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  • 1.
    Roos, Charlotte
    Gävle kommun.
    Delaktighet inom äldreomsorgen: Om att låta de äldre ta makten över sitt liv2009Book (Other (popular science, discussion, etc.))
  • 2.
    Roos, Charlotte
    Dalarna University, School of Health and Welfare, Care Sciences. Dalarna University, School of Health and Welfare, Caring Science/Nursing.
    Factors Associated with Older Peoples´ Perceptions of Dignity and Well-being at Residential Care Facilities.2021Conference paper (Refereed)
    Abstract [en]

    Dignity and well-being should be promoted in care of older people living at residential care facilities (RCFs). In addition, care should be person-centred. Dignity and well-being can be interpreted as person-centred outcomes. Older people living at RCFs experience a lack of dignity and well-being. To promote this, it is important to understand the associated factors to target. The aim of this study was to examine the associations between perceived dignity and well-being and factors related to attitudes of staff, the care environment and individual issues (age, gender, self-rated health and dementia) among older people living at RCFs. A national cross-sectional study was conducted retrospectively. All older people 65 years and older (n=71,696) living at RCFs in 2018 were invited to respond to the survey. The survey included the areas: self-rated health, indoor-outdoor-mealtime environment, performance of care, treatment from staff, safety, social activities, availability of staff and care in its entirety. Age, gender and diagnosed dementia were collected from two national databases. Data was analysed using ordinal logistic regression models. The result indicated that respondents who had experienced disrespectful treatment, who did not thrive in the indoor-outdoor-mealtime environment, who rated their health as poor and respondents with dementia had higher odds of being dissatisfied with dignity and well-being. There is a need to improve the prerequisites of staff regarding respectful attitudes and to improve the care environment. The Person-centred Practice framework, targeting the prerequisites of staff and the care environment, can be used as a theoretical framework for designing future improvements. 

  • 3.
    Roos, Charlotte
    Dalarna University, School of Health and Welfare, Care Sciences. Dalarna University, School of Health and Welfare, Caring Science/Nursing.
    Factors associated with older peoples´ perceptions of dignity and well-being in residential care facilities.2021Conference paper (Refereed)
    Abstract [en]

    Background: Dignity and well-being should be promoted in care of older people living in residential care facilities (RCFs). In addition, care in RCFs should also promote person-centred care. According to the person-centred practice (PCP) framework dignity and well-being are being described as the result of person-centred care. Thus, previous research indicate that older people living in RCFs (residents) experience a lack of dignity and well-being and improvements are needed. To know what to target to improve care it is important to understand what factors are associated with residents´experiences of dignity and well-being in RCFs. The aim of this study was to examine the associations between perceived dignity and well-being and factors related to attitudes of staff, the care environment and individual issues (age, gender, self-rated health and dementia) among residents. Our hypothesis was that residents’ perceptions of satisfaction with dignity and well-being are associated with the attitudes of staff, the indoor-outdoor-mealtime environment and individual factors. We suggest that perceptions of a) respectful attitudes of staff, b) supportive indoor-outdoor-mealtime environment and c) good health are associated with higher satisfaction regarding dignity and well-being. Methods: A national cross-sectional study was conducted. All residents 65 years and older (n=71 696) living in RCFs in Sweden in 2018 were included in the study. The response rate was 49%. Data was collected using a national survey by the Swedish National Board of Health and Welfare. The survey questions included the areas: self-rated health, indoor-outdoor-mealtime environment, performance of care and attitudes of staff. Age, gender and diagnosed dementia were collected from two national databases. Data was analysed using descriptive statistics and ordinal logistic regression models. Results: Respondents who had experienced disrespectful attitudes of staff, who did not thrive in the indoor-outdoor-mealtime environment, who rated their health as poor and respondents diagnosed with dementia had higher odds of being dissatisfied with aspects of dignity and well-being. Discussion and conclusion: To improve care regarding dignity and well-being there is a need a) to target the prerequisites of staff regarding respectful attitudes and b) to target the care environment. The Person-centred practice framework, targeting the prerequisites of staff (knowledge, skills and attitudes) and the care environment (physical environment), could be used as a theoretical framework for designing future improvements. Practical research implications: As the result indicate what factors to target to promote dignity and well-being, it can be used by managers and registered nurses when improving care and designing future interventions to promote dignity and well-being in RCFs. 

