Mat á líkamsvirkni aldraðra

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenSýnt hefur verið fram á hvernig skortur á hreyfingu eða líkamsvirkni getur haft áhrif á framgang ýmiskonar sjúkdóma og ýtt undir færniskerðingar á efri árum. Jafnframt er mikið rætt um hreyfingu sem meðferðarform og forvörn gegn ýmsum kvillum ellinnar. Ef hvatning til hreyfingar á að hitta í mark hjá öldruðum einstaklingum hlýtur hinsvegar að vera forgangsmál að afla upplýsinga um hversu líkamlega virkir eldri Íslendingar eru og hvernig hreyfingu þeir stunda. Mat á líkamsvirkni aldraðra er dæmi um staðlaðan spurningalista sem nýta má í slíkum tilgangi. Markmiðið með honum er að komast að því hversu mikið einstaklingar hreyfa sig í frístundum, við heimilisstörf og við vinnu. Niðurstaðan er heildarstig frá núll til 400 þar sem einstaklingar sem hreyfa sig meira fá fleiri stig. Listinn er auðveldur og fljótlegur í fyrirlögn og innihaldið fellur ágætlega að íslenskri menningu. Slíkar upplýsingar um hreyfingu geta t.d. nýst við uppbyggingu á einstaklings- og samfélagsmiðaðri þjónustu í formi forvarna og meðferðarúrræða

Quality improvement and measuring quality of care in home nursing using interRAI-HC quality indicators: intervention study

Efst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinnÖldruðum fer fjölgandi og hefur þörfin fyrir þjónustu í heimahúsi aukist í takt við það. Krafan um að heilbrigðisstofnanir veiti góða þjónustu og fé sé vel varið eykst stöðugt. Með tilkomu matstækisins interRAI-Home Care (interRAI-HC) og tilheyrandi gæðavísa opnast möguleikar á að meta gæði heilbrigðisþjónustu í heimahúsum. Tilgangur þessarar rannsóknar var að athuga hvort hægt væri að hafa áhrif á gæði þjónustu heimahjúkrunar með fræðslu til starfsfólks og notkun á gæðavísum interRAI-HC. Rannsóknin var megindleg íhlutunarrannsókn sem fylgdi fyrir-eftirrannsóknarsniði án samanburðarhóps. Gögnin voru byggð á upplýsingum úr mati sem framkvæmt var í interRAI-HC frá 31 skjólstæðingi heimahjúkrunar á Selfossi. Starfsfólk tók þátt í ákvörðunum varðandi val á þremur interRAI-HC gæðavísum sem stefnt var á að bæta með íhlutun í formi fræðslu. Að auki var fylgst með stöðu tíu gæðavísa sem íhlutunin beindist ekki sérstaklega að. Þátttakendur í rannsókninni voru á aldrinum 60 til 94 ára (meðalaldur 79,2 ár), hlutfall kvenna var 64,5% og bjuggu 51,6% skjólstæðinga einir. Starfsmenn ákváðu að beina íhlutun að gæðavísum um byltur, félagslega einangrun og ófullnægjandi verkjastillingu þeirra. Á rannsóknartímanum lækkaði hlutfall þeirra sem hlutu byltu úr 22,6% í fyrra mati í 0% í seinna mati (p = 0,012). Hinir tveir gæðavísarnir, sem íhlutun beindist sérstaklega að, lækkuðu hlutfallslega þó að munurinn væri ekki marktækur. Sjö af þeim tíu gæðavísum, sem íhlutun beindist ekki að, sýndu breytingar í átt til hins betra. Niðurstöður benda til að með fræðslu til starfsfólks sé hægt að bæta þjónustu við skjólstæðinga heimahjúkrunar. Starfsfólk var áhugasamt og vildi taka þátt og hafa áhrif á sína vinnu til hins betra. Niðurstöður benda einnig til að notkun interRAI-HC-matstækisins og gæðavísa þess sé gagnleg í umbótavinnu og geti nýst fleiri heilsugæslustöðvum.The need for home care is increasing as the elderly population is growing. Furthermore the demand for quality and efficiency in health care services is increasing. The interRAI-Home Care (interRAI-HC) instrument and the additional quality indicators open possibilities to evaluate quality in home care service. The aim of the study was to investigate if it was possible to influence the quality of home care service by improving staff knowledge and the use of interRAI-HC instrument. The study was a quantitative intervention study with before-after research design without a comparison group. The data were from the interRAI-HC assessments from 31 home nursing clients in the Selfoss area. The staff participated in selecting three interRAI-HC quality indicators needing an intervention in the form of lectures. Ten additional quality indicators were studied before and after the intervention. The mean age of the participants was 79.2 years (min. 60; max. 94), females were 64.5% and 51.6% lived alone. The quality indicators the staff selected for intervention were falls, social isolation and inadequate pain control. Over the research period the percentage of clients that had a fall decreased from 22.6% to 0% (p = 0.012). The other two quality indicators selected also decreased but not significantly. Seven of the 10 quality indicators not selected for improvement work also decreased, however not significantly. The findings indicate that by increasing staff knowledge, services to home care clients can be improved. The staff were very enthusiastic and wanted to participate and improve their work. Moreover, the findings indicate that the use of the interRAI-HC instrument and the quality indicators is valuable in quality improvement work and may be useful for other home care agencies

