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  • 51.
    Florin, Jan
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Lundberg Santesson, Inger
    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 tekniska högskola, Karolinska institutet.
    Quality of eLearning – How are we doing and can we do better2014In: NGL 2014, NEXT GENERATION LEARNING CONFERENCE, March 19–20 2014, Dalarna University, Falun, Sweden: Book of Abstract, Falun: Högskolan Dalarna, 2014, p. 46-46Conference paper (Refereed)
  • 52.
    Gromark, Sten
    et al.
    Chalmers Tekniska Högskola.
    Malmqvist, Inga
    Chalmers Tekniska Högskola.
    Fröst, Peter
    Chalmers Tekniska Högskola.
    Nylander, Ola
    Chalmers tekniska Högskola.
    Wijk, Helle
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Thörn, Catharina
    Göteborgs Universitet.
    SRE-AIDAH: Integrative ways of residing health and quality of residence2015In: ARCH 14: International Conference on Research on Health Care Architecture - Conference Proceedings / [ed] Ira Verma, Laura Nenonen, Helsinki, 2015Conference paper (Refereed)
    Abstract [en]

    Healthcare architecture has grown rapidly in recent years. However, there are still many questions remaining. The commission, therefore, is to share the existing research knowledge and latest results and to carry out research projects focusing more specifically on the health care situation in a variety of contexts. The ARCH14 conference was the third conference in the series of ARCH conferences on Research on Health Care Architecture initiated by Chalmers University. It was realized in collaboration with the Nordic Research Network for Healthcare Architecture .It was a joint event between Aalto University, Finnish Institute of Occupational Health (FIOH) and National Institute of Health and Welfare (THL International).The conference gathered together more than 70 researchers and practitioners from across disciplines and countries to discuss the current themes.

  • 53. Holmström, Paul
    et al.
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Scoping group interventions for suitability in participatory modeling2009In: OR (Operational Research) 51 Annual Conference, University of Warwick, 2009Conference paper (Refereed)
    Abstract [en]

    Over the past two decades System Dynamics (SD) modeling has been used in strategic thinking, policy testing, and quality improvement work. Many modelers have used SD in participatory group-modeling situations both as a method for fact elicitation and for group learning of the system. Several authors have stated that the modelling process is problematic and especially modelling with multi-professional groups. We conducted a scoping review of the literature on methods for group process work to identify methods that can be useful for the SD field. The article includes a description of several well-accepted methods from other fields for the briefing process at the early stages of a participatory modeling process.

  • 54. Holmström, Paul
    et al.
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Staff Retention and Job Satisfaction at a Hospital Clinic – A case study2004In: The 22th International System Dynamics Conferences, Oxford, 2004Conference paper (Other academic)
  • 55.
    Jansson, Monika
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Neljesjö, Maria
    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.
    Ossiannilsson, Ebba
    Lunds Universitet.
    Lesson learned from Implementation of  OER in the nursing program, Dalarna University, Sweden (IMPOERS)2014Conference paper (Refereed)
    Abstract [en]

    In the project IMPOERS, we have introduced Open Education Resourses (OER) in a nursing program. OER is one of the strongest driving forces for personalized learning. In the presentation we will report the preliminary results from the project. The use of OER is increasing in higher education. UNESCO stresses the pedagogical benefits of using OER (Hylén 2012, McGreal 2013, Punie & Haché UNESCO 2012). Today, the use of the web as an open sourse for knowledge acquisition is accepted in higher education providing new pedagogical possibilities and support for competence development. This impacts on students’ and teachers’roles and responsibility for learning, creation of learning content and activities and forms for interaction. Implementation of OER can reinforce an open culture of learning  and students can have more opportunities to achieve ownership of their own learning and thereby take greater responsibility for their studies, which may enhance both motivation and individualized learning. In addition, OER can improve the progression on learning and also contribute to and support a lifelong learning. Furthermore, OER may stimulate networking among the students, which can be maintained after the education period.

