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Carstensen, G., Rosberg, B., McKee, K. & Åberg, A. C. (2019). Before evening falls: Perspectives of a good old age and healthy ageing among oldest-old Swedish men. Archives of gerontology and geriatrics (Print), 82(May-June), 35-44
Open this publication in new window or tab >>Before evening falls: Perspectives of a good old age and healthy ageing among oldest-old Swedish men
2019 (English)In: Archives of gerontology and geriatrics (Print), ISSN 0167-4943, E-ISSN 1872-6976, Vol. 82, no May-June, p. 35-44Article in journal (Refereed) Published
Abstract [en]

The late life experiences of men in the oldest-old age group have been under-researched, and their perspectives on ageing successfully neglected. This study explored the perspectives of oldest-old Swedish men on what a ‘good old age’ and ageing successfully meant to them. A purposive sample of 17 men, aged 85-90 years, was drawn from the Uppsala Longitudinal Study of Adult Men. An interview guide explored participants’ perspectives on their ageing experiences and how they viewed ageing successfully. Participants were interviewed twice, with 1–2 weeks between interviews, and both interviews were recorded and transcribed. Content analysis identified four themes: i) Adaptation, concerning the ability to adapt to growing old with increasing limitations; ii) Sustaining Independence, related to financial resources and good health as the foundation for independence; iii) Belongingness, representing close relationships, established friendships, and the significance of the spouse; and iv) Perspectives of Time, also a common thread in all themes, in which past life experiences create an existential link between the past, the present and the future, establishing continuity of the self and enhancing life satisfaction. The participants presented themselves as active agents involved in maintaining meaning and achieving life satisfaction; a process related to the ability to manage changes in life. Our findings have resonance with models of healthy or successful ageing, but also diverge in important ways, since such models do not consider the significance of an individual’s life history for their present well-being, and primarily conceptualise health as an outcome, rather than as a resource.

Keywords
Life satisfactionhealthy agingOlder audultsMenContinuityAdaptationIndependenceBelongingnessTime
National Category
Nursing
Research subject
Health and Welfare; Health and Welfare
Identifiers
urn:nbn:se:du-29320 (URN)10.1016/j.archger.2019.01.002 (DOI)30711841 (PubMedID)2-s2.0-85060768267 (Scopus ID)
Available from: 2019-01-22 Created: 2019-01-22 Last updated: 2019-02-11Bibliographically approved
Bozkurt Ahman, H., Giedraitis, V., Cedervall, Y., Berglund, L., McKee, K., Rosendahl, E., . . . Åberg, A. C. (2018). Correlations Between Dual-Task Performance and Alzheimer’s Disease Cerebrospinal Fluid Biomarkers. In: : . Paper presented at The 14th International Congress of the European Geriatric Medicine Society, 2018 October 10-12, Berlin, Germany.
Open this publication in new window or tab >>Correlations Between Dual-Task Performance and Alzheimer’s Disease Cerebrospinal Fluid Biomarkers
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2018 (English)Conference paper (Refereed)
National Category
Clinical Medicine Health Sciences
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-27800 (URN)
Conference
The 14th International Congress of the European Geriatric Medicine Society, 2018 October 10-12, Berlin, Germany
Available from: 2018-06-12 Created: 2018-06-12 Last updated: 2018-06-12Bibliographically approved
Marmstål Hammar, L., Williams, C., Meranius, S. & McKee, K. (2018). Extended support to increase quality of life in spouse caregivers of older persons with dementia. A pilot study. In: : . Paper presented at American Geriatrics Society 2018 Annual General Meeting, Orlando, 3-5 May 2018.
Open this publication in new window or tab >>Extended support to increase quality of life in spouse caregivers of older persons with dementia. A pilot study
2018 (English)Conference paper, Oral presentation with published abstract (Refereed)
National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-27530 (URN)
Conference
American Geriatrics Society 2018 Annual General Meeting, Orlando, 3-5 May 2018
Available from: 2018-04-25 Created: 2018-04-25 Last updated: 2018-04-25Bibliographically approved
Lüdecke, D., Bien, B., McKee, K., Krevers, B., Mestheneos, E., Di Rosa, M., . . . Kofahl, C. (2018). For better or worse: Factors predicting outcomes of family care of older people over a one-year period. A six-country European study. PLoS ONE, 13(4), Article ID e0195294.
Open this publication in new window or tab >>For better or worse: Factors predicting outcomes of family care of older people over a one-year period. A six-country European study
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2018 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 13, no 4, article id e0195294Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: Demographic change has led to an increase of older people in need of long-term care in nearly all European countries. Informal carers primarily provide the care and support needed by dependent people. The supply and willingness of individuals to act as carers are critical to sustain informal care resources as part of the home health care provision. This paper describes a longitudinal study of informal care in six European countries and reports analyses that determine those factors predicting the outcomes of family care over a one-year period.

