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  • 1.
    Eide, Leslie S. P.
    et al.
    Department of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway.
    Giske, Tove
    Faculty of Health Studies, VID Specialized University, Bergen, Norway.
    Kuven, Britt Moene
    Department of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway.
    Johansson, Linda
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Consequences of the Covid-19 virus on individuals receiving homecare services in Norway: A qualitative study of nursing students’ reflective notes2021In: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955, Vol. 20, no 1, article id 208Article in journal (Refereed)
    Abstract [en]

    Reflective notes in nursing education can facilitate students’ understanding of how individuals in need of home healthcare services experience unfamiliar situations, such as a pandemic. The aim of this study is to describe the consequences of the COVID-19 virus for individuals receiving homecare services through the eyes of nursing students.

  • 2.
    Eide, W. M.
    et al.
    Department of Health and Social Sciences, Western Norway University of Applied Sciences, Inndalsveien 28, Bergen, 70305020, Norway.
    Johansson, Linda
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Eide, L. S.
    Department of Health and Social Sciences, Western Norway University of Applied Sciences, Inndalsveien 28, Bergen, 70305020, Norway.
    FIRST-YEAR nursing students’ experiences of simulation involving care of older patients: A descriptive and exploratory study2020In: Nurse Education in Practice, ISSN 1471-5953, E-ISSN 1873-5223, Vol. 45, article id 102797Article in journal (Refereed)
    Abstract [en]

    Mastering geriatric nursing skills takes time and its acquisition should start early in undergraduate nursing training. The purpose of this study is to synthesise and evaluate the learning experiences that first-year nursing students had following geriatric patient simulation and practice of clinical patient handover. Qualitative content analysis of survey comments from first-year students (n = 216) at a large university in Norway were performed. Simulation training included systematic patient observation of scenarios based on genuine geriatric cases in nursing homes and practice of clinical patient handover. Content analyses identified four generic categories: (1) ‘embodying theoretical knowledge’; (2) ‘increased awareness about one's self’; (3) ‘understanding that collaboration is needed’; (4) ‘preparing for future work life’. These themes provide evidence for students integrating geriatric theoretical knowledge with clinical skills as a result of simulation. Analysis of learning experiences shows that geriatric scenario simulation and practice of clinical patient handover are valuable instruments before entering clinical training with geriatric patients, even for novice students. The use of genuine simulation cases and instruction on the use of clinical handover instruments are effective in producing conceptual changes that prepare students for their first encounter with complex, real-world geriatric scenarios.

  • 3.
    Ernsth-Bravell, Marie
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Johansson, Linda
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Utmaningar i mötet med den äldre personen2021In: Distriktssköterskans specialistområden / [ed] E.-K. Hultgren, Lund: Studentlitteratur AB, 2021, 1, p. 455-473Chapter in book (Other academic)
  • 4.
    Ernsth-Bravell, Marie
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Johansson, Linda
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Finkel, D.
    Indiana University Southeast, New Albany, IN, USA.
    Using National Quality Registries In Gerontological Research: Pros and Cons2018In: Innovation in Aging, E-ISSN 2399-5300, Vol. 2, no suppl_1, p. 149-149Article in journal (Refereed)
    Abstract [en]

    Health care in Sweden usually focuses on single diseases and is less prepared to treat people with multimorbidity. Combining different national quality registries (NQR) can provide a broader picture of health care, preventive care, and health-promoting care of older people with multimorbidity. The aim of this study was to explore how NQRs can be used in gerontological health care research. A descriptive mixed-method study, including a case report and statistical analysis, was performed. Nine National Quality Registries, three health registries and a social care registry maintained by the Swedish government were individually matched to an older population (birth year 1896 to 1958) in the Swedish Twin Registry (n≈44000). Factor analysis demonstrated the people tended to fall into one of 4 clusters of registries: stroke/dementia/hip, heart/diabetes, arthritis-related, and other. Men were more highly represented in the heart/diabetes cluster. People in the arthritis cluster had the lowest mean age; people in the stroke/dementia/hip cluster had the highest mean age. 161 people were identified as “most ill elderly” (according to the definition by the Swedish government). Two of them were randomly selected for case reports. Each case appeared in 6–7 of the health quality registries, providing sufficient information to track their progression through the health care system until the point of death. The results highlight both pros and cons of using the quality registries as the basis for analysis and “registry-enriched” research designs, but more research needs to be performed to understand how NQRs can be used in gerontological research.

  • 5.
    Ernsth-Bravell, Marie
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Johansson, Linda
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Östlund, Lena
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Wellbeing without restraints and coercion, the zero vision2019Conference paper (Refereed)
  • 6. Fauth, B.
    et al.
    Johannesson, Susanne
    Jönköping University, School of Health and Welfare.
    Ernsth-Bravell, Marie
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Johansson, Linda
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Malmberg, Bo
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Johansson, B.
    Zarit, Steven
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology.
    Sustained and successful model in international gerontological education: A short study abroad course fostering research collaboration and educational training for over a decade2019Conference paper (Refereed)
  • 7.
    Finkel, Deborah
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Indiana Univ Southeast, New Albany, IN 47150 USA..
    Johansson, Linda
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Westerlind, Bjorn
    Linkoping Univ, Linkoping, Ostergotlands L, Sweden..
    Lindmark, Ulrika
    Karlstad Univ, Karlstad, Varmlands Lan, Sweden..
    Ernsth-Bravell, Marie
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    AGE AND SITE DIFFERENCES IN PLANNED AND PERFORMED ACTIONS IN RESPONSE TO IDENTIFIED RISKS IN OLDER ADULTS2022In: Innovation in Aging, E-ISSN 2399-5300, Vol. 6, no Supplement 1, p. 840-840Article in journal (Other academic)
    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.

  • 8.
    Finkel, Deborah
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Lindmark, Ulrika
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Jönköping University, School of Health and Welfare, HHJ. Centre for Oral Health.
    Johansson, Linda
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Ernsth-Bravell, Marie
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Oral health predicts quality of life in data from Swedish National Quality Registries2019Conference paper (Refereed)
  • 9.
    Hallgren, Jenny
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). School of Health Sciences, University of Skövde, Sweden.
    Johansson, Linda
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Lannering, Christina
    Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Futurum, Region Jönköping County, Sweden.
    Ernsth-Bravell, Marie
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Gillsjö, Catharina
    School of Health Sciences, University of Skövde, Sweden, and College of Nursing, University of Rhode Island, Kingston, United States.
    Health- and social care in the last year of life among older adults in Sweden2020In: BMC Palliative Care, E-ISSN 1472-684X, Vol. 19, no 1, article id 90Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: In the last years of life, burden of disease and disability and need of health- and social care often increase. Social, functional and psychological factors may be important in regard to social- and health care utilization. This study aims to describe use of health- and social care during the last year of life among persons living in ordinary housing or in assisted living facilities.

    METHODS: A retrospective study examining health- and social care utilization during their last year of life, using a subsample from the Swedish twin registries individually linked to several Swedish national quality registries (NQR). Persons that died during 2008-2009 and 2011-2012 (n = 1518) were selected.

    RESULTS: Mean age at death was 85.9 ± 7.3 (range 65.1-109.0). Among the 1518 participants (women n = 888, 58.5%), of which 741 (49%) were living in assisted living facilities and 1061 (69.9%) had at least one hospitalization during last year of life. The most common causes of death were cardiovascular disease (43.8%) and tumors (15.3%). A multivariable logistic regression revealed that living in ordinary housing, younger age and higher numbers of NQR's increased the likelihood of hospitalization.

    CONCLUSIONS: Persons in their last year of life consumed high amount of health- and social care although 12% did not receive any home care. Married persons received less home care than never married. Persons living in ordinary housing had higher numbers of hospitalizations compared to participants in assisted living facilities. Older persons and persons registered in fewer NQR's were less hospitalized.

  • 10.
    Hasanacevic, Dijana
    et al.
    Vård- och rehabteamet, Åtvidabergs kommun.
    Johansson, Linda
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Användning av robot vid äldre personers ­läkemedelshantering – intervjustudie med sjuksköterskor inom hemsjukvård i Sverige2023In: ÄIC Vetenskapligt supplement, ISSN 2003-9050, Vol. 3, no 1, p. 21-34Article in journal (Refereed)
    Abstract [en]

    Robot use in older people’s medication ­management – an interview study with community nurses ­in Sweden

    The aim of this study was to describe nurses’ experiences of using robots in medication management among older persons. Twelve nurses were interviewed by telephone, using an interview ­guide. Collected data were analysed using an inductive qualitative content analysis.

