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Nordin, S., Elf, M. & McKee, K. (2024). Development and initial validation of the staff perception of residential care environments (SPORE) instrument. International Journal of Older People Nursing, 19(1), Article ID e12596.
Open this publication in new window or tab >>Development and initial validation of the staff perception of residential care environments (SPORE) instrument
2024 (English)In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 19, no 1, article id e12596Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The impact of the physical environment on healthcare staff well-being and work performance is well recognised, yet there is a lack of instruments assessing environmental features from the perspective of staff working in residential care facilities (RCFs) for older people.

OBJECTIVES: To develop and provide initial validation of the instrument Staff Perceptions Of Residential care facility Environments (SPORE).

DESIGN: An instrument development and psychometric evaluation study.

METHODS: Based on material from a British project, items were translated and adapted for Swedish residential care facilities as SPORE. Care staff (N = 200), recruited from 20 Swedish RCFs, completed a questionnaire-based survey containing the SPORE instrument and two other instruments selected as suitable for use in the validation. In addition, an environmental assessment instrument was used for further validation. Analyses were performed at individual (staff) level and home (RCF) level.

RESULTS: The SPORE subscales demonstrated good internal consistency reliability and were moderately to strongly correlated at the individual level with the subscales of measures of person-centred care, and strongly correlated with the same measures at the home level. The SPORE subscales were also highly correlated with the total score of the instrument used to assess the quality of the physical environment.

CONCLUSION: The initial validation indicates that the SPORE instrument is promising for measuring care staff perceptions of environmental features in care facilities for older people. SPORE can be a valuable instrument for use in research and in practice to evaluate the environment as part of working towards high-quality care.

IMPLICATIONS FOR PRACTICE: The design of the physical environment within RCFs can affect the staff's health and work performance. The instrument is useful for evaluating the environment and informing decisions about design solutions that support staff in their important work.

Keywords
care environment, evidence-based design, healthcare staff, instrument development, nursing, older people, person-centred care
National Category
Other Health Sciences
Identifiers
urn:nbn:se:du-47469 (URN)10.1111/opn.12596 (DOI)001121330500001 ()38073273 (PubMedID)2-s2.0-85179329713 (Scopus ID)
Available from: 2023-12-12 Created: 2023-12-12 Last updated: 2024-02-01Bibliographically approved
Mauritzson, E., McKee, K. J., Elf, M. & Borg, J. (2023). Older Adults' Experiences, Worries and Preventive Measures Regarding Home Hazards: A Survey on Home Safety in Sweden. International Journal of Environmental Research and Public Health, 20(2), Article ID 1458.
Open this publication in new window or tab >>Older Adults' Experiences, Worries and Preventive Measures Regarding Home Hazards: A Survey on Home Safety in Sweden
2023 (English)In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 20, no 2, article id 1458Article in journal (Refereed) Published
Abstract [en]

Home safety is important for preventing injuries and accidents among older adults living at home. Feeling safe at home is also essential for older adults' well-being. Thus, this study aimed to explore older adults' perceptions of safety in their homes by examining their experiences, worries and preventive measures in relation to a range of potential home-based health and safety hazards. The study was a national cross-sectional telephone survey of 400 randomly selected adults over 70 years of age living at home in ordinary housing in Sweden. Participants were asked for their experience of, worry about, and preventive measures taken regarding fifteen home hazards. Data were also collected on background variables including age, health, and cohabitation status. Falls and stab/cut injuries were the most experienced hazards and worry was highest for burglary and falls, while preventive measures were most common for fire and burglary. While older adults' experience and worry regarding home hazards were associated with preventive measures, these associations were not strong and other factors were associated with preventive behaviour. Further identification of the main determinants of older adults' preventive behaviour can contribute to policy for effectively reducing home accidents.

