https://www.mdu.se/

mdu.sePublications
Change search
Link to record
Permanent link

Direct link
Zander, Viktoria, Med drORCID iD iconorcid.org/0000-0002-1587-2835
Alternative names
Publications (10 of 22) Show all publications
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
Show others...
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
Gustafsson, L.-K., Zander, V., Bondesson, A., Pettersson, T., Anbäcken, E.-M. & Östlund, G. (2022). Actions taken to safeguard the intended health care chain of older people with multiple diagnoses-a critical incident study. BMC Nursing, 21(1), Article ID 260.
Open this publication in new window or tab >>Actions taken to safeguard the intended health care chain of older people with multiple diagnoses-a critical incident study
Show others...
2022 (English)In: BMC Nursing, E-ISSN 1472-6955, Vol. 21, no 1, article id 260Article in journal (Refereed) Published
Abstract [en]

Background: Older people with multiple diagnoses often have problems coping with their daily lives at home because of lack of coordination between various parts of the healthcare chain during the transit from hospital care to the home. To provide good care to those persons who have the most complex needs, regions and municipalities must work together. It is of importance to develop further empirical knowledge in relation to older persons with multiple diagnoses to illuminate possible obstacles to person-centred care during the transition between healthcare institutions and the persons livelihood. The aim of the present study was to describe nurses' experienced critical incidents in different parts of the intended healthcare chain of older people with multiple diagnoses.

Methods: The sample consisted of 18 RNs in different parts of the healthcare system involved in the care of older people with multiple diagnoses. Data were collected by semi structured interviews and analysed according to Critical Incident Technique (CIT). A total of 169 critical incidents were identified describing experiences in recently experienced situations.

Results: The result showed that organizational restrictions in providing care and limitations in collaboration were the main areas of experienced critical incidents. Actions took place due to the lack of preventive actions for care, difficulties in upholding patients' legal rights to participation in care, deficiencies in cooperation between organizations as well as ambiguous responsibilities and roles. The RNs experienced critical incidents that required moral actions to ensure continued person-centred nursing and provide evidence-based care. Both types of critical incidents required sole responsibility from the nurse. The RNs acted due to ethics, 'walking the extra mile', searching for person-centred information, and finding out own knowledge barriers.

Conclusions: In conclusion and based on this critical incident study, home-based healthcare of older people with multiple diagnoses requires a nurse that is prepared to take personal and moral responsibility to ensure person-centred home-based healthcare. Furthermore, the development of in-between adjustments of organizations to secure cooperation, and transference of person-centred knowledge is needed.

Place, publisher, year, edition, pages
BMC, 2022
Keywords
Critical incidence technique, Home-based healthcare, Multiple diagnoses, Older people, Person-centred care, Care-coordination
National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-60077 (URN)10.1186/s12912-022-01039-1 (DOI)000858454500004 ()36131284 (PubMedID)2-s2.0-85138507105 (Scopus ID)
Available from: 2022-10-05 Created: 2022-10-05 Last updated: 2024-07-04Bibliographically approved
von Heideken Wågert, P., Florin, U., Gusdal, A. K., Eklund, C., Johansson-Pajala, R.-M. & Zander, V. (2022). FIK@RUMMET– en webb-plattform för minskad ensamhet och social isolering. Ä (3), 12-14, Article ID oktober.
Open this publication in new window or tab >>FIK@RUMMET– en webb-plattform för minskad ensamhet och social isolering
Show others...
2022 (Swedish)In: Ä, ISSN 2001-1164, no 3, p. 12-14, article id oktoberArticle in journal (Other (popular science, discussion, etc.)) Published
National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-61217 (URN)
Note

Författarna har fått tillstånd att tillgängliggöra artikeln i fulltext.

Available from: 2022-12-13 Created: 2022-12-13 Last updated: 2022-12-13Bibliographically approved
Borg, J., Gustafsson, C., Landerdahl Stridsberg, S. & Zander, V. (2022). Implementation of welfare technology: a state-of-the-art review of knowledge gaps and research needs. Disability and Rehabilitation: Assistive Technology
Open this publication in new window or tab >>Implementation of welfare technology: a state-of-the-art review of knowledge gaps and research needs
2022 (English)In: Disability and Rehabilitation: Assistive Technology, ISSN 1748-3107, E-ISSN 1748-3115Article, review/survey (Refereed) Epub ahead of print
Abstract [en]

Purpose: To offer guidance for future welfare technology research, this review provides an overview of current knowledge gaps and research needs as reported in primary scientific studies addressing the implementation of welfare technology for older people, people with disabilities and informal caregivers.

