Ulike boligformer eller behandlingssteder, ikke hjemme eller sykehjem
456. Borg M, Karlsson B, Tondora J, Davidson L. Implementing person-centered care in psychiatric rehabilita- tion: what does this involve? Isr J Psychiatry Relat Sci 2009;46(2):84-93.
Abstract: BACKGROUND: It has been challenging to move beyond the rhetoric of "recovery" and "per-
son-centered care" to concrete practices that embody these lofty, if also obvious, values. METHOD: This paper describes two examples of person-centered care: the practices of person-centered care planning from the U.S. and Open Dialogue from Finland. RESULTS: The key strategies that these two practices involve are 1) reorientation from patient to personhood; 2) reorientation of what is considered valued knowledge and expertise, and; 3) partnership and negotiation in decision-making. LIMITATIONS: This re- view focused on two examples of person-centered care which appear to be promising. Preliminary find- ings will need to be replicated and elaborated for such practices to be considered evidence-based. CON- CLUSION: It is possible to embody the values of person-centered care and recovery in everyday clinical and rehabilitative practice. A primary shift involved is in the role of patients and their family, friends, and peers and in the importance accorded their everyday life experiences and challenges. [References: 45]
457. Brunt D, Hansson L. Characteristics of the social environment of small group homes for individuals with severe mental illness. Nord J Psychiatry 2002;56(1):39-46.
Abstract: As part of research into small group homes run by local authorities for those with severe men-
tal illness the characteristics of the social environment was investigated. The ideal and real versions of the Community Oriented Program Environmental Scale (COPES) were administered to residents and staff of small group homes in a county in southern Sweden. Both these groups were also interviewed on their opinions as to the main characteristics that should exist in the social environment in small group homes. High levels of support, order and organization, and program clarity and a low level of anger and aggression distinguished the real social environment according to the residents. Differences between residents' and staff's perceptions were less pronounced than in most other studies, probably owing to a greater level of resident--staff interaction in the home-like milieu. In the interviews both the residents and staff emphasized the importance of social interaction as a major constituent in the social environment of small group homes. The COPES instrument appears to be valid for use in small group homes, although some concern can be raised about two of the subscales, Involvement and Practical Orientation. The so- cial environment, as rated by the residents and staff, was similar to that recommended for psychotic pa- tients and to that proposed as a suitable supportive profile together with low levels of staff control and an- ger and aggression
458. Brunt D, Hansson L. The quality of life of persons with severe mental illness across housing settings. Nord J Psychiatry 2004;58(4):293-8.
Abstract: The aim of the study was to compare the subjective quality of life of persons with severe men-
tal illness in inpatient settings and two types of supported housing, small congregate community resi- dences and independent living with support. Seventy-six persons living in three types of housing were in- terviewed using the Lancashire Quality of Life Profile. Analysis showed no differences in subjective and objective quality of life or in clinical and socio-demographic data between individuals living in the two types of supported community residences. Greater satisfaction in four life domains, living situation, social relations, leisure activities and work and two global measures, was registered by individuals in the pooled ratings from the two types of supported community residences as compared to those in inpatient settings. The former were also more satisfied than their counterparts were in inpatient settings concerning specific aspects of the living situation domain. It is concluded that differences in housing settings impact specifi- cally on the living situation life domain but also on other life domains as well as on global quality of life, despite few differences in objective quality of life indicators. There was no evidence to support the con- cept of the quality of life gradient across housing settings.
459. Meyer J. A non-institutional society for people with developmental disability in Norway. Journal of Intellec- tual and Developmental Disability 2003;28(3):305-8.
Hjemme
460. Askheim OP. Personal assistance for people with intellectual impairments: Experiences and dilemmas. Disability & Society 2003;18(3):325-39.
