Institutt for helse- og omsorgsfag

Ny veileder om pårørende i helse- og omsorgstjenesten

2017-01-01T00:00:00Z

Klausen, Rita Kristin
Senter for omsorgsforskning, nord har deltatt i ressursgruppen til utarbeidelsen av en ny veileder for pårørende i helse- og omsorgstjenesten. Denne veilederen er nå publisert.
Source at https://uit.no/om/enhet/aktuelt/nyhet?p_document_id=514237&p_dimension_id=88122

Group treatment targeting core stability and balance for persons with Multiple Sclerosis. An observational study

2014-05-07T00:00:00Z

Dybesland, Andreas Rosenberger
The purpose of the thesis was to gain insight into group physiotherapy practice for Persons with Multiple Sclerosis targeting core stability and balance exercises. Research regarding the interaction between the physiotherapist and patients, and how the physiotherapist solves challenges related to individualized treatment in the group, and changes in movement quality over time, is limited. The study is anchored in a phenomenological and hermeneutical philosophy of science, and based on three non-participatory observations during a 5-week group intervention in private physiotherapy practice. Content analysis using integrated perspectives from phenomenology, natural- and social sciences was performed. The analysis resulted in two main-themes; “Common structure and individual adaptations” and “Changes, motivation and progression”. The main-themes are supplemented by two sub-themes, “Core activation: Variations on a Theme” and “Individual hands-on: a two edged sword?” for the first, then “Taking part in ups and downs” and “Building movement as a layer of bricks”. The results indicate that individualized interaction between the physiotherapist and group participants are important for achieving core activation and movement quality in tasks given within a common structure. Targeted hands seem important for improving movement performance during training, understanding and learning related to activities of daily living. However, it is vital to reflect on the use of targeted hands related to self-initiated active movement, as the group setting lays some restrictions to individualization. The participants’ relations, awakening of changes in movement quality and success in tasks can promote motivation. The physiotherapists’ knowledge in movement analysis seems vital for achieving this. Gait analysis shows that tasks at the body functions and structure level improve movement quality in gait over time, thus indicating a learning effect. The findings underpin the importance of individual adaptations in group therapy, and that changes in core activation and postural control affect motivation, group dynamics and qualitative aspects of gait.

Koordinatorordning med kontinuitet som mål. Diskusjon av ordningen koordinator i spesialisthelsetjenesten i lys av forskning omkring continuity of care

2015-01-01T00:00:00Z

Høyem, Audhild
Pasienter og brukere med langvarige behov for ulike helse- og omsorgstjenester rapporterer ofte om manglende sammenheng i tjenestene, usikkerhet omkring hva som skal skje videre og hvem som tar ansvaret for hva. En stadig økende spesialisering har ført til at spesialisthelsetjenestene er blitt mer oppdelt, og at ansvarsområdet for den enkelte enhet snevres inn. Liggetiden i sykehusene har blitt stadig kortere, og Samhandlingsreformen legger opp til at kommunene skal ta oppgaver som tidligere ble ivaretatt av spesialisthelsetjenesten. Samtidig har pasienter fått styrket sine rettigheter – tjenestene skal være helhetlige og koordinerte.
Chapter in: Ergoterapi - mangfold og muligheter. red. Arntzen C, Gramstad A, Jentoft R. Stamsund: Orkana Akademisk; 2015, ISBN 978-82-8104-256-8
With permission from the publisher.

Mobility as a predictor of all-cause mortality in older men and women: 11.8 year follow-up in the Tromso study

2017-01-10T00:00:00Z

Bergland, Astrid; Jørgensen, Lone; Emaus, Nina; Strand, Bjørn Heine
Background: Disability in older adults is associated with loss of independence, institutionalization, and death. The aim of this study was to study the association between the Timed Up and Go (TUG) test and all-cause mortality in a population-based sample of older men and women.

Methods: Our study population was home dwellers aged 65 and above, who participated in the fifth wave of the Tromsø study. This study included the TUG test and a range of lifestyle and mortality predictors. Participants were linked to the Cause of Death Registry and followed up for mortality for a maximum of 11.8 years. Cox regression was used to investigate the association between TUG and total mortality.

