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Gustafsson, Lena-Karin, DocentORCID iD iconorcid.org/0000-0001-5670-6908
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Publications (10 of 62) Show all publications
Kirvalidze, M., Bostrom, A.-M., Liljas, A., Doheny, M., Hendry, A., Mccormack, B., . . . Calderon-Larranaga, A. (2024). Effectiveness of integrated person-centered interventions for older people's care: Review of Swedish experiences and experts' perspective. Journal of Internal Medicine
Open this publication in new window or tab >>Effectiveness of integrated person-centered interventions for older people's care: Review of Swedish experiences and experts' perspective
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2024 (English)In: Journal of Internal Medicine, ISSN 0954-6820, E-ISSN 1365-2796Article in journal (Refereed) Published
Abstract [en]

Older adults have multiple medical and social care needs, requiring a shift toward an integrated person-centered model of care. Our objective was to describe and summarize Swedish experiences of integrated person-centered care by reviewing studies published between 2000 and 2023, and to identify the main challenges and scientific gaps through expert discussions. Seventy-three publications were identified by searching MEDLINE and contacting experts. Interventions were categorized using two World Health Organization frameworks: (1) Integrated Care for Older People (ICOPE), and (2) Integrated People-Centered Health Services (IPCHS). The included 73 publications were derived from 31 unique and heterogeneous interventions pertaining mainly to the micro- and meso-levels. Among publications measuring mortality, 15% were effective. Subjective health outcomes showed improvement in 24% of publications, morbidity outcomes in 42%, disability outcomes in 48%, and service utilization outcomes in 58%. Workshop discussions in Stockholm (Sweden), March 2023, were recorded, transcribed, and summarized. Experts emphasized: (1) lack of rigorous evaluation methods, (2) need for participatory designs, (3) scarcity of macro-level interventions, and (4) importance of transitioning from person- to people-centered integrated care. These challenges could explain the unexpected weak beneficial effects of the interventions on health outcomes, whereas service utilization outcomes were more positively impacted. Finally, we derived a list of recommendations, including the need to engage care organizations in interventions from their inception and to leverage researchers' scientific expertise. Although this review provides a comprehensive snapshot of interventions in the context of Sweden, the findings offer transferable perspectives on the real-world challenges encountered in this field. image

Place, publisher, year, edition, pages
WILEY, 2024
Keywords
person-centered care, integrated care, older people, Sweden
National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-66552 (URN)10.1111/joim.13784 (DOI)001208107500001 ()38664991 (PubMedID)2-s2.0-85191252820 (Scopus ID)
Available from: 2024-05-08 Created: 2024-05-08 Last updated: 2024-05-08Bibliographically approved
Gusdal, A. K., Söderman, M., Pettersson, T., Kaup, J. & Gustafsson, L.-K. (2024). Healthcare and social care professionals’ experiences of respite care: a critical incident study. International Journal of Qualitative Studies on Health and Well-being, 19(1)
Open this publication in new window or tab >>Healthcare and social care professionals’ experiences of respite care: a critical incident study
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2024 (English)In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 19, no 1Article in journal (Refereed) Published
Abstract [en]

IntroductionAging in place is favoured among older persons and supported by research in Sweden, although it poses challenges for overburdened informal caregivers. While respite care can offer support, its accessibility is hindered by organizational challenges and informal caregivers' delays in using it. The experiences of informal caregivers are well-studied, but the professionals' experiences of respite care quality and critical incident management are underexplored.AimTo explore professionals' experiences of critical incidents in respite care, consequences for the persons being cared for, and strategies to manage critical incidents.Materials and methodsA qualitative, critical incident technique was used, and three group interviews with a total of 16 professionals were conducted.ResultsBarriers to quality respite care included communication gaps during care transitions, environmental shortcomings in respite care facilities, lack of support for informal caregivers, and inadequacies in respite care decisions. Strategies to manage critical incidents included individualized care, continuity and communication in care transitions, a conducive environment, support for informal caregivers, and care professionals' positive approach.ConclusionsThe study emphasizes the need for focused efforts on communication, continuity, and a supportive environment. Addressing identified challenges and applying suggested strategies will be key to maximizing the potential of respite care as a vital support for care recipients and their informal caregivers.

