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  • 151.
    Nielsen, Mie Marie
    et al.
    Danmark.
    Maribo, Thomas
    Danmark.
    Westergren, Albert
    Kristianstad University, Faculty of Health Science, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Melgaard, Dorte
    Danmark.
    Associations between eating difficulties, nutritional status and activity of daily living in acute geriatric patients2018In: Clinical Nutrition ESPEN, ISSN 2405-4577, Vol. 25, p. 95-99Article in journal (Refereed)
    Abstract [en]

    Background & aims

    Eating difficulties, having a poor nutritional status, and low activity of daily living are all prevalent issues in the geriatric population. The aim of this study was to explore associations between patients' eating difficulties, their nutritional status and their activity of daily living in patients aged 60 years or older who were admitted to an acute geriatric unit.

    Methods

    A cross-sectional study was conducted between March and September 2016 at the geriatric department of North Denmark Regional Hospital, Hjørring. The inclusion criteria were: ≥ 60years old and hospitalized for a minimum of 24 h. The patients' eating difficulties were assessed using the Minimal Eating Observational Form (MEOF-II), including observations related to ingestion, deglutition and energy/appetite. Eating difficulties were determined on the basis of one or more components of the MEOF-II. Poor nutritional status was defined as an age-specific low body mass index (BMI), <20 kg/m2 if < 70 years, or <22 kg/m2 if ≥ 70 years. Activity of daily living was assessed using the Barthel-100 Index and defined as low (<50) or high (≥50).

    Results

    A total of 297 geriatric patients were included; the mean age was 83.0 (7.7) years and 56.2% of the patients were female. The prevalence of eating difficulties was 55%. Geriatric patients with eating difficulties had a risk increase of 155% of having poor nutritional status (p = 0.003). Geriatric patients with eating difficulties had a risk increase of 60% of having low activity of daily living (p < 0.001).

    Conclusions

    Eating difficulties were highly prevalent in geriatric patients and were associated with poor nutritional status and reduced activity of daily living. The identification of eating difficulties may be important for nutritional interventions and maintenance or improvement of activities of daily living in the geriatric population

  • 152.
    Nilsson, Maria
    et al.
    Department of Health Sciences, Lund University, Lund, Sweden.
    Bladh, Stina
    Department of Health Sciences, Lund University, Lund, Sweden.
    Hagell, Peter
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE.
    Fatigue in Parkinson’s disease: measurement properties of a generic and a condition-specific rating scale2013In: Journal of Pain and Symptom Management, ISSN 0885-3924, E-ISSN 1873-6513, Vol. 46, no 5, p. 737-746Article in journal (Refereed)
    Abstract [en]

    Context: High quality fatigue rating scales are needed to advance understanding of fatigue nd determine the efficacy of interventions. Several fatigue scales are used in Parkinson’s isease, but few have been tested using modern psychometric methodology (Rasch analysis).

    Objectives: To examine the measuring properties of the generic Functional Assessment of hronic Illness Therapy - Fatigue (FACIT-F) scale and the condition-specific 16-item arkinson Fatigue Scale (PFS-16) using Rasch analysis.

    Methods: Postal survey data (n=150; 47% women; mean age, 70) were Rasch analyzed. FS-16 scores were tested according both to the original polytomous and the suggested lternative dichotomized scoring methods.

    Results: The PFS-16 showed overall Rasch model fit whereas the FACIT-F showed signs of isfit, which probably was due to a sleepiness-related item and mixing of ositively/negatively worded items. There was no differential tem functioning by disease uration but by fatigue status (greater likelihood of needing to sleep or rest during the day mong people classified as non-fatigued) in the PFS-16 and FACIT-F. However, this did not mpact total score based estimated person measures. Targeting and reliability (≥0.86) was ood, but the dichotomized PFS-16 showed compromised measurement precision. olytomous and dichotomized PFS-16 and FACIT-F scores identified 6, 3 and 4 statistically istinct sample strata, respectively.

    Conclusion: We found general support for the measurement properties of both scales. owever, polytomous PFS-16 scores exhibited advantages compared to dichotomous PFS-16 nd FACIT-F scores. Dichotomization of item responses compromises measurement recision and ability to separate people, and should be avoided.

  • 153.
    Nilsson, Maria H.
    et al.
    Lunds universitet.
    Hagell, Peter
    Kristianstad University, Research Environment PRO-CARE. Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap I.
    Iwarsson, S
    Lunds universitet.
    Psychometric properties of the general self-efficacy scale in Parkinson's disease2015In: Acta Neurologica Scandinavica, ISSN 0001-6314, E-ISSN 1600-0404, Vol. 132, no 2, p. 89-96Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: This study aimed to investigate the psychometric properties of the General Self-Efficacy Scale (GSE) in people with Parkinson's disease (PD). More specifically, we investigated data completeness, scaling assumptions, targeting, reliability, and construct validity.

    MATERIALS AND METHODS: This study involves data available from two different projects that included people diagnosed with PD for at least 1 year, yielding two samples (1 and 2). The combined total sample (N = 346; 60% men) had a mean (SD) age and PD duration of 71 (8.9) and 9 years (6.3), respectively. Both samples received a self-administered survey by mail, which was administered twice in sample 2. Additional data (e.g., clinical assessments) were available for Sample 1.

    RESULTS: Total GSE scores were computable for 336 participants (97%). Corrected item-total correlations exceeded 0.4. Principal component analyses identified one component (the eigenvalue of the first component extracted was 6.9), explaining 69% of the total variance. Floor and ceiling effects were < 6%. Internal consistency (coefficient alpha) was 0.95. Analyses of test-retest reliability yielded (ICC) values from 0.69 to 0.80. The highest value refers to those (n = 47) with identical self-ratings of mobility (in the on condition) at both tests; the standard error of measurement was 3.1 points. Construct validity was further supported by correlations in accordance with a priori expectations.

    CONCLUSIONS: This study provides support for the validity and reliability of GSE scores in people with PD; the GSE can thus serve as a valuable outcome measurement in clinical practice and research.

  • 154.
    Nilsson, Maria H.
    et al.
    Department of Health Sciences, Lund University.
    Westergren, Albert
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE.
    Carlsson, Gunilla
    Department of Health Sciences, Lund University.
    Hagell, Peter
    Department of Neurology, University Hospital, Lund.
    Uncovering indications of the international classification of functioning, disability, and health from the 39-item Parkinson's Disease Questionnaire2010In: Parkinson's Disease, ISSN 2090-8083, E-ISSN 2042-0080, p. 984673-Article in journal (Refereed)
    Abstract [en]

    The 39-item Parkinson's disease questionnaire (PDQ-39) is the most widely used patient-reported rating scale in Parkinson's disease (PD). However, recent studies have questioned its validity and it is unclear what scores represent. This study explored the possibility of regrouping PDQ-39 items into scales representing the International Classification of Functioning, Disability, and Health (ICF) components of Body Functions and Structures (BF), Activities and Participation (AP), and Environmental (E) factors. An iterative process using Rasch analysis produced five new items sets, two each for the BF and AP components and one representing E. Four of these were found to represent clinically meaningful variables: Emotional Impairment (BF), Gross Motor Disability (AP), Fine Motor Disability (AP), and Socioattitudinal Environment (E) with acceptable reliability (0.73–0.96) and fit to the Rasch model (total item-trait chi-square, 8.28–33.2; P>.05). These new ICF-based scales offer a means to reanalyze PDQ-39 data from an ICF perspective and to study its health components using a widely available health status questionnaire for people with PD.