    Three main categories were identified; Creating independence regards how the medicine dispensing robot contributes to the independence and autonomy of older people as well as increased responsibility, engagement, and feelings of security. Increased patient safety means that the right patient gets the right medicine at the right time, contributing to fewer adverse drug events. Saving resources highlights savings, both regarding the environment and human resources, as staff spend less time administering medication.

    The use of medicine dispensing robots can generate profits on individual, group, and organizational levels. However, it is important that implementation and use are individually adjusted.

  • 11.
    Holmqvist, Malin
    et al.
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Department of Public Health and Healthcare, Region Jönköping County, Jönköping, Sweden.
    Johansson, Linda
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Lindenfalk, Bertil
    Jönköping University, School of Health and Welfare, HHJ, Department for Quality Improvement and Leadership. Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Thor, Johan
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ, Department for Quality Improvement and Leadership.
    Ros, Axel
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Futurum, Region Jönköping County, Jönköping, Sweden.
    Older persons' and health care professionals' design choices when co-designing a medication plan aiming to promote patient safety: Case study2023In: JMIR Aging, E-ISSN 2561-7605, Vol. 6, article id e49154Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Harm from medications is a major patient safety challenge among older persons. Adverse drug events tend to arise when prescribing or evaluating medications; therefore, interventions targeting these may promote patient safety. Guidelines highlight the value of a joint plan for continued treatment. If such a plan includes medications, a medication plan promoting patient safety is advised. There is growing evidence for the benefits of including patients and health care professionals in initiatives for improving health care products and services through co-design.

    OBJECTIVE: This study aimed to identify participants' needs and requirements for a medication plan and explore their reasoning for different design choices.

    METHODS: Using a case study design, we collected and analyzed qualitative and quantitative data and compared them side by side. We explored the needs and requirements for a medication plan expressed by 14 participants (older persons, nurses, and physicians) during a co-design initiative in a regional health system in Sweden. We performed a directed content analysis of qualitative data gathered from co-design sessions and interviews. Descriptive statistics were used to analyze the quantitative data from survey answers.

    RESULTS: A medication plan must provide an added everyday value related to safety, effort, and engagement. The physicians addressed challenges in setting aside time to apply a medication plan, whereas the older persons raised the potential for increased patient involvement. According to the participants, a medication plan needs to support communication, continuity, and interaction. The nurses specifically addressed the need for a plan that was easy to gain an overview of. Important function requirements included providing instant access, automation, and attention. Content requirements included providing detailed information about the medication treatment. Having the plan linked to the medication list and instantly obtainable information was also requested.

    CONCLUSIONS: After discussing the needs and requirements for a medication plan, the participants agreed on an iteratively developed medication plan prototype linked to the medication list within the existing electronic health record. According to the participants, the medication plan prototype may promote patient safety and enable patient engagement, but concerns were raised about its use in daily clinical practice. The last step in the co-design framework is testing the intervention to explore how it works and connects with users. Therefore, testing the medication plan prototype in clinical practice would be a future step.

  • 12.
    Holmqvist, Malin
    et al.
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Department of Public Health and Healthcare, Region Jönköping County, Jönköping, Sweden.
    Ros, Axel
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Futurum, Region Jönköping County, Jönköping, Sweden.
    Lindenfalk, Bertil
    Jönköping University, School of Health and Welfare, HHJ, Department for Quality Improvement and Leadership. Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Thor, Johan
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Johansson, Linda
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    How older persons and health care professionals co-designed a medication plan prototype remotely to promote patient safety: Case study2023In: JMIR Aging, E-ISSN 2561-7605, Vol. 6, article id e41950Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Harm from medications is a major patient safety challenge. Most adverse drug events arise when a medication is prescribed or reevaluated. Therefore, interventions in this area may improve patient safety. A medication plan, that is, a plan for continued treatment with medications, may support patient safety. Participation of patients in the design of health care products or services may improve patient safety. Co-design, as in the Double Diamond framework from the Design Council, England, can emphasize patient involvement. As the COVID-19 pandemic brought restrictions to face-to-face co-design approaches, interest in remote approaches increased. However, it is uncertain how best to perform remote co-design. Therefore, we explored a remote approach, which brought together older persons and health care professionals to co-design a medication plan prototype in the electronic health record, aiming to support patient safety.

    OBJECTIVE: This study aimed to describe how remote co-design was applied to create a medication plan prototype and to explore participants' experiences with this approach.

    METHODS: Within a case study design, we explored the experiences of a remote co-design initiative with 14 participants in a regional health care system in southern Sweden. Using descriptive statistics, quantitative data from questionnaires and web-based workshop timestamps were analyzed. A thematic analysis of the qualitative data gathered from workshops, interviews, and free-text responses to the survey questions was performed. Qualitative and quantitative data were compared side by side in the discussion.

    RESULTS: The analysis of the questionnaires revealed that the participants rated the experiences of the co-design initiative very high. In addition, the balance between how much involved persons expressed their wishes and were listened to was considered very good. Marked timestamps from audio recordings showed that the workshops proceeded according to the plan. The thematic analysis yielded the following main themes: Everyone's perspective matters, Learning by sharing, and Mastering a digital space. The themes encompassed what helped to establish a permissive environment that allowed the participants to be involved and share viewpoints. There was a dynamic process of learning and understanding, realizing that despite different backgrounds, there was consensus about the requirements for a medication plan. The remote co-design process seemed appealing, by balancing opportunities and challenges and building an inviting, creative, and tolerant environment.

    CONCLUSIONS: Participants experienced that the remote co-design initiative was inclusive of their perspectives and facilitated learning by sharing experiences. The Double Diamond framework was applicable in a digital context and supported the co-design process of the medication plan prototype. Remote co-design is still novel, but with attentiveness to power relations between all involved, this approach may increase opportunities for older persons and health care professionals to collaboratively design products or services that can improve patient safety.

  • 13.
    Holmqvist, Malin
    et al.
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Department of Public Health and Healthcare, Region Jönköping County, Jönköping, Sweden.
    Thor, Johan
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Ros, Axel
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Futurum, Region Jönköping County, Jönköping, Sweden.
    Johansson, Linda
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Applying a Co-designed Medication Plan for SaferMedication Treatment in Older Persons – A Feasibility Study2023Manuscript (preprint) (Other academic)
  • 14.
    Holmqvist, Malin
    et al.
    Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare). Department of Hospital Pharmacy, Region Jönköping County; Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
    Thor, Johan
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Ros, Axel
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Futurum, Region Jönköping County; Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
    Johansson, Linda
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Evaluation of older persons' medications: a critical incident technique study exploring healthcare professionals' experiences and actions2021In: BMC Health Services Research, E-ISSN 1472-6963, Vol. 21, no 1, article id 557Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Older persons with polypharmacy are at increased risk of harm from medications. Therefore, it is important that physicians and nurses, together with the persons, evaluate medications to avoid hazardous polypharmacy. It remains unclear how healthcare professionals experience such evaluations. This study aimed to explore physicians' and nurses' experiences from evaluations of older persons' medications, and their related actions to manage concerns related to the evaluations.

    METHOD: Individual interview data from 29 physicians and nurses were collected and analysed according to the critical incident technique.

    RESULTS: The medication evaluation for older persons was influenced by the working conditions (e.g. healthcare professionals' clinical knowledge, experiences, and situational conditions) and working in partnership (e.g. cooperating around and with the older person). Actions taken to manage these evaluations were related to working with a plan (e.g. performing day-to-day work and planning for continued treatment) and collaborative problem-solving (e.g. finding a solution, involving the older person, and communicating with colleagues).

    CONCLUSION: Working conditions and cooperation with colleagues, the older persons and their formal or informal caregivers, emerged as important factors related to the medication evaluation. By adjusting their performance to variations in these conditions, healthcare professionals contributed to the resilience of the healthcare system by its capacity to prevent, notice and mitigate medication problems. Based on these findings, we hypothesize that a joint plan for continued treatment could facilitate such resilience, if it articulates what to observe, when to act, who should act and what actions to take in case of deviations from what is expected.

  • 15.
    Holmqvist, Malin
    et al.
    Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare). Region Jönköpings län.
    Thor, Johan
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Ros, Axel
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Region Jönköpings län.
    Johansson, Linda
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    "I trust my physician but want to be involved"  - Older persons' Experiences of regarding evaluation of their medication treatment2019Conference paper (Refereed)
  • 16.
    Holmqvist, Malin
    et al.
    Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare). Department of Clinical pharmacy, Region Jönköping County, Jönköping, Sweden.
    Thor, Johan
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Ros, Axel
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare).
    Johansson, Linda
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Older persons’ experiences regarding evaluation of their medication treatment: An interview study in Sweden2019In: Health Expectations, ISSN 1369-6513, E-ISSN 1369-7625, Vol. 22, no 6, p. 1294-1303Article in journal (Refereed)
    Abstract [en]

    Background: Older persons with polypharmacy are at increased risk of harm from medications, and this issue is a global patient safety challenge. Harm may arise at all stages of medication use and may cause hospital admission, additional resource uti ‐lization and lower patient satisfaction. Older persons’ participation in their own care may increase patient safety. Their views on the evaluation of their medication treat ‐ment, and their own involvement in it, are crucial yet poorly understood.

