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Fysisk aktivitet blant barn med funksjonshemming på rehabiliteringsopphold
Get PDFBackground: Physical activity is known to provide the same health benefits for both disabled and abled individuals(1). Nevertheless there are several studies showing unsatisfactory participation in physical activity among disabled children. Beitostølen Helsesportsenter is a rehabilitation centre offering guidance in facilitated sports for children, adolescents and adults. Objective: This pilot study aims to describe participation in physical activity among children referred to rehabilitation at Beitostølen Helsesportsenter. We also assessed the association between pain, environmental barriers and physical activity. Material and method: Eight children aged 9-13, admitted to a rehabilitation stay at Beitostølen Helsesportsenter, volunteered to join the study. The cross-sectional study is based on questionnaires, observation and semi-structured interviews. Results: 88% of the children had participated in physical activity at school and 100% in their leisure time the last year. 38% of the children reported pain, and 13% reported pain related to physical activity. Facilitated activities was emphasized as important among the children. Conclusion: The study showed that children at Beitostølen Helsesportsenter were physically active both at school and in their leisure time. Nevertheless it seems to be a lack of facilitated sports for disabled children. Pain did not seem to be a limiting factor.måsjekke
Sygepleje til ældre LGBT-personer
Get PDFArtiklen ønsker at skabe et sygeplejefagligt fokus på ældre LGBT-personer. I Danmark skønnes der at være 68.000 LGBT-personer over 65 år. Flere internationale studier viser, at ældre LGBT-personer specifikt oplever:
– Større ulighed i levevilkår sammenholdt med den øvrige befolkning
– Er i øget risiko for social isolation og ensomhed
– Oplever barrierer for adgang til pleje og ydelser på ældre- og sundhedsområdet
Dèt der er helt særlig ved de ældre LGBT-personer er, at de har været vidne til et samfund, hvor dét at være homoseksuel var forbundet med kriminalisering og forfølgelse. Frygten for stigmatisering og afvisning kan føre til, at ældre LGBT-personer ikke fortæller sundhedsprofessionelle om deres seksualitet. Ved at sygeplejersker undervises i LGBT-kompetencer, vil de være endnu bedre rustet til at kommunikere med mennesker med forskellige seksuel orientering, og forstå sundheds- og undervisningssektoren som et rum med seksuelt og kønslig mangfoldighed. En mere samlet viden om vilkårene for et værdigt liv hos ældre LGBT-personer i de nordiske lande savnes. Der savnes specifikt langt mere forskning om, hvordan sundhedsprofessionelle i Norden kan gøre det lettere for ældre LGBT-personer at være åbne omkring deres liv, seksualitet og kønsidentitet. Ved at blive undervist i LGBT-kompetencer kan sygeplejersker i de nordiske lande få mulighed for at blive endnu mere inkluderende over for alle seksuelle og kønslige minoriteter og på denne måde bedre undgå, at der er særlige grupper af befolkningen, der udsættes for en ubevidst diskrimination
The Effect of Telemedicine Follow-Up Care on Diabetes-Related Foot Ulcers: A Cluster Randomized Controlled Non- Inferiority Trial
Get PDFOBJECTIVE To evaluate whether telemedicine (TM) follow-up of patients with diabetes-related foot ulcers (DFUs) in primary health care in collaboration with specialist health care was noninferior to standard outpatient care (SOC) for ulcer healing time. Further, we sought to evaluate whether the proportion of amputations, deaths, number of consultations per month, and patient satisfaction differed between the two groups.
RESEARCH DESIGN AND METHODS Patients with DFUs were recruited from three clinical sites in western Norway (2012–2016). The cluster-randomized controlled noninferiority trial included 182 adults (94/88 in the TM/SOC groups) in 42 municipalities/districts. The intervention group received TM follow-up care in the community; the control group received SOC. The primary end point was healing time. Secondary end points were amputation, death, number of consultations per month, and patient satisfaction.
RESULTS Using mixed-effects regression analysis, we found that TM was noninferior to SOC regarding healing time (mean difference –0.43 months, 95% CI −1.50, 0.65). When competing risk from death and amputation were taken into account, there was no significant difference in healing time between the groups (subhazard ratio 1.16, 95% CI 0.85, 1.59). The TM group had a significantly lower proportion of amputations (mean difference –8.3%, 95% CI –16.3%, –0.5%), and there were no significant differences in the proportion of deaths, number of consultations, or patient satisfaction between groups, although the direction of the effect estimates for these clinical outcomes favored the TM group.