  • 155.
    Nilsson, Maria
    et al.
    Department of Health Sciences, Lund University, Lund, Sweden.
    Hariz, Gun-Marie
    Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden.
    Iwarsson, Susanne
    Department of Health Sciences, Lund University, Lund, Sweden.
    Hagell, Peter
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE.
    Walking ability is a major contributor to fear of falling in people with Parkinson’s disease: implications for rehabilitation2012In: Parkinson's Disease, ISSN 2090-8083, E-ISSN 2042-0080, p. 713236-Article in journal (Refereed)
    Abstract [en]

    Although fear of falling (FOF) is common in people with Parkinson's disease (PD), there is a lack of research investigating potential predictors of FOF. This study explored the impact of motor, nonmotor, and demographic factors as well as complications of drug therapy on FOF among people with PD. Postal survey data (including the Falls Efficacy Scale, FES) from 154 nondemented people with PD were analyzed using multiple regression analyses. Five significant independent variables were identified explaining 74% of the variance in FES scores. The strongest contributing factor to FOF was walking difficulties (explaining 68%), followed by fatigue, turning hesitations, need for help in daily activities, and motor fluctuations. Exploring specific aspects of walking identified three significant variables explaining 59% of FOF: balance problems, limited ability to climb stairs, and turning hesitations. These results have implications for rehabilitation clinicians and suggest that walking ability is the primary target in order to reduce FOF. Specifically, balance, climbing stairs, and turning seem to be of particular importance.

  • 156.
    Nilsson, Maria
    et al.
    Lund University.
    Jonasson, Stina
    Lund University.
    Lindholm, Beata
    Lund University.
    Hagell, Peter
    Kristianstad University, Faculty of Health Science, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Iwarsson, Susanne
    Lund university.
    Walking difficulties is the main contributor to fear of falling in people with Parkinson’s disease2017Conference paper (Refereed)
    Abstract [en]

    Fear of falling is more common and pronounced in people with Parkinson’s disease than in controls. We conducted a series of studies that used multivariable regression analyses to identify explanatory factors of fear of falling in people with Parkinson’s disease. Three independent samples were used. The first study (n=154) was a postal survey study that used well-established self-rating scales. The second study replicated the first one by using a clinical sample (n=104) and added unexplored motor aspects (e.g., gait speed, functional balance performance) as well as global cognition. The third clinical study (n=241) included independent variables that focused on personal (e.g. general self-efficacy) and environmental factors as well as Parkinson-related disabilities. In all three studies, walking difficulties was the strongest explanatory (60–68%) factor. The results imply that walking difficulties in daily life should be the primary target in order to reduce fear of falling in people with Parkinson’s disease.

  • 157.
    Norberg, Erika
    et al.
    Region Skåne CSK Kristianstad.
    Palmquist, Eva-Lott
    Kristianstads Kommun.
    Skog, Therese
    Region Skåne Hässleholm.
    Andersson, Kristina
    Kristianstads Kommun.
    Pajalic, Zada
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE.
    ”Mat efter behov”2012Other (Other (popular science, discussion, etc.))
  • 158.
    Norberg, Erika
    et al.
    Region Skåne CSK Kristianstad.
    Palmquist, Eva-Lott
    Kristianstads Kommun.
    Skog, Therese
    Region Skåne Hässleholm.
    Andersson, Kristina
    Kristianstads Kommun.
    Pajalic, Zada
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE.
    "Matiga smörgåsar"2012Other (Other (popular science, discussion, etc.))
  • 159.
    Ny, Pernilla
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap II. Kristianstad University, Research Environment PRO-CARE.
    Fokusgruppintervjuer med tolk2014In: Tvärkulturella studier / [ed] Pernilla NY, Malmö: Gleerups Utbildning AB, 2014, p. 81-103Chapter in book (Other academic)
  • 160.
    Ny, Pernilla
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap II. Kristianstad University, Research Environment PRO-CARE.
    Introduktion2014In: Tvärkulturella studier / [ed] Pernilla NY, Malmö: Gleerups Utbildning AB, 2014, p. 7-11Chapter in book (Other (popular science, discussion, etc.))
  • 161.
    Ny, Pernilla
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap II. Kristianstad University, Research Environment PRO-CARE.
    Tvärkulturella studier2014Collection (editor) (Other academic)
    Abstract [sv]

    I denna bok presenteras olika tvärkulturella perspektiv som hjälper studenter och andra intresserade att nå kunskap om hur kulturell bakgrund, både den egna och andras, kan spela roll vid inhämtande av data. Författarna delar med sig av sina välgrundade erfarenheter som forskare inom vården. De visar hur man kan planera och genomföra undersökningar med informanter från minoritetsgrupper som annars har svårt att göra sig hörda genom att ta hjälp av nyckelpersoner och tolkar. De visar också hur man kan genomföra studier utomlands. Men det är inte bara en fråga om praktiska lösningar, utan författarna ger även redskap för den (själv)kritiska reflektion som krävs för tillförlitlig tvärkulturell forskning.

    Boken riktar sig till studenter, forskare och yrkesverksamma som intresserar sig för hur vården kan utvecklas och förbättras för alla, oavsett bakgrund.

  • 162.
    Ny, Pernilla
    et al.
    Kristianstad University, Faculty of Health Science, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Khalaf, Atika
    Kristianstad University, Faculty of Health Science, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Maternal health care in a multiethnic setting with examples from Sweden, Scandinavia, and Europe2019In: Handbook of healthcare in the Arab World / [ed] Ismail Laher, Springer, 2019, p. 1-16Chapter in book (Other academic)
    Abstract [en]

    Women immigrating with their children are a vulnerable group often exposed to ill health and a bad environment. In Europe, women from the Middle East have a complex situation, but immigrant women from low socioeconomic status backgrounds are at highest risk, also with regard to the perinatal period in life. In Sweden all women, independent of their immigrant status are offered free high-quality perinatal care performed by midwives free of charge and nearly 100% use this care, though differently than the nonmigrant population. Often care is sought late in pregnancy, and problems with regard to communication affects the situation as well as care-seeking patterns. However, experiences from families’ originating from the Middle East show their high trust in midwives in Sweden. This trust must be handled with care since it is a great challenge for the health-care organization in Sweden as well as in other countries to host large migrating population, reaching out and communicating in a satisfactory way.

  • 163.
    Nyberg, Maria
    et al.
    Kristianstad University, School of Education and Environment, Avdelningen för Praktisk-estetiska ämnen. Kristianstad University, Research Environment Food and Meals in Everyday Life (MEAL).
    Olsson, Viktoria
    Kristianstad University, School of Education and Environment, Avdelningen för Praktisk-estetiska ämnen. Kristianstad University, Research Environment Food and Meals in Everyday Life (MEAL).
    Pajalic, Zada
    Linnaeus University.
    Örtman, Gerd
    Linnaeus University.
    Andersson, Håkan S.
    Linnaeus University.
    Blücher, Anna
    Linnaeus University.
    Wendin, Karin
    Kristianstad University, School of Education and Environment, Avdelningen för Praktisk-estetiska ämnen. Kristianstad University, Research Environment Food and Meals in Everyday Life (MEAL).
    Westergren, Albert
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap I. Kristianstad University, Research Environment PRO-CARE.
    Eating difficulties, nutrition, meal preferences and experiences among elderly: a literature overview from a Scandinavian context2015In: Journal of Food Research, ISSN 1927-0887, E-ISSN 1927-0895, Vol. 4, no 1, p. 22-37Article, review/survey (Refereed)
    Abstract [en]

    The risk of malnutrition increases with ageing, resulting in poorer health and higher risk of disease. Eating difficulties are important risk factors for malnutrition. Moreover, independence in relation to food and meals is highly rated by the elderly and has been associated with health and well-being. The purpose of this literature overview was to provide insights into nutritional status, food choice and preferences as well as the meal situations of home-living elderly (65+) people with motoric eating difficulties focusing on Scandinavia. The overall aim is to support independence and to prevent malnutrition. Nutritional status in the elderly was found to be negatively influenced by motoric eating difficulties including problems with manipulating food on the plate and transporting food to the mouth. Motoric eating difficulties may result in practical simplifications such as use of pre-prepared meals, less advanced cooking, and omission of certain meal constituents in order to avoid e.g. mismanagement and spillage. Eating difficulties are often accompanied by feelings of guilt and shame. Choosing smaller portions, reducing the number of eating episodes and not cooking independently have been associated with a higher risk of malnutrition. The nutritional effects of eating difficulties may be exacerbated by diminished chemosensory functions. Furthermore, both past and present food preferences should be considered in order to meet nutritional needs and meal satisfaction. Development of refined and socially accepted eating aids, in combination with tasty and nutritious products, is important in order to promote healthy and independent living among home-living elderly with motoric eating difficulties.

