The overarching concept of salutogenesis in the context of health care

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Self-care telephone talks as a health-promotion intervention in urban home-living persons 75+ years of age : a randomized controlled study

Aim: The aim of this study was to evaluate the effects of a telephone-based self-care intervention among urban living individuals 75+ years of age by comparing self-reported perceived health, mental health, sense of coherence, self-care ability, and self-care agency before and after the intervention. Materials and methods: In a randomized controlled study, 15 persons answered a questionnaire about perceived health, mental health, sense of coherence, self-care ability, and self-care agency. In a sex- and age-matched control group (n=15), the same questions were answered. Data were collected before and after intervention. An open-ended question about experiences of the intervention was included in the last questionnaire. The intervention consisted of a first meeting with health professionals and additional five self-care telephone calls. The control group did not receive any intervention or attention except for the questionnaires. Descriptive statistics were used to describe the study group. To compare the intervention group and control group on nominal and ordinal levels, the McNemar test and the Wilcoxon signed-rank test, respectively, were chosen. Results: Thirty individuals (14 females and 16 males) participated in the study, ranging in age between 75 and 93 years. A significant difference was obtained in the intervention group regarding mental health. Mental health improved significantly in the intervention group (P=0.037). In the control group, mental health, sense of coherence, self-care ability, and self-care agency showed worse outcome results after the intervention (19 weeks). Conclusion: Self-care telephone talks improved mental health significantly in our sample, and mental health focus could be understood as a possible condition for health promotion to take place. Structured self-care telephone talks have proved to be successful and a relevant method to use in practice

Ability for self-care in urban living older people in southern Norway

Published version of an article in the journal: Journal of Multidisciplinary Healthcare. Also available from the publisher at: http://dx.doi.org/10.2147/JMDH.S29388 Open AccessBackground: The number of older people living in urban environments throughout the world will increase in the coming years. There is a trend in most European countries towards improved health among older people, and increased life expectancy for both women and men. Norway has experienced less increase in life expectancy than some other European countries, and it is therefore important to investigate older urban Norwegian people's health and ways of living in a self-care environment, with special regard to health promotion. Aim: The aim of this study was to describe self-care ability among home-dwelling older (65+ years) individuals living in urban areas in southern Norway in relation to general living conditions, sense of coherence (SOC), screened nutritional state, physical activity, perceived self-reported health, mental health, and perceived life situation. Methods: In 2010, a randomized sample of 1044 men and women aged 65+ years who were living in urban areas in southern Norway answered a postal questionnaire consisting of five instruments, some background variables, and 17 health-related questions. Univariate and multivariate statistical methods were used in the analyses of the data. Results: The mean age of the participants was 74.8 years (SD = 7.1). Eighty-three percent of the participants had higher abilities to care for themselves. Self-care agency, perceived good health, being active, being frequently active, good mental health, not being at risk of undernutrition, and satisfaction with life were all positively related to self-care ability. Negative factors were perceived helplessness, receiving home nursing, being anxious, and being at a more advanced age. People aged 85+ years had worse mental health, were less physically active, and more at risk of undernutrition. Conclusion: Health professionals should focus on the health-promoting factors that reinforce older people's ability to care for themselves, and be aware of important symptoms and signs associated with a reduction in a person's self-care ability. Politicians should assume responsibility for health care with a special regard to senior citizens

Living alone, receiving help, helplessness, and inactivity are strongly related to risk of undernutrition among older home-dwelling people

Published version of an article in the journal: International Journal of General Medicine. Also available from the publisher at: http://dx.doi.org/10.2147/IJGM.S28507 Open Access.Background: Being at risk of undernutrition is a global problem among older people. Undernutrition can be considered inadequate nutritional status, characterized by insufficient food intake and weight loss. There is a lack of Norwegian studies focusing on being at risk of undernutrition and self-care ability, sense of coherence, and health-related issues among older home-dwelling people. Aim: To describe the prevalence of being at risk of undernutrition among a group of older home-dwelling individuals in Norway, and to relate the results to reported self-care ability, sense of coherence, perceived health and other health-related issues. Methods: A cross-sectional design was applied. A questionnaire with instruments for nutritional screening, self-care ability, and sense of coherence, and health-related questions was sent to a randomized sample of 450 persons (aged 65+ years) in southern Norway. The study group included 158 (35.1%) participants. Data were analysed using statistical methods. Results: The results showed that 19% of the participants were at medium risk of undernutrition and 1.3% at high risk. Due to the low response rate it can be expected that the nonparticipants can be at risk of undernutrition. The nutritional at-risk group had lower self-care ability and weaker sense of coherence. Living alone, receiving help regularly to manage daily life, not being active and perceived helplessness emerged as predictors for being at risk of undernutrition. The results indicate difficulties in identifying people at nutritional risk and supporting self-care activities to maintain a good nutritional status. Conclusion: Health care professionals have to be able to identify older home-dwelling people at risk of undernutrition, support self-care activities to enable people at risk to maintain a sufficient nutritional status, and be aware that older people living alone, who receive help, feel helpless, and are inactive are especially vulnerable

Testing two self-care-related instruments among older home-dwelling people in Norway

