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  • 1. Aanesen, Arthur
    et al.
    Westerbotn, Margareta
    Sophiahemmet University.
    Prospective study of a Swedish infertile cohort 2005-08: population characteristics, treatments and pregnancy rates2014In: Family Practice, ISSN 0263-2136, E-ISSN 1460-2229, Vol. 31, no 3, p. 290-7Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: We here report on results from a prospective study comprising 380 infertile couples undergoing infertility work-up and various treatments for infertility in our clinic. The aim was to investigate the overall birth rate as a result of different treatments, as well as spontaneous pregnancies.

    METHODS: Three hundred and eighty couples were consecutively included between December 2005 and May 2008. All couples underwent a fertility work-up, including hysterosalpingogram, hormonal characterization, clinical examination, screening for infectious diseases and semen analysis. The mean age of the women at the time of inclusion was 33.2 years. The mean duration of infertility prior to inclusion was 1.8 years. And 46.6% (n = 177) of the women had been pregnant prior to their first visit to the clinic and 30.0% (n = 114) had been pregnant earlier in their present relationship.

    RESULTS: As of November 2010, 57.3% (n = 218) of the women had given birth to a child when they were lost to follow up by the study. Spontaneous conception was observed in 11.3% (n = 43) of the women, 14.5% (n = 64) conceived after intrauterine insemination (IUI), 4.2% (n = 16) conceived after ovarian hyperstimulation and ovulation induction (OH/OI) and 28.4% (n = 113) after in vitro fertilization. There were 280 pregnancies and 58 spontaneous abortions (22.3%) in the group. Mean anti-mullerian hormone significantly correlated with antral follicle count and age and was significantly higher in the subgroup that became pregnant after IUI.

    CONCLUSIONS: Spontaneous pregnancies and IUI + OH/OI contributed significantly to the pregnancies observed in the total population. Predictive factors for pregnancy were anti-mullerian hormone in the group undergoing IUI treatment and in the age group ≥38-duration of infertility. Previous pregnancies, body mass index, estradiol, follicle stimulating hormone or having given birth prior to the infertility period were not predictive of pregnancy for the infertile couples in this study.

  • 2.
    Craftman, Åsa
    et al.
    Sophiahemmet University.
    Hammar, Lena M
    von Strauss, Eva
    Hillerås, Pernilla
    Sophiahemmet University.
    Westerbotn, Margareta
    Sophiahemmet University.
    Unlicensed personnel administering medications to older persons living at home: a challenge for social and care services2015In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 10, no 3, p. 201-210Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Administration of medication to care recipients is delegated to home-care assistants working in the municipal social care, alongside responsibility for providing personal assistance for older people. Home-care assistants have practical administration skills, but lack formal medical knowledge.

    AIM: The aim of this study was to explore how home-care assistants perceive administration of medication to older people living at home, as delegated to them in the context of social care.

    METHODS: Four focus groups consisting of 19 home-care assistants were conducted. Data were analysed using qualitative content analysis.

    RESULTS: According to home-care assistants, health and social care depends on delegation arrangements to function effectively, but in the first place it relieves a burden for district nurses. Even when the delegation had expired, administration of medication continued, placing the statutes of regulation in a subordinate position. There was low awareness among home-care assistants about the content of the statutes of delegation. Accepting delegation to administer medications has become an implicit prerequisite for social care work in the municipality.

    CONCLUSIONS: Accepting the delegation to administer medication was inevitable and routine. In practice, the regulating statute is made subordinate and consequently patient safety can be threatened. The organisation of health and social care relies on the delegation arrangement to meet the needs of a growing number of older home-care recipients.

    IMPLICATIONS FOR PRACTICE: This is a crucial task which management within both the healthcare professions and municipal social care needs to address, to bridge the gap between statutes and practice, to create arenas for mutual collaboration in the care recipients' best interest and to ensure patient safety.