Experience of health and health promotion among older community living people

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenBackground. Nurses and other health professionals need to know which factors can affect older people’s health as that can make analysis of their needs easier. Goal-directed work aimed at improving the health of older people requires an appreciation of their own perception of health and factors influencing health. Objective. The main objective of this study was to answer the research question: “How do older, community living people experience health and health maintaining and health promoting factors in old age?” Method. The methodology chosen for the study was the Vancouver-school of doing phenomenology and the results were constructed from 16 interviews with ten participants, five women and five men. Their age ranged from 69 to 87 years. The participants were community living and lived in urban as well as rural areas. Results. The findings describe the participants’ perception of health and their experience of factors that positively and negatively influenced their health and health promotion. The participants took responsibility for their own health and it was important to them to find purpose and joy in life. They emphasized maintaining their proficiency, both mentally and physically. It was important for them to be active in society and find fitting company. Finally, it was important for them to have a role, to contribute in a positive way and to keep their sense of dignity intact. Conclusions. Older community living people experience both positive and negative factors which influence their health. They should be given the opportunity to be responsible for their health. An instrument can be developed based on the data for use in health promoting visits to the elderly, when preparing discharge from hospitals and when older people visit primary health care. Thus individual strengths and challenges could be identified. If older clients would evaluate themselves using the instrument, a basis for dialogue is created and thus increased insight into their context realisedForsendur. Til að hægt sé að vinna að markvissri heilbrigðisþjónustu fyrir aldraða er mikilvægt að skilja reynslu þeirra af heilbrigði og jákvæðum og neikvæðum áhrifaþáttum heilbrigðis. Þá er mikilvægt fyrir hjúkrunarfræðinga og annað heilbrigðisstarfsfólk að þekkja hvernig aldraðir í heimahúsum viðhalda heilsu sinni og efla hana. Tilgangur. Að leita svara við rannsóknarspurningunni: „Hver er reynsla aldraðra, sem búsettir eru á eigin heimili, af heilbrigði og af því hvað viðheldur og eflir heilsu á efri árum?“ Aðferð. Vancouver-skólinn í fyrirbærafræði var notaður til að taka og vinna úr 16 viðtölum við tíu einstaklinga á aldrinum 69 til 87 ára, fimm konur og fimm karla. Þátttakendur voru búsettir á eigin heimili ýmist í þéttbýli eða dreifbýli. Niðurstöður. Þátttakendur lýstu reynslu sinni af heilbrigði og af þáttum sem hafa jákvæð eða neikvæð áhrif á heilsu þeirra og heilsueflingu. Fram kom hvernig þeir tóku ábyrgð á eigin heilsu og hvernig meðvitund um mikilvægi heilbrigðis jókst með aldrinum. Þeim var mikilvægt að finna tilgang og gleði í lífinu, viðhalda andlegri og líkamlegri færni sinni ásamt því að vera virkir í samfélaginu og halda reisn sinni. Ályktanir og notagildi. Aldraðir einstaklingar upplifa jákvæða og neikvæða þætti sem hafa áhrif á heilsuna og gæta þarf þess að gefa þeim tækifæri til að taka ábyrgð á eigin heilsu. Hægt er að þróa matskvarða sem byggist á þeim áhrifaþáttum heilbrigðis sem fram komu í rannsókninni. Kvarðinn getur nýst hjúkrunarfræðingum í heilsueflandi heimsóknum, við undirbúning útskriftar af sjúkrahúsi og í heilsugæslu. Þannig væri hægt að átta sig á styrk einstaklinganna og erfiðleikum sem þeir standa frammi fyrir. Ef einstaklingarnir merkja sjálfir inn á kvarðann getur skapast umræðugrundvöllur sem byði upp á bætta innsýn í aðstæður þeirra