     The Nursing program at Dalarna Univeristy in Sweden has been awarded with the EADTU´s E- xcellence Associates Label (Urbach 2009). The quality award involved the creation of  a roadmap for continuous development of e-learning and implementation of OER (Santesson et al., 2012). Thus, the overal goal with the IMPOERS research project was to introduce and implement the use of  OER as a pedagogical framework  in the nursing program at Dalarna University. The project aimed to describe how and in what way OER can be implemented and used for learning. OER was implemented in a course within the nursing  program and effects and the implementation process was studied with a mixed-method approach using questionnaires and interviews. The project focused on students' participation, knowledge, empowerment, responsibility over their  own learning processes and attitudes of using OER.

  • 56.
    Kylén, Maya
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Von Koch, Lena
    Pessah-Rasmussen, Hélène
    Marcheschi, Elizabeth
    Ytterberg, Charlotte
    Heylighen, Ann
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Chalmers University.
    The importance of the built environment in person-centred rehabilitation at home: study protocol2019In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 16, no 13, article id E2409Article in journal (Refereed)
    Abstract [en]

    Health services will change dramatically as the prevalence of home healthcare increases. Only technologically advanced acute care will be performed in hospitals. This-along with the increased healthcare needs of people with long-term conditions such as stroke and the rising demand for services to be more person-centred-will place pressure on healthcare to consider quality across the continuum of care. Research indicates that planned discharge tailored to individual needs can reduce adverse events and promote competence in self-management. However, the environmental factors that may play a role in a patient's recovery process remain unexplored. This paper presents a protocol with the purpose to explore factors in the built environment that can facilitate/hinder a person-centred rehabilitation process in the home. The project uses a convergent parallel mixed-methods design, with ICF (International Classification of Functioning, Disability and Health) and person-environment theories as conceptual frameworks. Data will be collected during home visits 3 months after stroke onset. Medical records, questionnaires, interviews and observations will be used. Workshops will be held to identify what experts and users (patients, significant others, staff) consider important in the built environment. Data will be used to synthesise the contexts, mechanisms and outcomes that are important to support the rehabilitation process at home.

  • 57.
    Kylén, Maya
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    von Koch, Lena
    Pessah-Rasmussen, Hélène
    Marcheschi, Elizabeth
    Ytterberg, Charlotte
    Heylighen, Ann
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Chalmers University.
    The Importance of the Built Environment in Person-Centred Rehabilitation at Home: Study Protocol2019In: International Journal of Environmental Research and Public Health, ISSN 1661-7827, E-ISSN 1660-4601, Vol. 16, no 13, article id 2409Article in journal (Refereed)
    Abstract [en]

    Health services will change dramatically as the prevalence of home healthcare increases.Only technologically advanced acute care will be performed in hospitals. This—along with theincreased healthcare needs of people with long-term conditions such as stroke and the rising demandfor services to be more person-centred—will place pressure on healthcare to consider quality across thecontinuum of care. Research indicates that planned discharge tailored to individual needs can reduceadverse events and promote competence in self-management. However, the environmental factorsthat may play a role in a patient’s recovery process remain unexplored. This paper presents a protocolwith the purpose to explore factors in the built environment that can facilitate/hinder a person-centredrehabilitation process in the home. The project uses a convergent parallel mixed-methods design,with ICF (International Classification of Functioning, Disability and Health) and person–environmenttheories as conceptual frameworks. Data will be collected during home visits 3 months after strokeonset. Medical records, questionnaires, interviews and observations will be used. Workshops will beheld to identify what experts and users (patients, significant others, sta) consider important in thebuilt environment. Data will be used to synthesise the contexts, mechanisms and outcomes that areimportant to support the rehabilitation process at home.

