To a great extent, older people in Sweden, often with extensive care needs, are cared for in their own home. Support is often needed from both family and professional caregivers. This study aimed to describe and analyse different aspects of health, functioning and social networks, and how they relate to formal and informal care in the home among older adults. Analyses were performed utilising data from the OCTO-2 study, with a sample of 317 people living in Jonkoping County, aged 75, 80, 85 or 90 years, living in their own homes. Data were collected with in-person-testing. Based on receipt of care, the participants were divided into three groups: no care, informal care only, and formal care with or without informal care. Descriptive statistics and multinomial regression analysis were performed to explore the associations between received care and different aspects of health (such as multimorbidity, polypharmacy), social networks (such as loneliness, number of confidants) and functioning (such as managing daily life). The findings demonstrate that the majority of the participants received no care at home (61%). Multimorbidity and polypharmacy were more common among those receiving some kind of care in comparison to those who received no care; moreover, those receiving some kind of care also had difficulties managing daily life and less satisfaction with their social networks. The multinomial logistic regression analyses demonstrated that age, functioning in daily life, perceived general health and satisfaction with the number of confidants were related to receipt of care, but the associations among these factors differed depending on the type of care that was received. The results show the importance of a holistic perspective that includes the older person's experiences when planning home care. The results also highlight the importance of considering social perspectives and relationships in home care rather than focusing only on health factors.

Older people in Sweden are increasingly being cared for in the own home, where professional caregivers play an important role. This study aimed to describe perceptions of caring responsibility in the context of older people’s homes from the perspective of professional caregivers from caring professions. Fourteen interviews were conducted with professional caregivers from different professions. The result show how professional caregivers perceive responsibility as limitless, constrained by time, moral, overseeing, meaningful and lonesome. Responsibility seems to affect caregivers to a large extent when the burden is high. Professional caregivers’ perceptions of responsibility, and the potential consequences of a perceived strained work situation therefore need to be addressed. The findings also indicate a need for professional support and guidance when it is difficult to distinguish between professional and personal responsibility.

Background

When the ageing population increases, the burden and responsibility of close family members will likely increase. Those closely related who assume a great responsibility can be significantly affected in health, well‐being and daily life.

Aim

This study aims to describe the life situation when family caregivers are imposed responsibility for an older person with complex care needs in their own home.

Methods

In this Swedish qualitative study, ten family caregivers were strategically selected in order to achieve variations in the life situation. A reflective lifeworld research design based on phenomenological philosophy was used throughout the data collection with the lifeworld interviews and the analytic process.

Findings

In terms of extensive responsibility, the life situation is complex and involves emotions that are difficult to manage. In essence, a paradoxical life situation is described which is experienced as both voluntarily and nonchosen at the same time. The responsibility never rests. The essential meaning is further illustrated with three constituents: loss of freedom, contradictory feelings and affected relationships.

Conclusion

A life situation with extensive responsibility for an older family member interferes with the whole life situation with an impact on health and relationships with other people. The findings are crucial for professional caregivers in order to capture the nature of family support in a way that enables a meaningful life for both the family caregiver and the older person being cared for. Knowledge of this will give professional caregivers an increased awareness of the life situation of family caregivers and provide a better understanding of the support they are longing for, and, in some countries, such as Sweden, also are entitled to by law.

Abstract Background: In line with changing demographics, conditions for older people have also changed. Older people are expected to live and be cared for in their own home for as long as possible. Increasing age also increases the risk of multimorbidity and the need for social services and health care services. Home care, instituted by different laws, is complex and requires cooperation from an older person when his/her home becomes a workplace for service providers.

Aim: This study aims to illuminate the meaning of being an older person with multimorbidity who lives alone and who is cared for in his/her own home.

Design: This study uses a qualitative design with a lifeworld approach.

Methods: Conducted in Sweden in 2016, the researchers interviewed 12 older persons that live alone and receive home care. Data was analysed using qualitative content analysis.

Results: The findings illustrate four sub-themes: adapting to a caring culture, being exposed, participation with limitations and being dependent on forced relationships. The overall theme reveals that older people experience a life-changing situation when receiving home care and they become a guest in their own home.

Conclusions: Becoming older with increased needs means to disrupt one’s life when one’s private home becomes a public arena. Caregivers need to be aware of the gap between their rights by law and an older person’s experiences of receiving home care. Only then can care be offered that enables older people to have a sense of control and experience their home as their own.

Implications for Practice: The findings emphasise the need to view older people as being self-determinant and independent. Older people receiving home care need to be seen as individuals, and their entire life situation should be considered by also acknowledging the important role played by relatives and caregivers.