  • 164.
    Nyberg, Maria
    et al.
    Kristianstad University, Research Environment Food and Meals in Everyday Life (MEAL). Kristianstad University, School of Education and Environment, Avdelningen för Mat- och måltidsvetenskap.
    Olsson, Viktoria
    Kristianstad University, Research Environment Food and Meals in Everyday Life (MEAL). Kristianstad University, School of Education and Environment, Avdelningen för Humaniora.
    Örtman, Gerd
    Linnaeus University, Kalmar, Sweden.
    Pajalic, Zada
    Norge.
    Andersson, Håkan S.
    Linnaeus University, Kalmar.
    Blücher, Anna
    Linnaeus University, Kalmar.
    Lindborg, Ann-Louise
    Mälardalen University, Västerås.
    Wendin, Karin
    Kristianstad University, Research Environment Food and Meals in Everyday Life (MEAL). Kristianstad University, School of Education and Environment, Avdelningen för Mat- och måltidsvetenskap.
    Westergren, Albert
    Kristianstad University, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna. Kristianstad University, Research Platform for Collaboration for Health.
    The meal as a performance: food and meal practices beyond health and nutrition2018In: Ageing & Society, ISSN 0144-686X, E-ISSN 1469-1779, Vol. 38, no 1, p. 83-107Article in journal (Refereed)
    Abstract [en]

    The proportion of elderly people in the population is increasing, presenting a number of new challenges in society. The purpose of this qualitative study was to investigate how elderly persons with motoric eating difficulties perceive and perform their food and meal practices in everyday life. By using Goffman's concept of performance as a theoretical framework together with Bourdieu's thinking on habitus, a deeper understanding of food and meal practices is obtained. Semi-structured interviews were conducted with 14 elderly people (aged between 67 and 87 years) and meal observations were carried out with 11 of these people. Participants were found to manage food and meal practices by continuously adjusting and adapting to the new conditions arising as a result of eating difficulties. This was displayed by conscious planning of what to eat and when, avoiding certain foods and beverages, using simple eating aids, but also withdrawing socially during the meals. All these adjustments were important in order to be able to demonstrate proper food and meal behaviour, to maintain the façade and to act according to the perceived norms. As well as being a pleasurable event, food and meals were also perceived in terms of being important for maintaining health and as ‘fuel’ where the main purpose is to sustain life. This was strongly connected to the social context and the ability to enjoy food and meals with family members and friends, which appeared to be particularly crucial due to the impending risk of failing the meal performance.

  • 165.
    Olsson Möller, Ulrika
    et al.
    Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap. Kristianstad University, Faculty of Health Science, Forskningsmiljön Människa - Hälsa - Samhälle (MHS). Kristianstad University, Faculty of Health Science, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education.
    Beck, Ingela
    Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, Faculty of Health Science, Avdelningen för sjuksköterskeutbildningarna och integrerad hälsovetenskap.
    Rydén, L
    Lund University.
    Malmström, M
    Lund University.
    A comprehensive approach to rehabilitation interventions following breast cancer treatment: a systematic review of systematic reviews2019In: BMC Cancer, ISSN 1471-2407, E-ISSN 1471-2407, Vol. 19, no 1Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Breast cancer (BC) is the most common type of cancer in women worldwide. Post-treatment, patients suffer from side effects and have various rehabilitation needs, which means that individualization is fundamental for optimal rehabilitation. This systematic review (SR) of SRs aims to evaluate the current evidence on rehabilitation interventions in female patients following BC treatment.

    METHODS: Full-text SRs published in English from 2009 were searched in Embase, PubMed, Cinahl Complete, PsycINFO, AMED, SCOPUS, and Cochrane Library.

    INCLUSION CRITERIA: SRs of randomized or non-randomized controlled trials investigating the effects of rehabilitation interventions in women following BC treatment. All outcomes were considered. Methodological quality was evaluated using the AMSTAR 2 tool and interrater agreement was evaluated. Out of 1269 citations retrieved, 37 SRs were included.

    RESULTS: Five rehabilitation areas were identified: exercise and physical activity (PA), complementary and alternative medicine (CAM), yoga, lymphoedema treatment, and psychosocial interventions. The most solid evidence was found in exercise/PA and yoga. Exercise interventions improved outcomes such as shoulder mobility, lymphoedema, pain, fatigue and quality of life (QoL). Effects of yoga were shown on QoL, anxiety, depression, sleep disturbance, fatigue and gastrointestinal symptoms. The effect of CAM was shown on nausea, pain, fatigue, anger and anxiety but these results need to be interpreted with caution because of low methodological quality in included studies in the SRs. Among the lymphoedema treatments, positive effects were seen for resistance training on volume reduction and muscle strength and psychosocial interventions such as cognitive behavioural therapy had positive effects on QoL, anxiety, depression and mood disturbance.

    CONCLUSIONS: This SR of SRs show solid positive effects of exercise/PA and yoga for women following BC treatment, and provides extended knowledge of the effects of CAM, yoga, lymphoedema treatment and psychosocial interventions. It is evident that more than one intervention could have positive effects on a specific symptom and that the effects depend not only on intervention type but also on how and when the intervention is provided. The results can be used as a foundation for individualized rehabilitation and aid health care professionals in meeting patients' individual needs and preferences.

    TRIAL REGISTRATION: PROSPERO ( CRD42017060912 ).

  • 166.
    Olsson, Viktoria
    et al.
    Kristianstad University, School of Education and Environment, Avdelningen för Humanvetenskap. Kristianstad University, Resrarch environment Food and Meals in Everyday Life (MEAL).
    Agerhem, Halina
    Ipsos, Sweden.
    Nyberg, Maria
    Kristianstad University, School of Education and Environment, Avdelningen för Humanvetenskap. Kristianstad University, Resrarch environment Food and Meals in Everyday Life (MEAL).
    Örtman, Gerd
    Linnaeus University.
    Pajalic, Zada
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap II. Kristianstad University, Research Environment PRO-CARE.
    Svensson, Therése
    Kristianstad University, School of Education and Environment, Avdelningen för Humanvetenskap. Kristianstad University, Resrarch environment Food and Meals in Everyday Life (MEAL).
    Blücher, Anna
    Linnaeus University.
    Andersson, Håkan S.
    Linnaeus University.
    Westergren, Albert
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap I. Kristianstad University, Research Environment PRO-CARE.
    Wendin, Karin
    Kristianstad University, School of Education and Environment, Avdelningen för Humanvetenskap. Kristianstad University, Resrarch environment Food and Meals in Everyday Life (MEAL).
    Improved everyday food for home living elderly – perception of protein and energy enrichment2015Conference paper (Other academic)
    Abstract [en]

    Protein-energy malnutrition can be a problem among elderly. A way to increase protein intake may be to enrich home-cooked foods. In this, special attention should be given to that the food is conveniently prepared and well accepted by the target group.

  • 167.
    Olsson, Viktoria
    et al.
    Kristianstad University, School of Education and Environment, Avdelningen för Mat- och måltidsvetenskap. Kristianstad University, Research Environment Food and Meals in Everyday Life (MEAL).
    Nyberg, Maria
    Kristianstad University, School of Education and Environment, Avdelningen för Mat- och måltidsvetenskap. Kristianstad University, Research Environment Food and Meals in Everyday Life (MEAL).
    Pajalic, Zada
    Linnéuniversitetet.
    Örtman, Gerd
    Linnéuniversitetet.
    Westergren, Albert
    Kristianstad University, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna. Kristianstad University, Research Platform for Collaboration for Health.
    Blucher, Anna
    Linnéuniversitetet.
    Andersson, Håkan
    Linnéuniversitetet.
    Wendin, Karin
    Kristianstad University, School of Education and Environment, Avdelningen för Mat- och måltidsvetenskap. Kristianstad University, Research Environment Food and Meals in Everyday Life (MEAL).
    Designing meals for elderly with eating difficulties: a cooperative approach2014Conference paper (Other academic)
    Abstract [en]

    Approximately 15 % of the Scandinavian population aged 60 and above suffer from eating difficulties with malnutrition as a risk factor. In an effort to improve their possibilities of a healthy and independent living, we have chosen the strategy to develop nutritious and tasty food in combination with functional eating aids to be integrated in the everyday lives of elderly.