  • 58.
    Kylén, Maya
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    von Koch, Lena
    Pessah-Rasmussen, Hélène
    Ytterberg, Charlotte
    Heylighen, Ann
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    The importance of the built environment in person-centred stroke rehabilitation at home2019In: The importance of the built environment in person-centred stroke rehabilitation at home, 2019Conference paper (Other academic)
    Abstract [en]

    Introduction: Health services will change dramatically as the prevalence of home healthcare increases. Only technologically advanced stroke acute care will be performed in hospitals. This, along with the rising demand for services to be more person-centred will place pressure on healthcare to consider quality across the continuum of care. Research indicates that planned discharge tailored to individual needs can reduce adverse events and promote competence in self-management. However, the environmental factors that may play a role in a patient’s recovery process remain unexplored. In this presentation, experiences and emerging findings from a research project targeting such issues will be presented. The purpose is to explore factors in the built environment that can facilitate/hinder a person-centred rehabilitation process in the home. Methods: The study uses a mixed methods design, with the ICF and person-environment theories as conceptual frameworks. Qualitative and quantitative data are currently collected from medical records and during home visits three months after stroke by use of questionnaires, interviews and observations. Workshops will be held to identify what experts and users (patients, significant others, staff) consider important in the built environment. Results: Emerging findings concerning the contexts and mechanisms that are important to support the rehabilitation process at home will be presented. Conclusions: Providing scientific knowledge that support patients’ recovery process in the home poses challenges for research that requires multidisciplinary knowledge. By bringing together international experts committed to improve care models and design, we will contribute to this under researched field and build capacity for the future.

  • 59.
    Lindblom, S.
    et al.
    Karolinska Inst, Stockholm, Sweden..
    Flink, M.
    Karolinska Inst, Stockholm, Sweden..
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Laska, A. C.
    Karolinska Inst, Stockholm, Sweden..
    von Koch, L.
    Karolinska Inst, Stockholm, Sweden..
    Ytterberg, C.
    Karolinska Inst, Stockholm, Sweden..
    Person-centered transitions for people with stroke - are we doing enough?: A Swedish example2018In: International Journal of Stroke, ISSN 1747-4930, E-ISSN 1747-4949, Vol. 13, p. 18-18Article in journal (Other academic)
  • 60. Lundberg Santesson, Inger
    et al.
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    How to achieve quality in practice-oriented education in an e-learning context2012In: Proceedings: EADTU 25th ANNIVERSARY CONFERENCE 2012:The role of open and flexible education inEuropean higher education systems for 2020: new models, new markets, new media, Pafos, Cyprus 27-28 September 2012 / [ed] Inger Lundberg Santesson, Marie Elf, 2012, p. 244-250Conference paper (Refereed)
  • 61.
    Lundberg Santesson, Inger
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Florin, Jan
    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.
    Att granska kvaliteten på e-lärande med hjälp av evidensbaserade indikatorer2014In: NU2014, Umeå 8-10 oktober: Abstracts, 2014, p. 139-139Conference paper (Refereed)
    Abstract [sv]

    Att granska kvaliteten på e-lärande med hjälp av evidensbaserade indikatorer

    Workshopen vänder sig till dig som arbetar med utveckling, lärande/undervisning, utveckling av webverktyg/ plattformar, program/kurser med särskilt intresse för att utvärdera och utveckla e-lärande/lärande. Här visas ett av de verktyg som finns för att genomföra en självvärdering på detta område.

     

    Bakgrund

    Sedan början av 2000-talet har utbildning med e-Lärande/webbaserat lärande bedrivits i sjuksköterskeprogrammet på Högskolan Dalarna. Vi har använt oss av olika webverktyg och undervisningsformer som har utgått från den enskilda studentens behov av lärande. Efter många års erfarenhet behövde vi granska kvaliteten på e-Lärandet och valde den Europeiska modellen E-xcellence+ från ”European Association of Distance Education Universities” (EADTU). Manualen består av 33 benchmarkingindikatorer inom ett antal områden (pedagogik, organisation, stöd och teknik) som lärosäten och program/kurser kan värdera sin kvalitet emot. Indikatorerna täcker fyra olika framgångsfaktorer för e-Lärande; tillgänglighet (accessibility), flexibilitet (flexibility), interaktivitet (interactivity) samt individualisering (personalisation).