CONCLUSIONS The results suggest that use of TM technology can be a relevant alternative and supplement to usual care, at least for patients with more superficial ulcers.måsjekke
Treadmill walking exercise training and brain function in multiple sclerosis: Preliminary evidence setting the stage for a network-based approach to rehabilitation
Get PDFExercise training has been identified as a highly promising approach for managing the cognitive consequences of multiple sclerosis (MS). This study represents a secondary analysis of resting-state functional connectivity (RSFC) magnetic resonance imaging data from a pilot treadmill walking exercise training intervention for improving cognitive processing speed (CPS) in MS. There were large intervention effects on RSFC between the thalamus and right superior frontal gyrus (d = 1.92) and left medial frontal gyrus (d = 1.70). There further were moderate-to-large intervention effects on CPS (d = 0.72). Such preliminary data highlight FC within thalamocortical circuitry as a potential target for rehabilitation interventions for improving CPS in cognitively impaired individuals with MS
IA-avtalen 2019–2024
No full textDen norske arbeidslivsmodellen har gitt gode resultater for sysselsetting, produktivitet, omstillingsevne og et lærende arbeidsliv. I Norge arbeider de fleste under gode og forsvarlige arbeidsforhold. På mange arbeidsplasser jobbes det godt og systematisk med å forebygge og redusere sykefravær og frafall, og mange tar også et stort samfunnsansvar ved å bidra til integrering og inkludering i arbeidslivet
Advance care planning in life-threatening pulmonary disease: a focus group study
Get PDFAdvance care planning (ACP) is a communication process for mapping a patient's wishes and priorities for end-of-life care. In preparation for the introduction of ACP in Norway, we wanted to explore the views of Norwegian pulmonary patients on ACP.
We conducted four focus group interviews in a Norwegian teaching hospital, with a sample of 13 patients suffering from chronic obstructive pulmonary disease, lung cancer or lung fibrosis. Analysis was by systematic text condensation.
Participants' primary need facing end-of-life communication was “the comforting safety”, implying support, information and transparency, with four underlying themes: 1) provide good team players; 2) offer conversations with basic information; 3) seize the turning point; and 4) balance transparency. Good team players were skilled communicators knowledgeable about treatment and the last phase of life. Patients preferred dialogues at the time of diagnosis and at different “turning points” in the disease trajectory and being asked carefully about their needs for communication and planning. Transparency was important, but difficult to balance.
ACP for patients with life-threatening pulmonary disease should rest upon an established patient–doctor/nurse relationship and awareness of turning points in the patient's disease progression. Individually requested and tailored information can support and empower patients and their relatives
Tillitsmodellen – hovedpilotering i Oslo kommune 2017-18
Get PDFBakgrunn, prosess og antagelser For å møte fremtidens utfordringer når det gjelder hjemmebaserte helsetjenester på en god måte er det behov for innovasjon og fornyelse. Formålet med prosjekt Tillitsmodellen har vært å utvikle et tillitsbasert alternativ til bestiller/utfører-modellen som • tar utgangspunkt i hva en enkelte tjenestemottager opplever som viktig, • gir økt ansvar og myndighet til fagpersonene, og • forenkler og forbedrer kontroll- og rapporteringsrutiner. Tillitsmodellen for de hjemmebaserte tjenestene i form av selvstyrende tverrfaglige team ble utviklet gjennom en omfattende nedenfra-og-opp-prosess i fire bydeler, med medvirkning fra representanter for brukere, fagorganisasjoner og medarbeidere i bydelene. Resultatet ble et nytt tjenestedesign og en ny forvaltningsmodell med saksbehandling i lokale team, med helhetlig ansvar for et avgrenset geografisk område. Man ønsket å oppnå følgende resultater med den nye forvaltningsmodellen: • økt trygghet, tilfredshet og selvbestemmelse for brukerne •økt motivasjon og arbeidsglede for fagpersonalet • økt fleksibilitet, effektivitet og kvalitet i tjenestene. Denne nye forvaltningsmodellen, «Tillitsmodellen», ble forpilotert i tre bydeler høsten 2017 og deretter videreutviklet og hovedpilotert i fire bydeler 2017-18
Personer med funktionsnedsättning och samisk bakgrund – policyrekommendationer
Get PDFI Norska Barne-, ungdoms- og familiedirektoratets (Bufdir) tidigare arbete med en rapport om levnadsvillkoren för personer med intellektuell funktionsnedsättning konstaterades det att det fanns väldigt lite kunskap om personer med intellektuell funktionsnedsättning och samisk bakgrund. I det fortsatta arbetet framkom också att det fanns väldigt lite kunskap generellt om personer med funktionsnedsättning och samisk bakgrund i de nordiska länderna.