    This new, multi-disciplinary project concerns the design of meals for those who experience difficulties in transporting food from the plate to the mouth. The present paper, as part of the project, aims at presenting today’s knowledge of what home-living Scandinavian elderly with pre-oral eating difficulties experience as important factors concerning the meal. The review of peer-reviewed research publications will be complemented with in-depth interviews, surveys and observation studies. Data will be used in a co-designing process, where elderly are involved in developing meals and eating aids that support independence and integrity.

    For elderly in general it is well known that food and drink preferences are affected by past experiences. However, impaired appetite, taste and smell as well as eating difficulties require special adaptations of food and beverages. Serving popular dishes and using distinct flavours and presentations improves meal satisfaction. Elderly suffering from e.g. hand tremor or difficulties in gripping often develop strategies to remain independent, of which one may be to omit meal constituents affecting the sensory and nutritional quality of the meal. Furthermore, the eating situation among people with eating difficulties is often associated with guilt and shame, and social withdrawal is therefore a common scenario.

    Remaining independent in respect to eating is highly valued among elderly. By integrating various dimensions of the meal, including nutritional and sensory aspects, in the development of functional eating aids, the possibility of a healthy and independent living among elderly increases.

  • 168.
    Olsson, Viktoria
    et al.
    Kristianstad University, School of Education and Environment, Avdelningen för Humanvetenskap. Kristianstad University, Research Environment Food and Meals in Everyday Life (MEAL).
    Nyberg, Maria
    Kristianstad University, School of Education and Environment, Avdelningen för Humanvetenskap. Kristianstad University, Research Environment Food and Meals in Everyday Life (MEAL).
    Pajalic, Zada
    Linnaeus University.
    Örtman, Gerd
    Linnaeus University.
    Westergren, Albert
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap I. Kristianstad University, Research Environment PRO-CARE. Kristianstad University, Research Platform for Collaboration for Health.
    Blücher, Anna
    Linnaeus University.
    Andersson, Håkan
    Linnaeus University.
    Wendin, Karin
    Kristianstad University, School of Education and Environment, Avdelningen för Humanvetenskap. Kristianstad University, Research Environment Food and Meals in Everyday Life (MEAL).
    Designing meals for elderly with eating difficulties: a cooperative approach2015Conference paper (Other academic)
    Abstract [en]

    Remaining independent in respect to eating is highly valued among elderly. By integrating various dimensions of the meal, including nutritional and sensory aspects, in the development of functional eating aids, the possibility of a healthy and independent living among elderly increases.

  • 169.
    Olsson, Viktoria
    et al.
    Kristianstad University, School of Education and Environment, Avdelningen för Praktisk-estetiska ämnen.
    Nyberg, Maria
    Kristianstad University, School of Education and Environment, Avdelningen för Praktisk-estetiska ämnen.
    Pajalic, Zada
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap II. Kristianstad University, Research Environment PRO-CARE.
    Örtman, Gerd
    Linneaus University.
    Westergren, Albert
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap I. Kristianstad University, Research Environment PRO-CARE.
    Blücher, Anna
    Linneaus University.
    Andersson, Håkan
    Linneaus University.
    Wendin, Karin
    Kristianstad University, School of Education and Environment, Avdelningen för Praktisk-estetiska ämnen.
    Designing meals for elderly with eating difficulties: a cooperative approach2014Conference paper (Refereed)
  • 170.
    Olsson, Yvonne
    et al.
    Lund University.
    Clarén, Lena
    Lund University.
    Alvariza, Anette
    Ersta Sköndal University College.
    Årestedt, Kristofer
    Ersta Sköndal University College.
    Hagell, Peter
    Kristianstad University, Research Environment PRO-CARE, Patient Reported Outcomes - Clinical Assessment Research and Education. Kristianstad University, Research Platform for Collaboration for Health. Kristianstad University, School of Health and Society, Avdelningen för Sjuksköterskeutbildningarna.
    Health and social service access among family caregivers of people with Parkinson's disease2016In: Journal of Parkinson's Disease, ISSN 1877-7171, E-ISSN 1877-718X, Vol. 6, no 3, p. 581-587Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Being a family caregiver for a person with Parkinson's disease (PD) can negatively impact health and wellbeing, but it appears less clear to what extent caregivers' health/social service needs are met.

    OBJECTIVE: We explored the extent to which PD family caregivers experience sufficient access to health/social services, as compared to age-matched controls; and the associations between this and demographic and health-related variables.

    METHODS: A cross-sectional survey of 66 PD family caregivers and 79 age-matched control subjects including the SF-36 health survey, the Nottingham Health Profile Sleep section (NHP-Sleep), and questions regarding contacts with various health/social related services and whether these were perceived as sufficient.

    RESULTS: People reporting insufficient access (n = 29) were more often PD family caregivers than controls (83% vs. 37%), did more often have a disease of their own (79% vs. 46%), and reported poorer health according to the SF-36 and the NHP-Sleep. Being a PD family caregiver (OR, 8.90), reporting more pain (OR, 1.02) and having an own disease (OR, 3.46) were independently associated with insufficient health/social service access.

    CONCLUSIONS: Our results imply that those in greatest need for health/social services (i.e., those with poorer health, an own disease, and who are PD family caregivers) are those whose health/social service needs are least met. Larger studies are needed for firmer conclusions and regarding how unmet health/social service needs impacts caregiver health and wellbeing. Health/social service providers should not only focus on patients but also consider their family members' needs.

  • 171.
    Pajalic, Oleg
    et al.
    Chalmers University.
    Pajalic, Zada
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE. Linnaeus University Sweden and Oslo and Akershus University Norway.
    An evaluation by elderly people living at home of the prepared meals distributed by their municipality: a study with focus on the Swedish context2015In: Global Journal of Health Science, ISSN 1916-9736, E-ISSN 1916-9744, Vol. 7, no 3Article in journal (Refereed)
    Abstract [en]

    Prepared meals distributed by municipalities is a service to elderly people, or persons with health related impairments, who live in their own home, have difficulties preparing their own food and cannot meet their food requirements in any other way. This study aimed to provide a brief picture of how elderly people living at home perceive the food they receive through their municipal food service and what is important to them. The data was collected using questionnaires. 274 out of 276 participants answered the questionnaire (n=173 women 62% and n=101 man 37%). The data was analyzed using Principal Component Analysis (PCA).

    The results showed that the elderly persons receiving meals through the service were often satisfied, especially with the size of the portions and the delivery time. Those who had been using the food delivery service for a longer time were not satisfied with the alternative dishes they were been offered. There was no significant difference between the views of either gender. Further, those who were receiving special food were, in general, unsatisfied with the meals delivered.

    Development of the food distribution service by systematic quality insurance and interactive knowledge exchange between the producers and consumers seems to be a way to promote a more holistic and individual adjusted service. Evaluation of the municipal FD service is a powerful tool that can contribute to the development of this service. The food service can be improved and consequently even the quality of life and health of its receivers. The present survey should be revisited and developed in order to detect differences between genders.

  • 172.
    Pajalic, Zada
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap II. Kristianstad University, Research Environment PRO-CARE.
    A researcher's self-reflection of the facilitation and evaluation of an action research project within the Swedish social and care context2014In: Global Journal of Health Science, ISSN 1916-9736, E-ISSN 1916-9744, Vol. 7, no 3, p. 105-110Article in journal (Refereed)
    Abstract [en]

    The AR’s (Lewin, 1946) assumption was that human beings exist in life spaces through interaction, and communication, and that knowledge development is the result of changes in cognitive structures through communication and involvement in research processes. And further, from the construction of new knowledge gained by learning from each other, comes the presumption to change. The participation is described as "citizen power" (Arnstein, 1969), which means being included in the development process. The degree of citizen power is based on partnership, delegated power and citizen control. All these steps are positioned at the highest level when ranking participation. Partnership means engaging and negotiating with the high level decision makers. The result of delegated power is apparent when the negotiations result in achieving leading decisions that influence a particular plan or programme.

