Anhörigas upplevelser i samband med vård av en äldre person i hemmet : En litteraturöversikt

SAMMANFATTNINGSyftet: Syftet med denna systematiska litteraturstudie var att studera hur anhöriga till äldre personer upplevde sin situation i i samband med att de vårdade sina äldre hemma, hur de hanterade sin situation, samt vilka strategier de använde sig av för att hantera sin roll som anhörigvårdare. Metod: Databaserna Cinahl och Medline användes i sökningarna efter relevanta artiklar. Sökord som användes var relative and older people and home care, home health care and family caregiver elderly people, family caregivers and care givers of aging people, elderly people and family care givers of aging people, family care givers of older people, family caregivers and frail elderly, family caregiver and older people and home care, home care older people and family caregivers older people, family caregivers older people. Efter genomläsning bedömdes 16 artiklar vara användbara i resultatet. Dessa kom från vetenskapliga tidskrifter och artiklarna innehöll både kvalitativa studier som kvantitativa studier. Resultat: De flesta anhörigvårdare var kvinnor, de kunde uppleva en högre belastning än män. De anhöriga påverkades både mentalt, fysiskt och emotionellt. De kände sig bundna men kunde även känna ett välbefinnande i vården av den äldre personen. Anhöriga upplevde sin roll som anhörigvårdare till äldre personer i hemmen som att de var delaktiga i omsorgen genom praktiskt som känslomässigt stöd. Deras situation hade även inverkan på deras upplevelse av stress och hur de hanterade situationen. En del äldre anhörigvårdare var själva äldre och i behov av hjälp. Konsekvenserna av deras reaktioner/upplevelser beskrevs som både subjektiv och objektiv belastning. Samt att de även var mindre benägna att söka stöd i form av avlastning för sina äldre personer. Slutsats: Rollen som anhörigvårdare till äldre personer som vårdas i hemmen innebar förändringar i anhörigas livssituation, de fick ta ett stort ansvar för den äldre personen. De upplevde stora påfrestningar både känslomässigt som praktiskt, många kände sig ensamma utan stöd, andra hade olika sätt att hantera sin situation. Äldre anhörigvårdare var mer utsatta för belastning av olika skäl när de vårdade äldre personer i hemmet, dels var de själva äldre samt att de själva kunde vara i behov av hjälp för sina hälsoproblem. Kvinnorna var den grupp anhörigvårdare som upplevde störst belastning i vården av äldre personer i hemmet. När det gällde att söka hjälp och stöd såg det olika ut bland anhörigvårdarna, trots att kvinnorna upplevde störst belastning var de minst benägna att söka hjälp.

Hälsa i vårdande gemenskap : gemenskapens betydelse för äldre

The aim of the study and research questions: The aim of this study is to illuminate how caring communion can aid in promoting health as becoming in elderly people in the context of natural caring. The target group of the study consists of elderly citizens living at home. The focus of this thesis is on the concept of communion and how caring communion can affect the inner health resources in a patient’s inner health domain, as well as how caring communion can support health as becoming and inner health resources in the elderly. The main research questions of this study are the following: 1) what does communion mean? 2) what does caring communion mean? 3) what is the connection between caring communion and health? Theoretical perspective: The theoretical perspective of this qualitative study relies on the caritative caring theory as developed by scholars of caring sciences at the Åbo Academi University’s Vasa unit. The caritas motive is based on an ethos built on a consideration of togetherness, i.e. caring communion, a place where one feels at home and where one can be the person one was meant to be. Methodology: A hermeneutic research approach based on Gadamer (1997) permeates the study. This entails that understanding and interpretation become central. The study conducted in the thesis is divided into three sub-studies. Sub-study one and two are based on ontological determination whereas the third sub-study is carried out by contextual determination. The first sub-study is conducted by etymological and semantic analysis of the concept of communion (gemenskap) based on Koort (1975) and the second sub-study by determining the basic epistemological category of the concept based on Eriksson (2010b). Sub-study three is conducted through content analysis of 18 multidisciplinary and 13 caring science articles and dissertations based on Kvale (2009). The aim in the third sub-study is to define caring communions in various contexts of meaning based on Eriksson´s model of conceptual determination (2010b). All studies are interpreted through hermeneutic interpretation where the continuous movement from a part of a whole, to the whole, to part again, leads to new understanding. Finally, the findings from all the three sub-studies are compared to the concepts of pre-understanding and the inner-health-domain model of Wärnås (2002). Results: The results of the study offer a description of the dimensions of caring communion and a model that illuminates how caring communion can further health as becoming. The fundamentals of caring communion rest on the idea of a human being’s absolute right to dignity as a base for communion. The concept of communion contains a moral, an ethical, and a spiritual component. In communion, there exists a moral and ethical responsibility and a willingness to commit oneself. The individual is part of a connection or relation and knows the aim and course for the communion. A caring connection, a caring culture, a caring atmosphere and caring listening are characteristics of caring communion. In caring communion, the elderly feel trusting and see themselves as unique, powerful, and valuable. The model demonstrates that when the elderly are able to rest in caring communion, the virtues of courage and faith become strong and desire for life awaken within the elderly and health as becoming becomes possible. Conclusions: The outcome of the study is that all communion is not necessarily caring communion. In order for communion to be caring and for the elderly to achieve health as becoming, there are certain criteria that must be met. This is especially important when designing activities for the elderly in the context of natural caring.

