Comparison of community health nurses' preventive home visits to older adults in Sweden and Slovenia: A literature review

Introduction: Community health nurses contribute significantly to better health, well-being and independence of older adults. The aim of the study is to compare preventive services for older adults in community health care between Sweden and Slovenia.Methods: Literature review and document analysis were used to conduct a qualitative comparative analysis. Literature was retrieved from the MEDLINE, CINAHL and COBIB databases. An analysis of documents such as sectoral legal bases, guidelines and expert recommendations in Slovenia and Sweden was also conducted. The analysis included sources related to preventive services for older adults living at home published between January 2000 and December 2020 in Slovene, English or Swedish.Results: Twenty units of literature were included in the review. Four comparative factors were identified: system and legal basis, organisation and scope, providers, and content. In Slovenia, all older adults are entitled to the same range of preventive services. Compared to Sweden, the organisation of community health care in Slovenia is more centralised, all older adults are entitled to the same scope of preventive health visits, while the level of education and scope of competences of healthcare providers are lower. In both countries, the content of preventive home visits to older adults is similar.Discussion and conclusion: In Slovenia, community health nurses with additional knowledge could prescribe medical devices and medications form a limited list, as well as coordinate care. This would allow them to act more independently in patients' home environment. Further development of more personalised preventive services for older adults depends on research, resource provision and consideration of the organisational culture.
Uvod: Preventivne obravnave v patronažnem varstvu pomembno prispevajo k samostojnosti, boljšemu zdravju in dobremu počutju starejših odraslih. Namen raziskave je primerjati preventivne obravnave starejših odraslih v patronažnem varstvu med Švedsko in Slovenijo. Metode: Na osnovi pregleda literature in analize dokumentov je bila narejena kvalitativna primerjalna analiza. Vključena je bila literatura iz podatkovnih bazah MEDLINE, CINAHL in COBIB. Narejena je bila tudi analiza dokumentov, kot so področne pravne podlage, smernice ter strokovna priporočila v Sloveniji in na Švedskem. Vključeni so bili viri objavljeni med januarjem 2000 in decembrom 2020, so se nanašali na preventivne obravnave starejših odraslih, ki živijo doma in so bili napisani v slovenščini, angleščini ali švedščini.Rezultati: V analizo smo vključili 20 enot literature. Opredeljeni so bili štirje faktorji primerjave: sistem in pravne podlage, organiziranost in obseg, izvajalci ter vsebina. V Sloveniji so vsi starejši odrasli upravičeni do enakega obsega preventivnih obravnav. V primerjavi s Švedsko je v Sloveniji bolj centralizirana organizacija patronažnega varstva, vsi starejši odrasli imajo enak obseg preventivnih obiskov, izobrazba in obseg kompetenc izvajalcev pa je v Sloveniji nižja. Vsebina preventivnih patronažnih obiskov starejših odraslih je v obeh državah podobna.Diskusija in zaključek: V Sloveniji bi lahko medicinske sestre v patronažnem varstvu z dodatnimi znanji pridobile tudi kompetence na področju predpisovanja z omejene liste zdravil in medicinskih pripomočkov ter koordinacije oskrbe. Tako bi lahko bolj samostojno delovale v domačem okolju pacientov. Za nadaljnji razvoj bolj personaliziranih preventivnih obravnav za starejše odrasle je pomembno raziskovanje, zagotavljanje virov in skrb za organizacijsko kulturo.u