  • 4.
    Roos, Charlotte
    Dalarna University, School of Health and Welfare, Care Sciences. Dalarna University, School of Health and Welfare, Caring Science/Nursing.
    Older people’s perceptions of what is needed to experience dignity and well-being at residential care facilities.2021Conference paper (Refereed)
    Abstract [en]

    Dignity and well-being are central values in the legislation on care of older people living in residential care facilities (RCFs) in Sweden. In addition, care of older people living in RCFs should be person-centred. Dignity and well-being can according to the person-centred practice framework be interpreted as person-centred outcomes. Despite this older people living in RCFs have described that they not fully experience dignity and well-being and improvements are needed. To improve care it is essential to know what to target. The aim of this study was therefore to describe residents’ perceptions and experiences of what is needed to live with dignity and a sense of well-being. A descriptive design with a qualitative approach was used. Open-ended interviews were carried out with 20 older people living at RCFs. Inductive content analysis was used to analyse data and one overarching theme and three categories emerged. The categories revealed the importance of, and that staff and the care environment supported, to manage daily life by oneself, to be shown respect and to belong to a social context. The overarching theme revealed the importance of having a feeling to still matter. For older people to experience the person-centred outcomes dignity and well-being managers at RCFs need to develop and support the staff prerequisites related to knowledge, skills and attitudes and to improve the care environment. According to the person-centred practice framework, the staff prerequisites and the care environment must be taken into account to achieve the person-centred outcomes dignity and well-being. 

     

    This study relates to global sustainability regarding development goal number three – Good health and well-being – implying to promote well-being for all in all ages. This study has a focus on older people and their experiences of what is needed to promote their well-being at RCFs. The results revealed, among other things, that it was important to manage daily life by oneself and this was related to health issues. This implies that this study also deals with health. The results from the study can be used to design improvements to promote older peoples´ health and well-being at RCFs, and in that way sustainability goal number three might be reached.

  • 5.
    Roos, Charlotte
    Dalarna University, School of Health and Welfare, Care Sciences. Dalarna University, School of Health and Welfare, Caring Science/Nursing.
    Older People’s Perceptions of what is Needed to Experience Dignity and Well-being at Residential Care Facilities2021Conference paper (Refereed)
    Abstract [en]

    Dignity and well-being are central values in care of older people living in residential care facilities. In addition, care of older people living in residential care facilities should be person-centred. Dignity and well-being can according to the person-centred practice framework be interpreted as person-centred outcomes. Despite this older people living in residential care facilities have described that they not fully experience dignity and well-being and improvements are needed. To improve care it is important to know what to target. The aim of this qualitative study was therefore to describe residents’ perceptions and experiences of what is needed to live with dignity and a sense of well-being. Interviews were carried out with older people living at residential care facilities (n=20). Inductive content analysis was used to analyse data and one overarching theme and three categories emerged. The result revealed the importance of, and that staff and the care environment supported, to manage daily life by oneself, to be shown respect and to belong to a social context. For older people to experience the person-centred outcomes dignity and well-being managers at residential care facilities need to develop and support the staff prerequisites related to knowledge, skills and attitudes and to improve the care environment. According to the person-centred practice framework, the staff prerequisites and the care environment must be taken into account to achieve the person-centred outcomes dignity and well-being.