Health Promotind Visits to 80 Years Old Individuals

Efst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinnStjórnvöld horfa í vaxandi mæli til heilsueflandi heimsókna til að ýta undir heilbrigða öldrun og viðhalda sjálfstæði aldraðra á eigin heimili. Lítið hefur þó borið á rannsóknum á þessari þjónustu. Markmið verkefnisins var að rannsaka einkenni og afdrif tveggja hópa aldraðra einstaklinga sem ýmist þáðu eða afþökkuðu heilsueflandi heimsókn. Aðferðin var megindleg samanburðarferil-rannsókn á fyrirliggjandi gögnum í Sögukerfinu. Gögnin byggðust á upplýsingum um 148 áttræða einstaklinga sem fengu boð um eina heilsueflandi heimsókn frá heilsugæslustöðinni á Selfossi á árunum 2005-2010. Alls þáðu 100 (68%) heilsueflandi heimsókn (51 karl og 49 konur) en 48 (32%) afþökkuðu (17 karlar og 31 kona). Marktæk tengsl voru á milli þess að hafa þegið heilsueflandi heimsókn og að vera á lífi einu (p = 0,014) og tveimur (p = 0,006) árum eftir heimsóknina. Marktækur munur reyndist á svefnlyfjanotkun þeirra sem þáðu eða afþökkuðu heimsókn (p = 0,011). Þeir sem þáðu heimsókn notuðu frekar svefnlyf (44%) en þeir sem afþökkuðu (21%). Meðal þeirra sem þáðu heilsueflandi heimsókn kom í ljós að rúmlega helmingur hópsins stundaði enga reglulega hreyfingu og 71% var yfir kjör- þyngd. Gagnagöt (missing data) í gagnagrunni takmörkuðu möguleika á úrvinnslu. Til að hægt sé að meta árangur heilsueflandi heimsókna er brýnt að bæta skráningu og efla notkun staðlaðra matskvarða. Æskilegt er að samræma heilsueflandi heimsóknir á landsvísu þannig að safna megi gögnum og nýta til að meta langtímaárangur fyrir stærri hópa eldra fólksHealth authorities are increasingly looking into health promoting visits as a way to foster healthy aging and enable older adults to maintain independence in their own homes. Research, however, is limited in this area. The objective of this study was to examine the characteristics and the survival rates of two groups of older individuals who either accepted or refused a health promoting visit. A quantitative, comparative cohort design was used to analyze available data in the health registry Saga. The data were based on information about 148 individuals, 80 years of age, who were invited by the primary health care center in Selfoss to receive one health promoting visit during the years 2005-2010. A total of 100 (68%) accepted the health visit (51 men and 49 women) and 48 (32%) rejected it (17 men and 31 women). There was a significant association between having received a visit and being alive one (p = 0,014) or two (p = 0,006) years after the visit. At the start of the study period there was a significant difference of sleeping pill usage between the groups (p = 0,011). Those who accepted visits were more likely to use sleeping pills (44%) than those who rejected the visits (21%). Among the factors that characterized the group that accepted the health promoting visit were that more than half of the group did not report regular physical activity and 71% were overweight or obese. Missing data in the health registry limited data analyses. Improved documentation and use of standardized assessment methods are essential to monitor the effects of health promoting visits. Coordinating health visits for the whole nation would open up possibilities to collect longitudinal data on the visits in a larger group of older adult

Basic mobility, accidental falls, and lifetime physical activity among rural and urban community-dwelling older adults : a population-based study in Northern Iceland

