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  • 1.
    Bergh, Ingrid
    et al.
    University of Skövde, School of Life Sciences.
    Gunnarsson, Magnus
    Department of Linguistics, Göteborg University, Göteborg, Sweden.
    Allwood, Jens
    Department of Linguistics, Göteborg University, Göteborg, Sweden.
    Odén, Anders
    Department of Geriatric Medicine, Göteborg University, Göteborg, Sweden.
    Sjöström, Björn
    University of Skövde, School of Life Sciences.
    Steen, Bertil
    Department of Geriatric Medicine, Göteborg University, Göteborg, Sweden.
    Descriptions of pain in elderly patients following orthopaedic surgery2005In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 19, no 2, p. 110-118Article in journal (Refereed)
    Abstract [en]

    The aims of this study were to investigate what words elderly patients, who had undergone hip surgery, used to describe their experience of pain in spoken language and to compare these words with those used in the Short-Form McGill Pain Questionnaire (SF-MPQ) and Pain-O-Meter (POM). The study was carried out at two orthopaedic and two geriatric clinical departments at a large university hospital in Sweden. Altogether, 60 patients (mean age =77) who had undergone orthopaedic surgery took part in the study. A face-to-face interview was conducted with each patient on the second day after the operation. This was divided into two parts, one tape-recorded and semi-structured in character and one structured interview. The results show that a majority of the elderly patients who participated in this study verbally stated pain and spontaneously used a majority of the words found in the SF-MPQ and in the POM. The patients also used a number of additional words not found in the SF-MPQ or the POM. Among those patients who did not use any of the words in the SF-MPQ and the POM, the use of the three additional words 'stel' (stiff), 'hemsk' (awful) and 'räd(d)(sla)' (afraid/fear) were especially marked. The patients also combined the words with a negation to describe what pain was not. To achieve a more balanced and nuanced description of the patient's pain and to make it easier for the patients to talk about their pain, there is a need for access to a set of predefined words that describe pain from a more multidimensional perspective than just intensity. If the elderly patient is allowed, and finds it necessary, to use his/her own words to describe what pain is but also to describe what pain is not, by combining the words with a negation, then the risk of the patient being forced to choose words that do not fully correspond to their pain can be reduced. If so, pain scales such as the SF-MPQ and the POM can create a communicative bridge between the elderly patient and health care professionals in the pain evaluation process.

  • 2.
    Bergh, Ingrid
    et al.
    University of Skövde, Department of Health Sciences. Department of Geriatric Medicine, Göteborg University, Vasa Hospital, Göteborg.
    Sjöström, Björn
    Department of Health Care Pedagogics, Göteborg University, Göteborg.
    Odén, Anders
    Department of Geriatric Medicine, Göteborg University, Vasa Hospital, Göteborg.
    Steen, Bertil
    Department of Geriatric Medicine, Göteborg University, Vasa Hospital, Göteborg.
    An application of pain rating scales in geriatric patients2000In: Aging Clinical and Experimental Research, ISSN 1594-0667, E-ISSN 1720-8319, Vol. 12, no 5, p. 380-387Article in journal (Refereed)
    Abstract [en]

    This study examined the applicability of three different pain rating scales, the Visual Analogue Scale (VAS), the Graphic Rating Scale (GRS) and the Numeric Rating Scale (NRS), in geriatric patients. Data collection was performed in a geriatric clinic at a university hospital. A structured interview was conducted with 167 patients (mean age = 80.5 years). Patients rated their current experience of pain twice with a 5-minute pause in-between on the VAS, GRS and NRS, and were then asked if they experienced pain, ache or hurt (PAH) or other symptoms. The correlations were high and significant both between the ratings of the VAS, GRS and NRS (r = 0.78-0.92; p < 0.001) (alternative-forms reliability), and between the test and retesting (r = 0.75-r = 0.83; p < 0.001) (test-retest reliability). A logistic regression analysis showed that the probability to accomplish a rating on the pain scales decreased with advancing age of the patient, and this was especially marked for the VAS. The probability of agreement between the patients' ratings of pain and the verbal report of PAH tended to decrease with advancing age; this was especially so for the VAS. Patients who verbally denied PAH but reported pain on the scales rated it significant lower (p < 0.001) than those who verbally reported PAH and rated the pain as well. Eighteen percent of patients who denied pain but rated a pain experience verbally expressed suffering or distress. The study suggests that pain rating scales such as the VAS, GRS and NRS can be used to evaluate pain experience in geriatric patients. However, agreement between verbally expressed experience of PAH, and the rated experience of pain tended to decrease with advancing age. This indicates that the pain-evaluating process will be substantially improved by an additional penetration supported by a wide variety of expression of hurt, ache, pain, discomfort and distress.