Results: Mean TUG score was 12.6 s, and men performed better than women. The oldest participants had poorer TUG score compared to younger participants, increasing 0.25 s per year. There was a significant association between TUG and all-cause mortality, and the association was equally strong in men and women. Across the TUG-score categories, from quickest fifth to slowest fifth, the mortality increased in a step-wise fashion. Compared to the quickest fifth, the slowest fifth had hazard ratio (HR) of 1.79 (95% confidence interval (CI) 1.33, 2.42) in a model adjusted for age and gender. For each standard deviation TUG-score the increase in HR was 1.23 (95% CI 1.14, 1.33). The association between the TUG score and mortality remained significant after adjusting for self-reported health, body mass index, smoking and education.

Conclusions: A significant association between the TUG score and mortality was observed in both men and women. Identifying older people with poor TUG may aid in identifying those at risk and thus targeted interventions may be applied.
Published version. Source at http://dx.doi.org/10.1186/s12913-016-1950-0

Living with disabled children in Malawi: Challenges and rewards

2016-08-24T00:00:00Z

Barlindhaug, Grete; Umar, Eric; Wazakili, Margaret; Emaus, Nina
Background:
Rehabilitation personnel need to be sensitive to the cultural aspects that constitute the environment of a disabled child’s family life.
Objectives:
The aim of this study was to gain insight on how families experience parenting of disabled children and how the families experience the support provided by the rehabilitation system in Malawi.
Method:
An anthropological field study combining interviews and observations was conducted in a rural district of Malawi in 2011. Permission was granted to follow four families, and this study presents the stories of two families, whose children have severe disabilities. We used phenomenological and narrative analyses to make sense of the stories.
Results:
The findings indicate that families with disabled children invest time and emphasise care for their disabled children. They feel enriched by their experience despite challenging situations with little support from the rehabilitation services. High standards of care demonstrating positive and moral attitudes have earned these families respect in their communities. Storytelling has created an opportunity for the families to understand and interpret their challenging situation with inherent contextual meaning.
Conclusion:
This study shows that families with disabled children draw on cultural and structural strengths that rehabilitation professionals should be aware of in their support to mothers and other caregivers of children with disabilities.
Source: doi: 10.4102/ajod.v5i1.254

Shared decision making from the service users’ perspective. A narrative study from community mental health centers in Northern Norway.

2016-08-15T00:00:00Z

Klausen, Rita Kristin; Blix, Bodil Hansen; Karlsson, Marie; Haugsgjerd, Svein; Lorem, Geir F
This article aims to contribute to the understanding of shared decision making as an important aspect of user involvement in mental health care from the perspectives of service users. A thematic analysis of interviews with 25 individual service users in three different community mental health centers in Norway identified different understandings of shared decision making. Shared decision making was identified as essential in four contexts: 1) during admission, 2) in individualized treatment, 3) in different treatment contexts, and 4) in user-professional relationships. We consider shared decision making to be intertwined with treatment from the service user perspective.
Post-print. Full text source available at: http://dx.doi.org/10.1080/15332985.2016.1222981

Lederen som innovatør og balansekunstner : en kvalitativ studie av lederes erfaringer fra forskningssamarbeid mellom helse- og velferdstjenestene og høyere utdanning

2016-01-01T00:00:00Z

Alstveit, Marit; Halvorsen, Anne; Willumsen, Elisabeth; Ødegård, Atle
Managers in health and welfare services have overall responsibility to develop the services according to official regulations and the needs of society. They are expected to provide high quality, research based services. Higher education is expected to transform education and research that improve the services, and to develop research collaborating with the practical field. This study investigates experiences of managers in health and welfare services taking part in research collaboration with higher education. Data were collected through focus group interviews with altogether 14 participants involved in 21 projects, and analysed by using qualitative content analyses. The experiences of the managers can be summarised as “Being an innovator and equilibrist in order to develop the service”. Managers appear to play an important role in bridging between health and welfare services and higher education. In order to enhance research partnerships between health and welfare services and higher education formal collaborative structures should be established.
Source: doi: 10.7557/14.4051

Changes in the body image of bone sarcoma survivors following surgical treatment - A qualitative study