Keywords
+70 years of age, community living, home safety, national survey, neighbourhood, older adults, preventive behaviour, self-reported health, social support, worry
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:du-45280 (URN)10.3390/ijerph20021458 (DOI)000917034900001 ()36674213 (PubMedID)2-s2.0-85146747093 (Scopus ID)
Available from: 2023-01-25 Created: 2023-01-25 Last updated: 2023-05-26Bibliographically approved
Åberg, A. C., Rosberg Petersson, J., Giedraitis, V., McKee, K. J., Rosendahl, E., Halvorsen, K. & Berglund, L. (2023). Prediction of conversion to dementia disorders based on timed up and go dual-task test verbal and motor outcomes: a five-year prospective memory-clinic-based study. BMC Geriatrics, 23(1), Article ID 535.
Open this publication in new window or tab >>Prediction of conversion to dementia disorders based on timed up and go dual-task test verbal and motor outcomes: a five-year prospective memory-clinic-based study
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2023 (English)In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 23, no 1, article id 535Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: While assessment tools can increase the detection of cognitive impairment, there is currently insufficient evidence regarding clinical outcomes based on screening for cognitive impairment in older adults.

METHODS: The study purpose was to investigate whether Timed Up and Go dual-task test (TUGdt) results, based on TUG combined with two different verbal tasks (name different animals, TUGdt-NA, and recite months in reverse order, TUGdt-MB), predicted dementia incidence over a period of five years among patients (N = 186, mean = 70.7 years; 45.7% female) diagnosed with Subjective Cognitive Impairment (SCI) and Mild Cognitive Impairment (MCI) following assessment at two memory clinics. Associations between TUG parameters and dementia incidence were examined in Cox regression models.

RESULTS: During follow-up time (median (range) 3.7 (0.1-6.1) years) 98 participants converted to dementia. Novel findings indicated that the TUGdt parameter words/time, after adjustment for age, gender, and education, can be used for the prediction of conversion to dementia in participants with SCI or MCI over a period of five years. Among the TUG-related parameters investigated, words/time showed the best predictive capacity, while time scores of TUG and TUGdt as well as TUGdt cost did not produce significant predictive results. Results further showed that the step parameter step length during TUGdt predicts conversion to dementia before adjustment for age, gender, and education. Optimal TUGdt cutoffs for predicting dementia at 2- and 4-year follow-up based on words/time were calculated. The sensitivity of the TUGdt cutoffs was high at 2-year follow-up: TUGdt-NA words/time, 0.79; TUGdt-MB words/time, 0.71; reducing respectively to 0.64 and 0.65 at 4-year follow-up.

CONCLUSIONS: TUGdt words/time parameters have potential as cost-efficient tools for conversion-to-dementia risk assessment, useful for research and clinical purposes. These parameters may be able to bridge the gap of insufficient evidence for such clinical outcomes.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT05893524: https://www.

CLINICALTRIALS: gov/study/NCT05893524?id=NCT05893524&rank=1 .

