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This overview of four evidence maps is based on systematic reviews of assessment and interventions in social work practice. The aim was to investigate the evidence and evidence gaps within four important areas for social work research and practice. Descriptive data on search strategies and domains were collected from four evidence maps, on Social Assistance, Substance Dependence, Care for older adults respectively for persons with disabilities. The scientific quality and scientific evidence were assessed. Key findings were summarised by analyzing and discussing common and specific elements in the evidence maps. The overview was undertaken in close collaboration between researchers with expertise in the field and a government agency. The overview identified both evidence and evidence gaps with respect to effects and experiences of interventions and assessment methods in four evidence maps. Evidence maps provide a comprehensive picture of the state of social services research and can thereby be of use to both researchers and practitioners, and in the production of evidence based social work., Denna artikel är en sammanställning av resultat från fyra kartläggningar av systematiska översikter om utredningar respektive insatser i socialt arbete. Syftet var att undersöka det vetenskapliga kunskapsläget, kunskap och kunskapsluckor, inom fyra viktiga områden av praktik och forskning i socialt arbete. Deskriptiva data om sökstrategier i litteraturdatabaser samt definierade domäner hämtades från fyra kartläggningar om socialbidrag, missbruk och beroende, omsorg om äldre personer samt personer med funktionsnedsättning. Översikternas vetenskapliga kvalitet och kunskapsläget bedömdes. Nyckelresultaten sammanfattades genom analys och diskussion av generella och specifika element i kartläggningarna. Sammanställningen har gjorts i nära samarbete mellan forskare från olika ämnesområden och SBU, en svensk kunskapsmyndighet. Såväl kunskap som vetenskapliga kunskapsluckor om effekter och erfarenheter av utredningar och insatser i de fyra områdena identifierades i sammanställningen. En kartläggning ger en omfattande bild av kunskapsläget för socialt arbete och kan därför vara användbart både för forskare och praktiker på vägen mot ett evidensbaserat socialt arbete.

Background: The use of digital technology might contribute to social engagement and mental health in an ageing population. Objective: To systematically map and describe the scientific knowledge and knowledge gaps on the effects of different types of digital tools for outcomes related to social engagement in older adults at risk for mental health decline. Methods: Thirteen groups of outcomes (domains) were defined, related to social engagement, by the use of digital tools. Thereafter, a systematic literature search was conducted in April 2017 to identify systematic reviews in line with the objective, an additional search for systematic reviews published since April 2017 was done in September 2019. In addition, reference lists as well as protocols from the Cochrane Collaboration and Campbell were searched. The final sample includes nine systematic reviews, published between 2012 and 2019, with both qualitative and quantitative results. Results: This evidence map shows that education in and use of digital tools, including computers and the internet, might decrease loneliness. Research is still limited, but the existing research points towards positive effects from the use of digital tools on outcomes related to social engagement, such as loneliness, social isolation, social interaction and/or social support, participation, depression, physical health/activities, as well as security, self-esteem or empowerment. Scientific knowledge gaps are present for the domains of quality of life, activities in daily living (ADL), cognition, autonomy, and usability. Conclusion: The evidence map shows inconclusive evidence about the effects on outcomes related to social engagement from the use of digital tools for older adults at risk of mental health decline or mental illness. More research is needed, and future research should include studies with a strong design, larger populations, and various subgroups of older adults in different contexts to further evaluate the effects of the d

Background: Fetal alcohol spectrum disorders (FASD) is an umbrella term covering several conditions for which alcohol consumption during pregnancy is taken to play a causal role. The benefit of individuals being identified with a condition within FASD remains controversial. The objective of the present study was to identify ethical aspects and consequences of diagnostics, interventions, and family support in relation to FASD. Methods: Ethical aspects relating to diagnostics, interventions, and family support regarding FASD were compiled and discussed, drawing on a series of discussions with experts in the field, published literature, and medical ethicists. Results: Several advantages and disadvantages in regards of obtaining a diagnosis or description of the condition were identified. For instance, it provides an explanation and potential preparedness for not yet encountered difficulties, which may play an essential role in acquiring much needed help and support from health care, school, and the socia ! services. There are no interventions specifically evaluated for FASD conditions, but training programs and family support for conditions with symptoms overlapping with FASD, e.g. ADHD, autism, and intellectual disability, are likely to be relevant. Stigmatization, blame, and guilt are potential downsides. There might also be unfortunate prioritization if individuals with equal needs are treated differently depending on whether or not they meet the criteria for a specific condition. Conclusions: The value for the concerned individuals of obtaining a FASD-related description of their condition - for instance, in terms of wellbeing - is not established. Nor is it established that allocating resources based, on whether individuals fulfil FASD-related criteria is justified, compared to allocations directed to the most prominent specific needs.