National Category
Nursing
Identifiers
urn:nbn:se:mdh:diva-66607 (URN)10.1080/17482631.2024.2352888 (DOI)001220124200001 ()38735060 (PubMedID)2-s2.0-85192908253 (Scopus ID)
Projects
Växelvårds-projektet
Available from: 2024-05-15 Created: 2024-05-15 Last updated: 2024-06-19Bibliographically approved
Pongthippat, W., Östlund, G., Darvishpour, M., Kijsomporn, J. & Gustafsson, L.-K. (2024). Illuminating health aspects for immigrant Thai women in Swedish transnational marriages. BMC Women's Health, 24(1), Article ID 337.
Open this publication in new window or tab >>Illuminating health aspects for immigrant Thai women in Swedish transnational marriages
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2024 (English)In: BMC Women's Health, E-ISSN 1472-6874, Vol. 24, no 1, article id 337Article in journal (Refereed) Published
Abstract [en]

Background: Women who are migrants experience discrimination and face major risks, including sexual exploitation, trafficking, and violence, which affect their health and well-being. This study explored critical health incidents experienced by immigrant Thai women in marriage migration. Methods: A qualitative explorative approach with in-depth interviews was used. Forty immigrant Thai women who currently or previously had a Swedish spouse were recruited for the study. An inductive critical incident technique was used to collect and analyze the data as the first step. In a second deductive step, the Newman system model was used to categorize health dilemmas. Results: The women reported 438 critical health incidents in five main areas. Psychological health dilemmas included emotional abuse, feeling overwhelmed due to family responsibilities and the stress of leaving family behind. Sociocultural health dilemmas included transnational family duties or not performing family duties. Physiological health dilemmas included experiencing physical violence and environmental, domestic or work accidents. Developmental health dilemmas included failing health, difficulties upholding the duties expected of a spouse in the target culture and caring for an elderly husband. Spiritual health dilemmas included critical incidents in which the women perceived themselves to have failed in their hopes and duties as a wife, which intensified their dependence on faith, particularly the Buddhist concept of karma. Conclusion: Professionals in health and welfare practices in Thailand together with professionals in Western countries who work with women in marriage migration situations need to recognize the psychological, sociocultural, physiological, developmental, and spiritual health dilemmas experienced by these women. Furthermore, civil organizations that meet Thai women in foreign countries, such as Buddhist cultural associations, would benefit from the multicultural knowledge revealed by the present study. This knowledge can facilitate healthcare and welfare support for women in marriage migration situations. 

Place, publisher, year, edition, pages
BioMed Central Ltd, 2024
Keywords
Critical incident technique, International marriages, Well-being, Women’s health, Adult, Emigrants and Immigrants, Female, Health Status, Humans, Marriage, Middle Aged, Qualitative Research, Southeast Asian People, Spouses, Stress, Psychological, Sweden, Thailand, aged, anxiety, Article, educational status, emotional abuse, family duties, health, health care personnel, human, immigrant, interview, knowledge, life expectancy, lifestyle and related phenomena, partner violence, pension, qualitative analysis, responsibility, semi structured interview, social support, sociodemographics, transnational marriages, ethnology, mental stress, migrant, psychology, Southeast Asian, spouse
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:mdh:diva-67902 (URN)10.1186/s12905-024-03071-6 (DOI)001244829300001 ()38867221 (PubMedID)2-s2.0-85195996868 (Scopus ID)
Available from: 2024-06-26 Created: 2024-06-26 Last updated: 2024-07-03Bibliographically approved
Gustafsson, L.-K., Anbäcken, E.-M., Östlund, G., Bondesson, A., Pettersson, T. & Zander, V. (2024). Implementation of a New Integrated Healthcare Model; Quality Aspects to Support the Complex Home Care of Older Adults with Multiple Needs. Journal of Multidisciplinary Healthcare, 17, 2879-2890
Open this publication in new window or tab >>Implementation of a New Integrated Healthcare Model; Quality Aspects to Support the Complex Home Care of Older Adults with Multiple Needs
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2024 (English)In: Journal of Multidisciplinary Healthcare, E-ISSN 1178-2390, Vol. 17, p. 2879-2890Article in journal (Refereed) Published
Abstract [en]

