Entrevistas

Res Nurs Health 2005;28(5):365-75.

Abstract: The purpose of this study was to describe nursing home residents' experiences and percep-

tions of relationships with caregivers and to explore their importance to thriving. Data were collected through field observations and open-ended interviews with 26 residents. Receiving appropriate care from kind caregivers made life easier for all residents but contributed to thriving only for some. One group of residents emphasized personal relationships to individual caregivers as essential to thriving. A second group reported that non-personal relationships contributed to thriving. A third group preferred distant rela- tionships to the caregivers but reported thriving as well. Personal relationships to individual caregivers were not essential to thriving for all residents.

526. Bergland A, Kirkevold M. The significance of peer relationships to thriving in nursing homes. J Clin Nurs 2008;17(10):1295-302.

Abstract: AIM AND OBJECTIVE: The purpose of this qualitative study was to describe nursing home

residents' perceptions of the significance of relationships with peer residents to their experience of thriv- ing. BACKGROUND: Interactions between nursing home residents are limited. Knowledge about the im- portance of peer interactions to the residents' experiences of thriving is scarce. DESIGN AND METHOD: The study had a descriptive exploratory design and included 26 mentally lucid residents in two nursing homes. Data collection methods included field observation and interviews. RESULTS: To contribute to an experience of thriving, peer relationships had to be experienced as positive and meaningful. A personal relationship to peer residents was not essential to an experience of thriving among all the residents. Some of the thriving residents who had not managed to establish a personal relationship expressed wishes for being involved with peers. The caregivers' role as facilitators in the development of meaningful

interactions contributing to thriving was essential. CONCLUSIONS: Nursing home residents have varied wishes, expectations and capacity to interact with peer residents and the significance of peer relation- ships to thriving also vary. A personal relationship to peer residents is not essential to the experience of thriving among all residents. RELEVANCE TO CLINICAL PRACTICE: Caregivers in nursing homes have a great impact on how social gatherings intended to develop positive peer interactions and on whether the social gatherings fulfil their intentions. Skilled caregivers can secure pleasant and meaningful social gath- erings in nursing homes contributing to an experience of thriving

527. Bergland A, Kirkevold M. Thriving in nursing homes in Norway: contributing aspects described by resi- dents. Int J Nurs Stud 2006;43(6):681-91.

Abstract: BACKGROUND AND OBJECTIVES: Knowledge about residents' perception of what contrib-

utes to well-being and thriving in nursing homes is scarce. The aim of this study was to investigate men- tally lucid residents' perspective on what contributes to thriving in a nursing home. DESIGN: A qualitative study with a descriptive-exploratory design. SETTINGS: Two nursing homes in Norway. PARTICIPANTS: 26 mentally lucid nursing home residents. METHODS: Data collection comprised participant observation and open-ended interviews. RESULTS: Two core aspects contributing to thriving were identified: The residents' attitude towards living in a nursing home and the quality of care and caregivers. The residents' attitude was the innermost core aspect. Five additional aspects contributing to thriving were identified: Positive peer relationships, participation in meaningful activities, opportunities to go outside the ward or nursing home, positive relationships with family, and qualities in the physical environment. CONCLU- SION: Several factors contribute to an experience of thriving. The findings challenge the 'traditional' pas- sive role of residents by documenting their active contributions to their level of thriving in a nursing home

528. Borge L, Martinsen EW, Ruud T, Watne O, Friis S. [Quality of life, loneliness and social contacts among persons with long-term mental illness]. Tidsskr Nor Laegeforen 2000;120(1):52-5.

Abstract: Chronic long-term patients who were residents in psychiatric nursing homes at a given point in

time were traced six years later. Over this period, there had been deep cuts in the number of psychiatric beds in the county in question; we wanted to assess how the patients now perceived their quality of life. All 107 patients were traced; of the 75 who were still alive, 74 took part in the study and were visited at their place of residence. 42 patients, mean age 56.9 years, were able to respond to personal questions regarding social contact, loneliness and quality of life. Health care providers were the most important per- sons in the patients' networks. Most patients reported a satisfactory quality of life; those who lived outside institutions (N = 21) tended to be more satisfied than those in residential care, they were more socially ac- tive and had better contact with their families. The variables loneliness, satisfaction with neighbourhood and leisure activities explained 63% of the variance in quality of life

529. Drageset J, Eide GE, Nygaard HA, Bondevik M, Nortvedt MW, Natvig GK. The impact of social support and sense of coherence on health-related quality of life among nursing home residents--a questionnaire survey in Bergen, Norway. Int J Nurs Stud 2009;46(1):65-75.

