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7. Sweden

Author

Jelic, Vesna, primary, Sandman, Per-Olof, additional, and Wahlund, Lars-Olof, additional

Published
2019
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21. Effects of a person-centred and health-promoting intervention in home care services- a non-randomized controlled trial

Author

Lämås, Kristina, Bölenius, Karin, Sandman, Per-Olof, Lindkvist, Marie, and Edvardsson, David

Subjects
Home care service, Omvårdnad, Research, RC952-954.6, Person-centred care, Intervention, Nursing, Home Care Services, Nursing Homes, Geriatrics, Patient-Centered Care, Surveys and Questionnaires, Older adults, Quality of Life, Humans, Geriatrics and Gerontology, Aged
Abstract

Background Home care recipients have reported little self-determination and opportunity to influence their own care. Person-centred care focusing on involvement has improved the quality of life of older adults in health care and nursing homes; however, knowledge about the effects of person-centred interventions in aged care at home is sparse. The aim of this study was to study the effects of a person-centred and health-promoting intervention, compared with usual care, on health-related quality of life, thriving and self-determination among older adults, and on job satisfaction, stress of conscience and level of person-centred care among care staff. Methods This is a non-randomized controlled trial with a before/after design. Participants from five home care districts in one municipality in northern Sweden were recruited to an intervention or control group. We evaluated health-related quality of life, thriving and self-determination among older home care recipients, and job satisfaction, person-centred care and stress of conscience among care staff. Evaluation was performed by questionnaires and responses were analysed using parametric and non-parametric statistical analyses. Results Eighty-one older adults and 48 staff were included in the study. A clinically moderate and statistically significant difference between the intervention and control groups was found in thriving and negative emotions among older adults. The intervention contributed to maintaining high thriving levels, in contrast to decreased thriving in the control group (intervention: + 1, control: − 4, p 0.026, CI: − 10. 766, − 0.717). However, the intervention group rated an increase in negative emotions, while the control group was unchanged (intervention: − 7 control: + − 0, p 0.048, CI: − 17.435, − 0.098). No significant effects were found among staff. Conclusions The intervention contributed to maintaining high levels of thriving in contrast to low levels found in the control group, and it seems reasonable to consider the intervention focus on staff as more person-centred and health-promoting. The finding that the intervention group had increase in negative emotions is difficult to interpret, and warrants further exploration. Even though the results are sparse, the challenges discussed may be of importance for future studies in the context of HCS. Trial registration NCT02846246. Date of registration: 27 July 2016.

Published
2020

23. Enacting person‐centred care in home care services for people with dementia.

Author

Hedman, Ragnhild, Sandman, Per‐Olof, and Edvardsson, David

Subjects
*NURSING, *MATHEMATICAL models, *HOME care services, *GROUNDED theory, *MEDICAL care, *PATIENT-centered care, *INTERVIEWING, *COMMUNITY health services, *DEMENTIA patients, *QUALITATIVE research, *THEORY, *NURSING research, *RESEARCH funding, *GROUP process
Abstract

Aims and objectives: To develop the theoretical understanding of the process of providing person‐centred home care for people with dementia. Background: People with dementia are increasingly cared for at home by family members and home care staff. Care of people with dementia should be person‐centred; however, little is known about how home care staff understand and enact person‐centred care in their daily work. Design: Grounded theory. Methods: Home care staff (n = 29) were recruited from home care services specialised in providing care for people with dementia. Group interviews were conducted, and a tentative theoretical model for providing person‐centred home care to people with dementia was outlined. Nine of the participants were then individually interviewed to further develop the model. The analysis was conducted parallel to the data collection, and hypotheses concerning the evolving theoretical model were continuously tested in the following interviews. The COREQ checklist for qualitative studies was used in reporting the study. Results: Person‐centred home care of people with dementia was conceptualised as a series of processes: Getting ready, getting in, giving care, getting out and finalising the story, each with subprocesses. Theatre metaphors were used to describe how the care was provided. A core process, Enacting and re‐enacting familiarity, was at centre in all processes. Conclusions: In the person‐centred care of people with dementia, familiarity had to be established and continuously fostered. When familiarity was in place, the care recipient and the home care staff acted as a team to perform the care. The theoretical works of Goffman were used to interpret the results. Relevance to clinical practice: The study provides a model for person‐centred care of people with dementia at home that deepens the understanding of its processes, prerequisites and outcomes. The model can inform education and administration of home care for people with dementia. [ABSTRACT FROM AUTHOR]

Published
2022
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49. The experience of being at home throughout the life span. Investigation of persons aged from 2 to 102

Author

Zingmark, Karin, Norberg, Astrid, and Sandman, Per-Olof

Subjects
Home -- Psychological aspects, Family life surveys -- Analysis, Health, Seniors
Abstract

One hundred and fifty persons aged two to 102 narrated their experiences related to the phenomenon 'being at home.' Several common interdependent and interrelated aspects of the experience of being at home were identified throughout the life span. These aspects are believed to entail cognitive, emotional, and conative dimensions of the experience: safety, rootedness, harmony, joy, privacy, togetherness, recognition, order, control, possession, nourishment, initiative, power, freedom. The sense of being related was found to be a common condition of the experience of being at home, i.e., related to significant others, significant things, significant places, significant activities, oneself, and transcendence. In the process of maintaining the experience of being at home throughout life the phenomena 'being given a home,' 'creating a home,' 'sharing a home,' and 'offering a home' were integral parts. A progression in the experience of being at home throughout the life span was identified.

Published
1995

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