  • 173.
    Pajalic, Zada
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE.
    Abstrakt presenterad på FOU dagen 2013, Sektionen för Hälsa och Samhälle, Sjuksköterskeprogrammet & PRO-CARE Titel: Matdistribution ur flera perspektiv2013Other (Other academic)
    Abstract [sv]

    Studiens övergripande syfte var att utifrån äldre hemmaboende personers, olika professioners samt beslutsfattarnas erfarenheter få insikt och beskriva matdistribution inom den kommunala omsorgen. De övergripande resultaten visade att matdistribution är komplex en organisation och att den är fragmenrerat organiserad. Dc involverade professionerna tog enbart ansvar för sina egna delar av matdistributionskedjan och det saknades en övergripande funktion som hade en övergripande bild och ansvar för matdistributionsprocessen. Resultaten visade även att vissa professioner (personalen i köket och taxichauffören) tog mer ansvar än der var tänkt i förhållande till deras komptens. Således finns det behov att beskriva ansvarsområden för alla involverade i matdistribution. Äldre personers erfarenheter indikerade att matdistribution inte bör ses som en fragmenterad social insats och symbol för heroende av andras hjälp. Srudien visar att matdistribution behöver organiseras så att de äldre personernas engagemang stärks. Systematiskt arbete och involvering på alla nivåer i denna organisation har visat sig vara en gynnsam startpunkt för utvecklingen av den kommunala mardisrriburionen. Denna studie visar vikten av kontinuerlig uppdatering av kunskaper hos olika professioner som är involverade i matdistributionskedjan. Resultaten visar att matdistribution inte enbart bör ses som en logistikfråga utan en samverkansfråga.

  • 174.
    Pajalic, Zada
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap II. Kristianstad University, Research Environment PRO-CARE.
    Att få maten lagad i sitt hem2015In: Äldre i centrum, ISSN 1653-3585, no 1, p. 42-42Article in journal (Other (popular science, discussion, etc.))
  • 175.
    Pajalic, Zada
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    Food preparation at home: an example of new practical strategies in the Swedish municipal food service - a qualitative study2013In: Journal of Food Research, ISSN 1927-0887, E-ISSN 1927-0895, Vol. 2, no 6, p. 72-79Article in journal (Refereed)
    Abstract [en]

    The purpose of the present study was to describe how one of 290 Swedish municipalities improved its FS service by terminating their earlier service of food distribution (FD) which was the delivery of ready cooked meals produced at a central kitchen in the community and introducing food preparation at the client’s home. The revised system is referred to as the new FS. This study was performed using an action research approach. The data was collected by individual- and group interviews and through participatory observations. The transcribed interview material was analysed using qualitative content analysis. The (n=30) subjects were recruited The findings of this study revealed that the new FS was experienced as being a good service, that the new municipal FS met individual needs in a better way and that the elderly recipients could participate more actively in planning and preparing their meals. In conclusion, it was found that having their food prepared at home was considered by many of the recipients to be synonymous with individually adjusted help. The results of the study could have implications for nursing, public administration and gerontology.

  • 176.
    Pajalic, Zada
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE.
    How public home care officers reason when making a needs assessment for food distribution to homebound elderly persons in Sweden2013In: Global Journal of Health Science, ISSN 1916-9736, E-ISSN 1916-9744, Vol. 5, no 5, p. 31-40Article in journal (Refereed)
    Abstract [en]

    Food distribution (FD) is a part of the public social and care service in Sweden aiming to prevent improper food intake for persons that they are unable to do their own shopping, and prepare their own meals, and in that way ensure reasonable standard of living. Before a person can be granted the FD service, from any municipality, an assessment of their individual requirements has to be made by a public home care officer.

    The aim of this study was to explore how public home care officers reason when they make a needs assessment for homebound elderly people.

    The data was collected through individual interviews (n=18). The transcribed interview material was analysed by means of the grounded theory method.

    The findings showed that the public home care officers were confronted with many challenges when making an assessment of a person’s individual needs. They are influenced by their subjective feelings related to their personal views as to what should be the right solution for the individual. However, they remained aware that they needed to be guided by the legal requirements.  Further, they described that the level of an individual’s living standard is a leading concept in the governing laws that they need to interpret. Interpretation of this concept is very subjective with the possible consequence that an assessment result may lead to inefficient support.

    In conclusion, the concept of a reasonable standard of living needs to be clearly defined, decision regarding FD should not take long time, need assessment and decision should be based on the whole picture behind each individual case and there are needs to develop general guidelines for making needs assessment. The findings in this study have implications for public administration, nursing and gerontology.

  • 177.
    Pajalic, Zada
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE. Linnaeus University Sweden and Oslo and Akershus University Norway.
    Matdistribution till hemma boende äldre personer – en aktionsforskningsstudie2011Conference paper (Other academic)
  • 178.
    Pajalic, Zada
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    Matdistribution till hemmaboende äldre personer ur flera perspektiv2013Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    The overall aim of this study was to gain insight into municipal food distribution from several perspectives: that of the clients, mainly elderly people, and also from the perspectives of different professionals and decision makers. An action research approach was chosen, as the characteristics of this method were deemed to be correct in relation to the basic aim of the study. This thesis is based on four empirical studies. Study I aimed to explore various professionals’ experiences of involvement in food distribution (FD) in order to get a comprehensive understanding of the organization, responsibilities and roles. The results showed that FD is a fragmentary intervention where a comprehensive perspective and clear roles of responsibility are lacking. Study II aimed to gain insight and to describe the experiences of home-living elderly people who receive hot meals distributed by their municipality. The results showed that there were feelings of dependency, and loneliness among the elderly participants, however they also expressed gratitude for the opportunity to have their meals delivered to their home.  Study III aimed to describe how the professionals can identify needs for improvement and improve the municipal FD service to home living elderly people. The need to update and increase the FD recipient’s knowledge in nutrition by sending information letters was found to be an important area to focus on. Evaluation of letters resulted in the decision to continue preparing and distributing information letters to all FD recipients twice a year and to make the information letters assessable on the websites of the six municipalities and county councils involved. Study IV aimed to describe the decision maker’s views on FD and to report their suggestions for which areas reported from studies I-III should be taken into consideration as starting points to improve the municipal FD. The findings resulted in the decisions to monitor the elderly’s health and wellbeing while providing FD and to increase the professionals’ competence and to create a forum for inter-professional communication. In conclusion, this thesis illustrates that there is a necessity to identify the needs for general improvement of FD by involving the participants and to start out from their personal experiences and in their own context.

  • 179.
    Pajalic, Zada
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE. Kristianstad University, Research Platform for Collaboration for Health.
    Matdistribution till hemmaboende äldre personer ur olika perspektiv. Presentation vid DiGiS, Malmö Skånes universitetssjukhus Geriatriska kliniken2013Other (Other (popular science, discussion, etc.))
  • 180.
    Pajalic, Zada
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap II. Kristianstad University, Research Environment PRO-CARE.
    Nursing students’ views on promoting successful breastfeeding in Sweden2014In: Global Journal of Health Science, ISSN 1916-9736, E-ISSN 1916-9744, Vol. 6, no 5, p. 63-69Article in journal (Refereed)
    Abstract [en]

    Promoting breastfeeding is important work for health-care personnel in the Swedish context. This promotion is multifaceted and demands the ongoing development of knowledge and competence among both health-care  personnel and patients.  The aim of the present study was to describe the nursing students’ perspectives on breastfeeding in Sweden. Data were obtained in the form of written reflections from nursing students (n=65) and examined using manifest content analysis. The results show that the factors of importance in promoting successful breastfeeding are information about breastfeeding’s benefits, traditions and cultural acceptance of the practice, and by government prohibition of infant formula. We conclude that knowledge about the benefits of breastfeeding needs to be prioritized continuously during education.

