to obtain consent and to avoid the use of coercion and restraints. However, care without consent exists and coercion and restraints are being used. In order to improve care, further knowledge is warranted.

AIMS: The purpose of this study was to explore staff's experiences of obtaining consent when caring for persons with dementia.

METHODS: In total 14 focus group interviews were conducted with staff with experience of dementia care who work in either home care or residential care in Sweden. An inductive qualitative content analysis was used to analyze the collected data.

RESULTS: Three categories were generated describing staff experiences of consent in dementia care: the person as the decision-maker, the staff as the decision-makers, and the viability of the consent. Overall, staff found it difficult to know if they really had consent from the individual. Even if the person verbally gave consent, it was challenging to know if the person really understood what they had consented to. Common to all three categories was the significance of the relationship between the person with dementia and staff: getting to know the person, recognizing the person's response in terms of their facial expressions and body language as well as being able to explain and justify specific actions to the person.

CONCLUSION: Staff need better conditions in dementia care, including training and time to reflect on how to obtain consent. A person-centered approach can be one way to develop care and ensure that persons with dementia are allowed autonomy and to share in making decisions.

Place, publisher, year, edition, pages
Sage Publications, 2023
Keywords
consent, dementia, elderly care, focus groups, qualitative content analysis
National Category
Gerontology, specialising in Medical and Health Sciences Nursing
Identifiers
urn:nbn:se:hj:diva-58911 (URN)10.1177/14713012221137472 (DOI)000885685000001 ()36380421 (PubMedID)2-s2.0-85142252508 (Scopus ID)HOA;;1711368 (Local ID)HOA;;1711368 (Archive number)HOA;;1711368 (OAI)
Available from: 2022-11-16 Created: 2022-11-16 Last updated: 2023-10-02Bibliographically approved
Finkel, D., Johansson, L., Westerlind, B., Lindmark, U. & Ernsth-Bravell, M. (2022). AGE AND SITE DIFFERENCES IN PLANNED AND PERFORMED ACTIONS IN RESPONSE TO IDENTIFIED RISKS IN OLDER ADULTS. Innovation in Aging, 6(Supplement 1), 840-840
Open this publication in new window or tab >>AGE AND SITE DIFFERENCES IN PLANNED AND PERFORMED ACTIONS IN RESPONSE TO IDENTIFIED RISKS IN OLDER ADULTS
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2022 (English)In: Innovation in Aging, E-ISSN 2399-5300, Vol. 6, no Supplement 1, p. 840-840Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

The Swedish health care system focuses on allowing older adults to “age in place”; however, that approach assumes that home health services are adequate to support health and prevent unnecessary decline. Data from the Senior Alert national quality register in Sweden were examined to compare the quality of care across care locations. First registration in Senior Alert was available for 2914 adults aged 57–109 (median age = 81): 3.6% dementia unit, 7.8% home health care, 4.4% rehabilitation unit, 62.8% hospital, 21.4% care home. There were significant differences across units in the number of identified risks in 4 categories: falls, malnutrition, oral health, and pressure ulcer. Individuals in rehabilitation units averaged 2.4 risks, individuals in dementia and care homes averaged 2.0 risks, and individuals in home health care and hospitals averaged 1.4 risks. For individuals with identified risks, the differences between planned and performed actions for each risk independently were greatest for those in home health care. Moreover, the correlation between total planned and performed actions in home health care was .79 for adults aged 65–80 years and .39 for adults aged 81 and over. The correlation did not differ across age for the other care units. Results suggest that individuals most in need of actions to address health risks (older adults in home health care) are least likely to have the actions performed. Training and support of workers responsible for home health care need to be improved if the “age in place” policy is to continue.

Place, publisher, year, edition, pages
Oxford University Press, 2022
National Category
Geriatrics
Identifiers
urn:nbn:se:hj:diva-60008 (URN)10.1093/geroni/igac059.3012 (DOI)000913044004187 ()
Available from: 2023-03-21 Created: 2023-03-21 Last updated: 2023-03-21Bibliographically approved
Organisations
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ORCID iD: ORCID iD iconorcid.org/0000-0003-4149-9787

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