     

    Metoden utgår från en självvärdering av e-Lärandet och starten är en s.k. webbaserad snabbvärdering (Quick-scan) som ligger till grund för en komplett värdering (full assessment) som även innefattar ett platsbesök med granskare från EADTU. Självvärderingen syftar till att peka på viktiga förbättringsområden som skall uttryckas i en handlingsplan (road map). Vi arbetade i en process under ett år som involverade nyckelpersoner från hela organisationen inklusive lärare och student. Självvärderingen gav oss en samlad bild av både kvalitet och funktion på övergripande organisation, stödjande enheter, kompetensbehov hos lärare samt hur väl e-Lärandet var involverat i våra utbildningsplaner och kursplaner.

     

    Syfte

    Syftet med Workshopen är att ge deltagarna kunskap om benchmarkingsystem och möjlighet att testa EADTU’s självvärderingsverktyg under handledning. Vi vill på så sätt dela med oss av vår erfarenhet med en självvärderingsprocess som har lett fram till en lokalt förankrad och välformulerad handlingsplan som utgör grunden för ett systematiskt förbättringsarbete för eLärandet.

     

    Arbetssätt

    Workshopen kommer att börja med en introduktion med plats för frågor och därefter får deltagarna delta i en Quick scan för att få en uppfattning om indikatorer som i detta verktyg anses vara av betydelse för god kvalitet på e-Lärande.

  • 62.
    Marcheschi, Elizabeth
    et al.
    Chalmers Tekniska Högskola.
    von Koch, Lena
    Karolinska Institutet .
    Pessah-Rasmussen, Hélène
    Lunds Universitet.
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Home setting after stroke, facilitators and barriers: a systematic literature review2018In: Health & Social Care in the Community, ISSN 0966-0410, E-ISSN 1365-2524, Vol. 26, no 4, p. E451-E459Article in journal (Refereed)
    Abstract [en]

    This paper seeks to improve the understanding of the interaction between patients with stroke and the physical environment in their home settings. Stroke care is increasingly performed in the patient's home. Therefore, a systematic review was conducted to identify the existing knowledge about facilitators and barriers in the physical environment of home settings for the stroke rehabilitation process. Based upon Arksey and O'Malley's framework, a Boolean search strategy was performed in the databases; CINAHL, Medline, Web of Science and Scopus. Fifteen articles were retained from the literature search conducted between August and November 2016, and two researchers independently assessed their quality based on the Swedish Council on Health Technology Assessment guidelines. The results suggest that despite the healthcare system's ongoing shift towards home-based rehabilitation, the role played by the physical environment of home settings is still considered a side finding. Moreover, the research appears to focus mainly on how this environment supports mobility and activities of daily living, whereas information regarding the psychosocial and emotional processes that mediate the interaction between stroke survivors and their home setting are missing. A lack of information was also found with regard to the influence of different geographic locations on the stroke rehabilitation process. Future investigations are therefore needed to advance the understanding of the role played by the physical environment of home settings in supporting stroke recovery.

  • 63.
    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.

  • 64.
    Miedena, Elke
    et al.
    Chalmers Tekniska Högskola.
    Lindahl, Göran
    Chalmers Tekniska Högskola.
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Chalmers Tekniska Högskola.
    Conceptualizing health promotion in relation to outpatient healthcare building design: a scoping review2019In: Health Environments Research & Design Journal, ISSN 1937-5867, E-ISSN 2167-5112, Vol. 12, no 1, p. 69-86Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: This review explored different conceptualizations of health promotion in the context of, and in relation to, outpatient building design.

    BACKGROUND: Today's healthcare organizations are implementing holistic healthcare approaches such as health promotion, while simultaneously increasing their outpatient services. These health promotion approaches, focused on empowering people to take control of their health, are expected to have implications for the outpatient healthcare building design. Yet there is limited knowledge what these may be. A review of the literature on the current state of the art is thus needed to enable and support dialog on future healthcare building design.

