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  • 1.
    Anåker, Anna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Heylighen, Ann
    KU Leuven, Belgium.
    Nordin, Susanna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Design quality in the context of healthcare environments: a scoping review2017In: Health Environments Research & Design Journal, ISSN 1937-5867, E-ISSN 2167-5112, Vol. 10, no 4, p. 136-150Article in journal (Refereed)
    Abstract [en]

    Objective:

    We explored the concept of design quality in relation to healthcare environments. In addition, we present a taxonomy that illustrates the wide range of terms used in connection with design quality in healthcare.

    Background:

    High-quality physical environments can promote health and well-being. Developments in healthcare technology and methodology put high demands on the design quality of care environments, coupled with increasing expectations and demands from patients and staff that care environments be person centered, welcoming, and accessible while also supporting privacy and security. In addition, there are demands that decisions about the design of healthcare architecture be based on the best available information from credible research and the evaluation of existing building projects.

    Method:

    The basic principles of Arksey and O’Malley’s model of scoping review design were used. Data were derived from literature searches in scientific databases. A total of 18 articles and books were found that referred to design quality in a healthcare context.

    Results:

    Design quality of physical healthcare environments involves three different themes: (i) environmental sustainability and ecological values, (ii) social and cultural interactions and values, and (iii) resilience of the engineering and building construction. Design quality was clarified herein with a definition.

    Conclusions:

    Awareness of what is considered design quality in relation to healthcare architecture could help to design healthcare environments based on evidence. To operationalize the concept, its definition must be clear and explicit and able to meet the complex needs of the stakeholders in a healthcare context, including patients, staff, and significant others.

  • 2.
    Eldh, Ann Catrine
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Jönsson, Birgitta
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Nordin, Susanna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Att ha eller riskera funktionsnedsättning och genomgå utbildning till sjuksköterska2015Student paper otherStudent thesis
  • 3.
    Elf, Marie
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    McKee, Kevin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Nordin, Susanna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Von Koch, Lena
    Wijk, Helle
    Designing for person-centered care in older people’s residential facilities2011In: Aging Clinical and Experimental Research, ISSN 1594-0667, E-ISSN 1720-8319, Vol. 23, no Suppl. 1, p. 270-Article in journal (Refereed)
  • 4.
    Elf, Marie
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Karolinska Institutet; Chalmers University of Technology.
    Nordin, Susanna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Karolinska Institutet.
    Wijk, Helle
    McKee, Kevin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    A systematic review of the psychometric properties of instruments for assessing the quality of the physical environment in healthcare2017In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 73, no 12, p. 2796-2816Article in journal (Refereed)
    Abstract [en]

    AIM: To identify instruments measuring the quality of the physical healthcare environment, describe their psychometric properties.

    BACKGROUND: The physical healthcare environment is regarded as a quality factor for healthcare. To facilitate evidence-based design there is a need for valid and usable instruments that can evaluate the design of the healthcare environment.

    DESIGN: Systematic psychometric review.

    DATA SOURCES: A systematic literature search in Medline, CINAHL, Psychinfo, Avery index and reference lists of eligible papers (1990-2016).

    REVIEW METHOD: COSMIN guidelines were used to evaluate psychometric data reported.

    RESULTS: Twenty-three instruments were included. Most of the instruments are intended for for healthcare environments related to the care of older people. Many of the instruments were old, lacked strong, contemporary theoretical foundations, varied in the extent to which they had been used in empirical studies and in the degree to which their validity and reliability had been evaluated.

    CONCLUSIONS: Although we found many instruments for measuring the quality of the physical healthcare environment, none met all of our criteria for robustness. Of the instruments, The Multiphasic environmental assessment procedure, The Professional environment assessment protocol and The therapeutic environment screening have been used and tested most frequently. The Perceived hospital quality indicators is user centred and combine aspects of the physical and social environment. The Sheffield care environment assessment matrix has potential as it is comprehensive developed using a theoretical framework that has the needs of older people at the centre. However, further psychometric and user-evaluation of the instrument is required. 