    Objectives: To identify opportunities to make the medication use process safer, we explored and described older persons’ experiences of evaluation of their medicationtreatment.

    Design: Semi‐structured interviews were performed with 20 community‐dwelling older persons (age 75‐91 years) in Sweden. Data were analysed using inductive quali ‐tative content analysis.

    Results: These older persons reported having a responsibility to engage in their med ‐ication evaluations, although some felt unable to do so or considered themselves un ‐concerned. Evaluation, in their experience, was facilitated by continuity of care and an invitation to participate. However, some older persons experienced not receivinga comprehensive medication evaluation.

    Discussion and conclusion: Older persons want to be actively involved in their medi ‐cation evaluations, and this may represent an underutilized resource in the pursuit of patient safety. Their trust in physicians to undertake evaluations on a regular basis, although that does not necessarily occur, may cause harm. Patient safety could benefit from a co‐production approach to medication evaluations, with health‐care professionals explicitly sharing information with older persons and agreeing on re ‐sponsibilities related to on‐going medication treatment.

  • 17.
    Huang, Yaqi
    et al.
    School of Nursing, Tianjin Medical University, Tianjin, China.
    Wang, Yulu
    School of Nursing, Tianjin Medical University, Tianjin, China.
    Yang, Jin
    School of Nursing, Tianjin Medical University, Tianjin, China.
    Johansson, Linda
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Ma, Bingxin
    School of Nursing, Tianjin Medical University, Tianjin, China.
    Zhang, Xiaojun
    School of Nursing, Tianjin Medical University, Tianjin, China.
    Lu, Qi
    School of Nursing, Tianjin Medical University, Tianjin, China.
    Wang, Yaogang
    School of Public Health, Tianjin Medical University, Tianjin, China.
    Zhao, Yue
    School of Nursing, Tianjin Medical University, Tianjin, China.
    Application of the International Classification of Functioning, Disability and Health (ICF) in dementia research and practice: A scoping review2023In: Aging & Mental Health, ISSN 1360-7863, E-ISSN 1364-6915, Vol. 27, no 2, p. 357-371Article, review/survey (Refereed)
    Abstract [en]

    OBJECTIVES: The International Classification of Functioning, Disability and Health (ICF) endorsed by the World Health Organization provides a conceptual framework for describing functioning and disability based on a biopsychosocial model. Although dementia is one of the leading causes of disability, yet little is known on the extent to how the ICF has been utilized in dementia research and practice. The study aimed to examine and map the current applications of the ICF with dementia from a body of earlier studies and to explore the potential use in person-centred dementia care.

    METHODS: The Arksey and O'Malley framework was used to guide the searching, selecting, and synthesizing process. The scoping review was reported following The Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Review (PRISMA-ScR) guidelines.

    RESULTS: A total of 34 studies were included. The applications of ICF were classified into 4 themes: (1) in clinical practice and the education of health professionals (n = 20); (2) community support services and income support (n = 3); (3) population-based, census, or survey data (n = 10); (4) advocacy and empowerment purposes (n = 1).

    CONCLUSION: The ICF has made a major impact on dementia in clinical settings. Findings strongly support applying the ICF to person-centered dementia care. In the future, more empirical studies are needed to expand the scope of ICF use in dementia research and practice.

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  • 18.
    Johansson, Linda
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Effects of using a preventive care model among persons with dementia in ordinary home and nursing home with poor nutritional status2018Conference paper (Refereed)
  • 19.
    Johansson, Linda
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Foodwork and meals in everyday life among persons with dementia and their partners2013Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The aim of this thesis was to explore and describe foodwork and meals for older persons with dementia and their partners in ordinary homes.

    Descriptive and explorative designs were used in the four papers this thesis is based on. Longitudinal data, including older home-living unlike-sex twins, were analysed using descriptive and analytical statistics. An ethnographic approach was used to describe everyday life for persons with dementia. Interviews with partners and staff were analysed using thematic analysis and qualitative content analysis, respectively.

    The results revealed that, among home-living older persons, there is an association between a person’s cognitive ability and nutritional status; i.e. low cognitive ability leads to increased risk of malnutrition. For home-living persons with dementia and their partners, foodwork and meals sometimes changed, meaning that shopping, preparing food and eating as well as social interaction become complicated, which seemed to lead to transitions in roles, routines and relations. There was foodwork that the persons with dementia could perform, and participants expressed a desire that abilities and independence be preserved. However, support was sometimes needed, and it was emphasized that this was based on the person’s needs, wishes and problems.

    In conclusion, there is an association between decreased cognitive ability and increased risk of malnutrition. Furthermore, foodwork and meals affected both persons with dementia and their partners. Therefore, early intervention whereby both partners in a couple get individually adjusted support is of importance. Consequently, a person-centred care approach can be useful in arranging the support.

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  • 20.
    Johansson, Linda
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Time to increase the involvement of persons with intellectual disability in palliative care and research2021In: Evidence-Based Nursing, ISSN 1367-6539, E-ISSN 1468-9618, Vol. 24, article id 103188Article in journal (Other academic)
  • 21.
    Johansson, Linda
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology.
    Björklund, Anita
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health.
    Sidenvall, Birgitta
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Christensson, Lennart
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. Ageing - living conditions and health.
    Spouses' experiences of mealtimes with a partner suffering from dementia2014In: The journal of aging research & clinical practice, ISSN 2273-421X, Vol. 3, no 4, p. 237-244Article in journal (Refereed)
    Abstract [en]

    Background: As difficulties in performing daily activities occur among persons with dementia, their spouses are also affected. This is also true for mealtimes, yet there is a lack of knowledge and research into how couples manage this situation at home. Objective: The aim of the study was to explore and describe spouses’ experiences of mealtimes in couples in which one partner has dementia. Design, Setting and Participants: Ten spouses were interviewed in their home in respect to their experiences regarding mealtimes when living with a partner diagnosed with dementia. To identify themes across the data set, thematic analysis was conducted. Results: One major theme, Recognizing and managing the range of mealtime change, was identified and showed that depending on where the families were in the dementia process their experienced varied. As progression occurred in the partners disease, routines, responsibilities and relationships were affected within the couple. Strategies the participants used tomanage mealtimes at home regarding these problems were highlighted such as getting support from social services, but also strategies they had learnt by themselves. Conclusion: These results generate an insight into what couples face, and their needs for support. Spouses experiences varied which indicates that it is important that support is based on individual needs. Hence, nursing staff should continuously pay attention to couples mealtime situation. Further it increases staff´s knowledge regarding possible solutions on how to involve persons with dementia in mealtime activities and maintain their nutritional intake.

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  • 22.
    Johansson, Linda
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology.
    Björklund, Anita
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Rehabilitation. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Sidenvall, Birgitta
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Christensson, Lennart
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Staff views on how to improve mealtimes for elderly people with dementia living at home2017In: Dementia, ISSN 1471-3012, E-ISSN 1741-2684, Vol. 16, no 7, p. 835-852Article in journal (Refereed)
    Abstract [en]

    Dementia commonly leads to difficulties in performing daily activities, which can also often affect the ability to prepare and eat meals. As a result, formal support to maintain good nutritional intake might be needed, but there is a lack of knowledge concerning how to support older persons with dementia living at home. The aim of this study was to explore and describe staff views on how to improve mealtimes for persons with dementia who are still living at home. A qualitative descriptive study was performed and data were collected during 2011–2012 through four focus group interviews with staff working in the homes of persons with dementia. Data were analyzed using inductive content analysis. The participants described several ways to improve mealtimes for persons with dementia and advocated adjustments facilitating the preservation of the persons’ independence. Finding suitable actions calls for knowledge about the person and his/her individual situation. Proposed actions were enabling meals at home, taking over, and moving meals outside of the home. In addition, it was found that, the types of meals served to these persons should be as familiar to the individual as possible. The results of this study indicate the importance of using a person-centered approach and meeting the individual needs when supporting people with dementia in regards to their meals when living at home. Individualized care in the home may be expensive, however, it is fair to say that people who become malnourished and admitted to hospitals is even more costly. Furthermore, sharing and reflecting experiences and knowledge can assist staff to identify ways to manage complex situations. Therefore, the use of refection should be a part of staff members’ everyday work.