Abstract: The article gives an account of how personal assistance is adapted to people with intellectual
impairments in Norway and the experiences with the arrangement for this target group. The findings of 2 empirical studies involving interviews and observations with 6 of 24 identified personal assistance users (aged 6-56 yrs) are presented. Most space, however, is given to a discussion of the challenges and di- lemmas of including people with intellectual impairments in the target group for personal assistance, since other people than the user as a rule fill the role as manager of the service. Special attention is paid to the parents' role since they often act as managers on behalf of their sons/daughters. Furthermore, the assis- tants' role is discussed and the importance of how they meet the users. Finally, there is a discussion of the consequences the extension of personal assistance to intellectually impaired users might have both for personal assistance as a service and for the ordinary care services.
461. Ballangrud R, Bogsti WB, Johansson IS. Clients' experiences of living at home with a mechanical ventila- tor. J Adv Nurs 2009;65(2):425-34.
Abstract: AIM: This paper reports on a study of how clients experience living with home mechanical ven-
tilation and how they experience care and supervision of healthcare personnel. BACKGROUND: The number of people living at home with mechanical ventilators is increasing, and this is considered a suc- cessful approach to reducing incapacity and mortality. METHOD: Qualitative interviews were conducted with 10 service users in 2006. The informants were 18-75 years old and had varying diagnoses and levels of functioning. The interviews were tape recorded, transcribed and analysed by qualitative content analy- sis. FINDINGS: Two main themes emerged: Theme 1. Having a home ventilator enhances quality of life-- a life worth living. The ventilator treatment builds up strength and improves well-being. Participants em- phasized that it was important to feel in control of their own situation and had an overriding wish to live a normal and active life; Theme 2. Competence and continuity of healthcare personnel are factors for suc- cess. The experience was that competence and follow-up by healthcare personnel varied, and that good quality teaching and information were important. CONCLUSION: Users of home mechanical ventilators should be active partners in their own care so that their experience is taken into account. It is important for clients having home mechanical ventilation to be empowered and have control in their daily lives, as well as having competent caregivers and continuity of care
462. Crossen-Sills J, Bilton W, Bickford M, Rosebach J, Simms L. Home care today: showcasing interdiscipli- nary management in home care. Home Healthc Nurse 2007;25(4):245-52.
463. Granerud A, Severinsson E. Preserving integrity: experiences of people with mental health problems liv- ing in their own home in a new neighbourhood. Nurs Ethics 2003;10(6):602-13.
Abstract: For patients with mental health problems, de-institutionalization has meant a shift from institu-
tional care to living in the community. However, several studies show that problems of stigmatization, loneliness and negative attitudes devalue the dignity and autonomy of these patients. The aim of this study was to gain a deeper understanding of how people with mental health problems experience living in an apartment of their own. The data collection method was focus group interviews. The constant com- parative method revealed the main category 'preserving integrity'. The subcategories were: the need for control over information, similar relationships with both friends and neighbours (symmetrical contact), and 'My home is my castle'. Participants who lived in a group home had little or no contact with their
neighbours. The participants experienced lack of acceptance and loss of autonomy when meeting people. Integrity was a necessary condition in order for them to become equal citizens, experience autonomy and dignity, and have the opportunity to develop social contacts
464. Granerud A, Severinsson E. The new neighbor: experiences of living next door to people suffering from long-term mental illness. Int J Ment Health Nurs 2003;12(1):3-10.
Abstract: The transition from hospital to community care for people with long-term mental illness is of
growing concern. The aim of the present study was to illuminate if and how people with long-term mental illness have affected their neighbourhood after re-establishing themselves in apartments of their own. Nineteen neighbours of group homes for people with long-term mental illness, in seven different commu- nities in eastern Norway, have been interviewed. The grounded theory procedures as well as the constant comparative method were employed to analyse the findings. From the data, one main category was iden- tified: the need for information
465. Granerud A, Severinsson E. The struggle for social integration in the community: the experiences of peo- ple with mental health problems. J Psychiatric & Mental Health Nursing 2006;13:(3):288-93.