En meningsfull tillvaro för den äldre människan : En litteraturöversikt

Syfte; Syftet med denna litteraturöversikt var att beskriva upplevelsen av vad som skapar en meningsfull tillvaro samt hur sjuksköterskan kan stödja och främja en meningsfull tillvaro för de äldre vid särskilda boenden. Metod; Studien genomfördes som en litteraturöversikt. Artiklar publicerade mellan åren 2000-2012 söktes i databaserna CHINAL, ELITE, PubMed, SweMed samt i tidskriften Vård i Norden. Resultat; Resultatet visade på att upprätthållandet av kroppens fysiska och mentala förmågor hade stor inverkan för den upplevda hälsan. Social gemenskap, goda vårdrelationer och ett aktivt delagande i den egna vardagen ansågs även placera den äldre i ett sammanhang, vilket också grundade för meningsfullhet och välbefinnande. Konklusion; För att uppnå en god omvårdnad av de äldre krävdes sjuksköterskor med ett stort kunnande och engagemang där goda omvårdnadsrelationer skapades utifrån den enskildes livsberättelse, behov och önskningar.

Från ord till handling : En kvalitativ studie om värdegrund och socialt innehåll för äldre på särskilt boende

Socialstyrelsens brukarundersökning visar att äldre som bor på särskilt boende är mest missnöjda med de aktiviteter och den sociala samvaron som verksamheten erbjuder. Äldreomsorgen bygger på den nationella värdegrunden som innefattar att den äldre ska få leva ett värdigt liv och känna välbefinnande, men det är inte klart hur denna värdegrund påverkar personalens arbetssätt eller de sociala aktiviteter som erbjuds. Vår studie angriper denna fråga. Fem särskilda boenden var representerade både från kommunala och privata vårdgivare i två olika kommuner. Semistrukturerade intervjuer genomfördes med de särskilda boendes enhetschefer, som sedan transkriberades och tematiskt analyserades. Vårt resultat tyder på att den nationella värdegrunden inom äldreomsorgen tolkas olika på alla de särskilda boendena. Alla enhetschefer la stor vikt på personcentrerad vård, men trots det så erbjöd man liknade sociala aktiviteter ofta då som gruppaktivitet. Resultaten diskuterar vi med hänvisning till Aktivitetsteorin och Gerotranscendenceteorin.