  • 181.
    Pajalic, Zada
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap II. Kristianstad University, Research Environment PRO-CARE.
    När maten kommer hem2015In: Äldre i centrum : tidskrift för aktuell äldreforskning, ISSN 1653-3585, no 1, p. 40-41Article in journal (Other (popular science, discussion, etc.))
  • 182.
    Pajalic, Zada
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    The Swedish municipal food distribution service to the elderly living at home as experienced by the recipient’s relatives2013In: Global Journal of Health Science, ISSN 1916-9736, E-ISSN 1916-9744, Vol. 5, no 6, p. 12-18Article in journal (Refereed)
    Abstract [en]

    The municipal Food distribution service (FD) to the elderly living at home is a part of the public social and care service in Sweden, The objective of this service is to ensure proper food intake for persons who are unable to do their own shopping, and prepare their own meals. The foremost reasons for the need of the FD service are in situations where there are illness related physical or psychological limitations.This means that the Swedish welfare system takes on the responsibility for its citizens when they have a legal social related need of care. Further, according to the Swedish social legislation, children or other relatives have no legal obligations to take care of their parents or elderly disabled relatives. This also means that the children or relatives of elderly people requiring social support have no legal right to be involved in the evaluation procedure of need assessment or the outcome of any social and care services granted by the Swedish social welfare system.

    The aim of the present study was to gain insight into how the relatives of elderly people living at home in Sweden experience the municipal service of ready-made meals distributed daily.

    The data was collected using in-depth interviews with relatives of elderly persons who use the municipal food distribution (FD) service (n=8). The transcribed interview material was analysed using the grounded theory method.

    The findings of this study revealed that the relatives of the municipal FD service recipients advocate for a food preparation service in the home of the recipient rather than the distribution of ready-made meals from a central kitchen. The results also revealed that the participating relatives felt frustrated by the legal limitations that make it impossible for them to influence the municipal FD service. The findings in this study also indicate that relatives should be considered as a resource in this matter and could actively participate, and have a positive influence on the quality of the municipal FD service for the elderly. The results of the study could have implications for nursing, public administration and gerontology.

  • 183.
    Pajalic, Zada
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE.
    Utvärdering av den nya matservicen i en medelstor skånsk kommun2013Report (Other academic)
  • 184.
    Pajalic, Zada
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    Utvärdering av den nya servicen matlagning i hemmet2013Report (Other academic)
    Abstract [en]

    Den nya matservicen, matlagning i hemmet, är en insats som riktar sig till en heterogen grupp äldre och som involverar ett stort antal personalgrupper. Vård- och omsorgsförvaltningen i Lunds kommun genomförde under år 2012 en förändring när det gäller matservice. Förändringen inriktades på att upphöra med matdistribution den 31 mars 2012 och införa insatsen matlagning i hemmet den 1 april 2012. Matlagning i hemmet definierades som en enklare form av matlagning med beräknad schablontid på ca 30 minuter. Intentionen med att införa matlagning i hemmet var att skapa en fungerande helhetslösning för brukare med stora vård- och omsorgsbehov, att öka valfriheten, öka kvaliteten på äldres måltider och att använda ekonomiska resurser på ett bättre sätt.

    Denna utvärdering är ett sätt att blicka tillbaka och kritiskt granska hur den nya matservicen har fallit ut och mvilka förbättringsmöjligheter som finns, i syfte att erbjuda matservice av hög kvalitet till kommunens invånare.

  • 185.
    Pajalic, Zada
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    Zada Pajalic presenterar sin forskning2013Other (Other (popular science, discussion, etc.))
  • 186.
    Pajalic, Zada
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE.
    Andersson, Kristina
    Kristianstads kommun.
    Palmquist, Eva-Lott
    Kristianstads kommun.
    Skog, Therese
    Region Skåne Hässleholm.
    Norberg, Erika
    Region Skåne CSK Kristianstad.
    Till dig som har matdistribution: det är aldrig för sent att träna2012Other (Other (popular science, discussion, etc.))
  • 187.
    Pajalic, Zada
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    Berggren, Vanja
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    Keys for change: stakeholders' perceptions and experiences of promotion of breastfeeding: a joint project between Sweden and Norway2012Conference paper (Refereed)
    Abstract [en]

    Findings from international research as well as fromSwedenshow that breastfeeding is important for infant health. Further there are still needs to continuously invest on the society level to promote the breastfeeding. Working together in international research collaborations can empower all partners involved.

     

    The project have  two aims: both to describe the successful factors of  Swedish and Norwegian breastfeeding interventions programs on national level, and to elucidate the present situation and background of the present low rates of  breastfeeding.

     

    Data will be collected by individual interviews with obstetricians, midwifes, district nurses, paediatricians and voluntary breastfeeding advisers in both countries.

     

    The findings will be used to promote breastfeeding and inspire other countries spatially high-income countries to focus on the benefits and importance of the breastfeeding to infant’s health.

  • 188.
    Pajalic, Zada
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE.
    Berggren, Vanja
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    The successful factors of Swedish and Norwegian breastfeeding interventions programs as inspiration to promote breastfeeding internationally - presentation of the future joint project between Sweden and Norway2012Conference paper (Refereed)
    Abstract [en]

    Findings from international research as well as from Sweden show that breastfeeding is important for infant health. Further there are still needs to continuously invest on the society level to promote the breastfeeding. Working together in international research collaborations can empower all partners involved.

     

    The projects’ aims are to describe the successful factors of Swedish and Norwegian breastfeeding interventions programs on national level, and to elucidate the present situation and background of the present low rates of breastfeeding. Further the aim is to develop the Nordic breastfeeding model.  

     

    Data will be collected between September and December 2013 by individual and focus group interviews with obstetricians, midwifes, district nurses, paediatricians and voluntary breastfeeding advisers in both countries. Further the outcomes from the interviews will be used to creation of the questionnaire that will be tested and power analysis performed during the spring at 2014.

     

    The findings will be used to promote breastfeeding and inspire other countries spatially high-income countries to focus on the benefits and importance of the breastfeeding to infant’s health.

  • 189.
    Pajalic, Zada
    et al.
    Kristianstad University, School of Health and Society. Kristianstad University, Forskningsplattformen Hälsa i samverkan. Kristianstad University, Research Environment PRO-CARE.
    Norberg, Erika
    Region Skåne CSK Kristianstad.
    Skog, Therese
    Region Skåne Hässleholm.
    Andersson, Kristina
    Kristianstads Kommun.
    Palmquist, Eva-Lott
    Kristianstads Kommun.
    Informationsbrev till matdistributionsmottagare2011Other (Other (popular science, discussion, etc.))
  • 190.
    Pajalic, Zada
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE. Linnaeus University Sweden and Oslo and Akershus University Norway.
    Palmquist, Eva-Lott
    Kristianstads kommun.
    Norberg, Erika
    Region Skåne CSK Kristianstad.
    Andersson, Kristina
    Kristianstads kommun.
    Skog, Therese
    Region Skåne Hässleholm.
    Till dig som har matdistribution: mellanmål för dig2011Other (Other (popular science, discussion, etc.))
  • 191.
    Pajalic, Zada
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE. Linnaeus University Sweden and Oslo and Akershus University Norway.
    Persson, Lena
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    Using story dialogue method: inspired by the PAR approach, to identify and develop problem areas in food distribution to elderly people living at home in five municipalities in Sweden2010In: Action Learning & Action Research Assosiation, ALARA, World Congress 2010: Participatory Action Research and Action Learning / [ed] Dr Susan Goff, 2010Conference paper (Other academic)
    Abstract [en]