  • 3.
    Craftman, Åsa
    et al.
    Sophiahemmet University.
    von Strauss, Eva
    Lundell Rudberg, Susanne
    Sophiahemmet University.
    Westerbotn, Margareta
    Sophiahemmet University.
    District nurses' perceptions of the concept of delegating administration of medication to home care aides working in the municipality: A discrepancy between legal regulations and practice2013In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 22, no 3-4, p. 569-578Article in journal (Refereed)
    Abstract [en]

    Aims and objectives.  To describe district nurses' perceptions of the concept of delegating medication management to unlicensed personnel working in municipal social care. Background.  The delegation of medical tasks involves responsibility and is regulated by law to avoid damage and injuries and to protect the patient. The delegation of the administration of medication is a multifaceted task. The delegating district nurse is responsible for the outcome and should also follow up the delegated task. Design.  A descriptive qualitative study, involving semi-structured interviews and content analysis. Methods.  Twenty district nurses were interviewed. The interviews were audio taped. The data were collected from April 2009-August 2010 and analysed using content analysis. Results.  The findings revealed that the statutes of delegation appear to be incompatible with practice, however, mostly due to lack of time. Communication between district nurses and home care aides, as well as tutoring, was regarded as important. The district nurses found it imperative to be available to the home care aides and made an effort to create a trusting atmosphere. Conclusions.  District nurses cannot manage their workload without delegating the administration of medication in the present organisational model of health care and social care. The statutes regarding delegating medicine tasks are also cumbersome and difficult to incorporate for district nurses who are responsible for the delegation. Relevance to clinical practice.  The findings elucidate the current situation as regards district nurses and the need to delegate the administration of medication. Health care and social care for home-dwelling older patients, as well as statutes, needs to be evaluated and updated to meet and be prepared for the increasing demands of care.

  • 4.
    Craftman, Åsa
    et al.
    Sophiahemmet University.
    Westerbotn, Margareta
    Sophiahemmet University.
    von Strauss, Eva
    Hillerås, Pernilla
    Sophiahemmet University.
    Marmstål Hammar, Lena
    Older people's experience of utilisation and administration of medicines in a health- and social care context2015In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 29, no 4, p. 760-768Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: People living at home who lack ability to manage their medicine are entitled to assistance to improve adherence provided by a home care assistant employed by social care.

    AIM: The aim was to describe how older people with chronic diseases, living at home, experience the use and assistance of administration of medicines in the context of social care.

    DESIGN: A qualitative descriptive study.

    METHODS: Ten participants (age 65+) living at home were interviewed in the participants' own homes. Latent content analysis was used.

    FINDINGS: The assistance eases daily life with regard to practical matters and increases adherence to a medicine regimen. There were mixed feelings about being dependent on assistance; it interferes with self-sufficiency at a time of health transition. Participants were balancing empowerment and a dubious perception of the home care assistants' knowledge of medicine and safety. Physicians' and district nurses' professional knowledge was a safety guarantee for the medicine process.

    CONCLUSIONS: Assistance eases daily life and medicine regimen adherence. Dependence on assistance may affect self-sufficiency. Perceived safety varied relating to home care assistants' knowledge of medicine.

    RELEVANCE TO CLINICAL PRACTICE: A well-functioning medicine assistance is crucial to enable older people to remain at home. A person-centred approach to health- and social care delivery is efficient and improve outcome for the recipient of care.

  • 5.
    Gransjön Craftman, Åsa
    et al.
    Sophiahemmet University.
    Grape, Charlotte
    Sophiahemmet University.
    Ringnell, Katarina
    Sophiahemmet University.
    Westerbotn, Margareta
    Sophiahemmet University.
    Registered nurses' experience of delegating the administration of medicine to unlicensed personnel in residential care homes2016In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 25, no 21-22, p. 3189-3198Article in journal (Refereed)
    Abstract [en]

    AIMS AND OBJECTIVE: The aim was to describe registered nurses' experience in the context of delegating the administration of medication to unlicensed personnel in residential care homes.

    BACKGROUND: The residents in residential care homes have a need for extensive care and nursing, and large amounts of medicines are common practice. Registered nurses' workload and difficulties in fulfilling their duties, such as administration of medicines, have led to frequent delegation of this task between the registered nurses and unlicensed assisting personnel. It is, of course, a great responsibility to ensure that the care of the older people remains safe while maintaining quality in the prevailing situation.