Skyddandets förnuft : En studie om anhöriga till hjälpbehövande äldre som invandrat sent i livet

This dissertation aims to examine and deepen the knowledge of family member caregiving where the care recipient is an elderly person who immigrated late in life. It also aims to contribute to the knowledge of the complexities underlying informal care giving and add to our understandings of what it means to be an immigrant in Sweden. The caregiver is in focus. The research conducted is explorative and partly inductive. The main material used is a qualitative interview study carried out with family members from different countries who are providing informal care to elderly immigrant relatives. The analysis gives three patterns of caregiving. One shows help from informal caregivers only who are not compensated economically. Another shows help from family members who are compensated. The third shows help from family members and staff from the public care system. Three ideal-typical informal caregiver roles show different positions vis-à-vis the new: “guardian”, “filter” and “reinterpreter of traditional care ideals”. Swedish born and immigrated informal caregivers are also compared through analysis of data gathered in telephone interviews with a representative selection of inhabitants in the County of Stockholm. A philosophy of action together with theory on integration and multiculturalism serves as theoretical frameworks to understand discrepancies and ambiguities in the data. Young immigrants experience different integration processes than do the older ones. They strive to protect older family members from changes linked to the migration experience. Talk about dependence on culture underlines family feelings and legitimates the processes of protection. Preconceptions about great differences between Swedish born and immigrant families are not supported by quantitative data. A conclusion is that protection can be understood in relation both to the traditional and the new, the latter in the forms of meetings with Swedish society where unequal relations prevail. It is a kind of counter-strategy where the range of actions is diminished, and thus it has its own logic. Protection can be loosened up when the circumstances change and the range of actions grow.

Within- and between-person variations as determinant factors to calculate the number of observations to estimate usual dietary intake of adolescents

This cross-sectional study describes the variation in the dietary intake of energy and macronutrients based on estimated coefficients of within- and between-person variation and intends to calculate the number of days required to evaluate the dietary intake of adolescents in Piracicaba, Brazil. The sample was made up by ninety-two adolescents aged between eleven and sixteen years. Interviews were performed to assess demographic, anthropometric and dietary variables, which were evaluated by the answers obtained through two 24-hour recalls. Descriptive analyses were performed and variances and Coefficients of variation within- and between-person were obtained by results of one-way ANOVA. The mean energy intake observed was 2,326.2 kilocalories; mean macronutrient intake came to 89.0 grams of fatty acids, 305.3 grams of carbohydrates and 82.2 grams of proteins. Coefficients of within-person variation ranged from 36% to 45%, while between-person coefficients varied from 26% to 31%. Variance ratios ranged from 1.35 (carbohydrate) to 2.62 (protein). The lowest number of observations required to correctly evaluate the usual diet calculated (r = 0.90) was six days, for carbohydrates while the highest was eleven, for proteins. Coefficients of variation were similar to those observed in international studies. We conclude that, in this study, two observations were sufficient to obtain reasonable correlations. However, six evaluations are necessary for these adolescents in order to obtain excellent correlations.

Person, existence and phenomenology: remarks on the conceptions of personalism of Emmanuel Mounier

This article aims to discuss the personalism of Emmanuel Mounier, especially his views on the person and existence, and its relation to phenomenology. Mounier does not refer to the influence of phenomenology on his thoughts. However, it is possible to notice that his philosophy was strongly influenced by phenomenological ideas. Personalism is a philosophy that says a person`s value as an absolute. The absolute here is understood as a purpose that gives meaning to all the political and social organization. Human existence is the starting point and fundamental postulate of personalism. This means that there is, therefore, a priority of the existence about the human nature, understanding this as an information ""ontological definitive"". This position is a requirement of epistemological reformulation, which means, within personalism, the attempt to develop a phenomenology of existence, located between the radical objectivism of the science and subjectivism of metaphysics.

A Hermeneutic Case Reconstruction of a published first-person narrative

Hermeneutic Case Reconstruction (Rosenthal, 1993) is a systematic method of analysing biographical self-presentations from an interpretivist perspective. The method consists of five major analytic steps. The first is an analysis of the biographical data that can stand independently of the narrator’s perspective. ‘Objective’ data is extracted from the text or interview transcript and ordered chronologically. Secondly, a thematic field analysis is undertaken in which the data is divided into separate units according to the type of text used, whilst keeping the sequence of these texts units intact. In this step, hypotheses are developed regarding the potential significance of the style and sequence of the events presented. The product of this second step is a reconstruction of the life story. A reconstruction of the life history then follows as the third step. The purpose of this step is to generate hypotheses about the meanings that biographical experiences might have had for the narrator at the time they occurred, given the sociocultural context in which they occurred. In the fourth step, microanalysis of individual text segments is undertaken, in which all hypotheses generated in the earlier steps are tested against the text for support or refutation. The final step consists of a contrastive comparison of the life history and life story. The life story and life history are compared to determine, for example, which aspects of the narrator’s experience have been emphasised or minimised. Through this comparison, the selective process is highlighted. This is referred to as the case structure. This paper describes an application of this method to a published first-person narrative of a woman’s experiences of sustaining a brain injury in a motor vehicle accident.