  • 23.
    Johansson, Linda
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Christensson, Lennart
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Sidenvall, Birgitta
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Managing mealtimes tasks: told by persons with dementia2011In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 20, no 17, p. 2552-2562Article in journal (Refereed)
    Abstract [en]

    AIM: To capture the self-description of managing mealtime tasks by persons with dementia.

    BACKGROUND: There are several factors that negatively affect food intake in persons with dementia that may increase the risk of developing malnutrition. Difficulties in managing daily activities increase gradually and mealtime tasks like food shopping, cooking and eating often become troublesome. Still, little is known about how persons with dementia themselves experience this issue.

    DESIGN: A qualitative study with an ethnographic approach.

    METHOD: Ten women and five men aged 69-86 with dementia were interviewed. Interviews were carried out in the informants' own homes and a thematic analysis was performed.

    RESULTS: The informants described that they wanted to be independent and that the memory loss was not affecting them to a great extent. Old habits and routines, as well as newly developed strategies, helped them manage mealtime tasks despite the disease. Informants were satisfied with their current situation, even though it sometimes meant that they had changed their way of managing mealtime tasks, for instance receiving meals-on-wheels.

    CONCLUSIONS: Persons with dementia seem to be able to manage mealtime tasks and these activities were based on old habits and routines. Independence was highly valued and managing mealtime tasks seems to be one way to appear independent.

    RELEVANCE TO CLINICAL PRACTICE:

    It is important for caregivers to understand that persons with dementia might not express difficulties in managing mealtime tasks for fear of losing their independence. It is, therefore, important to create a trustful relationship even before problems arise to be able to support the persons when necessary.

  • 24.
    Johansson, Linda
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Ernsth-Bravell, Marie
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Finkel, Deborah
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Health and social care in the most ill older persons2019Conference paper (Refereed)
  • 25.
    Johansson, Linda
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Ernsth-Bravell, Marie
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Östlund, Lena
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Kemi, Marie (Contributor)
    Jönköping kommun.
    Waldermarsson, Marika (Contributor)
    Jönköping kommun.
    Carlsson, Emma (Contributor)
    Jönköping kommun.
    Frank, Maria (Contributor)
    Jönköping kommun.
    Erfarenheter och uppfattningar av tvång och begränsningar vid vård och omsorg av personer med kognitiv nedsättning i Jönköpings kommun2023Report (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. 

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  • 26.
    Johansson, Linda
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Finkel, Deborah
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Department of Psychology, Indiana University Southeast, New Albany, IN, USA.
    Lannering, Christina
    Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Region Jönköping County, Futurum, Ryhov, Jönköping, Sweden.
    Dahl Aslan, Anna K.
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
    Andersson-Gäre, Boel
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare. Jönköping University, School of Health and Welfare, HHJ. IMPROVE (Improvement, innovation, and leadership in health and welfare). Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Region Jönköping County, Futurum, Ryhov, Jönköping, Sweden.
    Hallgren, Jenny
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). School of Health Sciences, University of Skövde, Skövde, Sweden.
    Lindmark, Ulrika
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Centre for Oral Health. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Ernsth-Bravell, Marie
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Using aggregated data from Swedish national quality registries as tools to describe health conditions of older adults with complex needs2021In: Aging Clinical and Experimental Research, ISSN 1594-0667, E-ISSN 1720-8319, Vol. 33, p. 1297-1306Article in journal (Refereed)
    Abstract [en]

    Background: Combining National Quality Registries (NQRs) with existing National Health Registries (NHRs) might make it possible to get a wider picture of older adults health situation. The aim was to examine the feasibility of aggregating data across different NQRs and existing NHRs to explore the possibility to investigate trajectories and patterns of disease and care, specifically for the most ill older adults.

    Method: A Swedish twin population (N = 44,816) was linked to nine NQRs and four NHRs. A descriptive mixed-method study was performed. A manifest content analysis identified which health parameters were collected from each NQR. Factor analysis identified patterns in representation across NQRs. Two case studies illustrated individual trajectories of care by using NQRs and NHRs.

    Results: About 36% of the population was registered in one or more NQRs. NQRs included 1849 variables that were sorted into 13 categories with extensive overlap across the NQRs. Health and function variables were identified, but few social or cognitive variables. Even though most individuals demonstrated unique patterns of multi-morbidities, factor analysis identified three clusters of representation in the NQRs with sufficient sample sizes for future investigations. The two cases illustrated the possibility of following patterns of disease and trajectories of care.

    Conclusions: NQRs seem to be a significant source for collecting data about a population that may be underrepresented in most research on aging because of their age and poor health. However, NQRs are primarily disease related, and further development of the registries to maximize coverage and utility is needed. 

  • 27.
    Johansson, Linda
    et al.
    Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology.
    Lannering, Christina
    Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Futurum, Region Jönköping County, Sweden.
    Anna K., Dahl Aslan
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Karolinska Institutet, Stockholm, Sweden.
    Changes in nutritional status and its association with death among older persons2016Conference paper (Refereed)
    Abstract [en]

    It is well known that malnutrition is common among older persons and has a negative impact on health. Even though there is a growing literature on nutrition and aging, few studies focus on longitudinal changes in later life. The aims of this study are to characterize general nutritional status development over time, to identify clusters of nutritional status trajectories, as well as to study the association between the nutritional status trajectories and death. The baseline sample is drawn from the Screening Across the Lifespan Twins (SALT) study. All participants of SALT that had at least 3 assessments according to Mini Nutritional Status Shortform (MNA-SF) documented in the Senior Alert quality register between 2008 and 2015 were included for analyses (N=1509). At the first registration, mean age was 82.4 ± 7.5. According to MNA-SF, 13.3% persons were malnourished, 44.9% were at risk of malnutrition, and 41.8 % were well nourished. Preliminary analysis indicate that despite a general decline in nutritional status in old age, there is a large variability in the sample, making the data suitable for latent class trajectory analyses. Initial analyses also indicate that decrease in nutritional status is associated with decreased survival. Consequently, deterioration in nutritional status seems to be associated with mortality. Detecting malnutrition in older age is important in order to avoid premature death.

  • 28.
    Johansson, Linda
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Lindmark, Ulrika
    Jönköping University, School of Health and Welfare, HHJ, Dept. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Centre for Oral Health. Jönköping University, School of Health and Welfare, HHJ. ADULT. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Siverskog, Anna
    Jönköping University, School of Health and Welfare, HHJ, Dept. of Social Work. Jönköping University, School of Health and Welfare, HHJ. SALVE (Social challenges, Actors, Living conditions, reseach VEnue). Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Äldre personer och våldsutsatthet2022In: Äldre personers utsatthet för våld i nära relationer: Interprofessionella perspektiv / [ed] L. Östlund, Lund: Studentlitteratur AB, 2022, p. 17-30Chapter in book (Other academic)
  • 29.
    Johansson, Linda
    et al.
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Ageing - living conditions and health.
    Sidenvall, Birgitta
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Ageing - living conditions and health.
    Malmberg, Bo
    Jönköping University, School of Health Science, HHJ, Institute of Gerontology. Jönköping University, School of Health Science, HHJ. Ageing - living conditions and health.
    Christensson, Lennart
    Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science. Jönköping University, School of Health Science, HHJ. Ageing - living conditions and health.
    Who will become malnourished?: A prospective study of factors associated with malnutrition in older persons living at home2009In: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 13, no 10, p. 855-861Article in journal (Refereed)
  • 30.
    Johansson, Linda
    et al.
    Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology.
    Silén, Marit
    University of Gävle, Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, Gävle, Sweden.
    Research methods in nursing students’ Bachelor's theses in Sweden: A descriptive study2018In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 66, p. 187-193Article in journal (Refereed)
    Abstract [en]

    Background: During the nursing programme in Sweden, students complete an independent project that allows them to receive both a professional qualification as a nurse and a Bachelor's degree. This project gives students the opportunity to develop and apply skills such as critical thinking, problem-solving and decision-making, thus preparing them for their future work. However, only a few, small-scale studies have analysed the independent project to gain more insight into how nursing students carry out this task.

    Objectives: The aim of the present study was to describe the methods, including ethical considerations and assessment of data quality, applied in nursing students’ independent Bachelor's degree projects in a Swedish context.

    Design: A descriptive study with a quantitative approach.

    Methods: A total of 490 independent projects were analysed using descriptive statistics.

    Results: Literature reviews were the predominant project form. References were often used to support the analysis method. They were not, however, always relevant to the method. This was also true of ethical considerations. When a qualitative approach was used, and data collected through interviews, the participants were typically professionals. In qualitative projects involving analysis of biographies/autobiographies or blogs participants were either persons with a disease or next of kin of a person with a disease.