Keywords
Demenetia disorder, Dual-task, Gait, Mild cognitive impairment, Subjective cognitive impairment
National Category
Geriatrics
Identifiers
urn:nbn:se:du-46896 (URN)10.1186/s12877-023-04262-w (DOI)001058979100001 ()37660032 (PubMedID)2-s2.0-85169513958 (Scopus ID)
Available from: 2023-09-05 Created: 2023-09-05 Last updated: 2023-11-20Bibliographically approved
Åberg, A. C., Rosberg Petersson, J., Giedraitis, V., McKee, K., Rosendahl, E. & Berglund, L. (2023). Prediction of conversion to dementia disorders based on Timed Up and Go dual-task test verbal outcomes: A longitudinal prospective memory-clinic-based study. In: : . Paper presented at The 19th International Congress of the European Union Geriatric Medicine Society, September 2023, Helsinki, Finland.
Open this publication in new window or tab >>Prediction of conversion to dementia disorders based on Timed Up and Go dual-task test verbal outcomes: A longitudinal prospective memory-clinic-based study
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2023 (English)Conference paper, Oral presentation with published abstract (Refereed)
National Category
Physiotherapy
Identifiers
urn:nbn:se:du-47225 (URN)
Conference
The 19th International Congress of the European Union Geriatric Medicine Society, September 2023, Helsinki, Finland
Available from: 2023-11-07 Created: 2023-11-07 Last updated: 2023-11-20Bibliographically approved
Rosberg Petersson, J., Berglund, L., Giedraitis, V., Halvorsen, K., Rosendahl, E., McKee, K. & Åberg, A. C. (2023). Step length during Timed Up and Go performance: preliminary results of a cross-sectional cohort study. In: : . Paper presented at The 19th International Congress of the European Union Geriatric Medicine Society, September 2023, Helsinki, Finland.
Open this publication in new window or tab >>Step length during Timed Up and Go performance: preliminary results of a cross-sectional cohort study
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2023 (English)Conference paper, Oral presentation with published abstract (Refereed)
National Category
Physiotherapy
Identifiers
urn:nbn:se:du-47226 (URN)
Conference
The 19th International Congress of the European Union Geriatric Medicine Society, September 2023, Helsinki, Finland
Available from: 2023-11-07 Created: 2023-11-07 Last updated: 2023-11-20Bibliographically approved
Dahlberg, L., McKee, K., Lennartsson, C. & Rehnberg, J. (2022). A social exclusion perspective on loneliness in older adults in the Nordic countries. European Journal of Ageing, 19(2), 175-188
Open this publication in new window or tab >>A social exclusion perspective on loneliness in older adults in the Nordic countries
2022 (English)In: European Journal of Ageing, ISSN 1613-9372, E-ISSN 1613-9380, Vol. 19, no 2, p. 175-188Article in journal (Refereed) Published
Abstract [en]

Several factors associated with loneliness are also considered indicators of social exclusion. While loneliness has been proposed as an outcome of social exclusion, there is limited empirical evidence of a link. This study examines the associations between social exclusion indicators and loneliness in older adults (60+ years) in four Nordic countries. Data from four waves of the European Social Survey were pooled, providing a total of 7755 respondents (Denmark n = 1647; Finland n = 2501, Norway n = 1540; Sweden n = 2067). Measures of loneliness, demographic characteristics, health, and eight indicators of social exclusion were selected from the survey for analysis. Country-specific and total sample hierarchical logistic regression models of loneliness were developed. Significant model improvement occurred for all models after social exclusion indicators were added to models containing only demographic and health variables. Country models explained between 15.1 (Finland) and 21.5% (Sweden) of the variance in loneliness. Lower frequency of social contacts and living alone compared to in a two-person household was associated with a higher probability of loneliness in all countries, while other indicators were associated with loneliness in specific countries: lower neighbourhood safety (Sweden and Denmark); income concern (Sweden and Finland); and no emotional support (Denmark, Finland, and Sweden). A robust relationship was apparent between indicators of social exclusion and loneliness with the direction of associations being highly consistent across countries, even if their strength and statistical significance varied. Social exclusion has considerable potential for understanding and addressing risk factors for loneliness.

National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Health and Welfare, Att leva i samhällets utkant: Social exkludering bland äldre kvinnor och män i Sverige; Health and Welfare, Ensamhet och hälsa bland äldre personer i Norden
Identifiers
urn:nbn:se:du-41223 (URN)10.1007/s10433-022-00692-4 (DOI)000774625200001 ()35663913 (PubMedID)2-s2.0-85127324200 (Scopus ID)
Available from: 2022-04-08 Created: 2022-04-08 Last updated: 2023-03-17
Nordin, S., McKee, K. & Elf, M. (2022). Exploring the design of physical environments for older adults – a qualitative study on staff perceptions of outdoor areas. In: : . Paper presented at The 5th Architecture Research Care and Health Conference (Arch22), Enabling health, care and well-being through design research, Delft, the Netherlands, 22-24 August 2022.
Open this publication in new window or tab >>Exploring the design of physical environments for older adults – a qualitative study on staff perceptions of outdoor areas
2022 (English)Conference paper, Poster (with or without abstract) (Refereed)
Abstract [en]

Background: Although the importance of the design of physical care environments for older adults and healthcare staff of residential care facilities (RCFs) is well recognized, few studies have taken the staff perspective regarding how environmental factors influence its users. This study considers healthcare staff perceptions of older adults’ RCFs with a focus on outdoor areas. 