Abstract: BACKGROUND AND OBJECTIVES: Few studies have examined the association between so-

cial support and health-related quality of life (HRQOL) among nursing home residents and whether the sense of coherence (SOC) modifies the effect of social support on health-related quality of life. The main aims of this study were to determine the relationship between social support and HRQOL and to investi- gate whether the SOC modifies the effect of social support on HRQOL. DESIGN: A cross-sectional, de- scriptive, correlational design. SETTINGS: All 30 nursing homes in Bergen in western Norway. PARTICI- PANTS: Two hundred and twenty-seven mentally intact long-term nursing home residents 65 years and older. METHODS: Data were obtained through face-to-face interviews using the SF-36 Health Survey, Social Provisions Scale and Sense of Coherence Scale. Possible relationships between the Social Provi- sions Scale and the eight SF-36 subdimensions were analysed using multiple linear regression while con- trolling for age, sex, marital status, education and comorbid illness. Interactions between the Sense of Coherence Scale and Social Provisions Scale were investigated. RESULTS: Attachment affected the mental health subdimension (p=0.001), opportunity for nurturance affected social functioning (p=0.003) and reassurance of worth affected vitality (p=0.001) after adjustment for demographic variables and co- morbid illness. After the analysis included the sense of coherence, nurturance still significantly affected social functioning and reassurance of worth still significantly affected vitality. No interaction with sense of coherence was found, and sense of coherence significantly affected all SF-36 subdimensions. CONCLU- SIONS: The opportunity to provide nurturance for others appears to be important for social functioning, and sense of competence and sense of self-esteem appear to be important for vitality. Further, the resi- dents' relationships with significant others comprise an important component of mental health. Finally, in- dependent of the level of sense of coherence, social support is an important resource for better health- related quality of life. Clinical nurses should recognize that social support is associated with health-related quality of life and pay attention to the importance of social support for the residents in daily practice

530. Drageset J, Natvig G, Eide G. Health-related quality of life among old residents of nursing homes in Nor- way. Int J Nursing Practice 2009;15:(5):455-66.

Abstract: Research in Norway on the health-related quality of life (HRQoL) of nursing homes residents

aged 65 or over. The Short-Form-36 Health Survey subscales were used to assess socio-demographic variables, medical factors and HRQoL, including physical and social functioning, pain, general and mental health and vitality. Differences according to age, gender and socioeconomic factors were analysed. 44 refs

531. Drageset J, Natvig GK, Eide GE, Clipp EC, Bondevik M, Nortvedt MW, et al. Differences in health-related quality of life between older nursing home residents without cognitive impairment and the general popula- tion of Norway. J Clin Nurs 2008;17(9):1227-36.

Abstract: AIM: To advance the understanding of health-related quality of life among older nursing home

residents by assessing their health-related quality of life and comparing this with norms from the general population. METHODS: The study used a two-group cross-sectional comparative design. The samples

comprised 227 nursing home residents aged 65-102 years with at least six months' residence and a rep- resentative population sample of 1137 Norwegian citizens aged 65-102 years. All nursing home residents had a Clinical Dementia Rating Scale score > or =0.5 and were capable of conversing. The respondents provided demographic information and were surveyed using the SF-36 Health Survey. We used univari- ate and multivariate linear models to identify possible differences in health-related quality of life between the nursing home residents and the general population, controlled for age, sex, marital status and educa- tion. RESULTS: After adjustment for age, group, sex, marital status and education, the nursing home residents scored significantly higher on bodily pain and on physical and emotional role limitation and sig- nificantly lower on the other SF-36 subscales, except social functioning, with the largest differences for physical functioning (mean nursing home 23.2 and mean general population 62.9). The general popula- tion scores on all subscales generally increased with increasing education but not among the nursing home residents. CONCLUSIONS: The mean SF-36 scale scores differed markedly between the nursing home residents and the general population, with the nursing home residents generally scoring lower. The association with background variables known to be related to health-related quality of life differed be- tween the groups. Healthcare professionals should increase attention to health-related quality of life among nursing home residents, periodically assess health-related quality of life and consider interven- tions that may improve health-related quality of life in older institutionalised populations. RELEVANCE TO CLINICAL PRACTICE: This study highlights the role of nurses and other health professionals in ensuring that nursing home residents have opportunities to improve their health-related quality of life