    DESIGN: A qualitative inductive descriptive study.

    METHODS: Data were collected using audio-recorded semistructured interviews with a purposive sample of 18 registered nurses and interpreted using manifest content analysis. The study was approved by the ethical research committee.

    RESULTS: Registered nurses found the organisation unsupportive with regard to nursing interventions. The delegation context was experienced as a grey zone; the rules and regulations were not in line with the unspoken expectation to delegate the administration of medicine to unlicensed personnel, in order to be able to manage their daily work.

    CONCLUSIONS: The slimmed organisation of residential care homes relies upon registered nurses' use of delegation of medicine administration to unlicensed assistant personnel. It becomes an inevitable assignment entailing a challenging responsibility for patient safety and the quality of care.

    RELEVANCE TO CLINICAL PRACTICE: The results of this study may contribute to a better understanding of the complexity of caring for older people in residential care homes and to improving the work environment of all healthcare personnel.

  • 6.
    Gransjön Craftman, Åsa
    et al.
    Sophiahemmet University.
    Grundberg, Åke
    Sophiahemmet University.
    Westerbotn, Margareta
    Sophiahemmet University.
    Experiences of home care assistants providing social care to older people: A context in transition2018In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 13, no 4, article id e12207Article in journal (Refereed)
    Abstract [en]

    AIM: The aim was to describe home care assistants' (HCA) experiences of providing social care in older people's own homes.

    BACKGROUND: With the increase in average life expectancy and related growth of the elder population, addressing geriatric care needs has become an increasingly vital issue. However, the frontline workforce faces major challenges in meeting these needs, including a lack of trained professionals entering the field.

    DESIGN: A qualitative inductive design was used.

    METHODS: A descriptive, qualitative study using focus group interviews and content analysis.

    FINDINGS: The findings revealed that HCAs are active in an area facing challenges due to an older home-dwelling generation. Transfer of tasks should be reviewed considering changes to the workforce's skill mix brought on by task shifting.

    CONCLUSIONS: Certain prerequisites are needed to enable unlicensed assistive personnel to perform a good job; they also need to receive affirmation that they are a crucial workforce carrying out multifaceted tasks. To improve and maintain the pull factors of social care work, it is crucial to clarify how older people's requirements influence the daily care relation.

    IMPLICATIONS FOR PRACTICE: The findings highlight HCAs' blurred responsibility when providing nursing and care to older people with multiple chronic conditions and functional disabilities. Increasing expectations are placed upon HCAs to cope with practical situations that are theoretically outside the bounds of social care. The findings contribute knowledge to further development of collaboration between social and health care providers as well as the important affirmation of this unlicensed personnel group in transition. A long-term plan is therefore needed to provide HCAs with the skills and tools they need to deliver care and support to older people with a variety of needs.

  • 7.
    Gransjön Craftman, Åsa
    et al.
    Sophiahemmet University.
    Johnell, Kristina
    Fastbom, Johan
    Westerbotn, Margareta
    Sophiahemmet University.
    von Strauss, Eva
    Time trends in 20 years of medication use in older adults: Findings from three elderly cohorts in Stockholm, Sweden2016In: Archives of gerontology and geriatrics (Print), ISSN 0167-4943, E-ISSN 1872-6976, Vol. 63, p. 28-35Article in journal (Refereed)
    Abstract [en]

    Abstract

    New drugs and expanded drug indications are constantly being introduced. Welfare states strive to provide equity in drug treatment for all of its citizens and todaýs healthcare systems spend financial resources on drugs for the elderly in a higher rate than for any other age group. Drug utilization in elderly persons has an impact in health and wellbeing in older people.

    The purpose of the research

    It was to describe the changes in medication use including people aged 78 years and over regardless of residence and other characteristics over 20 years.