Aim: This study aims to describe experiences of the implementation of a new integrated healthcare model for older adults with complex care needs due to multimorbidity, living at home, from a health and welfare personnel perspective. The goal was to diminish hospitalization and still carry out high quality care at home for older adults living with multimorbidity. The model was implemented by two organizations working in cooperation, the municipality, and the region that handles interprofessional social care and healthcare in people's homes. Materials and Method: Open-ended group interviews with personnel were carried out, three of the group interviews preimplementations of the model, and three of the group interviews post -implementation. The interviews were audiotaped and analysed according to the procedure of thematic analysis. Results: The quality of the integrated care model was based on care -chain cooperation, shared professionalism, and creating relations with the patient including closeness to next of kin, which was underlined by the participants. Unencumbered time gave the professionals the possibility to develop quality in integrated healthcare as part of integrated and person -centred care. The coproduction of education, research interviews and the follow-up meeting identified successes in diminishing hospitalization rates according to the participants' experiences of the post -implementation interviews. An identified failure was, however, that shared professionalism was not developed over time, rather the different responsibilities were accentuated according to the information retrieved at the follow-up meeting. Conclusion: Quality aspects of the model were identified in the present study. However, when implementation of a new model is completed, the organizations always have their own interpretation of how to further understand the model in question. Plain language summary: The intention of the present study was to follow the process of working with a new model of providing care at home, thus preventing increased numbers of hospital readmissions, based on the professionals<acute accent> point of view of what quality care is for older adults with complex care needs due to multimorbidity, living in their own home. The professionals were interviewed in group settings on several occasions during the implementation. The result showed hopeful expectations expressed by the professionals before the new model was implemented, such as a hope for getting more time for high -quality care for the older adults with multimorbidity. During the teamwork, the conversation within the team members was praised as a key factor that included shared professionalism from professionals with different levels of education and focus on their work. According to the staff, unnecessary hospital stays were reduced, while the interprofessional care -chain cooperation was improved through the work of the integrated care team. For many team members, the positive difference in both work and care satisfaction was highlighted in comparison to regular home care as they were able to use their multi -disciplinary skills and support.

Place, publisher, year, edition, pages
DOVE MEDICAL PRESS LTD, 2024
Keywords
integrated-care model, multi-morbidity, interprofessional care, home-based care, person-centred integrated care
National Category
Nursing
Identifiers
urn:nbn:se:mdh:diva-67891 (URN)10.2147/JMDH.S455935 (DOI)001248141100001 ()38894963 (PubMedID)
Available from: 2024-06-26 Created: 2024-06-26 Last updated: 2024-07-04Bibliographically approved
Westerholm, J., Gustafsson, L.-K. & Söderman, M. (2024). The need for acute assessments in home healthcare - Swedish registered nurses' experiences. International Journal of Qualitative Studies on Health and Well-being, 19(1), Article ID 2373541.
Open this publication in new window or tab >>The need for acute assessments in home healthcare - Swedish registered nurses' experiences
2024 (English)In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 19, no 1, article id 2373541Article in journal (Refereed) Published
Abstract [en]

PurposeThe study aims to describe Swedish RNs' experiences of acute assessments at home. More patients with complex nursing needs are cared for at home due to an ageing population. Registered nurses (RNs) who work with home healthcare need a broad medical competence and clinical experience alongside adapted decision support systems for maintaining patient safety in acute assessments within home healthcare.MethodsA content analysis of qualitative survey data from RNs (n = 19) working within home healthcare in Sweden.ResultsThere were challenges in the acute assessments at home due to a lack of competence since several of the RNs did not have much experience working as an RN in home healthcare. Important information was missing about the patients, such as access to medical records due to organizational challenges and limited access to equipment and materials. The RNs needed support in the form of cooperation with a physician, support from colleagues, and a decision support system.ConclusionTo increase the possibility of patient-safe assessments at home, skills development, collegial support, and an adapted decision support system are needed. Collaboration with primary healthcare, on-call physicians, and nursing staff, and having the opportunity to consult with someone also provide security in acute assessments.

Place, publisher, year, edition, pages
Taylor & Francis, 2024
Keywords
Acute assessments, decision support system, home healthcare, patient safety, qualitative content analysis, qualitative survey
National Category
Nursing
Identifiers
urn:nbn:se:mdh:diva-68039 (URN)10.1080/17482631.2024.2373541 (DOI)001257215800001 ()38934804 (PubMedID)2-s2.0-85197160205 (Scopus ID)
Available from: 2024-07-12 Created: 2024-07-12 Last updated: 2024-07-12Bibliographically approved
Johansson, C., Gustafsson, L.-K., Lindberg, D. & Asztalos Morell, I. (2023). Culturally sensitive active ageing seen through the lens of the welfare theory of health: assistant nurses’ views. Frontiers in Psychology, 14, Article ID 1161688.
Open this publication in new window or tab >>Culturally sensitive active ageing seen through the lens of the welfare theory of health: assistant nurses’ views
2023 (English)In: Frontiers in Psychology, E-ISSN 1664-1078, Vol. 14, article id 1161688Article in journal (Refereed) Published
Abstract [en]