  • 3.
    Bergh, Ingrid
    et al.
    University of Skövde, Department of Health Sciences. Department of Geriatric Medicine, Göteborg University.
    Sjöström, Björn
    University of Skövde, Department of Health Sciences.
    Odén, Anders
    Department of Geriatric Medicine, Göteborg University.
    Steen, Bertil
    Department of Geriatric Medicine, Göteborg University.
    Assessing pain and pain relief in geriatric patients with non-pathological fractures with different rating scales2001In: Aging Clinical and Experimental Research, ISSN 1594-0667, E-ISSN 1720-8319, Vol. 13, no 5, p. 355-361Article in journal (Refereed)
    Abstract [en]

    Although pain is a frequent problem among elderly patients, they are often omitted in clinical trials and few studies have focused on assessing pain relief in this population. The aim of this study was to compare geriatric patients' verbally reported effect of analgesics with changes in pain experience rated with four different rating scales: the Visual Analogue Scale (VAS), the Graphic Rating Scale (GRS), the Numeric Rating Scale (NRS), and the Pain Relief Scale (PRS). Altogether 53 geriatric patients (mean=82 yrs) with non-pathological fractures in 4 geriatric units at a large university hospital were selected. In connection with the administration of analgesics, the patients were asked to "Mark the point that corresponds to your experience of pain just now at rest" on the VAS, GRS and NRS. This was repeated after 1.5-2 hours, and a direct question was asked about whether the analgesic medication given in connection with the initial assessment had had any pain-alleviation effect. Two comparisons were conducted with each patient. The results show that the probability of accomplishing a rating on the VAS, GRS, NRS, and PRS was lower with advancing age in these elderly fracture patients. The correlations between the ratings of the VAS, GRS and NRS were strong and significant (r=0.80-0.95; p<0.001) both at the initial assessments and at the re-assessments. However, the verbally reported effects of the analgesics were often directly opposite to the changes in rated pain. Therefore, application of the VAS, NRS, GRS and PRS for the purpose of assessing pain relief must be combined with supplementary questions that allow the patient to verbally describe possible experience of pain relief.

  • 4.
    Bergh, Ingrid
    et al.
    University of Skövde, Department of Health Sciences. Department of Geriatric Medicine, Göteborg University, Gothenburg.
    Steen, Gunilla
    Department of Geriatric Medicine, Göteborg University, Gothenburg.
    Waern, Magda
    Institute of Clinical Neuroscience, Section of Psychiatry, Göteborg University, Gothenburg.
    Johansson, Boo
    Department of Psychology, Göteborg University, Gothenburg.
    Odén, Anders
    Department of Geriatric Medicine, Göteborg University, Gothenburg.
    Sjöström, Björn
    University of Skövde, Department of Health Sciences. Department of Health Care Pedagogics, Göteborg University, Gothenburg.
    Steen, Bertil
    Department of Geriatric Medicine, Göteborg University, Gothenburg.
    Pain and its relation to cognitive function and depressive symptoms: A Swedish population study of 70-year-old men and women2003In: Journal of Pain and Symptom Management, ISSN 0885-3924, E-ISSN 1873-6513, Vol. 26, no 4, p. 903-912Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to investigate the prevalence of pain and its characteristics, and to examine the association of pain with cognitive function and depressive symptoms, in a representative sample of 70-year-old men and women. Data were collected within the gerontological and geriatric population studies in Göteborg, Sweden (H-70). A sample of 124 men and 117 women living in the community took part in the study. A questionnaire was applied which included four different aspects of pain experience: prevalence, frequency of episodes of pain, duration and number of locations. In close connection to this, depressive symptoms were assessed using the Center for Epidemiological Studies Depression Scale. The prevalence of pain during the last 14 days was higher in women (79%; n = 91) than in men (53%; n = 65) (P<0.001). Women (68%; n = 78) also reported pain that had lasted for >6 months to a greater extent than men (38%; n = 46) (P<0.001). The frequency of episodes of pain was also higher among women, 64% (n = 74) reporting daily pain or pain several days during the last 14 days while 37% of the men (n = 45) did so (P<0.001). Women (33%, n = 38) also reported pain experience from ≥3 locations more often than men (11%; n = 13) (P<0.001). On the other hand, the association between depressive symptoms and pain experience was more evident in men than in women. Women were taking significantly more antidepressants compared to men (P<0.03). The results show that pain is common in 70-year-old people and especially in women. However, associations between depressive symptoms and the four aspects of pain experience were more pronounced among men. 