METHODS: Analyses are based on data from the EUROFAMCARE project, a longitudinal survey study of family carers of older people with baseline data collection in 2004 and follow-up data collection a year later in six European countries (Germany, Greece, Italy, Poland, Sweden, and the United Kingdom), N = 3,348. Descriptive statistics of the sample characteristics are reported. Binary logistic random-intercept regressions were computed, predicting the outcome of change of the care dyad's status at follow-up.

RESULTS: Where care is provided by a more distant family member or by a friend or neighbour, the care-recipient is significantly more likely to be cared for by someone else (OR 1.62) or to be in residential care (OR 3.37) after one year. The same holds true if the care-recipient has memory problems with a dementia diagnosis (OR 1.79/OR 1.84). Higher dependency (OR 1.22) and behavioural problems (OR 1.76) in the care-recipient also lead to a change of care dyad status. Country of residence explained a relatively small amount of variance (8%) in whether a care-recipient was cared for by someone else after one year, but explained a substantial amount of variance (52%) in whether a care-recipient was in residential care. Particularly in Sweden, care-recipients are much more likely to be cared for by another family or professional carer or to be in residential care, whereas in Greece the status of the care dyad is much less likely to change.

DISCUSSION: The majority of family carers continued to provide care to their respective older relatives over a one-year period, despite often high levels of functional, cognitive and behavioural problems in the care-recipient. Those family carers could benefit most from appropriate support. The carer/care-recipient relationship plays an important role in whether or not a family care dyad remains intact over a one-year period. The support of health and social care services should be particularly targeted toward those care dyads where there is no partner or spouse acting as carer, or no extended family network that might absorb the caring role when required. Distant relatives, friends or acquaintances who are acting as carers might need substantial intervention if their caregiving role is to be maintained.

National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-27456 (URN)10.1371/journal.pone.0195294 (DOI)000429081600041 ()29614108 (PubMedID)
Available from: 2018-04-05 Created: 2018-04-05 Last updated: 2018-04-26Bibliographically approved
Olsen, M., Dahlberg, L., Boström, A.-M., McKee, K. & Udo, C. (2018). Older people’s views on the important values in home help provision: a Swedish study. In: : . Paper presented at 24th Nordic Conference of Gerontology, Oslo, Norway, 2-4 May 2018..
Open this publication in new window or tab >>Older people’s views on the important values in home help provision: a Swedish study
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2018 (English)Conference paper, Poster (with or without abstract) (Refereed)
Abstract [en]

Little is known about the values that older people consider important in receipt of home help. Therefore, this study aimed to explore which values older people hold in relation to home help services and their experiences of how these values are reflected in the delivery of help. Interviews were conducted from November 2015 to March 2016 with 16 older persons (age ≥65 years) who received home help at the time of the study. Data were analysed using qualitative content analysis. Results identified values that older people find important in home help and suggest behaviours that should underpin home help, such as supporting the older person’s independence, building a reciprocal relationship and promoting a sense of safety and security (e.g., by providing information about what home help entails for the recipient). We conclude that it is important that care staff recognise and integrate these values into their actions on an interpersonal level in daily care, adopting a relation-oriented rather than a task-focused approach in the provision of home help for older people.