Funding Information: The research was funded with grants from the Icelandic Regional Development Institute (grant no. 102022), the University of Akureyri Research Fund (grant no. R-1803), the Akureyri Hospital Research Fund (without a grant number), and the Icelandic Nurses´ Association Research Fund (without a grant number). These financial sponsors played no role in the design, execution, interpretation of data, or writing of the study. The authors thank the study participants and the research assistants who visited all participants and collected data. Publisher Copyright: © 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.The objective of this research was to investigate late-life physical functioning and lifetime history of physical activity (PA) among older adults in rural and urban Arctic communities. Data was collected in a cross-sectional, population-based study among 65 to 92-year-old community-dwelling Icelanders (N = 175, 41% ≥75-year-old, 43% women, 40% rural). Late-life physical functioning was operationalised as: basic mobility (Timed Up and Go in seconds, TUG); fall risk (TUG≥12 sec); a fall (≥1 fall/year); and recurrent falls (≥2 falls/year). PA history was based on a self-assessment. Compared to urban participants, rural participants were more likely to have fallen recently, be at fall risk, and describe more PA history. Among urban participants, no fall in the past year was independently associated with more PA in middle adulthood; and worse basic mobility and late-life fall risk were independently associated with being in the ≥75-year-old group. Among rural participants, recurrent falls were independently associated with being a man; and better basic mobility was independently associated with more PA in late adulthood. To conclude, this evidence supports an important association between better late-life physical functioning and more mid- and late-life PA and encourages further research to understand high fall risk among older men in Arctic rural areas.Peer reviewe

Making Europe health literate : Including older adults in sparsely populated Arctic areas

Funding Information: This work was supported by the University of Akureyri, Iceland, under Grant R1803 and R2018, The Icelandic Regional Development Institute, under Grant 102022 and the Icelandic Council on Ageing, under Grant R2019. Publisher Copyright: © 2022, The Author(s).Background Older people have been identified as having lower health literacy (HL) than the general population average. Living in sparsely populated Arctic regions involves unique health challenges that may influence HL. The research aim was to explore the level of HL, its problematic dimensions, and its association with the selection of contextual factors among older adults living in sparsely populated areas in Northern Iceland. Method This was a cross-sectional study based on a stratified random sample from the national register of one urban town and two rural areas. The study included 175 participants (57.9% participation rate) who were community-dwelling (40% rural) and aged 65–92 years (M 74.2 ± SD 6.3), 43% of whom were women. Data were collected in 2017-2018 via face-to-face interviews, which included the standardised European Health Literacy Survey Questionnaire-short version (HLS-EU-Q16) with a score range from 0 to 16 (low-high HL). Results The level of HL ranged from 6–16 (M 13.25, SD ± 2.41) with 65% having sufficient HL (score 13–16), 31.3% problematic HL (score 9–12) and 3.7% inadequate HL (score 0–8). Most problematic dimension of HL was within the domains of disease prevention and health promotion related to information in the media. Univariate linear regression revealed that better HL was associated with more education (p=0.001), more resiliency (p=0.001), driving a car (p=0.006), good access to health care- (p=0.005) and medical service (p=0.027), younger age (p=0.005), adequate income (p=0.044) and less depression (p=0.006). Multivariable analysis showed that more education (p=0.014) and driving a car (p=0.017) were independent predictors of better HL. Conclusion Difficulties in HL concern information in the media. HL was strongly associated with education and driving a car however, not with urban-rural residency. Mobility and access should be considered for improving HL of older people.Background: Older people have been identified as having lower health literacy (HL) than the general population average. Living in sparsely populated Arctic regions involves unique health challenges that may influence HL. The research aim was to explore the level of HL, its problematic dimensions, and its association with the selection of contextual factors among older adults living in sparsely populated areas in Northern Iceland. Method: This was a cross-sectional study based on a stratified random sample from the national register of one urban town and two rural areas. The study included 175 participants (57.9% participation rate) who were community-dwelling (40% rural) and aged 65–92 years (M 74.2 ± SD 6.3), 43% of whom were women. Data were collected in 2017-2018 via face-to-face interviews, which included the standardised European Health Literacy Survey Questionnaire-short version (HLS-EU-Q16) with a score range from 0 to 16 (low-high HL). Results: The level of HL ranged from 6–16 (M 13.25, SD ± 2.41) with 65% having sufficient HL (score 13–16), 31.3% problematic HL (score 9–12) and 3.7% inadequate HL (score 0–8). Most problematic dimension of HL was within the domains of disease prevention and health promotion related to information in the media. Univariate linear regression revealed that better HL was associated with more education (p=0.001), more resiliency (p=0.001), driving a car (p=0.006), good access to health care- (p=0.005) and medical service (p=0.027), younger age (p=0.005), adequate income (p=0.044) and less depression (p=0.006). Multivariable analysis showed that more education (p=0.014) and driving a car (p=0.017) were independent predictors of better HL. Conclusion: Difficulties in HL concern information in the media. HL was strongly associated with education and driving a car however, not with urban-rural residency. Mobility and access should be considered for improving HL of older people.Peer reviewe