    Materials and methods

    The study population consisted of 4304 participants in three population-based cross-sectional surveys conducted in the Kungsholmen area of central Stockholm, Sweden. The participant’s current drug utilization was reviewed by physicians following standardized protocols. Data were statistical analyzed. Logistic regression models was used to estimate odds ratios and 95% confidence intervals for use of analgesics and psychotropic drugs in the cohorts of 2001 and 2007, controlling for age, gender, education and cognition.

    The principal results and major conclusions

    Results shows that the prevalence of medication use and polypharmacy in older adults has increased dramatically the late 1980s to the 2000s in central Stockholm, Sweden. In particular, the use of analgesics increased significantly, while some drug groups decreased, i.e., antipsychotics. Women used more medication than men in all three cohorts. Older adults living in service buildings used the largest amount of drugs in 1987, whereas those living in institutions were the most frequent users in 2001 and 2007.

  • 8.
    Hillerås, Pernilla
    et al.
    Sophiahemmet University.
    Aguero-Torres, H
    Jorm, Anthony F
    Westerbotn, Margareta
    Sophiahemmet University.
    Winblad, Bengt
    Well-being in nonagenarians and the impact of objective health2002In: Brain Aging International Journal, ISSN 1582-8352, EISSN 1582-8360, Vol. 2, no 2, p. 31-35Article in journal (Refereed)
  • 9.
    Lejman, Eva
    et al.
    Sophiahemmet University.
    Westerbotn, Margareta
    Sophiahemmet University.
    Pöder, Ulrika
    Wadensten, Barbro
    The ethics of coercive treatment of people with dementia2013In: Nursing Ethics, ISSN 0969-7330, E-ISSN 1477-0989, Vol. 20, no 3, p. 248-262Article in journal (Refereed)
    Abstract [en]

    The aim of the present study was to describe how registered nurses in nursing homes ensure legal security, good and safe nursing care and uphold the dignity of nursing home residents with severe dementia without violating residents' integrity. Semi-structured interviews were conducted with 10 charge nurses in a county in central Sweden. The transcribed interviews were examined using manifest and latent content analyses. The manifest analysis identified actual local routines involving coercive treatment and registered nurses' descriptions of complications and alternative measures. The latent analysis resulted in three themes describing nursing strategies: one with coercive treatment, one with coercive treatment under specific circumstances and one to prevent coercive treatment. Interpretations of legal terms regarding coercive treatment and inadequate gerontological nursing training and understaffing seem to preserve the use of coercive treatment.

  • 10.
    Lundell, Inger Wallin
    et al.
    Sophiahemmet University.
    Eulau, Louise
    Sophiahemmet University.
    Bjarneby, Frida
    Westerbotn, Margareta
    Sophiahemmet University.
    Women's Experiences with Healthcare Professionals after Suffering from Gender-Based Violence: An Interview Study2018In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 5-6, p. 949-957Article in journal (Refereed)
    Abstract [en]

    AIM AND OBJECTIVES: This study sought to describe how women in Mexico who have suffered from gender-based violence experience their encounters with healthcare professionals.

    BACKGROUND: Gender-based violence is a worldwide problem. Previous studies have described that women feel they are not being cared for appropriately during their encounters with healthcare professionals. This study was conducted in Mexico, which has a high rate of gender inequality.

    DESIGN: A descriptive, qualitative study was conducted.

    METHODS: Face-to-face interviews were conducted with seven women. An inductive content analysis was used to analyse the interviews.

    RESULTS: The analyses resulted in four categories: Feelings of guilt about being abused, Feelings of being unimportant, Feelings of taking time and Feelings of being insecure/secure. The women emphasised the importance of healthcare professionals taking time out of their busy schedules for them. When they treated the women with respect and genuine interest, the women felt secure. When the healthcare professionals did not meet these expectations, feelings of frustration and mistrust were elicited.

    CONCLUSIONS: Feelings of being listened to and safety were considered important aspects in a positive encounter, whereas feeling a lack of time or interest often led to negative experiences such as frustration with and distrust of the healthcare system. These results imply that healthcare professionals may have deficiencies with regard to how these women are treated because these women do not feel that they receive the proper support.