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. Ten healthcare staff from each facility were randomly selected and recruited by the care home managers. Healthcare staff completed the Staff Perception of Older People’s Residential Care Environments (SPORE) questionnaire. In this study, only written responses to open-ended questions on the physical care environment were analysed, using qualitative content analysis. 

Results: The importance of outdoor areas for the well-being of older adults was emphasised, and several requirements and deficiencies in the physical features of such areas were identified. Concerns were expressed about the lack of accessibility to outdoor areas. Physical features that can provide support for older adults when using outdoor areas, such as ramps and stable surfaces, were limited, as was their maintenance. 

Conclusions: This study shows the importance of taking the users’ needs into account when planning and designing RCFs for older adults. There is potential for improving the design of outdoor areas in order to provide safe and supportive physical care environments and to facilitate care delivery.

National Category
Nursing
Identifiers
urn:nbn:se:du-43151 (URN)
Conference
The 5th Architecture Research Care and Health Conference (Arch22), Enabling health, care and well-being through design research, Delft, the Netherlands, 22-24 August 2022
Available from: 2022-11-07 Created: 2022-11-07 Last updated: 2023-03-17Bibliographically approved
Naseer, M., McKee, K., Ehrenberg, A., Schön, P. & Dahlberg, L. (2022). Individual and contextual predictors of emergency department visits among community-living older adults: a register-based prospective cohort study. BMJ Open, 12(2), Article ID e055484.
Open this publication in new window or tab >>Individual and contextual predictors of emergency department visits among community-living older adults: a register-based prospective cohort study
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2022 (English)In: BMJ Open, E-ISSN 2044-6055, Vol. 12, no 2, article id e055484Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: To examine the extent to which contextual factors explain emergency department (ED) visits and ED revisits, additional to that explained by individual factors.

DESIGN: A register-based prospective cohort study.

SETTING: Swedish region of Dalarna.

PARTICIPANTS: Participants were 16 543 community-living adults aged 80 or older who were residents of the Dalarna region of Sweden, excluding older adults who moved out of Dalarna or into residential care during the study period.

OUTCOME MEASURES: Dependent variables were initial ED visit, and at least one ED revisit within 30 days of an initial ED visit.

RESULTS: Approximately 36% of the participants visited the ED during the study period with 18.9% returning to the ED within 30 days. For both initial ED visits and ED revisits, the addition of contextual factors to models containing individual factors significantly improved model fit (p<0.001; p<0.022) and the amount of variance explained in the outcome. In the final models, initial ED visit was significantly associated with older age, number of chronic diseases, receipt of home help, number of primary care visits, proportion of 80+ in the population and shorter distance to the ED; while an ED revisit was significantly associated with greater use of social care, number of hospital admissions and disposition (discharged; admitted to hospital) at initial ED visit.

CONCLUSION: Contextual factors explain variance in initial ED visit, additional to that explained by individual factors alone, which indicates inequitable access to ED care. These findings suggest considering local variations in contextual factors in order to improve health-related outcomes among older adults.