National Category
Nursing
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-27690 (URN)
Conference
24th Nordic Conference of Gerontology, Oslo, Norway, 2-4 May 2018.
Available from: 2018-05-18 Created: 2018-05-18 Last updated: 2018-05-21Bibliographically approved
Mocumbi, S., McKee, K., Munguambe, K., Chiau, R., Högberg, U., Hanson, C., . . . Bergström, A. (2018). Ready to deliver maternal and newborn care? Health providers' perceptions of their work context in rural Mozambique. Global Health Action, 11(1), Article ID 1532631.
Open this publication in new window or tab >>Ready to deliver maternal and newborn care? Health providers' perceptions of their work context in rural Mozambique
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2018 (English)In: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 11, no 1, article id 1532631Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Deficiencies in the provision of evidence-based obstetric care are common in low-income countries, including Mozambique. Constraints relate to lack of human and financial resources and weak health systems, however limited resources alone do not explain the variance. Understanding the healthcare context ahead of implementing new interventions can inform the choice of strategies to achieve a successful implementation. The Context Assessment for Community Health (COACH) tool was developed to assess modifiable aspects of the healthcare context that theoretically influence the implementation of evidence.

OBJECTIVES: To investigate the comprehensibility and the internal reliability of COACH and its use to describe the healthcare context as perceived by health providers involved in maternal care in Mozambique.

METHODS: A response process evaluation was completed with six purposively selected health providers to uncover difficulties in understanding the tool. Internal reliability was tested using Cronbach's α. Subsequently, a cross-sectional survey using COACH, which contains 49 items assessing eight dimensions, was administered to 175 health providers in 38 health facilities within six districts in Mozambique.

RESULTS: The content of COACH was clear and most items were understood. All dimensions were near to or exceeded the commonly accepted standard for satisfactory internal reliability (0.70). Analysis of the survey data indicated that items on all dimensions were rated highly, revealing positive perception of context. Significant differences between districts were found for the Work culture, Leadership, and Informal payment dimensions. Responses to many items had low variance and were left-skewed.

CONCLUSIONS: COACH was comprehensible and demonstrated good reliability, although biases may have influenced participants' responses. The study suggests that COACH has the potential to evaluate the healthcare context to identify shortcomings and enable the tailoring of strategies ahead of implementation. Supplementing the tool with qualitative approaches will provide an in-depth understanding of the healthcare context.

Keywords
Context assessment, health personnel, implementation science, maternal and neonatal care, validity
National Category
Health Sciences
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-28866 (URN)10.1080/16549716.2018.1532631 (DOI)000449336300001 ()30387378 (PubMedID)2-s2.0-85055915025 (Scopus ID)
Available from: 2018-11-05 Created: 2018-11-05 Last updated: 2018-12-28Bibliographically approved
Dahlberg, L. & McKee, K. (2018). Social exclusion and well-being among older adults in rural and urban areas. Archives of gerontology and geriatrics (Print), 79, 176-184
Open this publication in new window or tab >>Social exclusion and well-being among older adults in rural and urban areas
2018 (Swedish)In: Archives of gerontology and geriatrics (Print), ISSN 0167-4943, E-ISSN 1872-6976, Vol. 79, p. 176-184Article in journal (Refereed) Published
Abstract [en]

Background: Social exclusion (SE) is a process that limits participation in society across life domains, and is associated with poor quality of life. Neighbourhood exclusion has been identified as particularly important for older adults. This paper examines the association between SE and well-being in older adults from urban and rural areas, focusing on neighbourhood exclusion.

Methods: Using a cross-sectional survey design with a stratified sampling frame, participants (aged 65+) from rural (n=628) and urban (n=627) areas of Barnsley, United Kingdom, completed a questionnaire containing indicators of five SE domains: civic activity, material resources, social relationships, services and neighbourhood. Sequential linear regression models were developed for 1) total sample; 2) rural areas; and 3) urban areas, with well-being regressed on SE indicators after controlling for self-reported health.

Results: SE indicators explained 13.4% of the variance in well-being in the total sample (of which neighbourhood exclusion explained 1.2%); corresponding figures for the rural model were 13.8% (3.8%) and for the urban model 18.0% (1.7%); the addition of neighbourhood exclusion significantly improved all three models.  Five SE indicators were significant in the rural model, compared with seven in the urban model, with four common to both.