     

     

  • 6.
    Roos, Charlotte
    Dalarna University, School of Health and Welfare, Care Sciences. Dalarna University, School of Health and Welfare, Caring Science/Nursing.
    Promoting dignity and well-being in residential care facilities: Older persons’ perceptions and experiences of important aspects and associated factors2022Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Objective: The overall aim of this thesis was to increase knowledge regarding the perceptions and experiences of aspects and factors associated with perceived dignity and well-being among older persons living in residential care facilities. Study I describes residents’ perceptions and experiences regarding important aspects of experiencing dignity and well-being. Study II examines the associations between perceptions of dignity and well-being and the attitudes of staff, the indoor-outdoor-mealtime environments and individual factors for residents. Study III examines the same associations as Study II over a three-year period. Study IV examines residents’ perceptions of empowerment, person-centred climate and life satisfaction before and after a caregiver intervention concerning the Swedish national fundamental values of dignity and well-being. 

    Methods: The studies were performed in residential care facilities in Sweden. The participants were residents living in these facilities. Study I is a qualitative study that used semi-structured interviews to collect data. Data were analysed using qualitative content analysis. Study II, a cross-sectional study, and Study III, a longitudinal study, are based on national questionnaire data from the Swedish National Board of Health and Welfare. Data from 2016, 2017 and 2018 were used and analysed using descriptive statistics and ordinal logistic regression models. Study IV is a cluster-randomized controlled trial with a pre-and post-test design. Data were collected using the Patient Empowerment Scale, the Person-centred Climate Questionnaire – patient version, the Life Satisfaction Questionnaire and the EQ-5D questionnaire. Data were analysed using descriptive statistics, the Chi-square test, the Wilcoxon signed-rank test, the Mann-Whitney U test and generalized estimating equation models.

    Findings: To experience dignity and well-being it was important for residents to feel that they still matter. To feel this, it was vital to be able to manage daily life, to have influence and to belong to a social context (I). Residents who had experienced disrespectful attitudes of staff, who did not thrive in the indoor-outdoor-mealtime environments, who rated their health and mobility as poor, and who were diagnosed with dementia had higher odds of being dissatisfied with aspects of dignity and well-being (II). These associations were persistent over a three-year period (III). After an intervention concerning the Swedish national fundamental values of dignity and well-being, the residents in the intervention group reported higher scores for perceived empowerment, person-centred climate and life satisfaction (IV).

    Conclusion: To promote dignity and well-being, the attitudes of staff, the indoor-outdoor-mealtime environments and the individual factors of poor health, poor mobility and a dementia diagnosis need to be targeted. The Person-centred practice framework, targeting the prerequisites of staff and the care environment, could be used as a theoretical framework for designing improvement strategies that aim to promote dignity and well-being. First-line managers and registered nurses in residential care facilities have different knowledge and skills. They therefore need to work together as a team when developing improvement strategies that aim to promote the dignity and well-being of residents. In addition, residents should be included on the team given their knowledge regarding what is important for promoting dignity and well-being.

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  • 7.
    Roos, Charlotte
    Gävle kommun.
    Äldreassistent: Om människosyn, värdegrund och bemötande2010Book (Other (popular science, discussion, etc.))
  • 8.
    Roos, Charlotte
    et al.
    Dalarna University, School of Health and Welfare, Caring Science/Nursing. Dalarna University, School of Health and Welfare, Care Sciences.
    Alam, Moudud
    Dalarna University, School of Information and Engineering, Statistics.
    Swall, Anna
    Dalarna University, School of Health and Welfare, Caring Science/Nursing.
    Boström, Anne-Marie
    Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden.
    Marmstål Hammar, Lena
    Dalarna University, School of Health and Welfare, Caring Science/Nursing. School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden.
    Factors associated with older persons’ perceptions of dignity and well-being over a three-year period: A retrospective national study in residential care facilities2022In: BMC Geriatrics, E-ISSN 1471-2318, Vol. 22, no 1, article id 515Article in journal (Refereed)
    Abstract [en]

    Background: Dignity and well-being are central concepts in the care of older people, 65 years and older, world‑wide. The person-centred practice framework identifes dignity and well-being as person-centred outcomes. Older persons living in residential care facilities, residents, have described that they sometimes lack a sense of dignity and well-being, and there is a need to understand which modifable factors to target to improve this. The aim of this study was to examine the associations between perceptions of dignity and wellbeing and the independent variables of the attitudes of staf, the indoor-outdoor-mealtime environments, and individual factors for residents over a three-year period.