Keywords
accident & emergency medicine, international health services, public health
National Category
Health Sciences
Research subject
Health and Welfare, Varför söker äldre personer akutsjukvård? Orsaker, omständigheter och förklaringar
Identifiers
urn:nbn:se:du-39472 (URN)10.1136/bmjopen-2021-055484 (DOI)000754022100011 ()35140159 (PubMedID)2-s2.0-85124275853 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2015-00440Region Dalarna
Available from: 2022-02-15 Created: 2022-02-15 Last updated: 2023-08-28
Vicente, J., McKee, K., Magnusson, L., Johansson, P., Ekman, B. & Hanson, E. (2022). Informal care provision among male and female working carers: Findings from a Swedish national survey. PLOS ONE, 17(3), Article ID e0263396.
Open this publication in new window or tab >>Informal care provision among male and female working carers: Findings from a Swedish national survey
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2022 (English)In: PLOS ONE, E-ISSN 1932-6203, Vol. 17, no 3, article id e0263396Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: Informal carers in paid employment-working carers (WKCs)-have complex support needs. However, little is known about WKCs' pattern of informal care provision, the support they receive, the impact providing care has on their employment, and how these vary between male and female WKCs. This study describes the pattern of informal care provision and received support among Swedish WKCs.

RESEARCH METHOD/DESIGN: The study was a cross-sectional questionnaire-based survey of a stratified random sample of the Swedish population aged 18 or over. The questionnaire addressed the type and extent of informal care provided, support received and the impact of care provision on employment. Of the 30,009 people who received the questionnaire, 11,168 (37.3%) responded, providing an analytic sample of 818 (7.32% of respondents) employed or self-employed informal carers.

FINDINGS: A typical Swedish WKC was a middle-aged female, providing weekly or daily care to a non-cohabitant parent, who experiences care as sometimes demanding and receives no formal support as a carer. Female WKCs were more likely than males to care alone and with higher intensity, to report a need for help in meeting their care-recipient's needs, and to experience care as demanding. Approximately 17% of WKCs reported their employment had been affected due to caring, 40% their ability to work, and 31% their career development opportunities. Female WKCs' ability to work was affected more than males', and they were more commonly prevented from applying for work.

CONCLUSION: Swedish female WKCs compared to males provide more hours of informal care, across more care domains, more often alone. This places them in a challenging situation when combining paid work and care. Greater recognition of the challenges faced by WKCs is required in Sweden and other countries, as are policies to reduce gender inequalities in informal care provision in this group.

National Category
Nursing
Identifiers
urn:nbn:se:du-39850 (URN)10.1371/journal.pone.0263396 (DOI)35255080 (PubMedID)2-s2.0-85125974596 (Scopus ID)
Available from: 2022-03-15 Created: 2022-03-15 Last updated: 2022-05-05Bibliographically approved
Nilsen, C., Celeste, R. K., Lennartsson, C., McKee, K. & Dahlberg, L. (2022). Long-term risk factors for old-age social exclusion in Sweden: a 30-year longitudinal study. Archives of gerontology and geriatrics (Print), 103, Article ID 104760.
Open this publication in new window or tab >>Long-term risk factors for old-age social exclusion in Sweden: a 30-year longitudinal study
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2022 (English)In: Archives of gerontology and geriatrics (Print), ISSN 0167-4943, E-ISSN 1872-6976, Vol. 103, article id 104760Article in journal (Refereed) Published
Abstract [en]

PURPOSE OF THE RESEARCH: Social exclusion threatens quality of life in older age. However, there is a lack of research on social exclusion from life-course and gender perspectives. We investigated early- and midlife risk factors for old-age social exclusion among women and men.

MATERIALS AND METHODS: Two individually linked studies of Swedish nationally representative samples provided longitudinal data over a 30-year period on 1,819 people at baseline. Indicators of economic exclusion, leisure/social exclusion, and civic exclusion were assessed at early late life (M=70 years) and late life (M=81). Educational attainment, non-employment, psychological health problems and mobility problems were measured as risk factors at midlife (M=54) and late midlife (M=61). Path analysis derived a model of old-age social exclusion.

RESULTS: Exclusion on a domain in early late life led to exclusion on the same domain in late life, except for the economic domain. Leisure/social exclusion in early late life also led to civic exclusion in late life. Midlife risk factors influenced late-life exclusion almost exclusively through early late-life exclusion. While model fit could not be significantly improved by allowing coefficients to vary freely by gender, there was a stronger effect of non-employment on exclusion in women and a stronger effect of psychological health problems on exclusion in men.