Materials and methods: This paper conducted a state-of-the-art review based on systematic searches in 11 databases followed by a descriptive qualitative analysis of 21 selected articles.

Results: Knowledge gaps and research needs were identified concerning two categories: research designs and populations and focus of research. The articles reported needs for comparative studies, longitudinal studies, and demonstration trials as well as the development of co-design processes involving technology users. They also called for studies applying a social system theory approach, involving healthy and frail older adults, representative samples of users within and across countries, informal and formal caregivers, inter-and multidisciplinary teams, and care organizations. Moreover, there are reported needs for studies of acquirement, adoption and acceptance of welfare technology, attitudes, beliefs, and context related to welfare technology, caregiver perspectives on welfare technology, services to provide welfare technology and welfare technology itself.

Conclusions: There are considerable knowledge gaps and research needs concerning the implementation of welfare technology. They relate not only to the research focus but also to research designs, a social system theory approach and study populations.

Place, publisher, year, edition, pages
TAYLOR & FRANCIS INC, 2022
Keywords
Ambient assisted living, digital assistive technology, implementation, knowledge gaps, research needs, telecare, welfare technology
National Category
Medical and Health Sciences Other Mechanical Engineering
Identifiers
urn:nbn:se:mdh:diva-60033 (URN)10.1080/17483107.2022.2120104 (DOI)000854244700001 ()36103349 (PubMedID)2-s2.0-85138342173 (Scopus ID)
Available from: 2022-10-21 Created: 2022-10-21 Last updated: 2023-03-23Bibliographically approved
Johansson-Pajala, R.-M., Zander, V., Gustafsson, C. & Gusdal, A. K. (2022). No thank you to humanized robots: attitudes to care robots in elder care services. Home Health Care Services Quarterly, 41(1), 40-53
Open this publication in new window or tab >>No thank you to humanized robots: attitudes to care robots in elder care services
2022 (English)In: Home Health Care Services Quarterly, ISSN 0162-1424, E-ISSN 1545-0856, Vol. 41, no 1, p. 40-53Article in journal (Refereed) Published
Abstract [en]

The growing older population will increase the demands on the health and welfare systems, including elder care services. One way of meeting these growing service needs is to shift from traditional care services to technologically oriented services. Robotic innovations are gradually being introduced to elder care services. The aim was to explore attitudes toward the use of care robots in elder care services - specifically focusing on situations and interaction, influence, and emotions in interaction with care robots. Data were obtained from visitors at a welfare technology fair (n = 124). The results show that the most negative attitudes concerned if the care robots were humanized and had emotions. The attitudes toward interacting with care robots in general were predominately positive. In conclusion, concrete usage scenarios in elder care services need to be detected, based both on users' needs, digital literacy and on the maturity of the technology itself.

Place, publisher, year, edition, pages
TAYLOR & FRANCIS LTD, 2022
Keywords
Attitudes, care robots, elder care, older people, welfare technology
National Category
Social Work
Identifiers
urn:nbn:se:mdh:diva-57708 (URN)10.1080/01621424.2022.2052221 (DOI)000770853000001 ()35311474 (PubMedID)2-s2.0-85126761542 (Scopus ID)
Available from: 2022-03-30 Created: 2022-03-30 Last updated: 2022-12-05Bibliographically approved
Hochwälder, J., Gustafsson, L.-K., Östlund, G., Zander, V. & Elfström, M. L. (2022). Psychometric evaluation of the subjective well-being measure GP-CORE in a group of older adults in Sweden.. BMC Geriatrics, 22(1), Article ID 913.
Open this publication in new window or tab >>Psychometric evaluation of the subjective well-being measure GP-CORE in a group of older adults in Sweden.
Show others...
2022 (English)In: BMC Geriatrics, E-ISSN 1471-2318, Vol. 22, no 1, article id 913Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The world's growing population of older adults is one population that needs to be focused more regarding subjective well-being. It is therefore important to evaluate self-report instruments that measures general well-being for this specific group - older adults. The aim of the present study was to investigate psychometric properties of the Swedish translation of the GP-CORE (general population - Clinical Outcomes in Routine Evaluation) in a group of older adults (> 65 years).

METHODS: In this study, a psychometric evaluation of the GP-CORE is presented for 247 Swedish older adults (> 65 years), 184 women and 63 men who applied for home care assistance for the first time.