Erosion and soft drinks

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenObjective: Acidic soft drinks are well-known causes of dental erosion. This study aimed to determine differences in the in-vitro erosive effect of a selection of drinks on the Icelandic market. Materials and methods: 20 different brands of soft drinks were investigated. 13 freshly extracted human teeth were sawn in 2 pieces. The erosive effect of drinks was determined as the percentage weight loss of tooth pieces after immersion in the drinks. Drink samples were renewed daily, and the weight of the teeth was recorded. Results: Drinks containing citric acid had an average of 12.5% greater erosive effect than drinks containing phosphoric acid. Sugared soft drinks and energy drinks had a considerably higher erosive potential than water-based drinks. Flavored water containing citric acid showed similar erosive potential to cola drinks that contain phosphoric acid. Flavored and non-flavored water not containing acidic additives showed similar erosive effect to the control drinks water and milk. Overall, energy and sports drinks showed the most erosive effect, with sugary citric acid drinks close behind. Discussion: Advice to patients on consumption of soft drinks should recognize their erosive effects especially regarding flavored waters. Citric acid in drinks appears to be more erosive than phosphoric acid, particularly where sugar is also an ingredient, perhaps balancing sweetness and acidity.Þekkt er að gosdrykkir geta valdið glerungseyðingu. Með rannsókninni var ætlað að mæla glerungseyðandi mátt mismunandi gosdrykkja á tilraunastofu. Efniviður / Aðferð: 13 nýúrdregnar tennur voru sagaðar í tvennt og lagðar í 20 mismunandi gosdrykkjaböð og glerungseyðingarmáttur var metin út frá prósentu-þyngdartapi tannhlutanna. Daglega voru drykkirnir endurnýjaðir og tennurnar vigtaðar. Niðurstöður: Drykkir sem innihalda sítrónusýru hafa meiri glerungseyðandi mátt en þeir sem innihalda fosfórsýru. Sykraðir gosdrykkir og orkudrykkir eru meira glerungseyðandi en vatnsdrykkir. Bragðbætt vatn með sítrónusýru er jafn glerungseyðandi og þeir drykkir sem innihalda fosfórsýru. Bæði sýrulaust bragðbætt og óbragðbætt vatn var ekki glerungseyðandi líkt og samanburðardrykkirnir vatn og mjólk. Orku og íþróttadrykkir voru mest glerungseyðandi en sykur- og sítrónusýrudrykkir lágu mjög nálægt. Ályktun: Í leiðbeiningum ætti að leggja áherslu á mismunandi glerungseyðingamátt vatns/íþrótta- og orkudrykkja. Drykkir sem innihalda sítrónusýru eru meira glerungseyðandi en drykkir með fosfórsýru

ICF – loksins á íslensku kná þó hún sé smá

Efst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkin

Mat á líkamsvirkni aldraðra

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenSýnt hefur verið fram á hvernig skortur á hreyfingu eða líkamsvirkni getur haft áhrif á framgang ýmiskonar sjúkdóma og ýtt undir færniskerðingar á efri árum. Jafnframt er mikið rætt um hreyfingu sem meðferðarform og forvörn gegn ýmsum kvillum ellinnar. Ef hvatning til hreyfingar á að hitta í mark hjá öldruðum einstaklingum hlýtur hinsvegar að vera forgangsmál að afla upplýsinga um hversu líkamlega virkir eldri Íslendingar eru og hvernig hreyfingu þeir stunda. Mat á líkamsvirkni aldraðra er dæmi um staðlaðan spurningalista sem nýta má í slíkum tilgangi. Markmiðið með honum er að komast að því hversu mikið einstaklingar hreyfa sig í frístundum, við heimilisstörf og við vinnu. Niðurstaðan er heildarstig frá núll til 400 þar sem einstaklingar sem hreyfa sig meira fá fleiri stig. Listinn er auðveldur og fljótlegur í fyrirlögn og innihaldið fellur ágætlega að íslenskri menningu. Slíkar upplýsingar um hreyfingu geta t.d. nýst við uppbyggingu á einstaklings- og samfélagsmiðaðri þjónustu í formi forvarna og meðferðarúrræða

Gagnreynd sjúkraþjálfun - Kraftur og þróun í þitt starf - Samantekt úr erindi á Degi sjúkraþjálfunar 2. mars 2012

Efst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkin