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Abstract Background Health and social services provided at home are becoming increasingly important. Hence, there is a need for information on home care in Europe. The objective of this literature review was to respond to this need by systematically describing what has been reported on home care in Europe in the scientific literature over the past decade. Methods A systematic literature search was performed for papers on home care published in English, using the following data bases: Cinahl, the Cochrane Library, Embase, Medline, PsycINFO, Sociological Abstracts, Social Services Abstracts, and Social Care Online. Studies were only included if they complied with the definition of home care, were published between January 1998 and October 2009, and dealt with at least one of the 31 specified countries. Clinical interventions, instrument developments, local projects and reviews were excluded. The data extracted included: the characteristics of the study and aspects of home care 'policy & regulation', 'financing', 'organisation & service delivery', and 'clients & informal carers'. Results Seventy-four out of 5,133 potentially relevant studies met the inclusion criteria, providing information on 18 countries. Many focused on the characteristics of home care recipients and on the organisation of home care. Geographical inequalities, market forces, quality and integration of services were also among the issues frequently discussed. Conclusions Home care systems appeared to differ both between and within countries. The papers included, however, provided only a limited picture of home care. Many studies only focused on one aspect of the home care system and international comparative studies were rare. Furthermore, little information emerged on home care financing and on home care in general in Eastern Europe. This review clearly shows the need for more scientific publications on home care, especially studies comparing countries. A comprehensive and more complete insight into the state of home care in Europe requires the gathering of information using a uniform framework and methodology.

Abstract Background Insomnia is common among elderly people and associated with poor health. The Minimal Insomnia Symptom Scale (MISS) is a three item screening instrument that has been found to be psychometrically sound and capable of identifying insomnia in the general population (20-64 years). However, its measurement properties have not been studied in an elderly population. Our aim was to test the measurement properties of the MISS among people aged 65 + in Sweden, by replicating the original study in an elderly sample. Methods Data from a cross-sectional survey of 548 elderly individuals were analysed in terms of assumptions of summation of items, floor/ceiling effects, reliability and optimal cut-off score by means of ROC-curve analysis and compared with self-reported insomnia criteria. Results Corrected item-total correlations ranged between 0.64-0.70, floor/ceiling effects were 6.6/0.6% and reliability was 0.81. ROC analysis identified the optimal cut-off score as ≥7 (sensitivity, 0.93; specificity, 0.84; positive/negative predictive values, 0.256/0.995). Using this cut-off score, the prevalence of insomnia in the study sample was 21.7% and most frequent among women and the oldest old. Conclusions Data support the measurement properties of the MISS as a possible insomnia screening instrument for elderly persons. This study make evident that the MISS is useful for identifying elderly people with insomnia-like sleep problems. Further studies are needed to assess its usefulness in identifying clinically defined insomnia.

Background: As we age, staying physically active and reducing sedentary behavior becomes crucial. To understand how to achieve this, factors related to daily physical function such as five-time sit-to-stand (STS) time should be explored. This study aimed to investigate the associations between STS time, self-rated physical activity, physical function, health-related quality of life, physical and mental health in community-dwelling older adults aged ≥ 60 years. Method: Cross-sectional design with self-reported and objectively measured data from adults aged ≥ 60 years (n = 819), acquired from the Swedish National Study on Aging and Care. Data was analyzed through multiple linear regression. Results: The model (R2 = 0.268) showed that STS time was predicted by grip strength (β' = -0.204, p < 0.05), age (β' = 0.202, p < 0.05), health-related quality of life (β' = -0.192, p < 0.05), having fallen within the preceding twelve months (β' = -0.127, p < 0.05), physical activities of perceived light to moderate intensity (β' = -0.121, p < 0.05), one-leg stand (β' = -0.099, p < 0.05), and education level (β' = -0.092, p < 0.05). For STS time, health-related quality of life (β = -0.354, confidence interval [CI] (-0.509)–(-0.199)), having fallen within the preceding twelve months (β = -0.222, CI (-0.365)–(-0.078)), and physical activities of perceived light to moderate intensity (β = -0.166, CI (-0.278)–(-0.053)) were the most prominent predictors. Conclusion: The model highlights the importance of grip strength and health-related quality of life in predicting STS time in older adults. Clinicians can use these insights to develop interventions that maintain physical function by regularly assessing and monitoring these factors. Future research should explore the relationship between fall history, faster STS time, and the impact of grip strength and health-related quality of life on sedentary behavior among older adults. [ABSTRACT FROM AUTHOR]

Background: Patient involvement in the interdisciplinary bedside round (IBR) increases care quality and safety but is influenced and perceived differently by different round participants. Nursing and medical students are still not structurally embedded in the healthcare system, and they participate in interdisciplinary bedside rounds for educational purposes. Thus, the students may give a valuable perspective on patient involvement from the 'outside view'. Aim: This study aimed to describe nursing and medical students' perceptions of patient involvement in IBRs. Methods: This study has a qualitative design with individual interviews. Eighteen informants were recruited with the help of gatekeepers from two sites in Sweden: a university training health clinic and a county hospital. They participated in one‐to‐one semi‐structured interviews, which were analysed with an inductive qualitative content analysis approach. Ethical Issues and Approval: The study has been approved by the Swedish Ethical Review Authority. Informed consent was received from all participants. Results: The results yielded five categories. Two sub‐themes and one theme of meaning emerged as a 'red thread' across the categories. The theme of meaning was: 'In hospital rounds, the patient is a respected guest, but with a disadvantaged "alien status" due to the hosts' difficult medical language and unclear routines'. Students perceive patients are not fully involved in IBRs, and the healthcare team controls this involvement due to patients' lack of knowledge and vulnerability, the hectic hospital environment, and complicated medical language. Doctors lead IBRs and encourage or discourage patient involvement and nurses act as patient advocates, supporting their involvement. Conclusions: According to nursing and medical students, patients are seldom involved in IBRs due to multiple interaction barriers and despite communicational facilitators. Their involvement depends on healthcare professionals. Further research should investigate other IBRs stakeholders' perspectives on patient involvement in IBRs to facilitate it. [ABSTRACT FROM AUTHOR]

Objective: This study described the experiences and perceptions of how primary health care professionals (PHCPs) support patients with venous leg ulcers (VLUs) in self-care monitoring. Design: A qualitative approach with reflexive thematic analysis was used, with 24 individual qualitative open interviews. Setting: Primary health care clinics and community health care in four southern regions in Sweden. Subjects: Registered nurses, district nurses and nurse assistants who had experience of caring for patients with VLUs. In total, 24 interviews were conducted with PHCPs in Sweden. Results: PHCPs have a vital role in promoting patient independence and responsibility, identifying needs and adapting care strategies, while also recognising unmet needs in patients with VLUs. Conclusion: PHCPs actively monitor patients' self-care and establish caring relationships. They see a need for a structured primary health care work routine for ulcer management. KEY POINTS: PHCPs described encouraging patients by identifying needs, adapting care and promoting self-care monitoring using various skills and strategies. PHCPs described unmet needs and insufficient care practices for patients with VLUs. PHCPs pointed out the importance of establishing caring relationships in order to involve patients in their VLU treatment. [ABSTRACT FROM AUTHOR]

Purpose: The impact of a sedentary lifestyle on health and well-being is well recognized. However, there is limited understanding of how a lifetime of physical activity and sedentary behaviour influences an active lifestyle in older adults. The aim of this study was to describe how lived experience of physical activity and sedentary behaviour impacts daily activities among older adults, from a life course perspective. Methods: Qualitative content analysis was used; individual telephone interviews were conducted with fourteen older adults aged 71 to 92 years. The participants received initial support from community care and lived in ordinary housing in southern Sweden. Results: The interviews yielded one theme, "Navigating with an embodied activity compass," and two sub-themes: "Being guided by the past" and "Unveiling pathways through body awareness." Conclusions: Our study highlights how older adults' lived experiences of physical activity, with their connections to body awareness and acceptance, impact daily physical activity. These findings offer new knowledge for clinical practitioners balancing recommendations of sedentary behaviour and physical activity, to promote healthy daily physical activity among older adults. Future research and policies should consider the lived experiences of older adults when addressing public health matters related to sedentary behaviour and physical activity. [ABSTRACT FROM AUTHOR]