  • 5.
    Ek, Kristina
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Browall, Maria
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Eriksson, Monika
    Skaraborg Hospital, Skövde, Sweden.
    Eriksson, Irene
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Healthcare providers’ experiences of assessing and performing oral care in older adults2018In: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 13, no 2, article id e12189Article in journal (Refereed)
  • 6.
    Eriksson, Irene
    et al.
    University of Skövde, School of Health and Education. University of Skövde, Health and Education.
    Olofsson, Birgitta
    Department of Nursing Umeå University, Umeå, Sweden.
    Gustafson, Yngve
    Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden.
    Fagerström, Lisbeth
    Department of Health Sciences, University of Buskerud, Drammen, Norway.
    Older women's experiences of suffering from urinary tract infections2014In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 23, no 9-10, p. 1385-1394Article in journal (Refereed)
    Abstract [en]

    Aims and objectives: To describe and explore older women's experiences of having had repeated urinary tract infections (UTIs). Background: UTIs are one of the most common bacterial infections among older women. Approximately one-third of very old women suffer from at least one UTI each year. Despite the high incidence of UTI, little is known about the impact of UTI on health and daily life in older women. Design: A qualitative descriptive design. Methods: A qualitative study using semi-structured interviews was conducted with 20 Swedish women aged 67-96 years who suffered from repeated UTIs the preceding year. The data were analysed using qualitative content analysis. Results: Two main themes were identified: being in a state of manageable suffering and depending on alleviation. Being in a state of manageable suffering was described in terms of experiencing physical and psychological health problems, struggling to deal with the illness and being restricted in daily life. Depending on alleviation was illustrated in terms of having access to relief but also receiving inadequate care. Conclusions: This study demonstrated that UTIs are a serious health problem among older women that not only affects both physical and mental health but also has serious social consequences. The women in this study described the physical and psychological health problems, struggling to deal with the illness, being restricted in daily life, depending on access to relief and receiving inadequate care. Relevance to clinical practice: It is important to improve the knowledge about how UTI affects the health of older women. This knowledge may help nurses develop strategies to support these women. One important part in the supportive strategies is that nurses can educate these women in self-care. © 2013 John Wiley & Sons Ltd.

  • 7.
    Gillsjö, Catharina
    et al.
    University of Skövde, School of Life Sciences.
    Schwartz-Barcott, Donna
    University of Rhode Island.
    von Post, Iréne
    Åbo Academy University, Vasa.
    Home: The place the older adult can not imagine living without2011In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 11, no 10Article in journal (Refereed)
    Abstract [en]

    Background: Rapidly aging populations with an increased desire to remain at home and changes in health policy that promote the transfer of health care from formal places, as hospitals and institutions, to the more informal setting of one's home support the need for   further research that is designed specifically to understand the experience of home among older adults. Yet, little is known among health care providers about the older adult's experience of home. The aim of this study was to understand the experience of home as experienced by older adults living in a rural community in Sweden.

    Methods: Hermeneutical interpretation, as developed by von Post and Eriksson and based on Gadamer's philosophical hermeneutics, was used to interpret interviews with six older adults. The interpretation included a self examination of the researcher's experiences and   prejudices and proceeded through several readings which integrated the text with the   reader, allowed new questions to emerge, fused the horizons, summarized main and sub-themes and allowed a new understanding to emerge.

    Results: Two main and six sub-themes emerged. Home was experienced as the place the older adult could not imagine living without but also as the place one might be forced to leave. The older adult's thoughts vacillated between the well known present and all its comforts and the unknown future with all its questions and fears, including the underlying   threat of loosing one's home.

    Conclusions: Home has become so integral to life itself and such an intimate part of the older adult's being that when older adults lose their home, they also loose the place closest   to their heart, the place where they are at home and can maintain their identity, integrity and way of living. Additional effort needs to be made to understand the older adult's experience of home within home health care in order to minimize intrusion and maximize care. There is a need to more fully explore the older adult's experience with health care providers in the home and its impact on the older adult's sense of "being at home" and their health and overall well-being.

  • 8.
    Söderman, Mirkka
    et al.
    School of Health, Care and Social Welfare, Division of Caring Sciences and Health Care Education, Mälardalen University, Eskilstuna-Västerås, Sweden.
    Pietilä Rosendahl, Sirpa
    School of Health, Care and Social Welfare, Division of Caring Sciences and Health Care Education, Mälardalen University, Eskilstuna-Västerås, Sweden.
    Caring for Ethnic Older People Living with Dementia – Experiences of Nursing Staff2016In: Journal of Cross-Cultural Gerontology, ISSN 0169-3816, E-ISSN 1573-0719, Vol. 31, no 3, p. 311-326Article in journal (Refereed)
    Abstract [en]

    The total number of persons living with dementia is estimated to double every 20 years and ageing migrant populations are growing in several countries. There are gaps in the health and social care of people from other countries, regardless of the efforts made when someone has a dementia diagnosis; similarly, receiving care in sheltered accommodation is less common. The aim of this study was to explore and describe the nursing staff's experiences of caring for non-Swedish speaking persons living with dementia in a Finnish speaking group home in relation to a Swedish speaking group home in Sweden. 27 qualitative semi-structured interviews were analysed using qualitative content analyses. The first main category, "communication", concentrated on language abilities and deficiencies, non-verbal language, highlighting the consequences of not understanding and the benefits of a common language. The second main category, "culturally oriented activities", focused on being served traditional food, celebrating holidays at the group home, the importance of traditions and the importance of familiar music as cultural elements. The Swedish speaking nursing staff could provide qualitative and equitable care, but the challenge was greater for them than for the bilingual nursing staff who spoke the same language as the residents.

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