Assistant nurses caring for older adults with immigrant backgrounds are on the front lines of a practical, theoretical, and policy battlefield. They need to implement culturally sensitive care provision while not overstating the importance of culture, thereby, contributing to a negative picture of older immigrants as especially problematic. One proposed way to strike such a balance is the welfare theory of health (WTH). In this article, we let assistant nurses apply the WTH to a series of questions in four different vignettes representing the life stories of older persons who characterize typical dilemmas described by the theory. The results show that, through the lens of the WTH, assistant nurses looked for individual care preferences rather than stereotypical ideas about cultural characteristics. Further, the assistant nurses expressed a desire to get to know the persons more deeply to better interpret and understand their individual preferences. Thus, the theoretical framework is useful not only for exposing vulnerabilities to which some older adults with immigrant backgrounds may be exposed, but also for finding ways to mitigate the vulnerability by illuminating vital life goals and using them as a framework to organize care. This approach allows for mitigating the gap between the vital life goals and available resources to achieve a holistic state of health.

Place, publisher, year, edition, pages
Frontiers Media SA, 2023
Keywords
active ageing, assistant nurses, care, cultural sensitivity, good ageing, older adults, resources, vital life goals
National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-64427 (URN)10.3389/fpsyg.2023.1161688 (DOI)001071635900001 ()2-s2.0-85172005454 (Scopus ID)
Available from: 2023-10-09 Created: 2023-10-09 Last updated: 2023-10-11Bibliographically approved
Gustafsson, L.-K., Bondesson, A., Pettersson, T. & Söderman, M. (2023). Dilemmas in rehabilitation and patient strategies in an intensive home intervention: a follow-up study. International Journal of Qualitative Studies on Health and Well-being, 18(1), Article ID 2253001.
Open this publication in new window or tab >>Dilemmas in rehabilitation and patient strategies in an intensive home intervention: a follow-up study
2023 (English)In: International Journal of Qualitative Studies on Health and Well-being, ISSN 1748-2623, E-ISSN 1748-2631, Vol. 18, no 1, article id 2253001Article in journal (Refereed) Published
Abstract [en]

Background The original project, where older persons received reablement performed by an interprofessional team showed success factors for IHR. However, since there is a lack of knowledge about why some persons do not recover despite receiving IHR, this study follows up patients' experiences of IHR.Aim To describe older persons' perceived dilemmas in the reablement process within the framework of IHR.Method 11 CIT interviews with participants who have previously received IHR, were analysed, interpreted and categorized according to CIT. The study was approved by the Swedish Ethical Review Authority.Results The results showed disease-related dilemmas, fatigue or pain so that participants could not cope with the prescribed exercises. New diseases appeared, as well as medication side effects made exercising difficult, and painkillers became a prerequisite for coping with IHR. Low self-motivation and mistrust towards the staff emerged like lack of trust due to otherness such as sex, cultural background, or language also became critical.Conclusions Interventions that consider individual- and contextual dilemmas are very important. By recognizing critical situations, this study can work as a basis of evidence to further develop interventions for older people living in their own homes and to ensure them to stay there.

National Category
Medical and Health Sciences Health Sciences
Identifiers
urn:nbn:se:mdh:diva-64158 (URN)10.1080/17482631.2023.2253001 (DOI)001058063600001 ()2-s2.0-85169677576 (Scopus ID)
Available from: 2023-09-05 Created: 2023-09-05 Last updated: 2023-09-20Bibliographically approved
Gustafsson, L.-K., Söderman, M., Bondesson, A., Pettersson, T. & Kaup, J. (2023). HEMMA projektet - om äldres förutsättningar för kvarboende.
Open this publication in new window or tab >>HEMMA projektet - om äldres förutsättningar för kvarboende
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2023 (Swedish)Report (Other academic)
National Category
Other Health Sciences
Identifiers
urn:nbn:se:mdh:diva-64041 (URN)
Available from: 2023-08-17 Created: 2023-08-17 Last updated: 2023-08-29Bibliographically approved
Söderman, M., Bondesson, A., Pettersson, T. & Gustafsson, L.-K. (2023). “Intensive-Home-Rehabilitation” Intervention for Older Persons: A Follow-Up Study of Team Members’ Perceptions. Journal of Multidisciplinary Healthcare, 16, 2207-2216
Open this publication in new window or tab >>“Intensive-Home-Rehabilitation” Intervention for Older Persons: A Follow-Up Study of Team Members’ Perceptions
2023 (English)In: Journal of Multidisciplinary Healthcare, E-ISSN 1178-2390, Vol. 16, p. 2207-2216Article in journal (Refereed) Published
Abstract [en]