  • 11.
    Lundell Rudberg, Susanne
    et al.
    Sophiahemmet University.
    Westerbotn, Margareta
    Sophiahemmet University.
    Scheja, Max
    Lachmann, Hanna
    Sophiahemmet University.
    Investigating nursing students' transition from novice to motivated undergraduate students using CASS as a reflective tool2017Conference paper (Other academic)
  • 12.
    Sormunen, Taina
    et al.
    Sophiahemmet University.
    Aanesen, Arthur
    Fossum, Bjöörn
    Sophiahemmet University.
    Karlgren, Klas
    Westerbotn, Margareta
    Sophiahemmet University.
    Infertility-related communication and coping strategies among women affected by primary or secondary infertility2018In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 27, no 1-2, p. e335-e344Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Infertility is a worldwide problem and is experienced as psychologically stressful. Communication about infertility varies depending on clinical aspects, personal relationships and culture. The aim of this study was to explore infertility-related communication and coping strategies among women affected by, primary or secondary fertility problems.

    METHODS: A quantitative cross-sectional study design was used. One hundred ninety-nine women affected by primary and secondary infertility were recruited from one fertility clinic in Stockholm. A structured self-administered questionnaire was used to collect data. The answers were compared across the two groups using the chi-squared test for independence.

    RESULTS: The majority of the women discussed infertility related subjects with intimate friends and/or relatives and did not discuss the results of examinations and tests with people outside of the family. There were significant differences between the two groups. Twice as many women with secondary infertility acknowledged that they never talk about the causes or results of the tests and examinations with other people, compared with women with primary infertility. Approximately 25 percent of the women with primary infertility used distraction techniques, such as turning to work, as a coping strategy compared to women with secondary infertility (10%). Some women did not discuss the inability to conceive and reasons why they were childless with their spouses. Twelve percent of the women reported that they left the room when the subjects of children were being discussed. Approximately 30 percent of the participants did not ask friends or relatives for advice and a few were not able to discuss how tests and treatments affected them emotionally.

    CONCLUSION: The present study indicates that a majority of infertile women discuss about infertility-related subjects with their spouses. However they are less likely to discuss the reason for infertility and results of tests and examinations with people outside the family.

    RELEVANCE TO THE CLINICAL PRACTICE: The result of the current study can be useful regarding interventions for women affected by primary or by secondary infertility. The healthcare staff must be alert and attentive in order to pay attention to these possible challenges. Identification of women at risk of developing emotional problems due to communication difficulties regarding infertility-related issues merits close attention. This article is protected by copyright. All rights reserved.

  • 13.
    Sormunen, Taina
    et al.
    Sophiahemmet University.
    Karlgren, K
    Fossum, Bjöörn
    Sophiahemmet University.
    Aanesen, A
    Westerbotn, Margareta
    Sophiahemmet University.
    Social media in the infertile community: What do the bloggers blog about?2019Conference paper (Other academic)
  • 14.
    Sormunen, Taina
    et al.
    Sophiahemmet University.
    Westerbotn, Margareta
    Sophiahemmet University.
    Aanesen, A
    Karlgren, K
    Infertility related communication and coping strategies among women affected by fertility problems in Sweden2016Conference paper (Other academic)
  • 15.
    Westerbotn, Margareta
    Sophiahemmet University.
    Drug Use Among the Very Old Living in Ordinary Households: Aspects on Well-being, Cognitive and Functional Ability2007Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background: In Sweden today a major proportion of the population survive to old ages. To a large extent, the oldest old are capable of living longer in their own households; some of them are very healthy while others have multiple diagnoses or ailments caused by a normal ageing process. This means that many elderly persons receive their health care needs in their own home, and in the future this will be even more common. Drug use of the elderly is a complex field, and many drugs have side effects complicating the medical treatment and decreasing the quality of life.

     

    Aim: This thesis aims to explore and describe the medicine use and the medical situation of very old persons (¡Ý84 years) living in ordinary households, and to obtain knowledge of their views on the use of drugs.