2015-12-29T00:00:00Z

Fauske, Lena; Lorem, Geir F; Grov, Ellen Karine; Bondevik, Hilde
Background and Objectives: Among several long-term effects, people treated for cancer may experience an altered appearance. Our study aims to identify how visible body changes following surgical treatment affect the life and identity of primary bone sarcoma survivors 3–10 years after diagnosis. A qualitative, phenomenological, and hermeneutic design was applied. Methods: Sarcoma survivors (n ¼ 18) who were previously treated at Norwegian Radium Hospital, Oslo University Hospital, participated in the study. In-depth and semi-structured interviews were conducted and analyzed using inductive thematic analysis. Results: The main ﬁnding of this study concerned how altered appearance after bone cancer treatment in the hip/pelvis or lower extremities affected the participants’ self-esteem. Half of the participants expressed concerns about their visible differences, particularly those with functional impairment. They felt that it is important to hide the bodily signs of changes to appear as normal as possible, as well as attractive and healthy. They describe, with speciﬁc examples, how these changes inﬂuence their self-realization, especially their social life. Conclusions: Healthcare providers who guide bone sarcoma survivors during follow-up should develop a comprehensive understanding of what it means to cope with a changed and challenging body.
Source: DOI 10.1002/jso.24138

Reconnecting with oneself while struggling between life and death: The phenomenon of recovery as experienced by persons at risk of suicide

2016-07-15T00:00:00Z

Sellin, Linda; Asp, Margareta; Wallsten, Tuula; Wiklund Gustin, Lena
The body of knowledge regarding health and recovery as experienced by patients at risk of suicide is limited.More research is needed into the meaning of recovery and what strengthens the desire to live. The aim of this study was to describe the phenomenon of recovery in a context of nursing care as experienced by persons at risk of suicide. In line with a reflective lifeworld research approach, 14 patients from a psychiatric clinic in Sweden participated in phenomenon-oriented interviews. Data were analyzed to describe the essence of the phenomenon. The results reveal that the phenomenon of recovery means ‘reconnecting with oneself while struggling between life and death’. Three meaning constituents emerged: being in an expressive space and giving voice to oneself, regaining dignity through nurturing connectedness, and finding a balance in the tension between life and death. In conclusion, the meaning of recovery is to experience the ability to manage one’s own life. Professional caregivers need to acknowledge patients’ lifeworlds, in a way that enable patients to experience themselves as capable of managing their own lives. Professional caregivers should also facilitate the involvement of supportive relatives.
Manuscript. Published version available in International Journal of Mental Health Nursing, 26: 200–207. doi:10.1111/inm.12249

The association of grip strength from midlife onwards with all-cause and cause-specific mortality over 17 years of follow-up in the Tromsø Study

2016-08-25T00:00:00Z

Strand, Bjørn Heine; Cooper, Rachel; Bergland, Astrid; Jørgensen, Lone; Schirmer, Henrik; Skirbekk, Vegard; Emaus, Nina
Background Grip strength has consistently been found to predict all-cause mortality rates. However, few studies have examined cause-speci fi c mortality or tested age differences in these associations. Methods In 1994, grip strength was measured in the population-based Tromsø Study, covering the ages 50 – 80 years (N=6850). Grip strength was categorised into fi fths, and as z-scores. In this cohort study, models with all-cause mortality and deaths from speci fi c causes as the outcome were performed, strati fi ed by sex and age using Cox regression, adjusting for lifestyle-related and health-related factors. Results During 17 years of follow-up, 2338 participants died. A 1 SD reduction in grip strength was associated with HR=1.17 (95% CI 1.12 to 1.22) for all- cause mortality in a model adjusted for age, gender and body size. This association was similar across all age groups, in men and women, and robust to adjustment for a range of lifestyle-related and health-related factors. Results for deaths due to cardiovascular disease (CVD), respiratory diseases and external causes resembled those for all-cause mortality, while for cancer, the association was much weaker and not signi fi cant after adjustment for lifestyle-related and health-related factors. Conclusions Weaker grip strength was associated with increased all-cause mortality rates, with similar effects on deaths due to CVD, respiratory disease and external causes, while a much weaker association was observed for cancer-related deaths. These associations were similar in both genders and across age groups, which supports the hypothesis that grip strength might be a biomarker of ageing over the lifespan.
Source:http://jech.bmj.com/content/70/12/1214