Discussion: Neighbourhood exclusion explained more variance in well-being in rural than urban areas, whereas exclusion from services explained more variance in urban than rural areas. Area characteristics and the role of neighbourhood should be considered in policy initiatives to reduce SE and promote well-being.

Keywords
older people; social exclusion; well-being; rural/urban areas; neighbourhood
National Category
Social Work
Research subject
Health and Welfare, Social exkludering av äldre på före detta industriorter
Identifiers
urn:nbn:se:du-28320 (URN)10.1016/j.archger.2018.08.007 (DOI)000447149300028 ()30265913 (PubMedID)2-s2.0-85053753842 (Scopus ID)
Note

Open Access APC beslut 18/2018

Available from: 2018-08-15 Created: 2018-08-15 Last updated: 2018-11-01Bibliographically approved
Nordin, S., McKee, K. & Elf, M. (2018). Staff perceptions of the design of care environments for older people – a qualitative study. In: : . Paper presented at 24th Nordic Congress of Gerontology, Oslo, 2-4 May 2018..
Open this publication in new window or tab >>Staff perceptions of the design of care environments for older people – a qualitative study
2018 (English)Conference paper, Poster (with or without abstract) (Refereed)
Abstract [en]

Staff perceptions of the design of care environments for older people – a qualitative study

Background: Although research has shown the important role played by the physical care environment for residents and staff of residential care facilities (RCFs) for older people, few studies have taken the care staff perspective regarding how the environment influences their ability to provide high quality care. This paper considers care staff perceptions of older people’s RCFs.

Methods: Twenty RCFs in Sweden were purposively sampled to obtain facilities with varying building design, type of ownership, year of construction, building size and geographic location. From each RCF, ten staff were randomly selected and recruited by the care home managers. Staff completed the Staff Perception of Older People’s Residential Care Environments (SPORE) questionnaire. Written responses to open-ended questions on the care environment were analysed using qualitative content analysis.

Results: Several needs and deficiencies in the care environment were identified. The participants described problems with limited spaces and non-functional building design, and restricted access to outside areas. They also expressed the need for physical and cognitive support in the care environment such as handrails, hoists, adequate lighting and colour coding.

Conclusions: There is potential for improving the design of RCFs for older people to provide safe and supportive care environments for residents and to facilitate care delivery, by taking  the needs of the building users into account in future planning and design processes.

National Category
Health Sciences
Research subject
Health and Welfare; Health and Welfare
Identifiers
urn:nbn:se:du-27971 (URN)
Conference
24th Nordic Congress of Gerontology, Oslo, 2-4 May 2018.
Available from: 2018-06-20 Created: 2018-06-20 Last updated: 2018-06-20Bibliographically approved
McKee, K. & Dahlberg, L. (2018). The association between social exclusion and well-being in older adults from rural and urban areas. In: : . Paper presented at 24th Nordic Congress in Gerontology, Oslo, 2-4 maj 2018.
Open this publication in new window or tab >>The association between social exclusion and well-being in older adults from rural and urban areas
2018 (English)Conference paper, Poster (with or without abstract) (Refereed)
National Category
Social Work
Research subject
Health and Welfare, Social exkludering av äldre på före detta industriorter
Identifiers
urn:nbn:se:du-28358 (URN)
Conference
24th Nordic Congress in Gerontology, Oslo, 2-4 maj 2018
Available from: 2018-08-20 Created: 2018-08-20 Last updated: 2018-08-21Bibliographically approved
Cedervall, Y., Giedraitis, V., Berglund, L., McKee, K., Kilander, L., Rosendahl, E., . . . Åberg, A. C. (2018). Timed Up-and-Go dual-task performance – a marker for dementia?. In: : . Paper presented at World conference on Movement and Cognition, 2018, 27-29 July 2018, Boston, USA.
Open this publication in new window or tab >>Timed Up-and-Go dual-task performance – a marker for dementia?
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2018 (English)Conference paper (Refereed)
National Category
Clinical Medicine Health Sciences
Research subject
Health and Welfare
Identifiers
urn:nbn:se:du-27803 (URN)
Conference
World conference on Movement and Cognition, 2018, 27-29 July 2018, Boston, USA
Available from: 2018-06-12 Created: 2018-06-12 Last updated: 2018-06-12Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-8795-7555

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