  • 5.
    Elf, Marie
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Nordin, Susanna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Wijk, Helle
    Göteborgs Universitet.
    McKee, Kevin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Development of an instrument measuring the quality of residential care facilities for older people2016In: The 23rd Nordic Congress of Gerontology, 19-22 June 2016, in Tampere, Finland, 2016Conference paper (Refereed)
    Abstract [en]

    Aims. To validate the Swedish version of the Sheffield Care Environment Assessment Matrix (S-SCEAM). The instrument’s items measure environmental elements important for supporting the needs of older people, and conceptualized within eight domains.

    Methods. Item relevance was assessed by a group of experts and measured using content validity index (CVI). Test-retest and inter-rater reliability tests were performed.  The domain structure was assessed by the inter-rater agreement of a second group of experts, and measured using Fleiss kappa.

    Results. All items attained a CVI above 0.78, the suggested criteria for excellent content validity. Test-retest reliability showed high stability (96% and 95% for two independent raters respectively), and inter-rater reliability demonstrated high levels of agreement (95% and 94% on two separate rating occasions). Kappa values were very good for test-retest (κ = 0.903 and 0.869) and inter-rater reliability (κ = 0.851 and 0.832). Domain structure was good,  Fleiss’ kappa was 0.63 (range 0.45 to 0.75).   

    Conclusion. The S-SCEAM of 210 items and eight domains showed good content validity and construct validity. The instrument is suggested for use in measuring of the quality of the physical environment in residential care facilities for older persons.

  • 6.
    McKee, Kevin
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Nordin, Susanna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Developmentand initial validation of the Staff Perception Of Residential care Environments(SPORE) instrument2019Conference paper (Refereed)
    Abstract [en]

    Staff perceptions of the health care environment influence the delivery of person-centred care.  Little research has examined staff perceptions of health care environments, in part because of a lack of validated instruments.  This study reports the development and initial validation of the Staff Perception Of Residential care Environments (SPORE) instrument for use in residential care facilities for older people (RCFs).

    Items developed in a British project on the design of care environments were translated and adapted for the Swedish care context as SPORE (24 items, 5 sub-scales).  In a study of the physical environment and quality of care, 200 staff recruited from 20 RCFs sampled from across Sweden completed a questionnaire containing SPORE, the Person-centred Care Assessment Tool (PCAT), the Person-centred Climate Questionnaire – staff version (PCQ-S), and the Sheffield Care Environment Assessment Matrix –Sweden (SCEAM-S).

    All SPORE sub-scales were normally distributed with good internal consistency reliability (Cronbach αs=.85-.88). Correlations between SPORE and PCAT sub-scales ranged from .301-.503, and between SPORE and PCQ-S sub-scales from .353-.557.  RCF-level analyses (N=20) indicated that scores on SCEAM overall environment quality correlated significantly with all SPORE sub-scales (range=.496-.700).  The SCEAM Comfort sub-scale was correlated with all SPORE sub-scales (range=.509-.721), while the SCEAM Privacy sub-scale was correlated (r=.428) with the SPORE Staff Facilities sub-scale.  The SPORE Working and Caring for Residents sub-scale was correlated with SCEAM cognitive support (r=.502) and physical support (r=.566) sub-scales.

    The SPORE instrument demonstrated good psychometric properties and its sub-scales an excellent range of associations with staff perceptions of person-centred care and with objective assessments of the physical environment.  Further validation is required, but the SPORE instrument has potential for understanding how staff perceptions of the RCF environment relate to the delivery of person-centred care.

  • 7.
    Nord, Catharina
    et al.
    Linköpings Universitet .
    Nordin, Susanna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Explorations of urban residential quality: situations of dwelling, ageing and healthcaring. Inquiries of transdisciplinary nature2015Conference paper (Refereed)
    Abstract [en]

    Many assisted living facilities are located on the outskirts of urban areas. This might be due to lack of available land in central urban areas and the higher land costs associated with central areas of an urban structure. It might also be a result of a presumption that older people need a peaceful and quiet surrounding in old age, close to green areas, which would then be a better alternative than the city centre. However, research has shown that urban living is more health promoting than rural living to older people. This presentation aims to discuss pros and cons of the location of assisted living facilities in central or peripheral urban places. Different aspects will be highlighted with support of the three researchers’ studies of assisted living.