Falls among elderly are a major public health issue in Sweden. The aim was to determine whether nursing assistants can prevent falls by supervising community-living elderly individuals with a history of falling in performing individually designed home exercise programmes. A randomised controlled trial was performed in Sweden, in eight municipalities in the county of Örebro, during 2007-2009. Community-living persons 65 years or older having experienced at least one fall during the last 12 months were included. The intervention group consisted of 76 participants, and there were 72 in the control group. The interventions were free of charge and were shared between a physiotherapist and a nursing assistant. The former designed a programme aiming to improve balance, leg strength and walking ability. The nursing assistant supervised the performance of activities during eight home visits during a 5-month intervention period. The measures and instruments used were health-related quality of life (SF-36), activity of daily living (ADL-staircase), balance, (Falls Efficacy Scale, and Berg Balance Scale), walking ability (Timed Up and Go and the 3-metre walking test), leg strength, (chair stand test). All participants were asked to keep a structured calendar of their physical exercise, walks and occurrence of falls during their 12-month study period. Hospital healthcare consumption data were collected. Although the 5-month intervention did not significantly decrease the risk for days with falls, RR 1.10 (95% CI 0.58, 2.07), p = 0.77, significant changes in favour of the intervention group were noted for balance (p = 0.03), ADL (p = 0.035), bodily pain (p = 0.003) and reported health transition over time (p = 0.008) as well as less hospital care due to fractures (p = 0.025). Additional studies with more participants are needed to establish whether or not falls can be significantly prevented with this model which is workable in home-based fall prevention., Funding Agency:Region Örebro Län

Syfte Syftet med SBU:s rapport är att kartlägga vetenskaplig kunskap samt vetenskapliga kunskapsluckor. Detta baseras på systematiska översikter som undersökt effekter, upplevelser eller erfarenheter av digitala verktyg som social stimulans för att minska eller förebygga psykisk ohälsa bland äldre personer. Vad tillför denna kartläggning? För äldre personer med eller vid risk för psykisk ohälsa finns det översikter som visar att utbildning i och användning av dator och internet kan minska ensamhet men evidensläget är svagt. Kunskapsluckor finns för domänerna livskvalitet, ADL-förmåga (Aktiviteter i det Dagliga Livet), kognition, självständighet samt användbarhet av tekniken. Bakgrund Välfärdsteknik inrymmer digitala verktyg som syftar till att bibehålla eller öka trygghet, aktivitet, delaktighet eller självständighet för en person som har eller löper förhöjd risk att få en funktionsnedsättning. Välfärdsteknik kan fungera som ett hjälpmedel för den enskilde och utgörs av medicintekniska produkter alternativt konsumentprodukter vilka kan köpas i öppna handeln. Välfärdsteknik antas kunna bidra till ett aktivt och hälsosamt åldrande, även för åldrandeprocesser som sker genom hela livet och ter sig olika för varje individ. Metod En systematisk kartläggning innebär att frågeställningen och domäner identifieras. Dessa ligger sedan till grund för en systematisk litteratursökning. Efter litteratursökningen identifieras, relevans- och kvalitetsbedöms systematiska översikter och slutligen sammanställs resultaten i de inkluderade systematiska översikterna. Kartläggningen inkluderar ingen kvalitetsbedömning av de studier som ingår i de systematiska översikterna. Denna kartläggning utgår från sju översikter av medelhög kvalitet från åren 2012 till 2017 och presenterar data från både kvantitativ och kvalitativ forskningsdesign. I kartläggningen görs ingen evidensgradering. Mer detaljerad information kring metod samt avgränsningar finns i rapporten. Huvudresultat I kartläggningen i