CONCLUSIONS: This study confirms that old-age exclusion is persistent and dynamic, and influenced by risk factors experienced earlier in life. A holistic approach with integrated efforts across different policy areas is needed to efficiently reduce old-age social exclusion.

Keywords
Late life, Life course, Midlife, Path analysis, Social exclusion, Sweden
National Category
Sociology
Research subject
Health and Welfare, Att leva i samhällets utkant: Social exkludering bland äldre kvinnor och män i Sverige
Identifiers
urn:nbn:se:du-41903 (URN)10.1016/j.archger.2022.104760 (DOI)000830297700001 ()35797759 (PubMedID)
Available from: 2022-07-12 Created: 2022-07-12 Last updated: 2023-03-17Bibliographically approved
Projects
Trygga bostäder för äldre personer genom smart teknik; Publications
Mauritzson, E., McKee, K. J., Elf, M. & Borg, J. (2023). Older Adults' Experiences, Worries and Preventive Measures Regarding Home Hazards: A Survey on Home Safety in Sweden. International Journal of Environmental Research and Public Health, 20(2), Article ID 1458. Mauritzson, E., McKee, K., Elf, M. & Borg, J. (2022). Perceptions and experiences of safety at home: a survey among older adults in Sweden. In: 26th Nordic Congress of Gerontology. Abstracts: Change and continuity. Paper presented at 26th Nordic Congress of Gerontology, 26NKG, June 8-10, 2022 Odense, Denmark (pp. 277-277). Mauritzson, E., McKee, K., Elf, M. & Borg, J. (2022). Preventing accidents and injuries: older adults' experiences, worries, and preventive measures regarding home hazards. In: 36th Annual Conference of the European Health Psychology Society. Abstracts: Charting new territories in health psychology. Paper presented at 36th Annual Conference of the European Health Psychology Society, EHPS2022 (pp. 707-707).
Utveckling och utvärdering av en digital tvilling för personcentrerad hemtjänst från brukares och socialtjänstens perspektivHantera tid vid demens: Effekter av tidshjälpmedel på tidsuppfattning, tidshantering i vardagen och välbefinnande hos personer med demens; Publications
Persson, A.-C., Möller, M. C., Dahlberg, L., Löfgren, M. & Janeslätt, G. (2023). Assessing time processing ability and daily time management in persons with dementia: Psychometric properties of three instruments.. Australian Occupational Therapy Journal, 70(1), 3-17Persson, A.-C., Dahlberg, L., Janeslätt, G., Möller, M. & Löfgren, M. (2023). Daily time management in dementia: qualitative interviews with persons with dementia and their significant others. BMC Geriatrics, 23(1), Article ID 405. Persson, A.-C. -., Janeslätt, G., Dahlberg, L., Löfgren, M. & Möller, M. (2022). Associations between Time Processing Ability, Daily Time Management, and Dementia Severity. International Journal of Environmental Research and Public Health, 19(7), Article ID 3928. Dsouza, S. A., Ramachandran, M., Nishiura, Y., Venkatesh, B. T. & Dahlberg, L. (2021). Assessment of time-related deficits in older adults: a scoping review protocol.. BMJ Open, 11(9), Article ID e050521. Persson, A.-C., Boman, I.-L., Dahlberg, L., Janeslätt, G., Möller, M. C. & Löfgren, M. (2020). Lack of time and dependence on significant others: Occupational therapists´ experiences of prescribing time assistive technology for persons with dementia.. Scandinavian Journal of Occupational Therapy, 27(8), 614-624
Boendemiljöer för äldre – vad har betydelse för personen?Åldrande, ensamhet och psykisk hälsa: att förstå sambanden och möjliggöra förändring (REALM)
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-8795-7555

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