Abstract: Qualitative research in Norway on how people with mental health problems experience inte-
gration into the community. Patients' feelings of shame, fear of exclusion, loneliness and neglect and the effects of stigma on self-esteem are described. The implications for community mental health workers as- sisting patient social integration are discussed, and the importance of interpersonal relationships with family are considered. 26 refs
466. Hansson L, Middelboe T, Sorgaard KW, Bjarnason O, Nilsson L, Korkeila J, et al. Living situation, subjec- tive quality of life and social network among individuals with schizophrenia living in community settings. Acta Psychiatr Scand 2002;106(5):343-50.
Abstract: Investigated the relationships between characteristics of the living situation in the community
and subjective quality of life and social network among community-based individuals with schizophrenia. 418 individuals with schizophrenia from 10 sites were interviewed with regard to quality of life, psychopa- thology, social network and needs for care. Characteristics of the living situation investigated were: living alone or not, living with family or not, and having an independent or a sheltered housing situation. Results show an independent housing situation was related to a better quality of life concerning living situation and living with the family to a better quality of life concerning family relations. An independent housing situation was associated with a better social network regarding availability and adequacy of emotional re- lations. It is concluded that people with schizophrenia with an independent housing situation have a better quality of life associated with more favorable perceptions of independence, influence, and privacy. Their social network is better irrespective of whether they live alone or not, or with family or not.
467. Hovengen R, Edgren L, Maurstad J, Dalgard OS. Mental Health Promotion in a Poorly Functioning Neighbourhood: What can we Learn from an Unsuccessful Project? The International Journal of Mental Health Promotion 2006;8(2):31-6.
Abstract: The object of the study described was to evaluate the effect of a local environment project
which aimed to improve mental health by strengthening social integration. An attempt was made to moti- vate municipal authorities and politicians concerned with housing to alter structural background factors af- fecting well-being and develop general contact-creating activities and special supportive measures in the local environment. The study is a pretest/post-test design. The pre-test included 92 people and the post- test included 40 people who were still living in the housing estate at the end of the project. The results showed a significant improvement in integration, but no corresponding improvement in mental health. Participation in contact-creating activities affected neither social integration nor mental health, and the re- sults indicate that inhabitants with considerable mental problems did not take part. Background factors re- lated to wellbeing, such as leisure activities, meeting places and kindergartens, had improved, while in- stability in the local environment and housing costs had deteriorated.
468. Johansson K, Lilja M, Petersson I, Borell L. Performance of activities of daily living in a sample of appli- cants for home modification services. Scand J Occup Ther 2007;14(1):44-53.
Abstract: Home modification services are provided to support persons with functional limitations to live
independently at home. It is not well known what causes individuals to apply for home modifications, or in what kind of life situation this need appears. The aim of this study was to examine the relationship be- tween performance of activities of daily living, housing and living situation, and the home modification ap- plied for in a sample of home modification applicants. Further, the aim was to examine differences in per- formance of activities of daily living between subgroups with different social support. A total of 102 partici- pants were included in the study. Data on performance of activities of daily living was collected through in- terviews in the participants' homes, using structured instruments. The participants reported high levels of independence in activities of daily living, and were using assistive devices to a large extent. However, the applicants clearly experienced difficulties in performing activities related to the applied home modification. The study indicates that the main reason for applying for Home Modification Grants was perceived diffi- culties in performance of activities of daily living. This stresses the importance of including other aspects besides independence when trying to understand persons' activity performance and planning for occupa- tional therapy interventions
469. Langeland E, Wahl AK, Kristoffersen K, Nortvedt MW, Hanestad BR. Sense of coherence predicts change in life satisfaction among home-living residents in the community with mental health problems: a 1-year follow-up study. Quality of life research : an international journal of quality of life aspects of treat- ment, care and rehabilitation 2007;16(6):939-46.