RESULTS: The psychometric evaluation showed high acceptability; provided norm values in terms of means, standard deviations and quartiles; showed satisfactory reliability in terms of both internal consistency and stability; showed satisfactory validity in terms of convergent and discriminant validity; provided a very preliminary cut-off value and quite low sensibility and sensitivity and showed results which indicated that this scale is sensitive to changes. One gender difference was identified in that women without a cohabitant had a higher well-being than men without a cohabitant (as measured by GP-CORE).

CONCLUSIONS: The GP-CORE showed satisfactory psychometric properties to be used to measure and monitor subjective well-being in older adults (> 65 years) in the general population of community dwelling. Future studies should establish a cut-off value in relation to another well-being measure relevant for mental health in older adults.

Keywords
GP-CORE, Geriatric mental health, Older adults, Psychometrics, Subjective well-being
National Category
Medical and Health Sciences Health Sciences
Identifiers
urn:nbn:se:mdh:diva-61079 (URN)10.1186/s12877-022-03625-z (DOI)000889533600001 ()36443687 (PubMedID)2-s2.0-85142817038 (Scopus ID)
Available from: 2022-11-30 Created: 2022-11-30 Last updated: 2024-07-04Bibliographically approved
Zander, V., Gustafsson, C., Landerdahl Stridsberg, S. & Borg, J. (2021). Implementation of welfare technology: a systematic review of barriers and facilitators. Disability and Rehabilitation: Assistive Technology
Open this publication in new window or tab >>Implementation of welfare technology: a systematic review of barriers and facilitators
2021 (English)In: Disability and Rehabilitation: Assistive Technology, ISSN 1748-3107, E-ISSN 1748-3115Article, review/survey (Refereed) Published
Abstract [en]

Purpose Although studies addressing barriers to and facilitators of implementation of welfare technology have been published, no systematic review synthesising evidence on such factors has been found. The purpose of this study was therefore to identify and synthesise existing primary research on facilitators and barriers that influence the implementation of welfare technology for older people, people with disabilities and informal caregivers. Materials and methods A systematic search in 11 databases was performed using predefined inclusion and exclusion criteria to identify empirical studies that assess the implementation of welfare technology for older people, people with disabilities or informal caregivers. The search identified 33 publications with quantitative, qualitative and mixed method designs. The reported findings were thematically synthesised and conceptualised into themes. Results Six themes of facilitators and barriers that influence the implementation of welfare technology emerged: capacity, attitudes and values, health, expectations, participation and identity and lifestyle. These were presented from five perspectives: older persons and persons with disabilities, informal caregivers, health and care personnel, organisation and infrastructure and technology. The findings may be used as a means to structure the planning and evaluation of implementation processes of welfare technologies for older persons and persons with disabilities and to understand the complexities of implementation. Conclusions This knowledge generates deepened insights and structures to guide and evaluate the implementation processes of welfare technologies and engenders an understanding of the complexities of implementation.

Place, publisher, year, edition, pages
Taylor & Francis, 2021
Keywords
Ambient assisted living, caregivers, disabled persons, implementation, older people, systematic review, welfare technology
National Category
Nursing
Identifiers
urn:nbn:se:mdh:diva-55357 (URN)10.1080/17483107.2021.1938707 (DOI)000661718200001 ()34129802 (PubMedID)2-s2.0-85107965457 (Scopus ID)
Available from: 2021-07-01 Created: 2021-07-01 Last updated: 2022-12-13Bibliographically approved
Gusdal, A. K., Johansson-Pajala, R.-M., Zander, V. & von Heideken Wågert, P. (2021). Prerequisites for a healthy and independent life among older people: a Delphi study. Ageing & Society, 41(9), 2171-2187
Open this publication in new window or tab >>Prerequisites for a healthy and independent life among older people: a Delphi study
2021 (English)In: Ageing & Society, ISSN 0144-686X, E-ISSN 1469-1779, Vol. 41, no 9, p. 2171-2187Article in journal (Refereed) Published
Abstract [en]

The number of older people (aged 65+) will more than double by 2050 in Sweden. The ageing population is an increasing concern due to rising health-care costs and a shortage of health professionals. Older people generally prefer ageing in place, as long as they feel confident and comfortable. However, preventive and supportive measures are needed to maintain older people’s independence and active participation in society. The aim of this study is to explore the prerequisites for a healthy and independent life among older people in Sweden. A Delphi study was conducted in three rounds. In round 1, seven focus group interviews were performed with older persons aged 65–79, older persons aged ⩾80, next of kin of older persons, health professionals in primary and home health care, assistant nurses in home care, care managers and local politicians. The data were analysed using thematic analysis, resulting in 35 statements of the prerequisites needed for a healthy and independent life. These statements were sent to the participants from round 1, who were asked to evaluate the degree to which they agreed with each statement in round 2, and again in round 3. There was an agreement of at least 80 per cent for 31 of the 35 statements. When asked to identify the three prerequisites of most importance for a healthy and independent life, most participants stated: to have a social life, to have freedom of choice and power over one’s own situation, and to have the possibility to choose independently one’s type of housing. There was an overall high group agreement on the prerequisites needed for a healthy and independent life among older people. The main areas of importance were to have a social life, several dimensions of feeling safe and to retain one’s personal control.