    Methods: A national retrospective longitudinal mixed cohort study was conducted in all residential care facilities within 290 municipalities in Sweden. All residents aged 65 years and older in 2016, 2017 and 2018 were invited to responded to a survey; including questions regarding self-rated health and mobility, the attitudes of staf, the indooroutdoor-mealtime environments, safety, and social activities. Data regarding age, sex and diagnosed dementia/pre‑scribed medication for dementia were collected from two national databases. Descriptive statistics and ordinal logistic regression models were used to analyse the data.

    Results: A total of 13 763 (2016), 13 251 (2017) and 12 620 (2018) residents answered the survey. Most of them (69%) were women and the median age was 88 years. The odds for satisfaction with dignity did not difer over the three-year period, but the odds for satisfaction with well-being decreased over time. Residents who rated their health as good, who were not diagnosed with dementia/had no prescribed medication for dementia, who had not experienced disrespectful attitudes of staf and who found the indoor-outdoor-mealtime environments to be pleasant had higher odds of being satisfed with aspects of dignity and well-being over the three-year period.

    Conclusions: The person-centred practice framework, which targets the attitudes of staf and the care environment, can be used as a theoretical framework when designing improvement strategies to promote dignity and well-being. Registered nurses, due to their core competencies, focusing on person-centred care and quality improvement work, should be given an active role as facilitators in such improvement strategies.

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  • 9.
    Roos, Charlotte
    et al.
    Dalarna University, School of Health and Welfare, Care Sciences. Dalarna University, School of Health and Welfare, Caring Science/Nursing.
    Alam, Moudud
    Dalarna University, School of Information and Engineering, Statistics.
    Swall, Anna
    Dalarna University, School of Health and Welfare, Caring Science/Nursing.
    Boström, Anne‐Marie
    Division of Nursing Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden;Theme Inflammation and Ageing, Unit Nursing Ageing Karolinska University Hospital Huddinge Sweden;Research and Development UnitStockholms Sjukhem Stockholm Sweden.
    Marmstål Hammar, Lena
    Dalarna University, School of Health and Welfare, Caring Science/Nursing. Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden; School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden.
    Factors associated with perceptions of dignity and well‐being among older people living in residential care facilities in Sweden. A national cross‐sectional study2022In: Health & Social Care in the Community, ISSN 0966-0410, E-ISSN 1365-2524, Vol. 30, no 5, p. e2350-e2364Article in journal (Refereed)
    Abstract [en]

    The care of older people living in residential care facilities (RCFs) should promote dignity and well-being, but research shows that these aspects are lacking in such facilities. To promote dignity and well-being, it is important to understand which associated factors to target. The aim of this study was to examine the associations between perceived dignity and well-being and factors related to the attitudes of staff, the care environment and individual issues among older people living in RCFs. A national retrospective cross-sectional study was conducted in all RCFs for older people within 290 municipalities in Sweden. All older people 65 years and older (n = 71,696) living in RCFs in 2018 were invited to respond to the survey. The response rate was 49%. The survey included the following areas: self-rated health, indoor-outdoor-mealtime environment, performance of care, attitudes of staff, safety, social activities, availability of staff and care in its entirety. Data were supplemented with additional data from two national databases regarding age, sex and diagnosed dementia. Descriptive statistics and ordinal logistic regression models were used to analyse the data. Respondents who had experienced disrespectful treatment, those who did not thrive in the indoor-outdoor-mealtime environment, those who rated their health as poor and those with dementia had higher odds of being dissatisfied with dignity and well-being. To promote dignity and well-being, there is a need to improve the prerequisites of staff regarding respectful attitudes and to improve the care environment. The person-centred practice framework can be used as a theoretical framework for improvements, as it targets the prerequisites of staff and the care environment. As dignity and well-being are central values in the care of older people worldwide, the results of this study can be generalised to other care settings for older people in countries outside of Sweden.