    In this paper, we will discuss a study whose concern is to identify and develop areas of food distri­bution by testing a model that allows the practitioners to participate in the exploring of their own stories of everyday practice. The fundamental reason for engaging the practitioners in the research was to facilitate them in obtaining tools to reflect on practice and to inform about future actions. Our in­tention was to use PAR as the approach as to building a bridge between theory and practice for which the SDM proved to be suitable for gaining and analysing data. Some of the links between the PAR approach and the SDM are that both consist of continuous cycles of reflection and learning. The stories should be used as a powerful vehicle to discover new knowledge and to deepen the under­standing of professional practice issues. Reflection and story telling are closely related to the proces­sing of information and gaining new insights from experiences. To take stories from practitioners’ own experience is similar to that of the ‘look phase’ of PAR, which implies that what is happening is described and thus clarifies the core problem of what the practitioners would like to change. The ‘think phase’ of PAR, and the structured dialogue in the SDM, involves detailed de­scriptions, explanations and the exploring of the issues that are aggregated and focused on in the structured dialogue around questions such as: What can we do to move on; what actions could be taken; what happens if nothing is done; and what are the possible effects. Actual stories were used as “triggers” when probing questions were asked in a dialogical and structured form. The process involves the combination of having a dialogue and writing memo notes. The dialogue on various strategies, in­clu­ding weaknesses and strengths, continues until each action and the expected benefits of a chosen action have been adequately discus­sed. The dialogue has a constant focus on what is of greatest im­por­tance for a chosen action from an ethical, legal, economic, colla­borative and organisational point of view. Furthermore, the dialogue evaluation emphasises on how participants reflect on what the expected change is, how change comes about, and what the consequences of the change imply. Our conclusion is that the PAR approach and the use of SDM are suitable and systematic methods to generate data and to encourage collaboration between various professional groups, i.e. an active participation through dialogue where there are no restrictions in the communication and everybody’s voice is heard equally. In this study, as to critically reflect on how the SDM embodies a participatory and an ‘action’ oriented approach implies that, as a platform, an actual, real, case from practice was used. Chosen jointly and in agreement by the practitioners, the case should always be one with which all can be familiar and treat as their own. The starting point was our perception that the practitioners are the experts in their particular everyday work, and that they are able to identify problems them­selves, which would be resolvable through actions and changes in the daily routines. Another benefit of involving the practitioners was how their motivation to make changes to a particular problem they had deemed important to resolve increased. The systemic issues, which were identified in the study, call attention to the importance of systematic collaboration, and by using the SDM, issues that concern the organisation and its practice directly may be explored. This cyclical process provided an expanded understanding about the food distribution context. In addition, the dialogue has developed over time from focusing on formal aspects, such as routines, competence levels, responsibility and how to fill in forms, to include more organisational aspects. The practitioners felt that structured dialogues and ref­lecting gave them a better understanding about the food distribution context. The reciprocal relations that were rendered in the non-restrictive communication – down-up and up-down in PAR – were identified as important. Another important insight was that support from the parent organisation was necessary when actions were to be taken and changes in practice were to be made. In closing, the study stems from our shared deep engagement and absorption in practice and together we saw how stories unfolded. It became clear that a greater understanding of and by the various professional groups would have to be obtained in order to achieve changes in the practice of food distribution to elderly persons for which such understanding is a necessary starting point.

  • 192.
    Pajalic, Zada
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    Persson, Lena
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    Skovdahl, Kirsti
    The School of Medical and Health Sciences, Örebro University.
    Westergren, Albert
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE.
    Facilitating change, the decision-maker’s views of municipality organized food distribution to elderly people living at home and suggestions for development: a participatory action research study2012In: Public Administration Research, ISSN 1927-517X, Vol. 1, no 1, p. 14-23Article in journal (Refereed)
    Abstract [en]

    This study is the final part of a larger project with an action research approach focusing on food distribution (FD) within municipal service and care for elderly persons, living at home (≥65 years), from various perspectives. The aim was to describe the decision-makers’ the politicians and top level administrative manager’s views on the FD service, and to give feedback from the results of earlier studies based on information given by FD receivers, the perspectives of involved professionals, and the results of an intervention study and further to report the decision-makers suggestions for which areas should be taken into consideration as starting points to improve the FD process and practice. Data was gathered in two steps: step 1, through individual interviews (n=12) with the decision-makers during the spring of 2009, step 2a through feedback from previous studies, received during the autumn of 2011 and step 2b from discussions based on the feedback. The interview data was analysed using qualitative content analysis. The findings indicated a discrepancy between the reality and the political visions. It was shown that decision-maker’s needed to make decisions despite their uncertain knowledge of the complexity of the FD programmeThey considered what has been, what is, and will be, when setting goals. Their goal was that elderly person’s rights and needs should be fulfilled. This included freedom of choice and individual consideration. In addition, it meant, meeting elderly people’s medical and social needs. Three areas were found to require facilitation for change related to FD: 1) the monitoring of the elderly’s health and wellbeing while providing FD, 2) the increasing of professional competence, and 3) the creation of a forum for inter-professional communication. The findings in this study have implications for nursing, gerontology and public administration.

  • 193.
    Pajalic, Zada
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    Persson, Lena
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    Westergren, Albert
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE.
    Berggren, Vanja
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    Skovdahl, Kirsti
    School of Medical and Health Sciences, Örebro University.
    The experiences of elderly people living at home related to their receiving meals distributed by a municipality in Sweden2012In: Journal of Food Research, ISSN 1927-0887, Vol. 1, no 1, p. 68-78Article in journal (Refereed)
    Abstract [en]

    The purpose of the study was to describe the experiences of elderly people, living at home who receive hot meals that are distributed by their municipality. Qualitative content analysis was used to analyse the (n=13) interviews. The results showed that feelings of dependency, loneliness and gratitude were expressed by the participants in the study related to their meals being delivered home. Dependency was expressed as not having influence over the food products the meals were made from. Loneliness was expressed as being isolated and being confined at home alone due to difficulties getting out of the house, which was associated with the costs of taxis transportation. Gratitude was expressed by the sincere thanks for the possibility of receiving traditional meals delivered daily.

    The major conclusion of the study was the indication that greater attention should be paid to meet both the practical and psychological needs of elderly people.

  • 194.
    Pajalic, Zada
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    Persson, Lena
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    Westergren, Albert
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE.
    Skovdahl, Kirsti
    Hälsoakademin Örebro Universitet.
    Evaluation for change, the decision maker’s involvement in the development of food distribution to home living elderly people2012Conference paper (Refereed)
    Abstract [en]

    Findings from international research as well as from Sweden show that food distribution as a single inter­vention involves various professional groups on the various levels in organisation.

     

    The present research is one of several Action Research projects initiated as a result of a resolution on the highest political level aiming at achieving improvements within the care and service through collaboration between different levels in the organisations.

     

    The overall aim of this specific study is to describe the “top-down” perspective i.e. decision-makers involvement in identifying areas for the development of the food distribution chain.

     

    Data was collected in two steps, firstly by individual interviews with decision makers (politicians n=21, one administrative manager and one medical responsible nurse) and secondly by evaluation dialogue in group (n=23) discussion. The group discussions were based on findings from individual interviews and results from two previous studies focused on interviews with various professionals and food distribution recipients.

     

    The findings were that food distribution was seen as a multifaceted system that included three interrelated issues: the administration of work, the professional’s competence in nutrition and the relationship between various professional groups. To achieve a change, the central component of complexity needs to be clarified. When the issues are multifaceted the solutions need to regard the whole picture rather than its parts.

  • 195.
    Pajalic, Zada
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    Persson, Lena
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    Westergren, Albert
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE.
    Skovdahl, Kirsti
    Hälsoakademin Örebro Universitet.
    Evaluation for change, the decision maker’s involvement in the development of food distribution to home living elderly people2012In: International Conference Interprofessional Partnership: Improvement for Global Health Outcomes Thailand, 2012Conference paper (Refereed)
    Abstract [en]

    Findings from international research as well as fromSwedenshow that food distribution as a single inter­vention involves various professional groups on the various levels in organisation.

     

    The present research is one of several Action Research projects initiated as a result of a resolution on the highest political level aiming at achieving improvements within the care and service through collaboration between different levels in the organisations.