  • 8.
    Nordin, Susanna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Professional’s thoughts on light and colour in nursing home facilities2013In: Nordic light and colour 2012 / [ed] Szybinska Matusiak, B. & Fridell Anter, K., Trondheim: NTNU-trykk. , 2013Chapter in book (Refereed)
    Abstract [en]

    This study aimed at taking part of the thoughts about light and colour in nursing home facilities from the perspective of actors from different sectors within health care for older people. Eight persons were interviewed, and the material was analyzed using a qualitative content analysis. According to the findings both colour and light were perceived as important aspects within nursing home facilities. Colour contrasts were seen as supportive for persons with cognitive and visual disabilities, and were used mainly in bathrooms and dining rooms. The informants also reported the importance of adequate light due to decreasing visual functioning and strong lighting was perceived as essential in dining rooms. In addition, this study showed varying views from different professions on the relationship between colour and light concluding the importance of interdisciplinarity and exchange of knowledge.

  • 9.
    Nordin, Susanna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Karolinska Institutet, Dept of Neurobiology, Care Sciences and Society.
    The quality of the physical environment and its association with activities and well-being among older people in residential care facilities2016Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The physical environment can influence older people’s health and well-being, and is often mentioned as being an important factor for person-centred care. Due to high levels of frail health, many older people spend a majority of their time within care facilities and depend on the physical environment for support in their daily life. However, the quality of the physical environment is rarely evaluated, and knowledge is sparse in terms of how well the environment meets the needs of older people. This is partly due to the lack of valid and reliable instruments that could provide important information on environmental quality. Aim: The aim of this thesis was to study the quality of the physical environment in Swedish care facilities for older people, and how it relates to residents’ activities and well-being. Methods: The thesis comprises four papers where both qualitative and quantitative methods were used. Study I involved the translation and adaptation of the Sheffield Care Environment Assessment Matrix (SCEAM) into a Swedish version (S-SCEAM). Several methods were used including forward and backward translation, test of validity via expert consultation and reliability tests. In Study II, S-SCEAM was used to assess the quality of the environment, and descriptive data were collected from 20 purposively sampled residential care facilities (RCFs). Study III was a comparative case study conducted at two RCFs using observations, interviews and S-SCEAM to examine how the physical environment relates to older people’s activities and interactions. In study IV, multilevel modeling was used to determine the association between the quality of the physical environment and the psychological and social well-being of older people living in RCFs. The data in the thesis were analysed using qualitative content analysis, and descriptive, bivariate and multilevel statistics. Results: A specific result was the production of the Swedish version of SCEAM. The instrument contains 210 items structured into eight domains reflecting the needs of older people. When using S-SCEAM, the results showed a substantial variation in the quality of the physical environment between and within RCFs. In general, private apartments and dining areas had high quality, whereas overall building layout and outdoor areas had lower quality. Also, older people’s safety was supported in the majority of facilities, whereas cognitive support and privacy had lower quality. Further, the results showed that environmental quality in terms of cognitive support was associated with residents’ social well-being. Specific environmental features, such as building design and space size, were also noted, through observation, as influencing residents’ activities, and several barriers were found that seemed to restrict residents’ full use of the environment. Conclusions: This thesis contributes to the growing evidence-based design field. The S-SCEAM can be used in future research on the association between the environment and people’s health and well-being. The instrument could also serve as a guide in the planning and design process of new RCFs.

  • 10.
    Nordin, Susanna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Dahlberg, Lena
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    McKee, Kevin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Technology to support decision-making for older people with dementia2019Conference paper (Refereed)
  • 11.
    Nordin, Susanna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Chalmers.
    The Importance of the Physical Environment to Support Individualised Care2018In: Individualized Care - Theory, Measurement, Research and Practice / [ed] Riitta Suhonen, Minna Stolt and Evridiki Papastavrou, USA: Springer, 2018, p. 207-215Chapter in book (Other academic)
    Abstract [en]

    The physical environment is an important part of individualised care. Creating care environments tailored towards the individual person’s needs is essential for high-quality care and is increasingly recognized as being associated with improved health and well-being among older people. Today, care should be holistic and view the person behind the disease, taking that person’s perspective and treating the patient as a unique individual. Despite the emerging focus on individualised care approaches, the physical environment is still not considered as an integral part of care, and relatively little attention has been paid to environmental aspects. However, the physical environment has a great potential to facilitate or restrict care processes in a broad range of care settings, not least in residential care facilities for older people. The present chapter focuses on ways to support the individual in terms of the physical environment.