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  • 10.
    Roos, Charlotte
    et al.
    Dalarna University, School of Health and Welfare, Caring Science/Nursing.
    Fjellfeldt, Maria
    Dalarna University, School of Health and Welfare, Social Work.
    Mapping priorities in Swedish suicide prevention policy: What, how and who are prioritized. A qualitative document study2023In: Mental Health and Prevention, ISSN 2212-6570, Vol. 31, article id 200296Article in journal (Refereed)
    Abstract [en]

    Background: Suicide is a serious public health problem. All 194 member states of the World Health Organization have signed the Comprehensive Mental Health action plan 2013–2030 which tasks governments with implementing evidence-based interventions in community settings to prevent suicide at all stages of life. This study aims to map the priorities in suicide prevention policy in community-settings in Sweden, one of the World Health Organization's member states. Method: A document study, using data from suicide prevention policy documents in the 21 counties in Sweden. Data was analyzed using qualitative content analysis. Results: Suicide prevention interventions at the universal, selective and indicated prevention levels were prioritized. Most of the suicide prevention interventions intended to be implemented at each prevention level was evidence-based. Most of the suicide prevention interventions at all prevention levels did not prioritize any specific age group, however when age groups were targeted there were some emphases on children and adolescents. Conclusion: There is a need to improve suicide prevention interventions prioritizing age-groups who have high suicide rates. As educational interventions that encourage young people to develop their ability to face life challenges related to adolescence are found to be appropriate suicide prevention interventions, so too could educational interventions aimed at other age-groups be developed, to enable them to develop their ability to face life challenges related to their age. © 2023

  • 11.
    Roos, Charlotte
    et al.
    Department of Health and Caring Sciences, Faculty of Health and Occupational Studies, University of Gävle; Department of Public Health and Caring Sciences, Uppsala University.
    Silén, Marit
    Faculty of Health and Occupational Studies, University of Gävle.
    Skytt, Bernice
    Faculty of Health and Occupational Studies, University of Gävle.
    Engström, Maria
    Faculty of Health and Occupational Studies, University of Gävle.
    An intervention targeting fundamental values among caregivers at residential facilities: effects of a cluster-randomized controlled trial on residents’ self-reported empowerment, person-centered climate and life satisfaction2016In: BMC Geriatrics, E-ISSN 1471-2318, Vol. 16, no 1, article id 130Article in journal (Refereed)
    Abstract [en]

    Background: In Sweden the national fundamental values for care of older people state that care should ensure that they can live in dignity and with a sense of well-being. Our hypothesis was that a caregiver intervention targeting the national fundamental values would improve perceived empowerment, person-centered climate and life satisfaction among older people living in residential facilities.

    Methods: The study was a cluster-randomized controlled trial with a pre- and one post-test design, conducted in 27 units (17 study units) at 12 residential facilities for older people in five municipalities in central Sweden. The units in each municipality were randomly assigned to intervention or control group. The caregiver intervention was carried out using an interpretative approach with eight guided face-to-face seminars, where self-reflection and dialogue were used. Data were collected using questionnaires. The number of residents was 43 (78 %) in the intervention group and 37 (71 %) in the control group. The Chi-square test and Mann-Whitney U-tests were performed to detect differences between groups and Wilcoxon signed rank tests to explore differences in change over time within groups. Furthermore, generalized estimating equation (GEE) models were used to study effects of the intervention controlling for clustering effects.