Abstract: OBJECTIVES: There is a call for a further investigation of Sense of Coherence (SOC), the
central concept in salutogenesis, and its relation to health and life satisfaction. No previous studies have investigated the utility of SOC versus mental symptoms for the prediction of life satisfaction among people with chronic mental health problems (MHP). METHODS: The present study has a prospective design in- cluding a baseline assessment and a 1-year follow up. We recruited 107 adults from the community health care system. SOC was measured by the Sense of Coherence questionnaire, mental symptoms by the Symptom Checklist-90 revised and life satisfaction by The Quality of Life Scale (all Norwegian ver- sions). RESULTS: The results show that while SOC predicts change in life satisfaction (standardized beta coefficient for SOC was 0.39, P = 0.014), mental symptoms did not (standardized beta coefficient 0.00, P = 1.0). CONCLUSIONS: These findings emphasize the importance of assessing factors that may explain differences in life satisfaction over and above mental symptoms among people with MHP. The results in- dicate that improving SOC among people with MHP might provide important opportunities for improving their life satisfaction.
470. Nieuwboer A, De Weerdt W, Dom R, Truyen M, Janssens L, Kamsma Y. The effect of a home physio- therapy program for persons with Parkinson's disease. J Rehabil Med 2001;33(6):266-72.
Abstract: The purpose of this study was to evaluate the effect of a home physiotherapy program for per-
sons with Parkinson's disease. Thirty-three patients took part in the study using a within-subject controlled design. Functional activities including walking and carrying out transfers were measured at home and in the hospital before and after a 6-week baseline period, after 6 weeks home physiotherapy and after 3 months follow-up. Spatiotemporal and plantar force variables of gait were determined with video and po- dodynography. Treatment provided by community physiotherapists consisted of teaching cueing and con- scious movement control 3 times a week. The study revealed that patients had significantly higher scores on a functional activity scale after treatment in the home setting and to a lesser degree in hospital, a re- sult, which was partly sustained at follow-up. However, duration of the transfer movements, spatiotempo- ral and plantar force variables were not significantly improved except for stride length. The results support
application and development of the treatment concept and highlight that physiotherapy aimed at improv- ing function in Parkinson's disease is best provided in the home situation.
471. Pettersson I, Berndtsson I, Appelros P, Ahlstrom G. Lifeworld perspectives on assistive devices: lived ex- periences of spouses of persons with stroke. Scand J Occup Ther 2005;12(4):159-69.
Abstract: The purpose of this study was to explore how spouses of persons with a disability following
stroke describe their lived experiences regarding assistive devices in everyday life. A phenomenological lifeworld approach was used and conversational interviews were conducted with 12 spouses. Their lived experiences of assistive devices were explored in relation to four lifeworld existentials intertwined in eve- ryday life. The results showed that lived body concerns aspects of feelings, habits, and incorporation of the devices with one's own body. The devices are, from the spouses' perspective, a prerequisite for their partner with stroke living at home. Successively the devices are incorporated into the couples' homes, and they provide a new view of the environment, aspects related to lived space. The devices bring about a changed relation to lived time, related to past, present, and future. Further, lived human relation con- cerns changed relationships to husbands/wives with stroke, including a great responsibility due to the de- vices and their usage. The results also included stigmatizing aspects and a twofold relationship to health professionals regarding participation in decisions about prescribing assistive devices. Understanding the unique meaning of assistive devices from the spouses' perspective is vital for occupational therapists pre- scribing such devices
472. Rolie JP, Paulsen D, Aksnes H, Thorud LO. Home hemodialysis as an alternative to in-center dialysis. Tidsskr Nor Laegeforen 2006;126(21):2795-7.
Abstract: Background. Dialysis is a life-sustaining treatment for renal disease in its final stage. The
number of patients in dialysis has more than doubled over the last 10 years in Norway. The prognoses still show an increasing number of patients in need of dialysis. As haemodialysis (HD) is complicated to perform at home, peritoneal dialysis is the preferred alternative. HD is usually carried out 3 times a week at hospitals, in satellites or self-dialysis in some other institution. Home HD is rarely used in Norway, as opposed to in other Western-European countries. Material and method. We describe our first patient of- fered HD at home and give an overview of home HD. Results and Interpretation. Empirically, the in-