  • 12.
    Nordin, Susanna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    McKee, Kevin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    von Koch, Lena
    Karolinska Institutet, Institutionen för neurobiologi, vårdvetenskap och samhälle.
    Wijk, Helle
    Sahlgrenska Akademin, Göteborgs Universitet .
    Validating a tool for evaluating nursing home environments: Integrating research and expert evidence2012In: IFA 11TH GLOBAL CONFERENCE ON AGEING, 28 May – 1 June 2012 Prague, Czech Republic, Book of Abstracts, 2012Conference paper (Refereed)
  • 13.
    Nordin, Susanna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    McKee, Kevin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Wijk, Helle
    Sahlgrenska akademin, Göteborgs universitet.
    A person-centered design can support accessibility and equality in residential care facilities2013Conference paper (Refereed)
    Abstract [en]

    It is well known that the world foresees an ageing population for whom the physical environment plays a central role in everyday life and wellbeing. Creating a health care environment that ensures accessibility and equality, shows respect and dignity will therefore be a great challenge. With increasing levels of frailty many older persons will be more or less depending on the care environment. A modern person-centered building design considers both individual and specific needs related to old age, in order to support quality of life and care. However, many of the existing buildings do not meet modern standards and there is a need for methods to evaluate the quality of the building design. According to a recently performed review there are few validated tools measuring the physical environment, especially in terms of a person-centered approach. This study presents a translated and validated tool for evaluating design quality in nursing home facilities. The tool is based on the idea that there is a relationship between high quality caring environments and quality of life of older persons. It makes a person-centered evaluation of the building, covering aspects such as privacy, personalization, safety, choice and control. These are essential factors to assure older persons a dignified ageing as equal members of the society.

  • 14.
    Nordin, Susanna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    McKee, Kevin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Wijk, Helle
    Assessing the physical environment of older people’s residential care facilities: development of the Swedish version of the Sheffield Care Environment Assessment Matrix (S-SCEAM)2015In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 15, no 3, p. 1-11Article in journal (Refereed)
    Abstract [en]

    Background

    There is emerging evidence that the physical environment is important for health, quality of life and care, but there is a lack of valid instruments to assess health care environments. The Sheffield Care Environment Assessment Matrix (SCEAM), developed in the United Kingdom, provides a comprehensive assessment of the physical environment of residential care facilities for older people. This paper reports on the translation and adaptation of SCEAM for use in Swedish residential care facilities for older people, including information on its validity and reliability.

    Methods

    SCEAM was translated into Swedish and back-translated into English, and assessed for its relevance by experts using content validity index (CVI) together with qualitative data. After modification, the validity assessments were repeated and followed by test-retest and inter-rater reliability tests in six units within a Swedish residential care facility that varied in terms of their environmental characteristics.

    Results

    Translation and back translation identified linguistic and semantic related issues. The results of the first content validity analysis showed that more than one third of the items had item-CVI (I-CVI) values less than the critical value of 0.78.  After modifying the instrument, the second content validation analysis resulted in I-CVI scores above 0.78, the suggested criteria for excellent content validity. Test-retest reliability showed high stability (96% and 95% for two independent raters respectively), and inter-rater reliability demonstrated high levels of agreement (95% and 94% on two separate rating occasions). Kappa values were very good for test-retest (κ= 0.903 and 0.869) and inter-rater reliability (κ= 0.851 and 0.832).

    Conclusions

    Adapting an instrument to a domestic context is a complex and time-consuming process, requiring an understanding of the culture where the instrument was developed and where it is to be used. A team, including the instrument’s developers, translators, and researchers is necessary to ensure a valid translation and adaption. This study showed preliminary validity and reliability evidence for the Swedish version (S-SCEAM) when used in a Swedish context. Further, we believe that the S-SCEAM has improved compared to the original instrument and suggest that it can be used as a foundation for future developments of the SCEAM model.