Background: Reablement as a concept includes a health-promoting perspective with the goal of strengthening health and the ability to perform and participate in daily activities, a broader perspective than in general home care and rehabilitation. Reablement interventions have shown to be both more effective and to a greater extent improve the function and health-related quality of life of older persons when compared to traditional home-based care. Success factors for intensive-home-rehabilitation (IHR), an intervention based on the reablement concept, have been described earlier; however, there is a lack of knowledge about why some persons do not recover despite receiving IHR. Aim: The aim was to shed light on the older persons’ conditions during IHR from the perspective of the rehabilitation team members and to describe obstacles to recovery. Methods: Qualitative analysis of health and care records of persons (65+) who received IHR (n=19) performed by an interprofes-sional team. Results: The analysis revealed various problematic situations, dilemmas, that occurred in the older persons’ lives during IHR, as well as their consequences and the strategies employed by the older persons as a result. IHR aspects perceived as successful by the older persons also emerged, as well as differences in experiences of the physical and mental aspects of the IHR. Analysis also revealed reasons why the IHR might be experienced as broadly successful. Conclusion: The older persons seemed to be satisfied with IHR and achieved their goals; however, some seemed to need more time to reach their goals. Background factors such as having additional diagnoses and living alone might affect the rehabilitation process. Implication for Practice: The study provides knowledge regarding the importance of IHR for the recovery process for the increasing numbers of older persons, which might also be useful in other patient groups requiring otherwise long-term rehabilitation and recovery such as after covid-19 infection. 

Place, publisher, year, edition, pages
Dove Medical Press Ltd, 2023
Keywords
home-based care, intensive-home-rehabilitation, interprofessional team, older persons, reablement, recovery, rehabilitation process
National Category
Nursing
Identifiers
urn:nbn:se:mdh:diva-63967 (URN)10.2147/JMDH.S409879 (DOI)001045768500001 ()2-s2.0-85167331727 (Scopus ID)
Available from: 2023-08-16 Created: 2023-08-16 Last updated: 2024-07-04Bibliographically approved
Asztalos Morell, I., De, S., Johansson, C. & Gustafsson, L.-K. (2023). Middle-class older adults living alone in urban India: Older adults’ understandings of ageing alone. Journal of Religion, Spirituality & Aging, 1-26
Open this publication in new window or tab >>Middle-class older adults living alone in urban India: Older adults’ understandings of ageing alone
2023 (English)In: Journal of Religion, Spirituality & Aging, ISSN 1552-8030, p. 1-26Article in journal (Refereed) Published
Abstract [en]

This study sheds light on the value systems of the middle-class metropolitan older adults living alone, on the ageing self and the person's relationship to the surrounding society based on eight interviews. Ageing research has emphasized the traditional features of elderly care in India including its collectivist values rooted in filial piety and the extended family as well as embracement of disengagement influenced by the Hindu texts on two phases in later life: "hermit" and "renunciate". Increased social and geographical mobility, however, challenges traditional family systems. Using the example of the urban middle-class older adults living alone, this study explored whether living alone constitutes a challenge to the norms that previous research associated with Indian elderly care. Using abductive phenomenographic analysis the study found that the understandings of older adults in the study show great reflexivity concerning key aspects of their lives. Although the life conditions of older adults living alone deviated in many aspects from dominant traditional norms of filial piety and a care regime based on strong intergenerational interdependence, their responses and reflections mirrored assemblages of values deeply rooted in Hindu Vedic philosophy of the Ashramas and perceptions of independence, autonomy and self-reliance associated with Western "productive" aging.

Keywords
Ageing, middle-class urban India, culture, religion, living alone
National Category
Nursing
Identifiers
urn:nbn:se:mdh:diva-61719 (URN)10.1080/15528030.2022.2164395 (DOI)000911941400001 ()2-s2.0-85146255482 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2017-00031
Available from: 2023-02-01 Created: 2023-02-01 Last updated: 2023-02-13Bibliographically approved
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ORCID iD: ORCID iD iconorcid.org/0000-0001-5670-6908

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