     

    The overall aim of this specific study is to describe the “top-down” perspective i.e. decision-makers involvement in identifying areas for the development of the food distribution chain.

     

    Data was collected in two steps, firstly by individual interviews with decision makers and secondly by group discussions. The group discussions were based on findings from individual interviews and results from two previous studies focused on interviews with various professionals and food distribution recipients.

     

    The findings were that food distribution was seen as a multifaceted system that included three interrelated issues: the administration of work, the professional’s competence in nutrition and the relationship between various professional groups. To achieve a change, the central component of complexity needs to be clarified. When the issues are multifaceted the solutions need to regard the whole picture rather than its parts.

     

    Keywords: action research, decision-makers, food distribution in Swedish context, “top-down” perspective

     

    The short paper and presentation would fit in the key theme Health Care Management of the congress.

     

  • 196.
    Pajalic, Zada
    et al.
    Kristianstad University, School of Health and Society. Kristianstad University, Research Environment PRO-CARE. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    Persson, Lena
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    Westergren, Albert
    Kristianstad University, School of Health and Society. Kristianstad University, Research Environment PRO-CARE.
    Skovdahl, Kirsti
    School of Health and Medical Sciences, Örebro University.
    Food distribution within a municipality from different perspectives – older people, decision makers and professionals: an action research study2011Conference paper (Refereed)
    Abstract [en]

    The present research project is one of Action Research (AR) projects in a region in southern part of Sweden, Scania. All the AR projects originate as result of a decision on the highest political level. The decision was to do changes within the care service where collaboration between different care organisations should be advocated in aim to support and help care consumers. The care should be provided in more care consumer centred ways in which care consumers should be in the centre. These changes should emphasise public and care users’ involvement and participation in decisions around the treatment, service development and evaluation. The participatory service should be performed through a constructive dialogue between care users, health care professionals as a catalyst to common practice change.  The overall aim of the project was to explore FD to older people living alone in their own  homes from different perspectives: elderly as consumers, decision-makers and various professionals.  The specific aims were: 1)to explore various professionals’ experiences in relation to their involvement in food distribution in order to get a comprehensive understanding of the organisation, responsibilities and roles in the specific context (“bottom-up” perspective);

    2) to explore older people’s experiences of food distribution and their suggestions what they whish to change (“bottom-up” perspective); 3) to identify, suggest, implement and evaluate chosen actions issues together with various professionals and elderly people (“bottom-up” perspective); 4) the results from the studies 1-3 will be given as feedback to the decision-makers level and it will be start point for reflective reasoning by using Story Dialogue Method in aim to identify conditions for development of food distribution chain (“top-down” perspective).

     

    The short paper and presentation, on how to identify the practical issues involved and what can be done to create a receptive context for change, would fit in the fourth key theme of the congress.

  • 197.
    Pajalic, Zada
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    Persson, Lena
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    Westergren, Albert
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE.
    Skovdahl, Kirsti
    School of Medical and Health Sciences, Örebro University.
    Public home care professionals’ experiences of being involved in food distribution to home-living elderly people in Sweden: a qualitative study with an action research approach2012In: Journal of Nursing Education and Practice, ISSN 1925-4040, E-ISSN 1925-4059, Vol. 2, no 2, p. 41-51Article in journal (Refereed)
    Abstract [en]

    Background: Research focusing on Food Distribution (FD) from various professionals’ and organisational perspectivesare lacking. The aim of this study was therefore to explore various professionals’ experiences of involvement in FD inorder to get comprehensive understanding of the organisation, responsibilities and roles.

    Methods: This qualitative study is a part of a larger project with an action research approach focusing on FD in themunicipal home service and care for home-living elderly persons in a municipality in southern Sweden. The data wascollected through participatory observations (n=90 occasions and in total 480 hours), repeated focus group interviews (n =4) with different professionals (n =10) involved in the FD process and one individual interview. The material was analysedby qualitative manifest and latent content analysis.

    Results: The study indicates that Food Distribution is a fragmentary intervention where a comprehensive perspective andclear roles of responsibility are lacking. The FD organisation seemed to be strictly divided and limited by constraintsregarding time and money. The fragmented organisation led partly to staff only taking responsibility for their part of thechain and no one having the full picture of and responsibility for the FD process, but also to some professionals takingmore responsibility than they were supposed to.

    Conclusions: The aim of the study was met by using an action research approach. The study was however limited by thatno home help officers were represented. The FD appeared as an extremely complex chain of different but connectedactivities. It is not merely the distribution of a product, i.e. the meal box. The fragmentation of FD means that staff onlytakes responsibility for their part of the chain, and that no one has the full picture of or responsibility for the FD process.Consequently, there is a need for an outline of responsibilities. The findings have implications for nursing, gerontology,and in the care for the elderly.

  • 198.
    Pajalic, Zada
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    Skog, Therese
    Kostenheten Kristianstads kommun.
    Palmquist, Eva-Lott
    Kristianstads Kommun.
    Arvidsson, Andreas
    Osby kommun.
    Andersson, Pia
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Forskningsmiljön Oral Hälsa - Allmänhälsa - Livskvalitet.
    ”Munhälsa”: till dig som har matdistribution2013Other (Other (popular science, discussion, etc.))
  • 199.
    Pajalic, Zada
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE. Kristianstad University, Forskningsplattformen Hälsa i samverkan.
    Skovdahl, Kirsti
    Hälsoakademin Örebro Universitet.
    Westergren, Albert
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE.
    Persson, Lena
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap.
    How the professionals can identify needs for improvement and improve food distribution service for the home-living elderly people in Sweden - an action research project2013In: Journal of Nursing Education and Practice, ISSN 1925-4040, E-ISSN 1925-4059, Vol. 3, no 8, p. 29-40Article in journal (Refereed)
    Abstract [en]

    Background: Making changes to municipal social care and service has been found to be challenging to realise and highly multifaceted. The aim of this study was to describe how the professionals can identify needs for improvement and improve Food Distribution (FD) service for the home-living elderly people in Sweden.

    Methods: This study is part of a larger project with an action research approach focusing on to municipal FD to older people living in their own home in Sweden. The professionals involved in FD invited the first author to assist them in this process. The study participants were comprised of the following groups: “The Identification focus group” that identified need for improvement of FD (n= 5); “The Action focus group” that planned and choose suitable ‘action’ for improvement (n=5); “The First Evaluation group” (n=4) that evaluated the content of planned improvement and finally “The Second Evaluation group” (n=29) that evaluated the changes following improvement. The data was gathered and analysed by Story Dialogue Method.

    Results: The need to update and increase the FD recipient’s knowledge in nutrition by sending them informative letters was found to be an important area to focus on. The information letters (n=1700) were distributed to the all FD recipients in six municipalities in southern Sweden during April 2011. The results were evaluated during May 2011. The overall general estimation was that the content of the letters indicated that this was a suitable method for gaining information to make a nutrition competence update. Following this, “The Action focus group” decided: firstly, to continue preparing and distributing information letters to all FD recipients to be sent out twice a year, and secondly: to make the information letters accessible on the websites of the six municipalities and county councils involved.

    Conclusions: This study showed that systematic work inspired by an action research approach with motivated and involved participants can be beneficial and a starting point for the process of change in municipal service and care practice. The major conclusion of the study was that systematic reflection over everyday practice can be the vehicle for the future change of practice. The research process and the findings have implications for nursing, care of the elderly and gerontology.

  • 200.
    Pajalic, Zada
    et al.
    Kristianstad University, School of Health and Society, Avdelningen för Hälsovetenskap. Kristianstad University, Research Environment PRO-CARE. Linnaeus University Sweden and Oslo and Akershus University Norway.
    Therese, Skog
    Region Skåne Hässleholm.
    Norberg, Erika
    Region Skåne CSK Kristianstad.
    Palmquist, Eva-Lott
    Kristianstads kommun.
    Andersson, Kristina
    Omsorgsförvaltningen, kostenheten, Bånken, Kristianstads kommun.
    Till dig som har matdistribution: matens betydelse för dig2011Other (Other (popular science, discussion, etc.))
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