  • 15.
    Nordin, Susanna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Mckee, Kevin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Wijk, Helle
    Sahlgrenska Akademin, Göteborgs Universitet .
    Att anpassa ett engelskt instrument som mäter designkvalitet på äldreboende till svenska förhållanden: utmaningar och erfarenheter2012Conference paper (Refereed)
    Abstract [sv]

    Äldre tillbringar mycket tid i sin bostad varför kvalitet på den fysiska miljön har stor påverkan på deras livskvalitet. Det finns dock fortfarande en brist på giltiga instrument som kan utvärdera kvaliteten på byggnadsdesign. I denna artikel presenterar vi resultaten från den första fasen av ett projekt, i syfte att utveckla ett instrument för att utvärdera kvaliteten designen av den fysiska miljön. I denna fas har vi översatt och anpassat ett engelskt instrument till svenska förhållanden. Först utfördes en systematisk litteraturstudie över instrument för att utvärdera den fysiska vårdmiljön. Resultatet visade att Sheffield Care Environment Assessment Matrix (SCEAM) var ett instrument med potential för användning för särskilt boende för äldre och i svenska förhållanden. Först översattes instrumentet till svenska och därefter testades validiteten och reliabiliteten. I artikeln rapporteras utmaningar och erfarenheter av översättningsproceduren.

  • 16.
    Nordin, Susanna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    McKee, Kevin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Wijk, Helle
    Att översätta och anpassa ett engelskt instrument för bedömning av fysisk miljö på särskilt boende till svenska förhållanden: utmaningar och erfarenheter2012Conference paper (Refereed)
  • 17.
    Nordin, Susanna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    McKee, Kevin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Wijk, Helle
    Sahlgrenska akademin, Göteborg.
    Challenges in the cultural adaptation and validation of an instrument for evaluating residential care environments for older people2015Conference paper (Refereed)
  • 18.
    Nordin, Susanna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    McKee, Kevin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Wijk, Helle
    Sahlgrenska Akademin, Göteborg.
    Evaluating design quality in older people's residential care facilities: Adaptation of the Sheffield Care Environment Assessment Matrix (SCEAM) for use in Sweden with focus on linguistic challenges.2014Conference paper (Refereed)
    Abstract [en]

    Background

    There is increasing interest in how the physical enviroment can support health and well-being in residential care facilities (RCF) for older people. A recent review showed a lack of instruments for evaluating design quality in RCF. The SCEAM was identified as an instrument appropriate for Swedish RCF. SCEAM is a British instrument, developed to evaluate building design of RCF. The instrument is person-centered and uses the needs of frail older people as the basis for understanding how well the residential care facility is designed.

     

    Aim

    The aim of the present study was to translate, adapt, and further develop the SCEAM instrument for use in Sweden.

     

    Method

    The study had a mixed-method design using both quantitative and qualitative methods

     

    Procedure

    The forward-backward translation method was used in five stages, broadly within two phases: translation and adaptation. The translation phase involved: 1) forward translation and 2) backward-translation. The adaptation phase involved: 3) first test of content validity of the target language instrument; 4) consultation and further adaptation; 5) final test of content validity of the revised target language instrument

     

    Results

    In this paper we focus on the linguistic challenges in translation of an instrument developed to evaluate the quality of the physical environment of RCF. A lengthy process of translation of the Sheffield Care Environments Assessment Matrix (SCEAM) has produced an instrument that fill a need of an instrument with a strong focus on the importance of the physical environment of RCF in the society. The instrument has a potential for use when planning new environments, during interventions and follow up as for quality assessment.

     

  • 19.
    Nordin, Susanna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Wijk, Helle
    Sahlgrenska akademin, Göteborgs universitet.
    McKee, Kevin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    von Koch, Lena
    Institutionen för neurobiologi, vårdvetenskap och samhälle, Karolinska institutet.
    Translation and cultural adaptation of an instrument evaluating design quality in residential care facilities2013In: Nordic Advances in Health Care Sciences Research, November 13-14, 2013 in Lund: Abstract book, 2013, p. 96-96Conference paper (Refereed)
    Abstract [en]

    INTRODUCTION: The population is rapidly ageing and in the near future the number of elderly will exceed the number of children. Society faces a huge challenge providing older persons high quality care and a dignified old age. With increasing levels of frailty many older people are depending on the physical environment in order to manage their everyday life, and the building design is essential in supporting quality of life and person-centered care. However, methods for evaluating design quality in residential care facilities are lacking, especially in terms of person-centeredness. A British instrument was chosen on the basis that it captures several aspects in the care environment of importance for the quality of life and care for older people.AIM: This study aims at describing the process of translating and culturally adapting a British instrument for evaluating design quality in Swedish care facilities for older people. METHOD and RESULT: The process involves seven phases; forward translation, reconciliation, back translation, harmonization, cognitive debriefing, proof-reading and pre-testing. In the first phase the items were translated from the source to the target language followed by discussions between the researchers and the translator for reconciliation. Then the items were translated from the target language back into the source language. After language harmonization the instrument was reviewed and discussed by an expert group in order to identify imprecise concepts and receive valuable comments. Finally, the items were proof-read to correct typographical errors before pre-testing the instrument. Experiences and challenges of the procedure are discussed.CONCLUSION: Cultural appropriate instruments are essential in order to validly measure the design quality in residential care facilities. This study shows the complexity of translating and adapting a British instrument for use in a Swedish care context.

  • 20.
    Nordin, Susanna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    McKee, Kevin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Staff perceptions of the design of care environments for older people – a qualitative study2018Conference paper (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.

  • 21.
    Nordin, Susanna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    McKee, Kevin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Wijk, Helle
    Gothenburg University.
    Evaluating design quality of older people’s residential care facilities.2015In: ARCH 14 - International Conference on Research on Health Care Architecture - November 19-21, 2014, Espoo, Finland - Conference Proceedings / [ed] Verma & L. Nenonen, Helsinki, Finland: Aalto University , 2015, p. 315-323Conference paper (Refereed)
  • 22.
    Nordin, Susanna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    McKee, Kevin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Wallinder, Maria
    von Koch, Lena
    Wijk, Helle
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    The physical environment, activity and interaction in residential care facilities for older people: a comparative case study2017In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 31, no 4, p. 727-738Article in journal (Refereed)
    Abstract [en]

    The physical environment is of particular importance for supporting activities and interactions among older people living in residential care facilities (RCFs) who spend most of their time inside the facility. More knowledge is needed regarding the complex relationships between older people and environmental aspects in long-term care. The present study aimed to explore how the physical environment influences resident activities and interactions at two RCFs by using a mixed-method approach. Environmental assessments were conducted via the Swedish version of the Sheffield Care Environment Assessment Matrix (S-SCEAM), and resident activities, interactions and locations were assessed through an adapted version of the Dementia Care Mapping (DCM). The Observed Emotion Rating Scale (OERS) was used to assess residents’ affective states. Field notes and walk-along interviews were also used. Findings indicate that the design of the physical environment influenced the residents’ activities and interactions. Private apartments and dining areas showed high environmental quality at both RCFs, whereas the overall layout had lower quality. Safety was highly supported. Despite high environmental quality in general, several factors restricted resident activities. To optimise care for older people, the design process must clearly focus on accessible environments that provide options for residents to use the facility independently.

  • 23.
    Nordin, Susanna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. karolinska institutet.
    McKee, Kevin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Wijk, Helle
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Exploring environmental variation in residential care facilities for older people2017In: Health Environments Research & Design Journal, ISSN 1937-5867, E-ISSN 2167-5112, Vol. 10, no 2, p. 49-65Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: The aim of this study was to explore variation in environmental quality in Swedish residential care facilities (RCFs) using the Swedish version of the Sheffield Care Environment Assessment Matrix (S-SCEAM).

    BACKGROUND: Well-designed physical environments can positively impact on health and well-being among older persons with frail health living in RCFs and are essential for supporting person-centered care. However, the evidence base for informing the design of RCFs is weak, partly due to a lack of valid and reliable instruments that could provide important information on the environmental quality.

    METHODS: Twenty RCFs were purposively sampled from several regions, varying in their building design, year of construction, size, and geographic location. The RCFs were assessed using S-SCEAM and the data were analyzed to examine variation in environmental quality between and within facilities.