    Methods: This thesis combines quantitative and qualitative research methods. The quantitative studies (Study I, II and III) were based on data from the Kungsholmen Project, a population based study of elderly people living in a district of the inner city of Stockholm, Sweden. Data collection of the present studies was carried out from the third follow-up 1997-1998. The qualitative data (Study IV) was obtained 2005 through in-depth interviews with 25 elderly men and women, aged 85-97 years, living in ordinary households in Stockholm, Sweden. A pre-tested semi-structured questionnaire was used for the interviews.

    Results: The findings in Study I demonstrated that cardiovascular diseases are very frequent in this population (62%). Heart failure (47%) and hypertension (37%) were the most common conditions; and diuretics (69%), nitrates (31%) and cardiac glycosides (30%) were the most commonly prescribed drugs. Multivariate regression analyses showed that while being affected by a CV disease did not affect the emotional well-being of the participants (PANAS-PA, p=0.171; PANAS-NA, p=0.209), the use of cardiac glycosides (p=0.006) and nitrates (p=0.008) was associated with increased negative feelings. Study II revealed that 88% of the population took medicines on a regular basis, and only 23% of them received help with the handling of their medicines. Using logistic regression models controlling for sociodemographic variables, cognitive and functional status, female gender (OR: 2.8; 95% CI: 1.2-6.5) was the only variable associated with regular use of medicines. The results also showed that older age and functional disability as measured by ADL, increased the risk of receiving help with medicines, while higher cognitive status decreased the odds of receiving help. Using multiple regression models, we found that the only factor related to not receiving help from a family member was that of living alone (OR:0.05; 95% CI: 0.006-0.4). Study III showed that the prevalence of pain among very old persons was 46%, and the prevalence of pain treatment was 71%. Results from logistic regression analysis using all variables in the model indicated that pain reporting was not associated with age, gender or living conditions, but decreased with decreasing cognitive status and with increasing functional disability. Furthermore, pain treatment was not associated with age, gender, living conditions, cognitive and functional status. The qualitative data in Study IV indicated that most of the participants managed their medicines by themselves and were very content with this. Those elderly who received help with their medicines were also very pleased with this help. The findings also revealed that the most important components for the elderly to be able to remain living in their homes and to handle their medicines by themselves, were to have good cognitive ability, to be independent and to get support with their medicines from a close person as a back-up.

    Conclusions: This study revealed that a large proportion of very old people (¡Ý84 years) were living in ordinary households and used medicines regularly. Being a woman and living alone were associated with receiving help with medicines from the community help services. Cognitive and functional ability were revealed to be significant factors in the management of medicines, but also to affect the pain reporting, and type of received pain treatment. Most of the older participants managed to handle their medicines by themselves, and were very pleased by doing this. However, most of them were concerned about the risk of losing their memory, as they are getting older, because they knew that they would not be able to manage themselves any more and therefore would have to move to an institution.

  • 16.
    Westerbotn, Margareta
    et al.
    Sophiahemmet University.
    Agüero-Torres, Hedda
    Fastbom, Johan
    Hillerås, Pernilla
    Sophiahemmet University.
    A population-based study on well-being in the very old: the role of cardiovascular diseases and drugs2005In: Archives of gerontology and geriatrics (Print), ISSN 0167-4943, E-ISSN 1872-6976, Vol. 40, no 3, p. 287-97Article in journal (Refereed)
    Abstract [en]

    Cardiovascular diseases constitute the most common health problems in very old people. Consequently, cardiovascular drugs are the medicines that are most frequently used by elderly subjects. Although many studies have examined the physiological effect and adverse reactions of these drugs, knowledge on their effect on emotional well-being is missing. The present study aims to examine the association between cardiovascular diseases and their medical treatment on the emotional well-being of very old people. We investigated a representative group of elderly subjects gathered from a population-based study (n=235). Participants were 84 years or older and cognitively intact (mini-mental state examination (MMSE) > or =24 points). Well-being was assessed with the positive and negative affect schedule (PANAS), measuring different mood categories. Cardiovascular diseases were diagnosed following the International Classification of Diseases. In this population the prevalence of cardiovascular diseases was high (62%). Multivariate regression analysis showed that while being affected by a cardiovascular disease did not affect the emotional well-being of the subjects (PANAS-PA, p=0.171; PANAS-NA, p=0.209), the use of some cardiovascular drugs showed an association. Cardiac glycosides (p=0.006) and nitrates (p=0.008) were associated with increased negative feelings. Due to high prevalence of cardiovascular diseases and use of cardiovascular medicines, this finding has relevance on the quality of life of elderly people. However, due to the nature of this study we cannot assess cause-effect relationship of this positive association. Therefore, the present findings suggest that there is a need for clinical studies in this increasing and limited studied age group.