532. Drageset J, Nygaard HA, Eide GE, Bondevik M, Nortvedt MW, Natvig GK. Sense of coherence as a re- source in relation to health-related quality of life among mentally intact nursing home residents - a ques- tionnaire study. Health Qual Life Outcomes 2008;6:85.

Abstract: BACKGROUND: Sense of coherence (SOC) is a strong determinant of positive health and

successful coping. For older people living in the community or staying in a hospital, SOC has been shown to be associated with health-related quality of life (HRQOL). Studies focusing on this aspect among nurs- ing home (NH) residents have been limited. This study investigated the relationship between SOC and HRQOL among older people living in NHs in Bergen, Norway. METHODS: Based on the salutogenic theoretical framework, we used a descriptive correlation design using personal interviews. We collected data from 227 mentally intact NH residents for 14 months in 2004-2005. The residents' HRQOL and cop- ing ability were measured using the SF-36 Health Survey and the Sense of Coherence Scale (SOC-13), respectively. We analyzed possible relationships between the SOC-13 variables and SF-36 subdimen- sions, controlling for age, sex, marital status, education and comorbidity, and investigated interactions be- tween the SOC and demographic variables by using multiple regression. RESULTS: SOC scores were significantly correlated with all SF-36 subscales: the strongest with mental health (r = 0.61) and the weak- est with bodily pain (r = 0.28). These did not change substantially after adjusting for the associations with demographic variables and comorbidity. SOC-13 did not interact significantly with the other covariates. CONCLUSION: These findings suggest that more coping resources improve HRQOL. This may indicate the importance of strengthening the residents' SOC to improve the perceived HRQOL. Such knowledge may help the international community in developing nursing regimens to improve HRQOL for older people living in NHs

533. Drageset J. The importance of activities of daily living and social contact for loneliness: a survey among residents in nursing homes. Scand J Caring Sci 2004;18(1):65-71.

Abstract: The aim of this study was to examine associations between functional ability to perform basic

activities of daily living (ADL) functions (feeding, continence, going to the toilet, transferring from bed to chair, dressing and bathing), social contacts with family and friends/neighbours and emotional and social loneliness. A quantitative research approach, using a survey design, was performed. The sample com- prised 113 subjects aged 65-101 years, living in nursing homes. Data were gathered through structured interviews by using the following measures: the modified Katz Index of ADL, the Revised Social Provi- sions Scale (SPS), and Family and Friendship Contacts Scale. Descriptive statistics, factor analyses, mul- tiple correlation analyses and multiple regression analyses were used. Data showed a statistically signifi- cant relationship between dependence on the environment in carrying out ADL and low level of social loneliness. Likewise, high frequencies of social contact with sons, daughters and grandchildren had a sta- tistically significant effect on low level of social loneliness. A confirmatory factor analysis (varimax rotation, eigenvalue 1.0) was employed to explore the two predefined dimensions (attachment and social integra- tion) of the SPS. The results confirmed, to a very high degree, the two dimensions of the Weiss Model. Reliability (internal consistency), measured by Cronbach alpha, was 0.85 and 0.92, for attachment and social integration respectively. Based on this analysis, dependence in ADL function is important for a low level of social loneliness. From the present study it is concluded that ADL (feeding, continence, going to the toilet, transferring from bed to chair, dressing and bathing) and contact with a social network have a statistical effect on a low level of social loneliness. Hence, such associations may be of significance in nursing intervention and may influence the well-being of residents in nursing homes in different stages of life

