The Challenge of Coming to Terms with the Use of a New Digital Assistive Device: A Case Study of Two Persons with Mild Dementia

There is an increased interest in supporting persons with dementia with technical services in daily life. The aim of this case study was to explore the complex issues involved in the process from a user driven development to the acceptance and usage of a new digital assistive device for persons with mild dementia. Even though it was developed in a user driven process and personalized to meet their individual needs they rarely used it. To deepening the understanding of this disparity between actual usage and perceived usefulness, the participants were studied whilst performing daily life activities through participant observations and interviews. Their partners were interviewed two years after the first observations to clarify the change in needs over time. The results show that the participant needs encompassed occupation, safety, social interaction, and memory support together with the receipt of general support. The overriding requirement for both participants was a need to maintain their self-image. When the digital assistive device did not correspond with the participants’ expectations or view of themselves, their interest in using it faded, since the digital assistive device failed to support their self-image. The acceptance of a digital assistive device by a person with dementia is a process that begins with identifying and personalizing the functions of the device according to individual needs, and then supporting the usage and the gradual integration of the device into daily life. During this process, the person’s self-image must be taken into consideration and supported

Better long-term survival in young and middle-aged women than in men after a first myocardial infarction between 1985 and 2006. an analysis of 8630 patients in the Northern Sweden MONICA Study

<p>Abstract</p> <p>Background</p> <p>There is conflicting and only scant evidence on the effect of gender on long-term survival after a myocardial infarction (MI). Our aim was to analyse sex-specific survival of patients for up to 23 years after a first MI in northern Sweden and to describe time trends.</p> <p>Methods</p> <p>The Northern Sweden MONICA Myocardial Infarction Registry was linked to The Swedish National Cause of Death Registry for a total of 8630 patients, 25 to 64 years of age, 6762 men and 1868 women, with a first MI during 1985-2006. Also deaths before admission to hospital were included. Follow-up ended on August 30, 2008.</p> <p>Results</p> <p>Median follow-up was 7.1 years, maximum 23 years and the study included 70 072 patient-years. During the follow-up 45.3% of the men and 43.7% of the women had died. Median survival for men was 187 months (95% confidence interval (CI) 179-194) and for women 200 months (95% CI 186-214). The hazard ratio (HR) for all cause mortality after adjustment for age group was 1.092 (1.010-1.18, <it>P </it>= 0.025) for females compared to males, <it>i.e</it>. 9 percent higher survival in women. After excluding subjects who died before reaching hospital HR declined to 1.017 (95%CI 0.93-1.11, <it>P </it>= 0.7). For any duration of follow-up a higher proportion of women were alive, irrespective of age group. The 5-year survivals were 75.3% and 77.5%, in younger (<57 years) men and women and were 65.5% and 66.3% in older (57-64 years) men and women, respectively. For each of four successive cohorts survival improved. Survival time was longer for women than for men in all age groups.</p> <p>Conclusions</p> <p>Age-adjusted survival was higher among women than men after a first MI and has improved markedly and equally in both men and women over a 23-year period. This difference was due to lower risk for women to die before reaching hospital.</p

Bättre vård och roligare jobb med kreativ omsorg

Projekt Musik och rörelse ägde rum mellan 19 mars och 3 december 2008 i Arvidsjaur i samverkan mellan Arvidsjaur kommun och Norrbottens läns landsting. Deltagare var äldre som bodde på på två äldreboenden samt en grupp äldre i eget boende med stöd av hemtjänsten. Syftet var att genom kultur skapa aktivitet för deltagarna samt undersöka kulturens betydelse som verktyg inom äldreomsorgen. Deltagarna uttryckte sin uppskattning, var på gott humör, påfallande nöjda, trygga och belåtna. Nyfikenhet och intresse för fler kulturaktiviteter väcktes, nya bekantskaper gjordes och självförtroendet stärktes. För personalen bidrog musik- och rörelseträffarna att de kom de äldre närmare. De äldre öppnade upp sig och blev kontaktbara på ett sätt personalen tidigare inte hade upplevt. Musik och rörelseaktiviteter blev en väg till kommunikation

The challenge in meeting needs of persons with dementia with assistive technology

Godkänd; 2011; 20120419 (andbra

“It’s all about time and timing”: nursing staffs’ experiences with an agile development process, from its initial requirements to the deployment of its outcome of ICT solutions to support discharge planning

Background: Agile projects are statistically more likely to succeed then waterfall projects. The overall aim of this study was to explore the nursing staffs’ experiences with an agile development process, from its initial requirements to the deployment of its outcome of ICT solutions aimed at supporting discharge planning. Methods: An explorative design with quantitative and qualitative methods was used. Qualitative data was collected through seven focus group interviews. Quantitative data was collected via an ICT-system, and with an evaluation form submitted by fourteen registered nurses and nine district nurses. Results: Qualitative result of the experiences with the agile development process and its outcome resulted in one theme, four categories, and ten subcategories. The theme was found to be about time and timing, namely the amount of time for the different activities and the timing of activities within and between organisations. The agile development process increased the participants’ readiness for change by offering time to learn, practice, engage and reflect, and then adopt the ICT as a support to daily practice. Quantitative results showed a variated adoption of the ICT. Conclusion: There is a need for time to prepare, understand and adopt new tools, services and procedures and a need for additional time to prepare, understand and adopt the new among individuals, collectives, organizations, and sometimes even between different collectives or organizations. The agile development process offered the end-users involvement through the development process, which gave them time to change it both individually and collectively. However, there is a need for close collaboration between the development project team and management to reach an organizational change that is timely for both the individual and the collective change. When time or timing fails in the development or implementation process, there is a huge risk of non-adoption of new tools, services, or procedures or among the end-users