    METHOD: A scoping review of 4,506 papers, collected from four databases and three scientific journals in 2015, resulted in 14 papers relating health promotion to building design and outpatient healthcare. From the subsequent content analysis, multiple common themes and subthemes emerged.

    RESULTS: The review reveals diverse range of health promotion interpretations, three health promotion perspectives (health behavior, health equity, and sense of coherence), associated design approaches, design objectives, health-related outcomes, building features, and solutions.

    CONCLUSIONS: While diverse health promotion perspectives might merely represent variations in focus, these differences become problematic when relating to building design. To support further dialogs on development of health promotion in, and in relation to, the build environment, there is a need to strengthen the health promotion vocabulary. Further research is needed to compare different design approaches and how these can be combined to minimize contradicting implications for building design.

  • 65.
    Neljesjö, Maria
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Strömkvist, Ingegerd
    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.
    Omvårdnadspersonals upplevelser av vård i livets slutskede2014In: 22nd Nordic Congress of Gerontology, Gothenburg, 25-28 May 2014: Abstracts, 2014, p. Abstract number FoU-C1-Conference paper (Other academic)
    Abstract [sv]

    Bakgrund: Gruppen av äldre som har komplexa vård- och omsorgsbehov ökar och många av dessa personer vistas inom kommunal vård och omsorg. Flera av dem kommer att vårdas under sin sista tid inom den kommunala vård och omsorgen vilket ställer ökade krav på personalen inom äldreomsorgen. Sjuksköterskan har ansvaret för hälso- och sjukvården och omvårdnadspersonalen utför sociala

    omsorgsuppgifter samt hälso- och sjukvårdsinsatser. Sjuksköterskan har inte möjlighet att delta i det direkta omvårdnadsarbetet utan omvårdnadspersonalen blir oftast de som är närmast vårdtagaren.

    Syftet: Syftet med studien var att beskriva hur omvårdnadspersonal inom kommunens särskilda boende och korttidsboende upplever att vårda personer i livets slutskede.

    Metod: Studien bygger på åtta kvalitativa intervjuer med undersköterskor. Datainsamlingsmetoden baserades på Critical Incident Technique och som analysmetod användes kvalitativ innehållsanalys.

    Resultat: Det framkom att samarbetet till de övriga i teamet och närstående hade betydelse för hur vården utvecklades. Omvårdnadspersonalen kände i vissa omvårdnadssituationer att sjuksköterskan saknades och de upplevde ibland att de fick ta ett för stort medicinskt ansvar för döende människor. Det var svårare att vårda yngre än äldre människor då de lättare identifierade sig med dem. Omvårdnadspersonalen gav stöd till de närstående och kom familjerna nära. Närvaro utan krav och stress var av betydelse för interaktionen. Det visade sig att faktorer i miljön hade en påverkan då dessa kunde vara till hjälp eller till hinder i samspelet. Både den döende och de närstående behövde vara tillfreds med symtomlindringen och det var betydelsefullt att respektera patientens vilja. Efter döden var det viktigt att få ge ett värdigt omhändertagande.

    Slutsats: Det genomgåendet temat visade att interaktion och samverkan med vårdteamet, närstående och patienten var av avgörande betydelse för att vården i livets slut skulle bli trygg och värdig.

    Nytta för praktiken: Vården som ges i livets slutskede är av stor betydelse för den som vårdas men även för de närstående som ska leva vidare med minnena från dessa dagar. Genom att lyfta fram omvårdnadspersonalens egna upplevelser kan detta ge vägledning för kommande förbättringsarbeten. Resultatet i denna studie skulle kunna bidra till att skapa förståelse hos beslutsfattare om vilket stöd som omvårdnadspersonalen behöver för att den kommunala äldrevården ska kunna erbjuda god och säker vård i samband med livets slut.

  • 66.
    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.

  • 67.
    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)
  • 68.
    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.

  • 69.
    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)
  • 70.
    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.

  • 71.
    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.

  • 72.
    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.

  • 73.
    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)
  • 74.
    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)
  • 75.
    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.

     

  • 76.
    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.

  • 77.
    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.