534. Eika M. Samvaersfellesskap i sykehjem. Sykepleien 2007;95(18):74-5

535. Ellefsen B. Dependency as disadvantage - patients' experiences. Scand J Caring Sci 2002;16(2):157-64.

Abstract: Dependency as disadvantage - patients' experiences This is an empirical qualitative study of

the dependent community patient. The investigation raises the question of what it is like to be a highly de- pendent patient and how they relate to the situation. A non-probability, volunteer sample was selected from home nursing patients in a large town in Norway. The data were collected through in-depth inter- views with 15 patients in their home using a semistructured interview guide. A constant comparative ap- proach was used for analysing data. The results show that dependency has disadvantages like con- straints and burdens in daily life. The patient adjusts both in a reactive and proactive way. The constraints are apparent through reduced autonomy in daily life and limited possibilities for negotiation. The burden is demonstrated through uncertainty within the encounter situation, low esteem, and loss of privacy. Adjust-

ment is made through planning, guidance of the carer, acceptance of the situation, positive self-image and by protection of family and carer, and placing blame on the bureaucracy. The patient reacts in a more passive, reactive way regarding circumstances connected to the health care system and in a more proac- tive way by trying to influence the situation in the interaction in the private sphere of the patient's home

536. Frandin K, Borell L, Gronstedt H, Bergland A, Helbostad JL, Puggaard L, et al. A Nordic multi-center study on physical and daily activities for residents in nursing home settings: design of a randomized, con- trolled trial. Aging Clin Exp Res 2009;21(4-5):314-22.

Abstract: BACKGROUND AND AIMS: Nursing home residents constitute a frail, multi-diseased and het-

erogeneous group. As physical activity is essential for the preservation of function, personalized training and activities are of great importance. The main objective of this study was to describe the influence of an individually tailored intervention program, in a nursing home setting, on physical capacity, degree of de- pendence in Activities of Daily Living (ADL), long-term participation in physical and/or daily activities, and self-rated wellbeing. The aim of the present work is to describe the overall design of the study. METH- ODS: Nursing homes in Sweden, Norway and Denmark were involved, and 322 residents were random- ized to either Intervention or Control groups. The intervention lasted for three months and consisted of physical and daily activities, led by physiotherapists and occupational therapists, and was built on their evaluations and on the goals expressed by each resident. Tests of muscle strength, mobility, balance function and confidence, ADL, level of physical activity, wellbeing and cognitive function were performed at baseline, directly after the intervention period and three months later. RESULTS: They will be pre- sented in articles to follow. CONCLUSIONS: Although it is a great challenge to carry out an intervention study directed toward such a frail population, it is of great interest to find out whether individually tailored and enhanced activities can lead to decreased dependence in ADL and increased wellbeing

537. Hauge S, Kristin H. The nursing home as a home: a field study of residents' daily life in the common living rooms. J Clin Nurs 2008;17(4):460-7.

Abstract: AIM: This Norwegian-based study investigates how and to what extent the idea of the nursing

home as a home has been realized. BACKGROUND: For the last two decades, Norway, as other West- ern Country has had an explicit national policy that nursing homes should become more like homes. The research literature indicates that residents in nursing home seem to lack the opportunities to maintain a private sphere. DESIGN: A field study design was conducted. METHODS: Data were collected in 1999 in two long-term units in a traditional nursing home by using participant observation and interviewing the residents. A phenomenological hermeneutic analysis strategy was used to get an impression of the resi- dents' everyday life. RESULTS: The residents spend most of their time in the common living room. The common living room has an ambiguous boundary between the public and private spheres, unlike the clear boundaries characterizing a home. The relationship among the residents is fragile, and the residents who can, withdraw from the common living room. CONCLUSIONS: Despite having single rooms and more home-like interior decoration, the residents in nursing home still have reduced opportunity to develop a private everyday lifestyle. The long-term unit examined in this research had a forced relationship between the residents, and the residents with best health resources systematically withdraw from the common area to control both where and with whom they wish to spend their time. RELEVANCE TO CLINICAL PRACTICE: This study lays the foundation for rethinking daily routines in long-term units in nursing homes. One way to realize the idea of the nursing home as a home could be to define the living room as a clear public area and to give the residents a chance to develop a more private lifestyle by alternating