Anaphoric choices in Japanese fictional novels: the discourse arrangement of noun phrases, zero and third person pronouns

By examining Japanese fictional novels, this article will discuss how anaphoric devices (noun phrases (NPs), third person pronouns (TPPs), and zero anaphors) are selected and arranged in a given discourse. The traditional view of anaphora considers the co-referential relationship between anaphoric devices to be syntagmatic; that is, a pronoun, for example, refers back to its antecedent. It also declares the hierarchical order of information values between anaphoric devices; NPs are semantically the most informative, indicating an episode boundary, and pronouns less informative. Furthermore, zero anaphora is the most referentially transparent, showing the most accessibility of a topic. However, real text shows the contrary. NPs occur frequently while there is no apparent discourse boundary, and the same episode is continuous. This is because zero anaphors and TPPs (if they occur) break down readily due to the nature of a forthcoming sentence and the NP is reinstated, in order to continue the same topic in a given discourse. Therefore, the article opposes the traditional view of anaphora. Based on the concept of text processing, using ‘mental representations’, this article will determine certain occurrence patterns of the three anaphoric devices.

Check your biosignals here: a new dataset for off-person ECG biometrics

The Check Your Biosignals Here initiative (CYBHi) was developed as a way of creating a dataset and consistently repeatable acquisition framework, to further extend research in electrocardiographic (ECG) biometrics. In particular, our work targets the novel trend towards off-the-person data acquisition, which opens a broad new set of challenges and opportunities both for research and industry. While datasets with ECG signals collected using medical grade equipment at the chest can be easily found, for off-the-person ECG data the solution is generally for each team to collect their own corpus at considerable expense of resources. In this paper we describe the context, experimental considerations, methods, and preliminary findings of two public datasets created by our team, one for short-term and another for long-term assessment, with ECG data collected at the hand palms and fingers. (C) 2013 Elsevier Ireland Ltd. All rights reserved.

Building a person home behavior model based on data from smart house sensors 2015

Dissertação para a obtenção do grau de Mestre em Engenharia Electrotécnica Ramo de Energia

Person Localization Using Sensor Information Fusion

Nowadays the incredible grow of mobile devices market led to the need for location-aware applications. However, sometimes person location is difficult to obtain, since most of these devices only have a GPS (Global Positioning System) chip to retrieve location. In order to suppress this limitation and to provide location everywhere (even where a structured environment doesn’t exist) a wearable inertial navigation system is proposed, which is a convenient way to track people in situations where other localization systems fail. The system combines pedestrian dead reckoning with GPS, using widely available, low-cost and low-power hardware components. The system innovation is the information fusion and the use of probabilistic methods to learn persons gait behavior to correct, in real-time, the drift errors given by the sensors.

Off-the-person electrocardiography: performance assessment and clinical correlation

Previous work by our group introduced a novel concept and sensor design for “off-the-person” ECG, for which evidence on how it compares against standard clinical-grade equipment has been largely missing. Our objectives with this work are to characterise the off-the-person approach in light of the current ECG systems landscape, and assess how the signals acquired using this simplified setup compare with clinical-grade recordings. Empirical tests have been performed with real-world data collected from a population of 38 control subjects, to analyze the correlation between both approaches. Results show off-the-person data to be correlated with clinical-grade data, demonstrating the viability of this approach to potentially extend preventive medicine practices by enabling the integration of ECG monitoring into multiple dimensions of people’s everyday lives. © 2015, IUPESM and Springer-Verlag Berlin Heidelberg.