    Conclusions: Although most of the projects were literature reviews, it seemed unclear to the nursing students how the data should be analysed as well as what ethical issues should be raised in relation to the method. Consequently, further research and guidance are needed. In Sweden, independent projects are not considered research and are therefore not required to undergo ethics vetting. However, it is important that they be designed so as to avoid possible research ethics problems. Asking persons about their health, which occurred in some of the empirical projects, may therefore be considered questionable. 

  • 31.
    Johansson, Linda
    et al.
    Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Wijk, H.
    University of Gothenburg, Sweden.
    Christensson, Lennart
    Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Improving nutritional status among persons with dementia by performing individualized interventions2016Conference paper (Refereed)
    Abstract [en]

    Poor nutritional status is common among persons with dementia and negatively associated with subjective health, mobility and mortality. When malnutrition occurs it is challenging to improve the nutritional status. The aim of the study was to investigate if a structured preventive care process could increase body weight, among persons with dementia at risk of malnutrition or malnourished. The structured preventive care process includes four steps which have been registered in a national quality register: 1) Risk assessment by Mini nutritional assessment-Short Form. 2) Team-based analysis of underlying causes (19 evidence-based risk factors) performed by staff including professionals like nurses, nurse assistants, occupational therapists and physiotherapists. 3)  Planning and performing interventions based on the need and problems of the individual (28 evidence-based actions) and 4) evaluation of performed interventions (body weight). A prepost design was used with body weight measured during baseline (0) and follow-up (7–106 days later). In total 526 persons with dementia at risk of malnutrition 176 The Gerontological Society of America Copyedited by: OUP at :: on January 10, 2017 http://gerontologist.oxfordjournals.org/ Downloaded from or malnourished, 65 years and older and with a care contact, were included. Results: 109 persons was registered in all four steps i.e. a team-based analysis of underlying causes have been performed. An improvement in the nutritional status was observed in these individuals (baseline Md 60.0 kg; follow-up Md 62.0  kg; p-value 0.013). No improvement was detected among those missing an analysis of underlying causes. Accordingly, by planning care in a structured way and give individualized interventions based on underlying causes can help improve nutritional status among persons with dementia at risk of malnutrition or malnourished.

  • 32.
    Johansson, Linda
    et al.
    Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology.
    Wijk, Helle
    University of Gothenburg, Sweden.
    Christensson, Lennart
    Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Health Care Professionals' Usage and Documentation of a Swedish Quality Registry Regarding Preventive Nutritional Care2017In: Quality Management in Health Care, ISSN 1063-8628, E-ISSN 1550-5154, Vol. 26, no 1, p. 15-21Article in journal (Refereed)
    Abstract [en]

    Objectives: To describe health care staff members' usage and documentation in a Swedish quality registry focusing on a preventive care process regarding the risk area of malnutrition among persons with dementia. The preventive care process includes risk assessment, analysis of underlying causes, planning and performing interventions, as well as evaluating effects.

    Methods: Data were collected from 2 Swedish quality registries, Senior Alert and the Swedish Dementia Register (Svedem). In total, 1929 people with dementia were assessed and 1432 registered as being at risk of malnutrition or malnourished.

    Results: Performed nutritional interventions were registered in approximately 65% of cases. In more than 80% of registrations, the analyses of underlying causes were missing. Those who had registered underlying causes had significantly more interventions and the evaluation of the performed intervention was registered. The time between assessment and evaluation depended on care setting and ranged from 0 to 702 days.

    Conclusions: Limitations in registration were noted; however, the register allows staff to focus on nutritional care and has resulted in many risk assessments. Rarely people were registered in all steps of the preventive care process. Large variances in when the performed interventions were evaluated makes it difficult to measure improvements.

  • 33.
    Johansson, Linda
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Wijk, Helle
    Sahlgrenska Academy, Institute of Health and Care Sciences, Gothenburg, Sweden.
    Christensson, Lennart
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Improving Nutritional Status of Older Persons with Dementia Using a National Preventive Care Program2017In: The Journal of Nutrition, Health & Aging, ISSN 1279-7707, E-ISSN 1760-4788, Vol. 21, no 3, p. 292-298Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The aim of the study was to investigate the outcome of change in body weight associated with use of a structured preventive care process among persons with dementia assessed as at risk of malnutrition or malnourished. The preventive care process is a pedagogical model used in the Senior Alert (SA) quality register, where nutrition is one of the prioritized areas and includes four steps: assessment, analysis of underlying causes, actions performed and outcome.

    DESIGN: An analysis of data from SA with a pre-post design was performed.

    SETTING: The participants were living in ordinary housing or special housing in Sweden.

    PARTICIPANTS: 1912 persons, 65 years and older, registered in both SA and the dementia quality register Svedem were included.

    INTERVENTION: A national preventive care program including individualized actions.

    MEASUREMENTS: The Mini Nutritional Assessment-Short Form was used to assess nutritional status at baseline. Body weight was measured during baseline and follow-up (7-106 days after baseline).

    RESULTS: 74.3% persons were malnourished or at risk of malnutrition. Those at risk of malnutrition or malnourished who were registered in all four steps of the preventive care process, increased in body weight from baseline (Md 60.0 kg) to follow-up (Md 62.0 kg) (p=0.013). In those with incomplete registration no increase in body weight was found.

    CONCLUSION: Using all steps in the structured preventive care process seems to improve nutritional status of persons with dementia assessed as at risk of malnutrition or malnourished. This study contributes to the development of evidence-based practice regarding malnutrition and persons with dementia.

  • 34.
    Johansson, Linda
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Östlund, Lena
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Geriatrisk vård och omsorg2020In: Äldre och åldrande: grundbok i gerontologi / [ed] Marie Ernsth Bravell & Lena Östlund, Malmö: Gleerups Utbildning AB, 2020, 3, p. 301-352Chapter in book (Other academic)
  • 35.
    Johansson, Linda
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Östlund, Lena
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Utsatthet hos personer med demenssjukdom2022In: Äldre personers utsatthet för våld i nära relationer: Interprofessionella perspektiv / [ed] L. Östlund, Lund: Studentlitteratur AB, 2022, p. 113-133Chapter in book (Other academic)
  • 36.
    Johansson, Yvonne A.
    et al.
    Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Gillsjö, Catharina
    Tsevis, Theofanis
    Nasic, Salmir
    Bogdanovic, Nenad
    Johansson, Linda
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Kenne Sarenmalm, Elisabeth
    Risk factors associated with delirium among older hospitalized patients, with focus on frailty and co-morbidityManuscript (preprint) (Other academic)
  • 37.
    Johansson, Yvonne A
    et al.
    Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Tsevis, Theofanis
    Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden; Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Nasic, Salmir
    Skaraborg Hospital, Skövde, Sweden; Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Gillsjö, Catharina
    School of Health Sciences, University of Skövde, Skövde, Sweden; College of Nursing, University of Rhode Island, Kingston, RI, USA.
    Johansson, Linda
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Bogdanovic, Nenad
    Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden; Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
    Kenne Sarenmalm, Elisabeth
    Skaraborg Hospital, Skövde, Sweden; School of Health Sciences, University of Skövde, Skövde, Sweden; Institute of Health and Care Science, Sahlgrenska Academy, Centre for Person-Centred Care Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
    Diagnostic accuracy and clinical applicability of the Swedish version of the 4AT assessment test for delirium detection, in a mixed patient population and setting2021In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 21, no 568Article in journal (Refereed)
    Abstract [en]

    Delirium is common in older hospitalized patients. It has serious consequences e.g., poor health outcomes, mortality and increased costs. Despite that, many cases are undetected. Early detection of delirium is important in improving outcomes and use of assessment tools improves detection rates. The 4AT is a brief screening tool for delirium detection, which has not previously been translated into Swedish. The study aim was to evaluate diagnostic accuracy and clinical applicability of a Swedish version of the screening tool 4AT for delirium detection.