En process för utveckling av hållbar evidensbaserad arbetsterapi

Bakgrund: För att uppnå hög kvalitet inom arbetsterapi måste ny kunskap hela tiden övervägas, reflekteras ochintegreras i det dagliga arbetet. Implementering av ny kunskap kräver ett långsiktigt förbättringsarbete med struktur, stödoch tid för att lyckas. Professionsanpassade modeller och ramverk avser att stödja arbetsterapeutisk intervention ochutveckla professionell kompetens. När modellerna används ger det förutsättningar för hållbart förbättringsarbete ochevidensbaserat arbetssätt men har i mycket begränsad utsträckning studerats ur detta perspektiv.Syfte: att utforska och beskriva hur ett långsiktigt förbättringsarbete vid en arbetsterapienhet baserat på OccupationalTherapy Intervention Process Model (OTIPM) utvecklades.Metod: Studien var en kvalitativ beskrivande studie av skriftliga dokument från långsiktigt förbättringsarbete. Dokumentenbestod av a) enhetsplaner, b) dokumentering från förbättringsarbetet, c) resultat av genomförda patientenkäter, d)resultat av genomförda journalgranskningar, e) ett generellt arbetsterapiprogram och sju specifika arbetsterapiprogram(både aktuella och reviderade versioner), f) aktuell journalföringsmanual, g) 20 patientinformationer, h) 90 rutindokument.Data analyserdes med mönsterjämförelser (pattern matching).Resultat/preliminärt resultat: Analysen av dokumenten bildade tre huvudmönster: a) omorientering mot OTIPM, b)implementeringen av OTIPM, c) säkerställande av hållbarheten av implementeringen. Varje mönster innehöll ett antalfaser som beskrev skälen till varför varje fas påbörjades, vad som påbörjades i varje fas och vad förbättringsarbetetresulterade i, flera av faserna blev startpunkter för nya förbättringar som fortsatte kontinuerligt genom åren.Slutsats: Resultatet visar hur en arbetsterapeutisk praxismodell som till exempel OTIPM, kan vägleda enförbättringsprocess och hålla den pågående under en länge tid och därigenom stödja hållbara kontinuerliga förbättringar ien arbetsterapi verksamhe

Arbetsterapeuters erfarenheter av förbättringsarbete : en resa mot hållbar evidensbaserad praktik

Bakgrund: Arbetsterapeuter har skyldighet att bedriva en evidensbaserad verksamhet baserad på bästa tillgängligavetenskapliga kunskap, professionens expertkunnande, patienternas erfarenheter och tillgängliga resurser. Forskningvisar dock att implementering av evidensbaserade åtgärder kan vara besvärliga att omsätta i praktiken och påbörjadeförbättringsarbeten kan vara svåra att få hållbara över tid. Det har även visat sig att praxismodeller där de används gerförutsättningar för ett evidensbaserat arbetssätt men användandet har studerats i begränsad omfattning.Syfte: var att utforska arbetsterapeuters erfarenheter av att delta i ett långsiktigt förbättringsarbete baserad påOccupational Therapy Intervention Process Model (OTIPM).Metod: Data utgjordes av semistrukturerade intervjuer med 19 arbetsterapeuter i tre fokusgrupper år 2006 ochuppföljande tre fokusgruppsintervjuer år 2011. Materialet analyserades med kvalitativ innehållsanalys.Resultat/preliminärt resultat: Det långsiktiga förbättringsarbetet beskrevs som en resa mot en hållbar ochevidensbaserad praktik. Resultatet visar på en förändringsresa med tre sammanflätade perspektiv; 1) omvandla tankaroch handlingar genom återkommande kollegial reflektion, 2) hantera den upplevda dubbelheten av förändring, 3)utveckla en ömsesidigt professionell kultur.Slutsats: Studien visar hur ett reflekterande kollegialt förhållningssätt och användning av en arbetsterapeutisk praxismodell kan leda till implementering av evidensbaserad kunskap som stödjer kontinuerliga hållbara förbättringar ipraktiken

A Transition Towards Digital Home Visits in Social Care and Home Health Care During the Corona Pandemic

During the pandemic, physical meetings were supposed to decrease as much as possible to avoid the virus to spread. Before the pandemic, the physical meeting favoured social care and home health care in Sweden. One solution was to digitize as many of these meetings as possible. Therefore, we investigated this transition in a web survey, including questions with predetermined and open-ended answers. The web-survey was sent to co-workers in home health care and social care in a middle-seized municipality in Sweden. The results showed that not all meetings could be transformed, like meetings with citizens with hearing or cognitive impairments. Challenges related to the transformation were instability in technical equipment, the professionals’ and citizens’ knowledge of handling technical equipment, and access to technical equipment support. Despite this did the co-workers digitize meetings whenever possible, adding operational and problem-solving attitude to the transformation. Due to this study’s limitation, like respondents from one municipality and the pandemic’s length, we intend to investigate further and understand the development of the transformation and how knowledge in the area increases