We aimed to use the digital platform maintained by the local health service providers in Southeast Sweden for integrated monitoring of disparities in vaccination and morbidity during the COVID-19 pandemic. The monitoring was performed in the adult population of two counties (n = 657,926) between 1 February 2020 and 15 February 2022. The disparities monitored were relocated (internationally displaced), substance users, and suffering from a psychotic disorder. The outcomes monitored were COVID-19 vaccination, SARS-CoV-2 test results, and hospitalization with COVID-19. Relocated residents displayed an increased likelihood of remaining unvaccinated and a decreased likelihood of testing as well as increased risks of primary SARS-CoV-2 infection and hospitalization compared with the general population. Suffering from a major psychiatric disease was associated with an increased risk of remaining unvaccinated and an increased risk of hospitalization but a decreased risk of SARS-CoV-2 infection. From the digital monitoring, we concluded that the relocated minority received insufficient protection during the pandemic, suggesting the necessity for comprehensive promotion of overall social integration. Persons with major psychiatric diseases underused vaccination, while they benefitted from proactively provided testing, implying a need for active encouragement of vaccination. Further research is warranted on legal and ethical frameworks for digital monitoring in vaccination programs. [ABSTRACT FROM AUTHOR]

BackgroundChronic somatic health conditions are a global public health challenge. Being engaged in one’s own health management for such conditions is important, and mobile health (mHealth) solutions are often suggested as key to promoting engagement. ObjectiveThe aim of this study was to review, critically appraise, and synthesize the available research regarding engagement through mHealth for persons with chronic somatic health conditions. MethodsAn integrative literature review was conducted. The PubMed, CINAHL, and Inspec databases were used for literature searches. Quality assessment was done with the guidance of Critical Appraisal Skills Programme (CASP) checklists. We used a self-designed study protocol comprising 4 engagement aspects—cognitive, behavioral and emotional, interactional, and the usage of mHealth—as part of the synthesis and analysis. ResultsA total of 44 articles met the inclusion criteria and were included in the analysis. mHealth usage was the most commonly occurring engagement aspect, behavioral and emotional aspects the second, cognitive aspects the third, and interactional aspects of engagement the least common aspect in the included articles. The results showed that there is a mix of enablers and barriers to engagement in relation to the 4 engagement aspects. The perceived meaningfulness and need for the solution and its content were important to create and maintain engagement. When perceived as meaningful, suitable, and usable, mHealth can support knowledge gain and learning, facilitate emotional and behavioral aspects such as a sense of confidence, and improve interactions and communications with health care professionals. ConclusionsmHealth solutions have the potential to support health care engagement for persons with chronic somatic conditions. More research is needed to further understand how, by which means, when, and among whom mHealth could further improve engagement for this population.

Purpose: The study aimed to describe primary health care professionals lived experiences of supporting recovery in persons with stress-related disorders. Methods: This study was based on a phenomenological approach known as reflective lifeworld research (RLR). Seventeen health care professionals working in primary health care were included in the study. Lifeworld interviews were conducted to collect data. The data were analysed in accordance with the phenomenological RLR principles of openness, flexibility and bridling. Results: Health care professionals experienced supporting recovery as a complex process with a need for a tailored approach, regardless of profession. In an alliance, the health care professionals encounter the persons where they are based on their own narratives about their life situation. In an interpersonal platform, the health care professionals use a lingering and flexible approach. Support is provided by encouraging existential reflection and learning as well as guiding the person to consider their own needs. This supports the person's quest for a sustainable recovery process in his/her life situation. Conclusions: We conclude that supporting recovery requires a genuinely person-centred care in which elements of existential care are crucial. Primary health care for persons with stress-related disorders could benefit from the development of additional research and models for such an approach. [ABSTRACT FROM AUTHOR]