  • 17.
    Westerbotn, Margareta
    et al.
    Sophiahemmet University.
    Blomberg, Tobias
    Renström, Evelina
    Saffo, Nina
    Schmidt, Lina
    Jansson, Britten
    Aanesen, Arthur
    Transgender people in Swedish healthcare: The experience of being met with ignorance2017In: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593Article in journal (Refereed)
  • 18.
    Westerbotn, Margareta
    et al.
    Sophiahemmet University.
    Fahlström, Elin
    Sophiahemmet University.
    Fastbom, Johan
    Agüero-Torres, Hedda
    Hillerås, Pernilla
    Sophiahemmet University.
    How do older people experience their management of medicines?2008In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 17, no 5A, p. 106-15Article in journal (Refereed)
    Abstract [en]

    AIM: The aim of this study was to describe how older people living at home in Stockholm, Sweden, experienced the management of their own medication regimen from their own perspective. BACKGROUND: Very old people tend to use more medicines, and without proper medication, many of them would not function well and would not be able to remain in their own homes. METHODS: This qualitative study involved audiotaped interviews with 25 very old persons. Inclusion criteria: aged >or=85 years, mini-mental state examination >or=24, living at home, taking medicines regularly. Data collected May-June 2005, analysed using content analysis. DESIGN: Descriptive study. RESULTS: Findings revealed that most participants managed their medicines by themselves and were very content with this. Older people who received some help with their medicines were also very pleased with that help. The most important components for older people were to have good cognitive ability, to be independent and to get support with their medicines from a close person as a back up. CONCLUSION: Our results indicate that most of the participants were very pleased with their medicine management, either on their own or they were able to get some help. There was, however, a need for assistance in delivering the medicines to their homes. RELEVANCE TO CLINICAL PRACTICE: Understanding how older people experience their management of medicines and to reveal the components which may affect them in this situation is important to improve nursing care. To observe the life of an older person as a whole is important in nursing care, so that the person's behaviour can be understood, as how older people manage to handle their medicines may have an impact on their autonomy and on health-care resource use.

  • 19.
    Westerbotn, Margareta
    et al.
    Sophiahemmet University.
    Hillerås, Pernilla
    Sophiahemmet University.
    Fastbom, Johan
    Agüero-Torres, Hedda
    Factors influencing the handling of medicines among very old people living at home in an urban area2006In: Aging Clinical and Experimental Research, ISSN 1594-0667, E-ISSN 1720-8319, Vol. 18, no 6, p. 497-502Article in journal (Refereed)
    Abstract [en]

    BACKGROUND AND AIMS: Elderly people in Sweden live longer in their own homes, some of them with good health, and others with chronic conditions that require medical treatment. Thus, the aim of this study was to investigate factors influencing elderly people's handling of their medicines. METHODS: Cross-sectional population-based study. Participants were 333, aged 84+ years, living in their own homes. Information on regular drug use was obtained from interviews. Descriptive statistics were used to describe the population, and logistic regression models were used to investigate the factors associated with receiving help in handling medicines. The Mini-Mental State Examination (MMSE) measured cognitive status, and the basic Activities of Daily Living (ADL) assessed functional status. RESULTS: Most participants were women living alone. 88% of this population took medicines on a regular basis and 23% of them received help with medicine handling. Using logistic regression models controlling for sociodemographic variables, cognitive and functional status, female (OR=2.8, 95% CI=1.2-6.5) was the only variable associated with regular use of medicines. Older age and functional disability in ADL increased the risk of receiving help with medicines, while higher cognitive status decreased the odds of receiving help. The only factor related to receiving help from a family member was living alone (OR=0.05; 95% CI=0.01-0.40). CONCLUSIONS: This study indicates that cognitive and functional problems require increased help with handling medicines. These results stress the need for ongoing vigilance of, and support for, people with this high-risk profile.