  • 38.
    Lannering, Christina
    et al.
    Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Ernsth-Bravell, Marie
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Andersson, Ann-Christine
    Jönköping University, School of Health and Welfare, The Jönköping Academy for Improvement of Health and Welfare.
    Johansson, Linda
    Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology.
    Effects of a preventive care process for prevention of malnutrition, falls and pressure ulcers among older people living in Swedish nursing homesManuscript (preprint) (Other academic)
  • 39.
    Lannering, Christina
    et al.
    Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Region Jönköping County, Futurum, Länssjukhuset Ryhov.
    Ernsth-Bravell, Marie
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Johansson, Linda
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Prevention of falls, malnutrition and pressure ulcers among older persons: nursing staff’s experiences of a structured preventive care process2017In: Health & Social Care in the Community, ISSN 0966-0410, E-ISSN 1365-2524, Vol. 25, no 3, p. 1011-1020Article in journal (Refereed)
    Abstract [en]

    A structured and systematic care process for preventive work, aimed to reduce falls, pressure ulcers and malnutrition among older people, has been developed in Sweden. The process involves risk assessment, teambased interventions and evaluation of results. Since development, this structured work process has become web-based and has been implemented in a national quality registry called ‘Senior Alert’ and used countrywide. The aim of this study was to describe nursing staff’s experience of preventive work by using the structured preventive care process as outlined by Senior Alert. Eight focus group interviews were conducted during 2015 including staff from nursing homes and homebased nursing care in three municipalities. The interview material was subjected to qualitative content analysis. In this study, both positive and negative opinions were expressed about the process. The systematic and structured work flow seemed to only partly facilitate care providers to improve care quality by making better clinical assessments, performing team-based planned interventions and learning from results. Participants described lack of reliability in the assessments and varying opinions about the structure. Furthermore, organisational structures limited the preventive work.

  • 40.
    Lannering, Christina
    et al.
    Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Region Jönköping County, Futurum, Länssjukhuset Ryhov, Sweden.
    Johansson, Linda
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Ernsth-Bravell, Marie
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    The effect of a structured nutritional care programme in Swedish nursing homes2017In: The Journal of Nursing Home Research Sciences, ISSN 2496-0799, no 3, p. 64-70Article in journal (Refereed)
    Abstract [en]

    Objective: Malnutrition with consequent weight loss is a well-known problem among older frail persons living in nursing homes. The objective of this study was to examine the effect of a structured preventive care programme including an individualized nutrition plan. Design: A retrospective study, based on already collected data from two different nursing home populations. One population constituted a group of nursing home residents receiving the nutritional care programme (ncp-group), including individually performed nutritions actions. The ncp-group (N=135) was registered in the national quality registry Senior Alert (SA), a platform for following of this preventive care process. The other population constituted a group of nursing home residents receiving “care as usual” (n=186), ie not using the nutritional care programme, collected from the study SHADES. The two populations was compared by a quasi-experimental pre-posttest design with a follow-up time of 5–7 months.

    Settings: Nursing homes in Sweden.

    Participants: Two populations of nursing home residents assessed to be at risk for malnutrition, or to be already malnourished, according to the short form of the Mini Nutritional Assessment (MNA-SF).

    Intervention: The ncp-group received a structured, individually targeted care programme including risk assessments, team-based decisions on actions, and evaluation of results.

    Measurements: Body weight and weight changes were monitored over time. Additionally, nutritional status was described using the MNA-SF scores and body mass index (BMI).

    Results: No statistically significant differences in body weight, MNA-SF or BMI between the groups were found at follow-up. However, within-group analyses in the group followed in SA showed improved outcomes.

    Conclusion: This suggest small differences in nutritional care provided at nursing homes working with SA and “care as usual” in nursing homes, not working with SA.

  • 41.
    Lindmark, Ulrika
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Centre for Oral Health. Jönköping University, School of Health and Welfare, HHJ. ADULT. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Ernsth-Bravell, Marie
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Johansson, Linda
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Finkel, Deborah
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Oral health is essential for quality of life in older adults: A Swedish National Quality Register Study2021In: Gerodontology, ISSN 0734-0664, E-ISSN 1741-2358, Vol. 38, no 2, p. 191-198Article in journal (Refereed)
    Abstract [en]

    Objective: To examine the relationship between QoL and oral health from two Swedish national quality registries (NQRs).

    Background: Oral health plays an important part in general health, which might also affect QoL. No studies have examined the relationships between QoL and oral health in late adulthood based on aggregated data from Swedish NQRs.

    Material and methods: Four NQRs incorporated the EQ-5D, which assesses 5 aspects of QoL: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. Items from the Revised Oral Assessment Guide, obtained from the NQR Senior Alert, were used to identify older adults at risk for oral health issues.

    Results: A total of 510 individuals had data on all relevant variables. Analyses indicated significantly higher QoL for individuals without risk of oral health problems (M = −0.15 (SD = 1.01)), compared to those with risk (M = −0.75 (SD = 1.52)). Logistic regression analysis showed that lower QoL (OR = 0.69 (0.49, 0.97)), mental status (OR = 0.37 (0.19, 0.71)), lower self-rated health (OR = 0.59 (0.42, 0.85)) and higher age (OR = 1.07 (1.01, 1.13)) were significantly related to risk of oral health problems. Higher BMI (OR = 1.13 (0.99, 1.30)), living alone (OR = 2.37 (0.93, 6.06)) and more years of education (OR = 1.15 (1.01, 1.31)) were associated with higher risk of oral health problems.

    Conclusions: Oral health is a significant component of quality of life in late adulthood. NQRs are of value for healthy ageing research in populations that may be underrepresented in research studies.

  • 42.
    Lindmark, Ulrika
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Oral health. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Jansson, Henrik
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Natural Science and Biomedicine. Jönköping University, School of Health and Welfare, HHJ. Oral health. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Department of Periodontology, Centre of Oral Health Sciences, Malmö University, Malmö, Sweden.
    Lannering, Christina
    Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Region Jönköping County, Futurum, Ryhov, Jönköping, Sweden.
    Johansson, Linda
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology.
    Oral health matters for the nutritional status of older persons: A population-based study2018In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 5-6, p. 1143-1152Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVES: To explore the association between oral health and nutritional status in the context of daily care for older people.

    BACKGROUND: Oral problems often increase with age and affect a person's ability to chew and swallow. They might also influence the ability to maintain a satisfactory nutritional status. Oral health awareness is therefore of great importance in nursing care for older people.

    DESIGN: A retrospective cross-sectional study.

    METHODS: Data from the Swedish quality register, Senior Alert, were used, including structured assessments of both oral and nutritional status using the Revised Oral Assessment Guide-Jönköping and the Mini Nutritional Assessment. In total, 1,156 persons (mean age: 82.8 ± 7.9) had both oral and nutritional assessments registered by the nursing staff in daily care.

    RESULTS: Approximately 29% of participants had moderate oral health problems. Another 12% had severe problems. Over 60% of the persons were considered at risk of malnutrition or were malnourished. There was a weak correlation between poor nutritional status and poor oral health, and approximately one-third of the persons who were at risk or malnourished had simultaneous oral problems. A multivariate logistic regression revealed that when problems involving voice and swallowing were present, there was also a greater possibility of being assessed as at risk of malnourishment or being malnourished.

    CONCLUSION: There is a relationship between oral health problems and nutritional status, indicating the importance of evaluating oral health status in older persons with nutritional problems.

    RELEVANCE TO CLINICAL PRACTICE: Nursing staff involved in care for older people should be aware of the importance of including regular oral health check-ups in their work. There is also a need for nursing staff members and oral health professionals to exchange knowledge.

  • 43.
    Lu, Qi
    et al.
    Jönköping University, School of Health and Welfare, HHJ. ADULT. Tianjin Medical University, China.
    Mårtensson, Jan
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Zhao, Y.
    Tianjin Medical University, China.
    Johansson, Linda
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology.
    Living on the edge: Family caregivers’ experiences of caring for post-stroke family members in China: A qualitative study2019In: International Journal of Nursing Studies, ISSN 0020-7489, E-ISSN 1873-491X, Vol. 94, p. 1-8Article in journal (Refereed)
    Abstract [en]

    Background: Globally, one-third of the 15 million people with stroke suffer permanent physical, cognitive, and emotional impairment. Because of traditional Chinese culture and the limited development of the primary healthcare system, most stroke survivors are cared for and live with their family after hospital discharge. However, previous literature shows a lack of qualitative studies on family caregivers’ experience of caring for their relatives in China.

    Objectives: The aim of this study was to explore the experience of family caregivers taking care of stroke survivors in China.

    Methods: An explorative design was used wherein qualitative semi-structured interviews were conducted with family caregivers in China. Family caregivers were selected from one city and three communities using a purposive sampling method until no new data were generated (n = 26). A thematic analysis was used for the data analysis in this study.

    Findings: Family caregivers’ experience was described as living on the edge, which pulled their lives in multiple directions, created an unstable situation, and reduced their well-being and health. The participants believed they had total responsibility and felt that this was expected from both themselves and society. Little external understanding and insufficient support was emphasised, resulting in the caregivers feeling all alone, drained by caring, and like prisoners in their own lives. The family caregivers had to face all of the family events and make all of the decisions by themselves. They expressed love for their family members with stroke, but this was often overshadowed by feelings of sadness, depression, sensitivity, and anger. This resulted in an inability to see how things could improve and in the family caregivers being uncertain about the future.