    Results: Primary outcome measures were empowerment, person-centered climate and life satisfaction. In the intervention group, improvements at follow-up were found in residents’ self-reported empowerment (n = 42; p = 0.001, Median difference 4.0, 95 % CI 1.5;6.0), person-centered climate (n = 42; p ≤0.001, Median difference 8.0, 95 % CI 4.5;11. 4) and life satisfaction regarding the factor quality of everyday activities (n = 40; p = 0.033, Median difference 9.7, 95 % CI 1.0;21.9) while disempowerment decreased (n = 43; p = 0.018, Median difference -1.3, 95 % CI -2.0;0.0). In the control group person-centered climate decreased (n = 37; p = 0.002, Median difference -8.5, 95 % CI -13.6;-3.0) and quality of everyday activities (n = 36; p = 0.012, Median difference -11.6, 95 % CI-21.7;-3.4). Change over time between groups was significant for empowerment (p = 0.001, Median difference 6.0, 95 % CI 3.0;9.0), disempowerment (p = 0.006, Median difference -2.0, 95 % CI -4.0;-1.0) and person-centered climate (p ≤ 0.001, Median difference 16.0, 95 % CI 9.7;23.0) and for life satisfaction regarding the factor quality of everyday activities (p = 0.002, Median difference 22.1, 95 % CI 8.2;37.4). Results of GEE confirmed earlier results; revealed interaction effects for empowerment (parameter estimate -5.0, 95 % CI -8.3;-1.8), person-centered climate (parameter estimate -16.7, 95 % CI -22.4;-10.9) and life satisfaction regarding the factor quality of everyday activities (parameter estimate -25.9, 95 % CI -40.3;-11.5).

    Conclusion: When the Swedish national fundamental values were put into practice increases in empowerment, person-centered climate and quality of everyday activities were found among older people with intact cognitive ability living in residential facilities. Limitations to consider are the differences between the two groups at baseline, drop-outs and that neither the data collector nor the outcome assessors were blinded to group assignment of participants. 

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  • 12.
    Roos, Charlotte
    et al.
    Dalarna University, School of Health and Welfare, Caring Science/Nursing.
    Swall, Anna
    Dalarna University, School of Health and Welfare, Caring Science/Nursing.
    Marmstål Hammar, Lena
    Dalarna University, School of Health and Welfare, Caring Science/Nursing. Karolinska Institute, Stockholm; Mälardalen University, Västerås.
    Boström, Anne-Marie
    Skytt, Bernice
    Promoting the person-centred aspects of dignity and well-being: learning from older persons’ experiences of living in residential care facilities2023In: Working with Older People, ISSN 1366-3666, E-ISSN 2042-8790, Vol. 27, no 3, p. 219-229Article in journal (Refereed)
    Abstract [en]

    Purpose – Dignity and well-being are key aspects of the legislation and policies that regulate care of olderpersons worldwide. In addition, care of older persons should be person-centred. Dignity and well-being aredescribed as results of person-centred care (PCC). The purpose of this study was to gain an understanding ofimportant aspects for older persons to experience dignity and well-being in residential care facilities (RCFs).

    Design/methodology/approach – This study had a qualitative approach, and individual semi-structuredinterviews were conducted with 20 older persons living in RCFs. Data were analysed using inductive contentanalysis.

    Findings – To experience dignity and well-being older persons emphasized the importance ofpreserving their identity. To do this, it was important to be able to manage daily life, to gain support andinfluence and to belong to a social context. However, the findings indicate a need for improvements.

    Practical implications – Insights into older persons’ experiences of important aspects for experiencingdignity and well-being in RCFs can be used by first-line managers and registered nurses when designingimprovement strategies to promote PCC.

    Originality/value – Dignity and well-being are described as results of PCC. The findings provide anunderstanding of what older persons perceive as important for experiencing dignity and well-being inRCFs. The findings are useful when designing improvement strategies to promote PCC.

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