  • 78.
    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)
  • 79.
    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.

  • 80.
    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.

  • 81.
    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)
  • 82.
    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. 

  • 83.
    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)
  • 84.
    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)
  • 85.
    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.

  • 86.
    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.

  • 87.
    Olai, Lena
    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.
    Eldh, Ann Catrine
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Wallin, Lars
    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.
    Implementing oral health-care guidelines in long-term-care: the role and support of managers2015Conference paper (Refereed)
    Abstract [en]

    Aim: There is an essential need to bridge the know-do gap in terms of oral-health-care for frail older people; while there are evidence based guidelines readily available, these guidelines are not altogether implemented in long-term-care (LTC) for older people. Facilitating knowledge translation has been found a complex undertaking, encompassing for example tailoring of evidence in relation to the specific context, considering the barriers and strengths of each setting. While managers and leaders have been found to influence implementation, studies focusing strategies to support the managers have only recently been launched. The aim of this pilot study in Swedish LTC is to support managers in facilitating implementation of evidence-based oral-care guidelines. Methods: Oral-health and knowledge translation experts provided a three month support programme for five managers in four LTC units, including knowledge of national guidelines tailored to LTC, and guidance for the managers on how to collate and execute guideline implementation plans, considering their behaviours, attitudes and actions as leaders in facilitating guideline implementation, underpinned by Gifford’s Model of Leadership. Oral-health measures were collected before and after the intervention, along with managers and staff experience. Results: Although the older people residing in the LTC units mainly had individual care plans for their oral care, and these aligned with the national guidelines, the oral care routines applied varied considerably. The managers were eager to support guideline implementation, and suggested that the intervention programme sustained their ambition. However, unclear roles and urgent everyday issues took its toll, leaving limited opportunities for managers to engage. Conclusions: Implementation of evidence based oral health-care guidelines requires support from primary leaders. Yet, they themselves need to be supported by the context, including top level management as well as staff, and all stakeholders involved in oral care issues need to be engaged.

  • 88. Shannon, M. M.
    et al.
    Lipson-Smith, R.
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing. Göteborgs universitet; Karolinska institutet.
    Olver, J.
    Kramer, S.
    Bernhardt, J.
    Bringing the single versus multi-patient room debate to vulnerable patient populations: a systematic review of the impact of room types on hospitalized older people and people with neurological disorders2018In: Intelligent Buildings International, ISSN 1750-8975, E-ISSN 1756-6932Article in journal (Refereed)
    Abstract [en]

    Single-patient rooms are commonly recommended in acute hospital environments. People with neurological disorders, and those who are older, have complex clinical presentations requiring support and recovery for physical, cognitive, and social consequences of their brain injury, and/or chronic health problems. It is currently unknown what type of patient room, or what physical characteristics in such rooms, might be most desirable for the recovery of such people. We explored how hospital single-patient rooms are similar to or different from multi-bed rooms, and how the impact of room type has been measured in this group of people. A systematic mixed studies review was conducted to interrogate these questions. We identified 182 studies (mostly quantitative in design), 19 of which proceeded to formal data extraction. The findings show lack of clarity of salient physical characteristics in either room type for our review population. Importantly, apart from some signal of infection control benefits, our findings do not show evidence to support the use of single-patient rooms with older people and people with neurological disorders for other important outcomes. More investigation of the under-recognized potential of the patient room environment for shaping patient physical, cognitive, and social well-being in specific hospitalized populations is required.

  • 89. Shannon, Michelle M
    et al.
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Churilov, Leonid
    Olver, John
    Pert, Alan
    Bernhardt, Julie
    Can the physical environment itself influence neurological patient activity?2019In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 41, no 10, p. 1177-1189Article in journal (Refereed)
    Abstract [en]

    PURPOSE: To evaluate if a changed physical environment following redesign of a hospital ward influenced neurological patient physical and social activity.

    METHODS: A "before and after" observational design was used that included 17 acute neurological patients pre-move (median age 77 (IQR 69-85) years Ward A and 20 post-move (median age 70 (IQR 57-81) years Ward B. Observations occurred for 1 day from 08.00-17.00 using Behavioral Mapping of patient physical and social activity, and location of that activity. Staff and ward policies remained unchanged throughout. An Environmental Description Checklist of each ward was also completed.

    RESULTS: Behavioral Mapping was conducted pre-/post-move with a total of 801 Ward A and 918 Ward B observations. Environmental Description Checklists showed similarities in design features in both neurological wards with similar numbers of de-centralized nursing stations, however there were more single rooms and varied locations to congregate in Ward B (30% more single-patient rooms and separate allied health therapy room). Patients were alone >60% of time in both wards, although there was more in bed social activity in Ward A and more out of bed social activity in Ward B. There were low amounts of physical activity outside of patient rooms in both wards. Significantly more physical activity occurred in Ward B patient rooms (median = 47%, IQR 14-74%) compared to Ward A (median = 2% IQR 0-14%), Wilcoxon Rank Sum test z = -3.28, p = 0.001.

    CONCLUSIONS: Overall, patient social and physical activity was low, with little to no use of communal spaces. However we found more physical activity in patient rooms in the Ward B environment. Given the potential for patient activity to drive brain reorganization and repair, the physical environment should be considered an active factor in neurological rehabilitation and recovery. Implications for Rehabilitation Clinicians should include consideration of the impact of physical environment on physical and social activity of neurological patients when designing therapeutic rehabilitation environments. Despite architectural design intentions patient and social activity opportunities can be limited. Optimal neurological patient neuroplasticity and recovery requires sufficient environmental challenge, however current hospital environments for rehabilitation do not provide this.

  • 90.
    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)
  • 91.
    Svedbo Engström, Maria
    et al.
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Wijk, Helle
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Evidence-based briefing for sustainable healthcare environments2011In: World Sustainable Building Conference SB11, Helsinki, 2011Conference paper (Refereed)
    Abstract [en]

    The aim of the study was to survey the evidence-based information in initial briefs for healthcare environments. The focus was on the initial brief, when the aim is foremost to express design requirements and specifications from the user’s point of view. The study audit 29 briefs by using a new developed instrument to examine the content and quality of information in briefs (CQB-I) (Content and Quality of Briefs Instrument), a new developed and tested instrument. The rationale behind the study is that the brief is one important outcome of a design process that has not been studied as much as necessary. Despite the stated importance of a well developed brief, there exist few studies of the content and quality of the briefs created in design process of new healthcare spaces. The use of Evidence-Based Design (EBD) to support designers to make decisions based on available knowledge about the impact of design solutions on people, costs and management has been addressed recently. Briefing (programming) should enable the communication of the end user’s need into design requirements and thus it is of utmost importance that this is communicated through a brief. The brief should also be a significant base for expressed outcomes for a building performance evaluation. The analysis showed that a majority of the briefs included some kind of evidence-based information. Though, in most of them the information was very sporadic and the information mainly addresses local statistics such as of the number of patients, beds, personnel, and length of stay. There were only two briefs that contain evidence-based information throughout the entire brief.

  • 92.
    Udo, Camilla
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work. Center for Clinical Research Dalarna, Falun.
    Neljesjö, Maria
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Strömkvist, Ingegerd
    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. Karolinska Institutet; Chalmers University of Technology.
    A qualitative study of assistant nurses’ experiences of palliative care in residential care2018In: Nursing Open, E-ISSN 2054-1058, Vol. 5, no 4, p. 527-535Article in journal (Refereed)
    Abstract [sv]

    Aim

    To explore assistant nurses' experiences and perceptions of both positive and negative aspects of providing palliative care for older people in residential care facilities.

    Design

    A qualitative explorative study.

    Methods

    Critical incidents were collected through semi‐structured face‐to‐face interviews and analysed by performing a qualitative content analysis.