    Conclusion: All of these findings increased understanding and added knowledge of this topic that has been seldom studied in China. Healthcare authorities and professionals should recognise and understand the lives and situations of family caregivers since their relatives had a stroke to further identify their difficulties and needs. Appropriate and effective support, both from government and society, should be planned and implemented for family caregivers to relieve them from caring for their relatives with stroke and maintaining the quality of their own lives.

  • 44.
    Lu, Qi
    et al.
    Jönköping University, School of Health and Welfare, HHJ. ADULT. Jonkoping Univ, Sch Hlth & Welf, Jonkoping, Sweden.;Tianjin Med Univ, Sch Nursing, Tianjin, Peoples R China..
    Mårtensson, Jan
    Jönköping University, School of Health and Welfare, HHJ, Dept. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT. Jonkoping Univ, Sch Hlth & Welf, Jonkoping, Sweden..
    Zhao, Yue
    Tianjin Med Univ, Sch Nursing, Tianjin, Peoples R China..
    Johansson, Linda
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Jonkoping Univ, Sch Hlth & Welf, Jonkoping, Sweden..
    Needs of family members caring for stroke survivors in China: A deductive qualitative content analysis study by using the caregiver task inventory-252022In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 22, no 1, article id 96Article in journal (Refereed)
    Abstract [en]

    Background

    In China, family caregivers are usually the main carers of relatives after stroke due to traditional Chinese culture and the limited development of the primary healthcare system. This responsibility often results in burdens and negative health outcomes. However, family caregivers seldom receive support. To improve informal care, as well as the health and well-being of family caregivers, it is important to identify their needs.

    Objective

    This study aimed to deductively explore the needs of family members caring for stroke survivors in China.

    Methods

    Twenty-six semi-structured interviews were performed with family caregivers of stroke survivors who were selected from one city and three communities by purposive sampling. A deductive qualitative content analysis method was performed by using the Caregiver Task Inventory-25 (CTI-25), an instrument measuring the needs of family caregivers, as a framework.

    Results

    All subscales, as well as all belonging items in the CTI-25, were identified in the present study, meaning that the family caregivers had needs related to learning to cope with new role, providing care according to care-receiver's needs, managing own emotional needs, appraising supportive resources, and balancing caregiving needs and one's own needs. Moreover, needs related to financial support, both direct and indirect, were identified but not part of the CTI-25.

    Conclusion

    These findings identified that family caregivers of stroke survivors in China had various needs, which is important knowledge when assessing needs and improving health care for family caregivers. Cultural adjustments and modifications should be made if CTI-25 is used in mainland China. This study also indicated a comprehensive and holistic perspective (individual, community, and social level) when identifying, assessing needs or implementing interventions to support family caregivers.

  • 45.
    Siebmanns, Sandra
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Johansson, Peter
    Department of Health, Medicine and Care, Linköping University, Norrköping, Sweden; Department of Internal Medicine and Department of Health, Medicine and Care, Linköping University, Norrköping, Sweden.
    Ulander, Martin
    Department of Clinical Neurophysiology, Linköping University Hospital, Linköping, Sweden.
    Johansson, Linda
    Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Andersson, Gerhard
    Department of Behavioral Sciences and Learning, Linköping University, Linköping, Sweden; Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Broström, Anders
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT. Department of Clinical Neurophysiology, Linköping University Hospital, Linköping, Sweden.
    The effect of nurse-led Internet-based cognitive behavioural therapy for insomnia on patients with cardiovascular disease: A randomized controlled trial with 6-month follow-up2021In: Nursing Open, E-ISSN 2054-1058, Vol. 8, no 4, p. 1755-1768Article in journal (Refereed)
    Abstract [en]

    Aim: To test the effect of nurse-led Internet-based cognitive behavioural therapy for insomnia (I-CBTI), tailored for patients with cardiovascular disease (CVD), with a 6-month follow-up.

    Design: A two-arm parallel-group randomized controlled trial (RCT) registered at clinicaltrials.gov (NTC03938805) and reported according to the CONSORT checklist.

    Methods: Forty-eight patients (mean age 72 years, 65% men) diagnosed with CVD and insomnia were randomized to either 9-week nurse-led I-CBTI with support, or an Internet-based self-study programme without support (control group). Insomnia Severity Index (ISI) and Short Form Health Survey (SF-12) were used as primary and secondary outcomes.

    Results: ISI showed a significant treatment effect of I-CBTI compared to the control group at 9-week follow-up. The mean ISI score in the I-CBTI group at 9 weeks post-treatment was maintained at the 6-month follow-up. Patients' adherence to I-CBTI was associated with a better effect on both the ISI and SF-12.

  • 46.
    Siebmanns, Sandra
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Ulander, M.
    Linkoping University Hospital, Department of clinical neurophysiology, Linkoping, Sweden.
    Sandberg, Jonas
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Johansson, Linda
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Johansson, P.
    Linkoping University Hospital, Department of Cardiology and Department of Medical and Health Sciences, Linkoping, Sweden.
    Broström, Anders
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Insomnia in patients with cardiovascular disease - a review of causes, consequences and nursing interventions2017In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 16, no Suppl. 1, p. S31-S31Article in journal (Refereed)
    Abstract [en]

    Introduction: Insomnia is defined as a subjective complaint of difficulty to initiate sleep, difficulty to maintain sleep, and early morning awakenings that occur at a minimum of 3 nights per week for 3 months. The prevalence of insomnia in the general adult population is estimated to 12–20%. The prevalence is even higher among those with cardiovascular disease (CVD). Insomnia has a significant impact on the individual’s health and quality of life.

    Aim: To examine causes, consequences and nursing interventions for insomnia in patients with CVD.

    Design: Literature review.

    Method: Electronic search through PubMed and Cinahl for studies published 2001-2016. Insomnia, CVD, causes, consequences, interventions and nurse-led intervention were used as keywords. Detected duplicates, irrelevant studies and others (i.e., editorials, letters) were removed. “Insomnia and CVD” resulted in 214 hits, “insomnia and CVD and causes” in 394 hits, “insomnia and CVD and consequences” in 35 hits, and “insomnia and CVD and interventions” resulted in 51 hits.

    Results: Insomnia causes impaired daytime functioning, poorer cognitive function and a feeling of isolation. The pathophysiological consequences of insomnia are associated with increased risk for arteriosclerosis and CVD (i.e., caused by an increased inflammatory processes). Pharmacological treatment for insomnia have been used for some time (i.e., sedative, hypnotics and antidepressant), but there are concerns about tolerance and dependence, as well as other side effects (i.e., falls, cognitive changes and unusual sleep behaviours) which requires a thorough risk and benefit analysis before prescription. Non-pharmacological treatments such as Cognitive behavioural therapy (CBT) and internet-based CBT (I-CBT) for insomnia, led by therapists, is a less expensive intervention used in previous studies for othe rpatient groups. Despite positive results for both CBT andI-CBT (i.e., improved performance, increased quality of life and reduced symptom burden) in these studies no nurse-led interventions (i.e., of any type) intended for patients with CVD and insomnia were found.

    Conclusion: I-CBT for insomnia seems to be an accessible and effective treatment for other patient groups. The lack of nurse-led interventions, highlights the need for future studies in patients with CVD and insomnia.

  • 47.
    Siebmanns, Sandra
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Ulander, M.
    Linkoping Univ Hosp, Dept Clin Neurophysiol, Linkoping, Sweden.
    Sandberg, Jonas
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Johansson, Linda
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology.
    Johansson, P.
    Linkoping Univ, Dept Cardiol, Linkoping, Sweden.
    Broström, Anders
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    Internet-based CBT for insomnia in the general population - a description of design, measurements and interventions in recent RCT studies2018In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 27, no 1, SI, p. 290-291, article id P436Article in journal (Refereed)
    Abstract [en]

    Objectives/Introduction: Internet-based cognitive behavioural therapy for insomnia (ICBTi) has been proposed as an effective, accessible, non-pharmacologic treatment for insomnia disorder. The objective was to perform a literature review of published randomized controlled trials (RCT).

    Methods: Literature review. PubMed was used to identify RCTs ofICBTi published since 2013. Keywords were insomnia, ICBT and RCT. The search resulted in 40 hits. Papers with study designs and methods not relevant to the objective were removed (n = 29). Reasons for exclusion were: only study protocol, not internet-based, and results based on old data.

    Results: Design: Recruitment were done via e-mail, from websites, online ads, and advertisements in local newspapers.

    Inclusion criteria: Six studies based their inclusion only on ISI score (from >7to>=15). 3 studies used a combination of ISI and DSM-IV. Two studies used DSM-IV only.

    Sample sizes: 4 studies had less than 100 participants, and 2 studies over 200, the mean number was 139 participants (48-303). The mean age varied from 15 to 52 years. Significantly more female participants in all studies.