    RESULTS: There was substantial variation in the quality of the physical environment between and within RCFs, reflected in S-SCEAM scores related to specific facility locations and with regard to domains reflecting residents' needs. In general, private apartments and dining areas had high S-SCEAM scores, while gardens had lower scores. Scores on the safety domain were high in the majority of RCFs, whereas scores for cognitive support and privacy were relatively low.

    CONCLUSIONS: Despite high building standard requirements, the substantial variations regarding environmental quality between and within RCFs indicate the potential for improvements to support the needs of older persons. We conclude that S-SCEAM is a sensitive and unique instrument representing a valuable contribution to evidence-based design that can support person-centered care.

  • 24.
    Nordin, Susanna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    McKee, Kevin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Wijk, Helle
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Residential care facilities for older people: Describing the quality of the physical environment2015Conference paper (Refereed)
  • 25.
    Nordin, Susanna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Karolinska institutet.
    McKee, Kevin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Wijk, Helle
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Karolinska institutet.
    The association between the physical environment and the well-being of older people in residential care facilities: a multilevel analysis2017In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 73, no 12, p. 2942-2952Article in journal (Refereed)
    Abstract [en]

    AIMS: To investigate the associations between the quality of the physical environment and the psychological and social well-being of older people living in residential care facilities.

    BACKGROUND: Many older people in care facilities have cognitive and physical frailties and are at risk of experiencing low levels of well-being. High quality physical environments can support older people as frailty increases and promote their well-being. Although the importance of the physical environment for residents' well-being is recognised, more research is needed.

    DESIGN: A cross-sectional survey of 20 care facilities from each of which 10 residents were sampled. As the individual resident data was nested in the facilities, a multilevel analysis was conducted.

    METHODS: Data were collected during 2013 and 2014. The care facilities were purposely sampled to ensure a high level of variation in their physical characteristics. Residents' demographic and health data were collected via medical records and interviews. Residents' well-being and perceived quality of care were assessed via questionnaires and interviews. Environmental quality was assessed with a structured observational instrument.

    RESULTS: Multilevel analysis indicated that cognitive support in the physical environment was associated with residents' social well-being, after controlling for independence and perceived care quality. However, no significant association was found between the physical environment and residents' psychological well-being.

    CONCLUSION: Our study demonstrates the role of the physical environment for enhancing the social well-being of frail older people. Professionals and practitioners involved in the design of care facilities have a responsibility to ensure that such facilities meet high quality specifications. 

  • 26.
    Nordin, Susanna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Wijk, Helle
    McKee, Kevin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    A review of existing tools for assessing the design quality of healthcare environments2011Conference paper (Other academic)
  • 27.
    Nordin, Susanna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Wijk, Helle
    McKee, Kevin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Assessment of the physical environment - a way to high quality care2012Conference paper (Refereed)
  • 28.
    Nordin, Susanna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Wijk, Helle
    Sahlgrenska Akademin, Göteborg.
    McKee, Kevin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Care staff's perceptions of older people's care environments2014Conference paper (Refereed)
    Abstract [en]

    Care staff’s perception of older people’s care environments

    Older persons living in residential care facilities are a highly frail group, often suffering from functional and cognitive impairment. The interaction among the well-being of the residents, the care provided and the design of the building has to be understood and considered when designing care environments. A supportive environment for both residents and care staff is a recognized dimension of quality of care and consequently the staff’s satisfaction with the care environment is important for the care given and in turn the older person’s wellbeing.

     

    AIM

    The aim with this study was to describe the care staff’s perception of older people’s residential care environments in terms of improvements to meet the users needs.

     

    METHOD

    This study has a qualitative design focusing on an open-ended question of a self-completion questionnaire. There was 50 nursing staff from 14 different residential care facilities included in the study. The questionnaire, Staff Perception of Older People’s Residential Care Environments (SPORE) contains items on staff satisfaction with the care environment together with an open-ended question on staff’s perception of the needs for environmental improvements. The responses were analyzed with content analysis.

     

    RESULTS

    According to the results, the care staff perceived deficiendes in the residential care environments and several aspects were highlighted as being in need of improvement. During the process of analysis, five categories emerged:  Environments for physical support, Environments for cognitive support, Room for recreation, Access to outside areas, and Room space and building layout. These categories were found to be related to the possibilities to access the care environment and are represented by the theme Accessibility.