PURPOSE: To explore home care staff experiences in relation to assistive devices and the use of assistive device at work. METHOD: Individual conversational interviews with 14 home care staff were used. Qualitative content analysis was used to analyse the data. RESULTS: A broad meaning attached to the use of assistive devices at work emerged in three themes. In 'staff's role at work in relation to assistive devices', their different roles emerged in relation to knowledge and instruction as well as safeguarding the user. 'Assistive devices as a product and their significance for staff' showed that devices were an integrated part of staff work in the users' home. Devices influenced staff cooperation, feelings and were significant in relation to time and finance. Regarding 'assistive devices and their significance for the user from the staff's perspective', the staff felt that devices were a prerequisite for the user coping with everyday life and they also had an emotional significance. CONCLUSION: Assistive devices play a significant and important role for home care staff. An increased understanding among prescribers and other health care staff about home care staff knowledge about, work with and experience from assistive devices could contribute to a better care and rehabilitation for home care recipients.

Because dementia is a progressive disease, the need for care in municipal shelter accommodations might change over time, raising the crucial question whether to relocate an individual. The aim of the study was to investigate the number of relocations between municipal dementia housing units and to examine the patterns and reasons for relocation, together with the various municipal prerequisites for carrying out relocation. Thirty-three managers of 101 dementia care units in 12 municipalities in Sweden were interviewed, and records of persons who had moved into or out of the dementia care units during the year 2002 were reviewed retrospectively. The results showed that turnover occurred in 35% of the 865 rooms during the year. Of those relocations, 78 (9%) were persons who moved to another accommodation-either into (59), between (13), or out of (6) a dementia care unit. This finding indicates that there are situations in which remaining in place was considered less appropriate than relocating a single individual with dementia to other accommodations with or without dementia specialization. The most common reason for relocation within the municipal shelters was an increased need for care.

The aims of the dissertation were 1. to describe the work content of subordinate caring staff in the care of the elderly; 2. to describe and analyse available knowledge of the work situation, particularly in elderly care; 3. to discuss health and well-being of subordinate caring staff; 4. to compare and discuss different care settings for the aged as organisations; 5. to relate the work situation to different care settings; 6. to identify overloading and promoting work situations. The study is based on concepts stemming from two research traditions, theories of working life and organisation. Data are both qualitative and quantitative: transcribed interviews, a literarysurvey and a postal questionnaire. The work was overall perceived as being independent and rewarding, however mentally and physically straining. The relationship with the recipient, the micro-organisation, was the most significant value of work, however more pronounced among municipal staff. The micro-organisation was superior to the overall organisation. Working in nursing homes was perceived as being the most straining compared to work in home help services, municipal institutions and home nursing, which was favourable. Staff in nursing homes and home nursing were theoretically better educated than the staff in other settings whose attitude towards theoretical studies were ambivalent. Thus, ambivalent attitudes, dilemmas and discrepancies were found. These are a natural consequences of staff interaction with the recipient, which admits experiences both of satisfaction and hopelessness, but also caused by the loose link between the organisation as a whole, the micro-organisation and the studied staff respectively. The concepts of demand and control is theoretically interesting and should be related do different occupational groups, to the dominating content and to the most important aspect of work.

A study of home care and home health services was undertaken in three Swedish municipalities. Persons who received extended home care and home health care were interviewed. The interviews covered different themes such as impairments, care needs, functions and activities in the horizontal social network (the informal network), and opinions concerning how care is and should be provided. A modified ADL-index was used to assess the functional level of daily living. Care needs were measured by the judgement of the care recipient, and by the interviewer's judgement. The correspondence between these measures was high, with some exceptions. Lower correspondence between the measures was obtained for three categories of care recipients: individuals with communicative dysfunctions, younger individuals with reduced ability to move and, thirdly, individuals with psychosocial problems. Problems concerning measurement of care given by family members were also identified and discussed., Article in swedish.