    Results

    A total of 40 critical incidents from daily work was described by assistant nurses. The results showed that close cooperation between unlicensed and licensed professionals was crucial to provide good care but was sometimes negatively affected by the organizational structure. The availability of professionals was identified as a critical factor in providing good care at the end of life in a consultative organization. The most prominent findings were those that indicated that, especially in a consultative organization, there seems to be a need for clear roles, comprehensive and clear care plans and a solid support structure to ensure continuity of care.

  • 93.
    Udo, Camilla
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Neljesjö, Maria
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Strömkvist, Ingegerd
    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.
    Assistant nurses’ experiences and perceptions of palliative care situations in residential care2016Conference paper (Refereed)
  • 94.
    Udo, Camilla
    et al.
    Dalarna University, School of Education, Health and Social Studies, Social Work.
    Neljesjö, Maria
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Strömkvist, Ingegerd
    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.
    P177 Assistant Nurses’ Experiences and Perceptions of Palliative Care Situations in Residential Care2016In: Journal of Pain and Symptom Management, ISSN 0885-3924, E-ISSN 1873-6513, Vol. 52, no 6Article in journal (Refereed)
  • 95. Verma, Ira
    et al.
    Aalto, Leena
    Malmqvist, Inga
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Design for well-being in older people’s residential environments: Sustainable Design in Finland and Sweden2011In: World Sustainable Building Conference SB11, Helsinki, Finland , 2011Conference paper (Refereed)
    Abstract [en]

    Good design in residential areas promotes socially sustainable neighborhoods, the well being of the residents and the notion of “aging in place”. Stimulating environment engages residents to their neighborhood and encourages communication. Beneficial spatial design helps in way finding and increases the sense of security. Theme This paper focuses on the common spaces in residential environments for elderly. User-centric, residential environments that promote social and physical accessibility can be attained by means of spatial planning, acoustics and lightning as well as other architectural means. With aging the living environment becomes smaller and elderly spend lot of their time indoors. Elderly prefer to live in their own homes but at the same time they feel more isolated. New residential buildings have to be designed to extend the individual apartments to the common space and to facilitate social interactions. Common spaces also need to be useful for different kinds of activities in a short-time as well as in a long-time perspective. Methods Finnish and Swedish housing projects for elderly are studied. The design and use of common multipurpose spaces are analyzed through architectural plans, usability walk-through methods, observation of activities and use of spaces, and interviews with users. Results The study brings together Swedish and Finnish knowledge to support the design of the residential buildings for the elderly. The project will contribute to evidence-based knowledge concerning the common spaces in residential environments for elderly. The study findings should feed into policy on housing for older people which could enhance sustainability and the quality of living environments of this important section of our population.

  • 96.
    Åberg, Anna Cristina
    et al.
    Dalarna University, School of Education, Health and Social Studies, Medical Science.
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Nordmark, S
    Lyhagen, J
    Lindberg, I
    Finch, T
    The Swedish version of the normalisation process theory measurement s-nomad: Translation, adaptation and pilot testing2018In: BMJ Evidence-Based Medicine, ISSN 2515-446X, Vol. 23, no Suppl 1, p. A33-A33Article in journal (Refereed)
  • 97.
    Åberg, Anna Cristina
    et al.
    Dalarna University, School of Education, Health and Social Studies, Medical Science.
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Caring Science/Nursing.
    Nordmark, S
    Lyhagen, J
    Lindberg, I
    Finch, T
    The Swedish version of the Normalization Process Theory Measure S-NoMAD: Translation, adaptation and pilot testing2018Conference paper (Refereed)
  • 98.
    Öhrn, Kerstin
    et al.
    Dalarna University, School of Education, Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Sjödén, PO
    Wahlin, YB
    Elf, Marie
    Dalarna University, School of Education, Health and Social Studies, Health and Caring Sciences/Oral Health Science.
    Oral Health and Quality of life among head and neck cancer or hematological malignancies2001In: Supportive Care in Cancer, ISSN 0941-4355, E-ISSN 1433-7339, Vol. 9, no 7, p. 528-38Article in journal (Other academic)
12 51 - 98 of 98
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