     

     

    CONCLUSION

    This study shows that the care staff perceives a need for improvements in order to offer accessible residential care environments. It is crucial that older people with disabilities can move around safely and independently, and find the way within and outside the building. Therefore, it should be a core issue to design care environments with high accessibility to support this frail group of people.

  • 29.
    Nordin, Susanna
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Wijk, Helle
    Sahlgrenska akademin, Göteborgs universitet.
    McKee, Kevin
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Designing for person-centered care in residential care facilities2014Conference paper (Refereed)
    Abstract [en]

    Designing for person-centered care in residential care facilities

    Authors:

    Nordin S, Dalarna University, Falun, Sweden; Wijk H, Sahlgrenska University Hospital, Göteborg, Sweden; McKee K, Dalarna University, Falun, Sweden; Elf M, Dalarna University, Falun, Sweden

    The physical environment is a resource for promoting health and wellbeing, and affects people’s behavior and functioning. In residential care facilities for older persons, the physical environment has a particular significance, as with increasing levels of frailty many older people depend on aspects of the environment to compensate for reduced levels of functioning in order to manage their everyday life. A high-quality building design can ensure that a care facility promotes residents’ quality of life and person-centered care. However, methods for evaluating design quality in residential care facilities are lacking, especially methods that adopt a person-centered approach. This paper presents a Swedish version of an instrument developed for the evaluation of residential care facilities in the United Kingdom, The Sheffield Care Environment Assessment Matrix (SCEAM).

    The Swedish version of the instrument, S-SCEAM consists of 215 items that indicate the presence or absence of building features.  Each item belongs to one of several domains that address important aspects of residents’ quality of life such as community, privacy, physical support, choice and control. The instrument can be applied to different types of care facilities and can be used as a guide when planning and designing new care buildings, to assess existing ones or to evaluate care buildings quantitatively for research purposes. For example, the relationship between design quality and quality of life of residents can be examined statistically.

    In Sweden, there have been no instruments evaluating residential care facilities, and the knowledge is limited regarding the relationship among the quality of the design, the quality of care and the quality of life of older persons. Evaluating care environments is an important step to achieve evidence based knowledge in this field. In the longer term such knowledge can be brought into policy on housing for frail older people and contribute to enhancing the quality of living environments and life experiences of this vulnerable section of our population.

  • 30.
    Shannon, Michelle
    et al.
    Florey Institute, Melbourne .
    Nordin, Susanna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Anåker, Anna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Bernhardt, Julie
    Florey Institute, Melbourne .
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Theoretical frameworks used in built environment research – a scoping review2017Conference paper (Refereed)
  • 31. Wijk, Helle
    et al.
    Nordin, Susanna
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Karolinska Institutet.
    Vårdmiljöns betydelse för hälsa och välbefinnande2017In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 94, no 2, p. 156-166Article in journal (Other (popular science, discussion, etc.))
    Abstract [sv]

    Medvetenheten om vårdmiljöns betydelse för patientens hälsa ökar världen över. Det syns tydligt då vårdprogram, nationella riktlinjer och standarder inom vård och omsorg i ökad grad beaktar aspekter av den fysiska miljöns betydelse för god vård. Även ett stort antal forskningsartiklar har presenterats genom åren som illustrerar betydelsen av arkitektur och design. Exempel på nya rön är vikten av en tillgänglig vårdmiljö som är lätt att tolka och förstå, vikten av en vårdmiljö där det finns möjlighet till privathet, samt inte minst en estetiskt tilltalande miljö som visar respekt och värdighet för besökaren. För att nya forskningsrön ska komma patienter och vårdare till gagn krävs att dessa implementeras i praktiken. En viktig utgångspunkt är dialogen mellan företrädare för vård, arkitektur, design och kultur och att deras kunskapsbidrag samspelar utifrån en gemensam övertygelse om att detta främjar patientens hälsa och välbefinnande. I denna artikel diskuteras hur olika delar och innehåll i miljön påverkar varandra och måste ses i sitt sammanhang.

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