    Data collection: ISI combined with sleep diary was the most commonly used primary or secondary outcome measurements (n =7), 2 used ISI only, and 2 used sleep diary only. Other common instruments were, PSQI, HADS, DBAS-16 and CES-D. All studies had pre- and post-treatment measurements, but none during the intervention. The follow-up-period varied between 8 weeks and 3 years. The most common follow-up time was 6 months (n = 4), with a range from 4 weeks3years.Intervention: Most of the studies (n = 10) used traditional ICBTi-treatments (i.e., stimulus control, sleep restriction, relaxation, sleep hygiene). One study did not include stimulus control. The treatment duration were six weeks (n = 8), eight weeks (n = 2) and nine weeks (n = 1). All except one used therapist guided support.

    Results: All studies showed significant post treatment improvements on sleep outcomes.

    Conclusions: All studies showed significant improvement with regard to sleep. The total number of participants in the studies was relatively low. Most studies are not based on clinical samples, which may affect the generalizability of the findings.

    Disclosure: Nothing to disclose

  • 48.
    Siebmanns, Sandra
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Ulander, M.
    Linkoping University Hospital, Department of clinical neurophysiology, Linkoping, Sweden.
    Sandberg, Jonas
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Johansson, Linda
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology.
    Johansson, P.
    Linkoping University Hospital, Department of Cardiology and Department of Medical and Health Sciences, Linkoping, Sweden.
    Broström, Anders
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Internet-based Intervention to treat insomnia in patients with cardiovascular disease2017In: European Journal of Cardiovascular Nursing, ISSN 1474-5151, E-ISSN 1873-1953, Vol. 16, no Suppl. 1, p. S75-S75Article in journal (Refereed)
    Abstract [en]

    Introduction: Insomnia (i.e., trouble initiating sleep,maintaining sleep or difficulties getting enough sleep) is a prevalent problem among patients with cardiovascular disease (CVD). It is associated with physical and mental symptoms such as impaired daytime functioning, worries and depressive symptoms. Recent studies in other patient groups have described Internet-based Cognitive behavioral treatment (I-CBT) as a promising accessible and cost effective intervention. Few if any studies are conductedin CVD patients with insomnia despite the possibility of reduced symptom burden, reduced cardiovascular morbidity and improved quality of life (QoL).

    Aim: To describe the design, content and measures in theHit-IT study, an intervention developed to treat insomnia in patients with CVD.

    Design: An explorative design with 1 year followup including 200 primary care patients with CVD and insomnia from 4 centers. Patients will be randomized to 9 weeks of I-CBT, or to a control group receiving internetbased sleep hygiene without support.

    CONTENT: The I-CBT intervention starts with a 1 week introduction, 2 weeks of psychoeducation (i.e., CVD and insomnia), followed by a 6 weeks treatment part (i.e., sleep hygiene, stimulus control and sleep restriction). Participants can communicate with a nurse and receive feedback during treatment. A psychologist will act as back-up.

    MEASURES: Questionnaires will be administered at baseline, during and post intervention at 6 and 12 months’. The questionnaires will focus on e.g., educational effects, as well as on effects regarding symptoms; sleep/insomnia (PSQI, ISI, ESS, sleep diary), depressive symptoms (PHQ-9), as well as QoL (SF12). The participants’ experience of the program will be explored by repeated interviews (at baseline, after 3 weeks, 6 weeks and after the intervention).

    Conclusion: Depending on its effectiveness a nurseled I-CBT program can be a possible tool for insomnia treatment in cardiovascular care.

  • 49.
    Siebmanns, Sandra
    et al.
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science.
    Ulander, M.
    Linkoping Univ Hosp, Dept Clin Neurophysiol, Linkoping, Sweden.
    Sandberg, Jonas
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Johansson, Linda
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping). Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology.
    Johansson, P.
    Linkoping Univ, Dept Cardiol, Linkoping, Sweden.
    Broström, Anders
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ADULT.
    "You can’t always get what you want” - methodological challenges with an internet-based CBT intervention for insomnia among patients with cardiovascular disease2018In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 27, no 1, SI, p. 291-291, article id P437Article in journal (Refereed)
    Abstract [en]

    Objectives/Introduction: Internet‐based cognitive behavioural therapy for insomnia (ICBTi) is a frequently used intervention. Published studies are promising, but methodological limitations (e.g., heterogeneity, low number of participants, unclear adherence to the intervention) have been reported. The aim was to describe methodological challenges perceived in the Hit‐IT study, an ongoing ICBTi study for patients with insomnia and cardiovascular disease (CVD).

    The Hit‐IT study: Design: RCT with 1‐year follow‐up. All patients with CVD (i.e., myocardial infarction, heart failure, atrial fibrillation and angina) from 6 primary care centers are screened for insomnia and during a clinical examination diagnosed according to DSM‐V criteria.Intervention: 9 weeks I‐CBTi (1‐week introduction, 2 weeks psychoeducation on CVD/insomnia, 6 weeks of sleep hygiene, stimulus control and sleep restriction) vs 3 weeks internet‐based sleep hygiene education.Questionnnaires: Sleep (Pittsburg Sleep Quality Index, Insomnia Severity Index, sleep diary), depressive‐ and cardiac symptoms (Patient Health Qurestionnaire‐9, Cardiac Anxiety Questionnaire) and Quality of Life (SF‐12) at baseline, during and after intervention (after 6 and 12 months).

    Methods: Interim analysis with descriptive statistics.

    Results: Out of 2170 approached patients with diagnosed CVD1508 (70%) responded (No=1330/Yes=178). Of the 178 approvals (124 men/54 women), 54 did not complete internet‐based screening (no e‐mail, declined participation and for unknown reasons). Of the 124 participants who completed screening, 40 (34 men/6 women, age range 42‐84 years) were excluded (ISI < 8). In addition, 32 were excluded after telephone contact and clinical examination (declined participation n = 10, no clinical insomnia n = 14, sleep apnea n = 4,restless legs n = 2, epilepsy n = 1, pharmacological side effect n = 1). Currently 46 participants have been randomized in the Hit‐IT study (15 females, 31 males, mean age 71 years/Range 41‐92 years). 19 participants have completed control group (1 dropout related to technical problems, 3 in treatment). In the intervention group, 6 have completed, 4 intentions to treat, 3 dropouts (n = 2 unknown reason, n = 1 technical problems), 10 participants in treatment.

    Conclusions: Clear methodological challenges with regard to the strenuous patient inclusion process are identified. The current study has a higher mean age and higher number of participating men than current ICBTi studies in general population.

    Disclosure: Nothing to disclose.

  • 50.
    Silén, Marit
    et al.
    Faculty of Health and Occupational Studies, Department of Health and Caring Sciences, University of Gävle, Sweden.
    Johansson, Linda
    Jönköping University, School of Health and Welfare, HHJ, Dep. of Nursing Science. Jönköping University, School of Health and Welfare, HHJ. ARN-J (Aging Research Network - Jönköping).
    Aims and theoretical frameworks in nursing students' Bachelor's theses in Sweden: A descriptive study2016In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 37, p. 91-96Article in journal (Refereed)
    Abstract [en]

    Background

    Nursing students' independent projects in Sweden not only provide an opportunity to receive a professional qualification as a nurse but also gain a Bachelor's degree in nursing. The aim of these projects is to demonstrate knowledge and understanding within the major field of the education.

    Objectives

    This study aimed to describe and analyze the topics as well as theoretical frameworks and concepts in nursing students' independent projects, which lead to a Bachelor's degree, in a Swedish context.

    Design

    A total of 491 independent projects, written by nursing students in Sweden, were included in the study.

    Methods

    Topics together with theoretical frameworks and concepts in the projects were identified. Similar topics and theoretical frameworks and concepts, respectively, were grouped into subcategories, and similar subcategories were then merged into a main category. The number of entries in each category was counted for descriptive statistics in order to allow for the demonstration of magnitude.

    Results

    The most common topics concerned experiences and managing when having an illness, experiences of care and of being a caregiver, and healthcare staff's care and knowledge. The nursing theories/models that were most often used were Eriksson's Theory of Caritative Caring, Travelbee's Human-to-Human Relationship Model, and Orem's Self-care Theory. Among the non-nursing theories/models, perspectives and concepts lifeworld, ethical values and principles, existential concepts and quality of life/health-related quality of life, were most often used by these students.

    Conclusion

    There may be some difficulty in finding a topic for the project that is relevant for both a professional qualification as a nurse, as well as for achieving the requirements of a Bachelor's degree in nursing. The study indicates that there is a need to widen the student's understanding of different nursing theories/perspectives/models/concepts during nursing education so that students are familiar with a broad range of these when conducting their independent project.

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