Artikkelen rapporterer en studie hvor hensikten var å teste reliabilitet og validitet av de norske versjonene av de to egenomsorgsrelaterte instrumentene "Self‐care Ability Scale for the Elderly" (SASE) og "Nutritional Form For the Elderly" (NUFFE) blant eldre hjemmeboende personer.Older persons’ ability and agency for self‐care is an important issue. Therefore, the development of reliable and valid instruments to measure self‐care with regard to both clinical nursing practice and personal health is important for nursing research and practice. To test reliability and validity of the Norwegian versions of the two self‐care‐related instruments, the Self‐care Ability Scale for the Elderly (SASE) and the Nutritional Form For the Elderly (NUFFE) among older home‐dwelling individuals. A postal questionnaire that contained these instruments, background variables, health‐related questions and two other self‐care‐related instruments was completed by a randomised sample of 158 older persons in southern Norway. Reliability was assessed as internal consistency and validity as concurrent and construct validity. SASE reached a Cronbach’s alpha coefficient of 0.85 and significant Spearman’s rank correlations for 16 of 17 items. For NUFFE, a Cronbach’s alpha coefficient of 0.64 was obtained and significant correlations for 13 of 15 items. Validity was supported for both instruments. An appropriate cut‐off was found for SASE. For NUFFE, a low cut‐off point was obtained. SASE was shown to have sufficient psychometric properties and can be used in research and clinical practice among older persons. The psychometric properties of NUFFE can be assessed as sufficient, but further studies are needed regarding the cut‐off point

Lived experiences of self-care among older physically active urban-living individuals

Published version of an article in the journal: Clinical Interventions in Aging. Also available from the publisher at: http://dx.doi.org/10.2147/cia.s39689 Open accessBackground: Promoting physical activity is a public health priority in most industrial countries, and physical function is an important factor when taking into consideration older people's self-care and health. Despite the increasing challenges associated with urbanization and the aging population, urban life appears to be positive in many ways for urban dwellers. However, the manner in which older people live in urban settings and how this influences their ability to take care of themselves should be considered important knowledge for health professionals and politicians to acquire. The aim of this study was to describe the lived experiences of self-care and features that may influence health and self-care among older urban home-dwelling individuals who are physically active. Methods: Ten subjects, three women and seven men, who were aged 65-82 years and identified to be physically active, were interviewed. The interviews were recorded, transcribed verbatim, and analyzed according to the descriptive phenomenological method devised by Giorgi. Results: Our findings showed beneficial self-care. The participants lived active everyday lives and were frequently physically active. They were part of a supportive, inclusive, and promoting fellowship, and they had the opportunity to travel. They utilized their competence and experienced making themselves useful. It was a privilege to be part of a family life as a husband, wife, parent, and/or a grandparent. They acknowledged physical and mental limitations, yet they felt they were in good health. Conclusion: Health professionals and politicians should identify places where fellowship and relationships can be built, as well as encourage older people to use their competence by engagement in volunteering. These interventions are important to support older people's self-care and health. This may also be a way to reduce ageism in Western societies

Despite symptom severity, do nursing home residents experience joy-of-life? The associations between joy-of-life and symptom severity in Norwegian nursing home residents

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Non-proliferation in areas of limited statehood: the contribution of international regimes to controlling mass destruction capacities in war and crisis zones

Controlling nuclear, biological or chemical weapons is often particularly difficult where the proliferation risks are high: in areas of limited statehood. This raises the question of how to adapt international regimes so that they are better able to contribute to the disarmament and non-proliferation of weapons of mass destruction (WMD) under the challenging conditions of war and crisis. Experiences over the past few years in states such as Iraq, Libya and Syria - where central governments do not completely control the respective state's territory - have been mixed. They do show, however, that multilateral non-proliferation regimes play an indispensable role in controlling WMD, including in crisis areas. First, it is important to gain and focus the political support of the state in question, the relevant great powers and international organisations. Second, the practical conditions for a mission to secure and disarm WMD and investigate alleged use of such weapons have to be established. To obtain these goals, existing rules should be made flexible and adapted. Regimes should be reformed in line with the motto, "As few rules as necessary, as much preparation as possible". Four aspects need to be kept in mind: prevention should be reinforced, crisis planning needs to be improved, stakeholders have to be included, and the role of the Security Council should be upgraded. Medium-size powers such as Germany have the capacities and political weight to promote the evolution of global regulatory instruments. This would also counteract proliferation in Europe's neighbourhood. (Autorenreferat

Kultur og helse i HUNT – En metodeevaluering

Flere studier har indikert at det er sammenheng mellom kulturdeltagelse og helse, men mange av studiene har vesentlige svakheter. Befolkningsstudier med et stort antall deltagere har flere fordeler, bl.a. er det mulig å kontrollere for konfunderende faktorer. Men i slike undersøkelser må antall spørsmål ofte begrenses, og det kan derfor stilles spørsmål ved hvor presis og relevant informasjonen blir. Ved HUNT3 (2006-08) ble to spørsmål om kulturdeltagelse inkludert: «Hvor mange ganger har du i løpet av de siste 6 måneder vært på/i: Museum, kunstutstilling/konsert, teater, kino/kirke, bedehus/idrettsarrangement", og «Hvor mange ganger har du løpet av de siste 6 måneder selv drevet med: Foreningsvirksomhet/musikk, sang, teater/menighetsarbeid/friluftsliv/dans/trening, idrett». Målet med denne studien var å undersøke hvordan spørsmålene ble oppfattet og tolket. Var informasjonen relevant til bruk i en epidemiologisk studie som HUNT? Det ble gjennomført tre fokusgruppeintervjuer med til sammen 17 deltakere i alderen 20 til 80 år. Flertallet hadde høyere utdanning. Tema som gikk igjen ble gruppert i kategorier, som bestod av beskrivelser over informantenes synspunkter og meninger. Hovedinntrykket fra fokusgruppeintervjuene var at informantene mente at spørsmålene i HUNT3 ga et grovt estimat på kulturaktivitetene i befolkningen. Vår konklusjon er at spørsmålene var tilstrekkelig presise til å bruke i analyser på gruppenivå