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  • 51.
    Nordin, Susanna
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Elf, Marie
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    McKee, Kevin
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    Wijk, Helle
    Sahlgrenska akademin, Göteborgs universitet.
    A person-centered design can support accessibility and equality in residential care facilities2013Konferensbidrag (Refereegranskat)
    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.

  • 52.
    Nordin, Susanna
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Elf, Marie
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    McKee, Kevin
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    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)2015Ingår i: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 15, nr 3, s. 1-11Artikel i tidskrift (Refereegranskat)
    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.

  • 53.
    Nordin, Susanna
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Elf, Marie
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Mckee, Kevin
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    Wijk, Helle
    Sahlgrenska Akademin, Göteborgs Universitet .
    Att anpassa ett engelskt instrument som mäter designkvalitet på äldreboende till svenska förhållanden: utmaningar och erfarenheter2012Konferensbidrag (Refereegranskat)
    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.

  • 54.
    Nordin, Susanna
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Elf, Marie
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    McKee, Kevin
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    Wijk, Helle
    Att översätta och anpassa ett engelskt instrument för bedömning av fysisk miljö på särskilt boende till svenska förhållanden: utmaningar och erfarenheter2012Konferensbidrag (Refereegranskat)
  • 55.
    Nordin, Susanna
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Elf, Marie
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    McKee, Kevin
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    Wijk, Helle
    Sahlgrenska akademin, Göteborg.
    Challenges in the cultural adaptation and validation of an instrument for evaluating residential care environments for older people2015Konferensbidrag (Refereegranskat)
  • 56.
    Nordin, Susanna
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Elf, Marie
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    McKee, Kevin
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    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.2014Konferensbidrag (Refereegranskat)
    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.

     

  • 57.
    Nordin, Susanna
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Elf, Marie
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Wijk, Helle
    Sahlgrenska akademin, Göteborgs universitet.
    McKee, Kevin
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    von Koch, Lena
    Institutionen för neurobiologi, vårdvetenskap och samhälle, Karolinska institutet.
    Translation and cultural adaptation of an instrument evaluating design quality in residential care facilities2013Ingår i: Nordic Advances in Health Care Sciences Research, November 13-14, 2013 in Lund: Abstract book, 2013, s. 96-96Konferensbidrag (Refereegranskat)
    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.

  • 58.
    Nordin, Susanna
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    McKee, Kevin
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    Elf, Marie
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Staff perceptions of the design of care environments for older people – a qualitative study2018Konferensbidrag (Refereegranskat)
    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.

  • 59.
    Nordin, Susanna
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    McKee, Kevin
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    Elf, Marie
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Wijk, Helle
    Gothenburg University.
    Evaluating design quality of older people’s residential care facilities.2015Ingår i: 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, s. 315-323Konferensbidrag (Refereegranskat)
  • 60.
    Nordin, Susanna
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    McKee, Kevin
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    Wallinder, Maria
    von Koch, Lena
    Wijk, Helle
    Elf, Marie
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    The physical environment, activity and interaction in residential care facilities for older people: a comparative case study2017Ingår i: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 31, nr 4, s. 727-738Artikel i tidskrift (Refereegranskat)
    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.

  • 61.
    Nordin, Susanna
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. karolinska institutet.
    McKee, Kevin
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    Wijk, Helle
    Elf, Marie
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Exploring environmental variation in residential care facilities for older people2017Ingår i: Health Environments Research & Design Journal, ISSN 1937-5867, E-ISSN 2167-5112, Vol. 10, nr 2, s. 49-65Artikel i tidskrift (Refereegranskat)
    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.

  • 62.
    Nordin, Susanna
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    McKee, Kevin
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    Wijk, Helle
    Elf, Marie
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Residential care facilities for older people: Describing the quality of the physical environment2015Konferensbidrag (Refereegranskat)
  • 63.
    Nordin, Susanna
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Karolinska institutet.
    McKee, Kevin
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    Wijk, Helle
    Elf, Marie
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad. Karolinska institutet.
    The association between the physical environment and the well-being of older people in residential care facilities: a multilevel analysis2017Ingår i: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 73, nr 12, s. 2942-2952Artikel i tidskrift (Refereegranskat)
    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. 

  • 64.
    Nordin, Susanna
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Wijk, Helle
    McKee, Kevin
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    Elf, Marie
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    A review of existing tools for assessing the design quality of healthcare environments2011Konferensbidrag (Övrigt vetenskapligt)
  • 65.
    Nordin, Susanna
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Wijk, Helle
    McKee, Kevin
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    Elf, Marie
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Assessment of the physical environment - a way to high quality care2012Konferensbidrag (Refereegranskat)
  • 66.
    Nordin, Susanna
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Wijk, Helle
    Sahlgrenska Akademin, Göteborg.
    McKee, Kevin
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    Elf, Marie
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Care staff's perceptions of older people's care environments2014Konferensbidrag (Refereegranskat)
    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.