Nordens välfärdscenter fick därför 2013 i uppdrag från Bufdir att utföra en förstudie där man sammanfattade den kunskap som fanns och gav förslag på ett projekt som skulle kunna generera mer forskning och kunskap inom området. Utifrån denna förstudie och kunskapsöversikt (Personer med funktionsnedsättning och samisk bakgrund) så fick Nordens välfärdscenter i uppdrag av Bufdir att koordinera och genomföra projektet Samer med funktionsnedsättning.
Projektet har arbetat med följande målgrupp:
Personer som har allvarlig medfödd, tidigt förvärvad eller långvarig fysisk eller kognitiv funktionsnedsättning, och som definierar sig som samisk och som är bosatt i en samisk kommun som tillhör ett samiskt förvaltningsområde.
De samiska förvaltningsområdena består av 8 kommuner i Norge, 19 kommuner i Sverige, och 4 kommuner i Finland.
Alla de nordiska länderna samt Åland, Grönland och Färöarna har ratificerat FN:s konvention om rättigheter för personer med funktionsnedsättning (The Convention on the Rights of Persons with Disabilities, UNCRPD). Det innebär att konventionen är en självklar utgångspunkt för nordiska frågor som relaterar till funktionshinder. Policyrekommendationer som är framtagna inom detta projekt är också skrivna med utgångspunkt i UNCRPD.
Projektet har pågått mellan 2013 och 2017 och har genererat fem stycken forskningsrapporter, två från Norge, två från Sverige och en från Finland.
Rapporten innehåller en sammanfattning på nordsamiska och på engelska.måsjekke
Unlocking the limitations: living with chronic obstructive pulmonary disease and receiving care through telemedicine - a phenomenological study
Get PDFAims and objectives
To describe the lived experiences of quality of life among a group of patients living with chronic obstructive pulmonary disease who were included in a telemedical intervention after hospitalisation for disease exacerbation.
Background
Patients with chronic obstructive pulmonary disease have high symptom burden, poor control of symptoms and a need for greater requirements in care. Telemedicine can provide benefits for patients with chronic obstructive pulmonary disease by improving self-management.
Design
Descriptive phenomenological approach.
Methods
Ten in-depth interviews were conducted with chronic obstructive pulmonary disease patients participating in a telemedical intervention. The collected data were analysed using a descriptive phenomenological research method.
Results
Living with chronic obstructive pulmonary disease was experienced as creating physical and mental limitations of the diseased body and an increasing identity as a patient, which led to impaired quality of life. Being included in the telemedicine intervention increased accessibility to healthcare services and support from telemedicine nurses. Self-measurement of health data increased participants’ clinical insight and created a mutual clinical language in dialogue with telemedicine nurses, which led to increased quality of life. However, receiving care through telemedicine was also experienced as a dual chore.
Conclusions
Telemedicine can reduce the perceived limitations imposed by chronic obstructive pulmonary disease through four key elements: (i) improving accessibility to healthcare services, (ii) increasing support from health professionals, (iii) strengthening clinical insight and (iv) developing a mutual clinical language, thus increasing quality of life. The transparency facilitated through telemedicine in this healthcare context encourages open decision-making, where the participants can increase their knowledge and improve acknowledgement of and collaboration with telemedicine nurses.
Relevance to clinical practice
Telemedicine can be beneficial when rethinking care for chronic obstructive pulmonary disease by providing knowledge on how living with chronic obstructive pulmonary disease can affect the experience of receiving care through telemedicine and further determine for whom telemedicine is useful.måsjekke
LGBQ-Specific Elderly Housing as a “Sparkling Sanctuary”: Boundary Work on LGBQ Identity and Community in Relationship to Potential LGBQSpecific Elderly Housing in Sweden
Get PDFThis study explored how boundaries in relationship to community and identity were created and negotiated among lesbian, gay, bisexual, and queer (LGBQ) people within the framework of picturing LGBQ-specific elderly housing as a housing alternative in older age, by applying focus group methodology. “An island as a sparkling sanctuary” was identified as a metaphor for how symbolic resources defining the LGBQ community can be manifested in LGBQ-specific qualities of elderly housing. The boundary work underlying this manifestation included elaborations on the dilemma between exclusiveness and normality. The findings illustrate further how symbolic resources and collective identities were developed through dialectic interplay between internal and external definitions. Further, the findings show how boundary work generated shared feelings of similarity and group membership. The associated symbolic and social resources not only served to deal with difficult situations but also to manifest LGBQ identity and sense of community as a “gold medal.