  • 20.
    Westerbotn, Margareta
    et al.
    Sophiahemmet University.
    Hillerås, Pernilla
    Sophiahemmet University.
    Fastbom, Johan
    Agüero-Torres, Hedda
    Pain reporting by very old Swedish community dwellers: the role of cognition and function2008In: Aging Clinical and Experimental Research, ISSN 1594-0667, E-ISSN 1720-8319, Vol. 20, no 1, p. 40-6Article in journal (Refereed)
    Abstract [en]

    BACKGROUND AND AIMS: Pain is a common and unpleasant problem among elderly people and affects the possibility for them to remain living in their own homes. The aims of this study were therefore to report the prevalence of pain reporting and pain treatment, and their association with functional and cognitive status in a very old population. METHODS: Cross-sectional population-based study. Participants were 333, aged 84 years or older, living at home alone or with someone in Kungsholmen, in central Stockholm, Sweden. Information on pain was obtained from interviews. The Mini- Mental State Examination (MMSE) measured cognitive status and the index of basic Activities of Daily Living (ADL) functional status. Descriptive statistics were used to describe the population and logistic regression models to investigate factors associated with pain reporting and pain treatment. RESULTS: The prevalence of pain was 46%, and the prevalence of pain treatment 71%. Results from logistic regression analysis including all variables in the model showed that pain reporting was not associated with age, gender or living conditions. However, pain reporting was correlated with cognitive and functional status. There was no association between pain treatment and age, gender, living conditions, cognitive or functional status. CONCLUSIONS: Pain is common among the oldest old. Our results indicate that cognitive and functional status affect pain reporting. Poor cognitive status was associated with less pain reporting, whereas poor functional status was associated with more pain reporting.

  • 21.
    Westerbotn, Margareta
    et al.
    Sophiahemmet University.
    Kneck, Åsa
    Hovland, Olav Johannes
    Elrond, Malene
    Pedersen, Ingrid
    Lejonqvist, Gun-Britt
    Dulavik, Johild
    Ecklon, Tove
    Nilsson, Inga-Lill
    Sigurdardottir, Árún K
    Taking part in Nordic collaboration; nursing students' experiences and perceptions from a learning perspective: A qualitative study2015In: Nurse Education Today, ISSN 0260-6917, E-ISSN 1532-2793, Vol. 35, no 5, p. 712-717Article in journal (Refereed)
    Abstract [en]

    BACKGROUND: Nordic networking of different kinds has a long tradition aiming to increase collaboration and understanding between citizens in different countries. Cultural competence in relation to health care and nursing is important for clinical nurses and is a central issue in nurse education.

    OBJECTIVE: To gain an understanding of what nurse students experienced and learned during an intensive course in diabetes together with students and nurse educators from Denmark, Finland, Iceland, Norway, Sweden and the Faroe Islands.

    METHODS: In 2012, an intensive course within the Nordic network, Nordkvist, was conducted in Faroe Islands with the theme "Nursing - to live a good life with diabetes". To answer the objective of the study, 26 students conducted written reflections based on two questions. The data was analyzed using qualitative content analysis.

    RESULTS: Through meetings with nurse students and educators from the Nordic countries the intensive course strengthened the students' identification with the nursing profession. The students gained new perspectives on diabetes, such as how complex it can be to live with a chronic illness. Because of the difficulties in understanding one another and because of different mother tongues, the students gained a better understanding of patients' vulnerability in relation to hospital jargon and how it felt to be in an unfamiliar place.

    CONCLUSIONS: The intensive course increased the students' personal and professional growth, cross-cultural competence, and their identification with nursing. Students' understanding of health care in the Nordic countries improved as similarities and differences were recognized.

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