  • 67.
    Nordin, Susanna
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Wijk, Helle
    Sahlgrenska akademin, Göteborgs universitet.
    McKee, Kevin
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    Elf, Marie
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Designing for person-centered care in residential care facilities2014Konferensbidrag (Refereegranskat)
    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.

  • 68.
    Nosowska, Geraldine
    et al.
    Effective Practice Ltd..
    McKee, Kevin
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    Dahlberg, Lena
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete. Karolinska Institutet.
    Using structured observation and content analysis to explore the presence of older people in public fora in developing countries2014Ingår i: Journal of Aging Research, ISSN 2090-2204, E-ISSN 2090-2212, s. 860612-Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    There is a lack of research on the everyday lives of older people in developing countries. This exploratory study used structured observation and content analysis to examine the presence of older people in public fora, and considered the methods’ potential for understanding older people’s social integration and inclusion. Structured observation occurred of public social spaces in six cities each located in a different developing country, and in one city in the United Kingdom, together with content analysis of the presence of people in newspaper pictures and on television in the selected countries. Results indicated that across all fieldwork sites and data sources, there was a low presence of older people, with women considerably less present than men in developing countries. There was variation across fieldwork sites in older people’s presence by place and time of day, and in their accompanied status. The presence of older people in images drawn from newspapers was associated with the news/non-news nature of the source. The utility of the study’s methodological approach is considered, as is the degree to which the presence of older people in public fora might relate to social integration and inclusion in different cultural contexts.

  • 69.
    Olsen, Marie
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Dahlberg, Lena
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    Boström, Anne-Marie
    Institutionen för Neurobiologi, Vårdvetenskap och Samhälle, Karolinska Institutet.
    McKee, Kevin
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    Udo, Camilla
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    Older people’s views on the important values in home help provision: a Swedish study2018Konferensbidrag (Refereegranskat)
    Abstract [en]

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

  • 70.
    Olsen, Marie
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    Dahlberg, Lena
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    McKee, Kevin
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    Udo, Camilla
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    Older people´s views on the core values of home care2015Konferensbidrag (Övrigt vetenskapligt)
    Abstract [en]

    The care of older people and the underpinning values of care of older people in a recent government report on dignity in care. Care of older people should be based on six aspects of dignity which is the foundation for a dignified life. These are: integrity, such as privacy and bodily integrity; Self-determination; involvement in decisions about their care; individualized care; good health and social care; and a good interaction to the older person and their families.

    Despite a strong policy agenda on individually adapted care and values, social care research has usually not been undertaken from the perspective of the older care-receiver themselves. Even less is known about preferences of older care receivers with dementia, despite that they compose approximately 34 percent of older care receivers who have support from home help.

    Such pronouncements raise a question regarding the extent to which proposed ‘core values’ of social care are based on the actual values of the users, that is, the older care receivers.

    The study will be undertaken by means of a qualitative cross-sectional study, with semi-structured interviews.

     The population will include two groups: older care receivers (65 years or older) with or without dementia. The sample size is estimated to approximately 20-30 participants in each group.

    The interviews will be analyzed with content analysis. 

    This study will provide an increased understanding of older care receivers’ preferences and create conditions for a more individualized and person-centered care. This study will also contribute to strengthening the evidence-based practice in social care.

     

  • 71.
    Olsen, Marie
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Omvårdnad.
    McKee, Kevin
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    Dahlberg, Lena
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    Udo, Camilla
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    Understanding older people’s experiences of home care through the capability approach2015Konferensbidrag (Övrigt vetenskapligt)
    Abstract [en]

    The core concepts of CA

    In the theoretical framework of CA, well-being is constituted by a person’s unique way of functioning and capabilities. This means that a person's well-being is personal and involves freedom of choice which in turn means they have a number of options. Although many people may have the same resources, it is of importance to study how these resources are converted into how they function. Thus, wellbeing is about the person's freedom to achieve in general and the capabilities to function in particular (Sen, 1995).

    Strength of the capability approach

    The capability approach is a useful tool for matching objective evaluations with subjective metrics. Furthermore, although one’s individual abilities are in focus, contextual factors, and subjective perceptions and experiences, are taken into consideration.

    Critiques against the CA

    The capability approach has been criticized for being too individual-centered and not taking sufficient account to social structures in society. It is difficult to know what a person would choose to do if other options were available. Therefore, to operationalize abilities involves uncertainties.

  • 72. Orrell, A.
    et al.
    McKee, Kevin
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    Torrington, J.
    Barnes, S.
    Darton, R.
    Netten, A.
    Lewis, A.
    The relationship between building design and residents’ quality of life in extra care housing schemes2013Ingår i: Health and Place, ISSN 1353-8292, E-ISSN 1873-2054, Vol. 21, s. 52-64Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Well-designed housing is recognised as being an important factor in promoting a good quality of life. Specialised housing models incorporating care services, such as extra care housing (ECH) schemes are seen as enabling older people to maintain a good quality of life despite increasing health problems that can accompany ageing. Despite the variation in ECH building design little is known about the impact of ECH building design on the quality of life of building users. The evaluation of older people’s living environments (EVOLVE) study collected cross-sectional data on building design and quality of life in 23 ECH schemes in England, UK. Residents’ quality of life was assessed using the schedule for the evaluation of individual quality of life-direct weighting (SEIQoL-DW) and on the four domains of control, autonomy, self-realisation and pleasure on the CASP-19. Building design was measured on 12 user-related domains by means of a new tool; the EVOLVE tool. Using multilevel linear regression, significant associations were found between several aspects of building design and quality of life. Furthermore, there was evidence that the relationship between building design and quality of life was partly mediated by the dependency of participants and scheme size (number of living units). Our findings suggest that good quality building design in ECH can support the quality of life of residents, but that designing features that support the needs of both relatively independent and frail users is problematic, with the needs of highly dependent users not currently supported as well as could be hoped by ECH schemes. © 2013 Elsevier Ltd.

  • 73.
    Orrell, Alison
    et al.
    University of Sheffield.
    McKee, Kevin
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    Dahlberg, Lena
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    Gilhooly, Mary
    Brunel University.
    Parker, Stuart
    University of Sheffield.
    Improving continence services for older people from the service-providers’ perspective: a qualitative interview study2013Ingår i: BMJ Open, ISSN 2044-6055, E-ISSN 2044-6055, Vol. 3, nr 7Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective: To examine in depth the views and experiences of continence service leads in England on key service and continence management characteristics in order to identify and to improve our understanding of barriers to a good-quality service and potential facilitators to develop and to improve services for older people with urinary incontinence (UI).

    Design: Qualitative semistructured interviews using a purposive sample recruited across 16 continence services.

    Setting: 3 acute and 13 primary care National Health Service Trusts in England.

    Participants: 16 continence service leads in England actively treating and managing older people with UI.

    Results: In terms of barriers to a good-quality service, participants highlighted a failure on the part of commissioners, managers and other health professionals in recognising the problem of UI and in acknowledging the importance of continence for older people and prevalent negative attitudes towards continence and older people. Patient assessment and continence promotion regardless of age, rather than pad provision, were identified as important steps for a good-quality service for older people with UI. More rapid and appropriate patient referral pathways, investment in service capacity, for example, more trained staff and strengthened interservice collaborations and a higher profile within medical and nurse training were specified as being important facilitators for delivering an equitable and highquality continence service. There is a need, however, to consider the accounts given by our participants as perhaps serving the interests of their professional group within the context of interprofessional work.

    Conclusions: Our data point to important barriers and facilitators of a good-quality service for older people with UI, from the perspective of continence service leads. Further research should address the views of other stakeholders, and explore options for the empirical evaluation of the effectiveness of identified service facilitators.

  • 74. van den Heuvel, Eleanor
    et al.
    Gilhooly, Mary
    Sutherland, Ian
    Jowitt, Felicity
    McKee, Kevin
    Högskolan Dalarna, Akademin Hälsa och samhälle, Socialt arbete.
    Dahlberg, Lena
    Högskolan Dalarna, Akademin Hälsa och samhälle, Socialt arbete.
    Parker, Stuart
    Gaydecki, Patrick
    Ratcliffe, Norman
    Bichard, Jo-Anne
    Long, Adele
    Cotterill, Nikki
    Orme, Susie
    Tackling ageing continence through theory, tools and technology (TACT3)2013Rapport (Övrigt vetenskapligt)
  • 75.
    Vethanayagam, Natalie
    et al.
    Barnsley Hospital, Barnsley, United Kingdom.
    Orrell, Alison
    Bangor University, School of Social Sciences, Bangor, United Kingdom.
    Dahlberg, Lena
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    McKee, Kevin
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    Orme, Susan
    Barnsley Hospital, Barnsley, United Kingdom.
    Parker, Stuart G
    Newcastle University, Institute of Health and Society, Newcastle, United Kingdom.
    Gilhooly, Mary
    Brunel University London, Department of Clinical Sciences, London, United Kingdom.
    Understanding help-seeking in older people with urinary incontinence: An interview study2017Ingår i: Health & Social Care in the Community, ISSN 0966-0410, E-ISSN 1365-2524, Vol. 25, nr 3, s. 1061-1069Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    The prevalence of urinary incontinence (UI) increases with age and can negatively affect quality of life.  However, relatively few older people with UI seek treatment.  The aim of this study was to explore the views of older people with UI on the process of seeking help.

    Older people with UI were recruited to the study from three continence services in the north of England: a geriatrician-led hospital outpatient clinic (n=18), a community based nurse-led service (n=22) and a consultant gynaecologist-led service specialising in surgical treatment (n=10). Participants took part in semi-structured interviews, which were transcribed and underwent thematic content analysis.

    Three main themes emerged: Being brushed aside, in which participants expressed the feeling that general practitioners did not prioritise or recognise their concerns; Putting up with it, in which participants delayed seeking help for their UI due to various reasons including embarrassment, the development of coping mechanisms, perceiving UI as a normal part of the ageing process, or being unaware that help was available; and Something has to be done, in which help-seeking was prompted by the recognition that their UI was a serious problem, whether as a result of experiencing UI in public, the remark of a relative, the belief that they had a serious illness, or the detection of UI during comprehensive geriatric assessment.

    Greater awareness that UI is a treatable condition and not a normal part of ageing is needed in the population and amongst health professionals. Comprehensive geriatric assessment appeared an important trigger for referral and treatment in our participants.  Screening questions by health care professionals could be a means to identify, assess and treat older people with UI.

  • 76.
    Åberg, Anna Cristina
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Medicinsk vetenskap. Uppsala universitet.
    Cedervall, Y
    Giedraitis, V
    Berglund, L
    Lennhed, B
    Rosendahl, E
    McKee, Kevin
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    Kilander, L
    Can Timed Up-and-GO (TUG) Dual Task Performance Aid Diagnosis of Dementia?2017Konferensbidrag (Refereegranskat)
  • 77.
    Åberg, Anna Cristina
    et al.
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Medicinsk vetenskap.
    Cedervall, Y
    Lundberg, C
    Giedraitis, V
    Berglund, L
    Kilander, L
    Ingelsson, M
    Rosendahl, E
    McKee, Kevin
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    Timed Up-and-Go dual-task performance in people with cognitive impairment2018Konferensbidrag (Refereegranskat)
  • 78. Åhman, Hanna Bozkurt
    et al.
    Giedraitis, Vilmantas
    Cedervall, Ylva
    Lennhed, Björn
    Berglund, Lars
    McKee, Kevin
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Socialt arbete.
    Kilander, Lena
    Rosendahl, Erik
    Ingelsson, Martin
    Åberg, Anna Cristina
    Högskolan Dalarna, Akademin Utbildning, hälsa och samhälle, Medicinsk vetenskap. Uppsala University.
    Dual-task performance and neurodegeneration: Correlations between timed up-and-go dual-task test outcomes and Alzheimer's disease cerebrospinal fluid biomarkers2019Ingår i: Journal of Alzheimer's Disease, ISSN 1387-2877, E-ISSN 1875-8908Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Tools to identify individuals at preclinical stages of dementia disorders are needed to enable early interventions. Alterations in dual-task performance have been detected early in progressive neurodegenerative disorders. Hence, dual-task testing may have the potential to screen for cognitive impairment caused by neurodegeneration. Exploring correlations between dual-task performance and biomarkers of neurodegeneration is therefore of interest.

    OBJECTIVE: To investigate correlations between Timed Up-and-Go dual-task (TUGdt) outcomes and Alzheimer's disease (AD) cerebrospinal fluid (CSF) biomarkers amyloid-β 42 (Aβ42), total tau (t-tau), and phosphorylated tau (p-tau).

    METHODS: This cross-sectional cohort study included 90 participants (age range 49-84 years) undergoing memory assessment, who were subsequently diagnosed with AD, other dementia disorders, mild cognitive impairment, or subjective cognitive impairment. TUG combined with "Naming Animals" (TUGdt NA) and "Months Backwards" (TUGdt MB), respectively, were used to assess dual-task performance. The number of correct words and time taken to complete the tests were measured. The CSF biomarkers were analysed by ELISA. Spearman's rank correlation was used for analyses between TUGdt outcomes (TUGdt NA and TUGdt MB), and CSF biomarkers, adjusted for age, gender, and educational level.

    RESULTS: The number of correct words, as well as the number of correct words/10 s during TUGdt NA correlated negatively to CSF t-tau and p-tau. No correlations were found between any time scores and CSF biomarkers.

    CONCLUSION: The correlations between TUGdt NA and t-tau and p-tau may indicate that neurodegeneration affects dual-task performance. Longitudinal studies are needed to further explore dual-task testing in screening for cognitive impairment due to neurodegeneration.

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