National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-47415 (URN)10.1017/S0144686X20000306 (DOI)000681728700013 ()2-s2.0-85082201421 (Scopus ID)
Available from: 2020-03-23 Created: 2020-03-23 Last updated: 2021-11-05Bibliographically approved
Gusdal, A. K., Johansson-Pajala, R.-M., Arkkukangas, M., Ekholm, A. & Zander, V. (2021). Preventing Falls and Malnutrition among Older Adults in Municipal Residential Care in Sweden: A Registry Study. Sage Open Nursing, 7
Open this publication in new window or tab >>Preventing Falls and Malnutrition among Older Adults in Municipal Residential Care in Sweden: A Registry Study
Show others...
2021 (English)In: Sage Open Nursing, E-ISSN 2377-9608, Vol. 7Article in journal (Refereed) Published
Abstract [en]

Introduction: Older adults in municipal residential care are among the most vulnerable and in need of most care. The prevalence of negative events, such as falls and malnutrition, is increased among these older adults. The need for strategies to prevent falls and malnutrition is emphasized in guidelines and systematic, individualized risk assessments are prerequisites for adequate interventions. Objectives: The overall purpose of this study was to investigate the assessed risks of, and risk factors for, falling and malnutrition and the correlations between these assessed risks among older women and men in residential care. Further, the purpose was to investigate the consistency between planned and performed interventions among women and men assessed as at risk. Methods: A cross-sectional registry study based on risk assessment data in the Swedish national quality registry, Senior Alert. Altogether, 5,919 older adults ≥65 in nursing homes and dementia care units in 19 municipalities in Sweden were included. Results: Of the older adults, 77% were at risk of falls, and 59% were at risk of malnutrition. The most prevalent risk factors for falls were previous falls and not being cognitively oriented; and for malnutrition were having mild or severe dementia or depression. A significant positive correlation between the risk of falling and the risk of malnutrition was found. Less than half of the planned interventions for falls and malnutrition were performed. Care staff’s least common interventions to prevent falls were balance, muscular function, and strength training, which contrasts with the recommendations; interventions to prevent malnutrition were only partially adhering to recommendations. Conclusions: This cross-sectional registry study points towards the importance of using an evidence-based approach, based on adherence to recommended guidelines, in the prevention of falling and malnutrition. Further, the implementation of clinical practice guidelines is needed, which requires educational training for care staff and supportive leadership.

Place, publisher, year, edition, pages
SAGE Publications Inc., 2021
Keywords
fall, malnutrition, older adults, prevention, quality registry
National Category
Health Sciences
Identifiers
urn:nbn:se:mdh:diva-55528 (URN)10.1177/23779608211026161 (DOI)000689591400001 ()34286078 (PubMedID)2-s2.0-85109643104 (Scopus ID)
Available from: 2021-08-05 Created: 2021-08-05 Last updated: 2022-12-12Bibliographically approved
Anbäcken, E.-M., Östlund, G., Zander, V., Bondesson, A., Pettersson, T. & Gustafsson, L.-K. (2021). Team-Talk and Time; keys to support in complex care of older adults at home. In: ECSWR 2021 10th European Conference for social work research: Book of abstracts. Paper presented at 10th European conference for social work research (ECSWR) Bucharest/digital, 5-7 May, 2021 (pp. 215).
Open this publication in new window or tab >>Team-Talk and Time; keys to support in complex care of older adults at home
Show others...
2021 (English)In: ECSWR 2021 10th European Conference for social work research: Book of abstracts, 2021, p. 215-Conference paper, Oral presentation with published abstract (Refereed)
National Category
Social Sciences
Identifiers
urn:nbn:se:mdh:diva-56186 (URN)
Conference
10th European conference for social work research (ECSWR) Bucharest/digital, 5-7 May, 2021
Available from: 2021-10-13 Created: 2021-10-13 Last updated: 2022-10-19Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-1587-2835

Search in DiVA

Show all publications