Background

The workplace is an essential source of social capital for many people; it provides mutual support and gives meaning to life. However, few prospective studies have thoroughly investigated the importance of aspects of social capital in the workplace. The aim of this study was to investigate the associations between aspects of social capital (social support, sense of community, and quality of leadership) at the workplace, and work ability, working degree, and vitality among women with a history of long-term sick leave from human service organizations.

Methods

A longitudinal cohort study was performed among women with a history of long-term sick leave. The study started in 2005, and the women were followed up at 6 months, 1 year, and 6 years using self-reported questionnaires (baseline n = 283). Linear mixed models were used for longitudinal analysis of the repeated measurements of prospective degree of work ability, working degree, and vitality. Analyses were performed with different models; the explanatory variables for each model were social support, sense of community, and quality of leadership and time.

Results

Social capital in terms of quality of leadership (being good at solving conflicts and giving high priority to job satisfaction), sense of community (co-operation between colleagues) and social support (help and support from immediate superiors and colleagues) increased the women’s work ability score (WAS) as well as working degree over time. Additionally, social capital in terms of quality of leadership increased the women’s vitality score over time.

Conclusions

A sustainable return-to-work process among individuals with a history of long-term sick leave, going in and out of work participation, could be supported with social support, good quality of leadership, and a sense of community at the workplace. The responsibility for the rehabilitation process can not be reduced to an individual problem, but ought to include all stakeholders involved in the process, such as managers, colleagues, health care services, and the social security agency.

A reflective team (RT) is a team of professional carers who reflect on a specific caring issue under the direction of an RT leader. The goal for the reflective process is to accomplish care improvement based on research and proven experience, and the first step is to reflect upon the competence that already exists in the context where RT takes place. This study aims to bring previous unarticulated competence for dementia care to the surface, after it has been reflected during RT sessions. Ten staff nurses who work close to patients with dementia and attend RT sessions on regular basis were interviewed about their competence for dementia care. Through a phenomenographic analyze two qualitatively separated categories emerged; general caring skills and specific dementia caring skills. It is concluded that specific skills for dementia care build on general caring skills, and that tacit knowledge can emerge to proven experience when it has been reflected in RT.

Needle-related medical procedures (NRMPs) are something that all young children need to undergo at some point. These procedures may involve feelings of fear, pain and anxiety, which can cause problems later in life either when seeking healthcare in general or when seeking care specifically involving needles. More knowledge is needed about supporting children during these procedures.

AIM:

This study aims to explain and understand the meaning of the research phenomenon: support during NRMPs. The lived experiences of the phenomenon are interpreted from the perspective of younger children.

METHOD:

The analysis uses a lifeworld hermeneutic approach based on participant observations and interviews with children between 3 and 7years of age who have experienced NRMPs.

RESULTS:

The research phenomenon, support for younger children during NRMPs, is understood through the following themes: being the centre of attention, getting help with distractions, being pampered, becoming involved, entrusting oneself to the safety of adults and being rewarded. A comprehensive understanding is presented wherein younger children experience support from adults during NRMPs in order to establish resources and/or strengthen existing resources.

CONCLUSIONS:

The manner in which the child will be guided through the procedure is developed based on the child's reactions. This approach demonstrates that children are actively participating during NRMPs. Supporting younger children during NRMPs consists of guiding them through a shared situation that is mutually beneficial to the child, the parent and the nurse. Play during NRMP is an important tool that enables the support to be perceived as positive.

AbstractAim To investigate the relationships between return to work and social support outside work among women on long-term sick leave from human service organizations. Background Work is an important part of life and is, in general, considered to be supportive of health and wellbeing. Few studies have thoroughly investigated the importance of aspects of social support outside work for return to work. Methods A cohort of women on long-term sick leave was followed with questionnaires from 2005 to 2012. Results The availability of social attachment increased the women's work ability, return to work, and vitality significantly more over time. There were positive relationships between return to work and seeking support in terms of emotional support and comfort and expressing unpleasant feelings. Conclusions Important resources to increase return to work can be found in factors outside work, such as close social relationships and support seeking. Thus, it is important to take the woman's whole life situation into account and not focus solely on aspects related to the workplace.

Background Needle-related medical procedures (NRMPs) are often frightening and cause children anxiety and pain. Only a few studies have examined the perspectives of younger children. More knowledge is needed about younger children's experiences in caring situations such as NRMPs. Aim The aim of this study was to explain and understand the consequences related to NRMPs from younger children's perspectives. Methods Participant observations and interviews with younger children who had experienced NRMPs were analysed using a lifeworld hermeneutic approach. Results Experiencing fear is central for younger children during an NRMP and interpretation of its consequences formed the basis for the following themes: seeking security, realizing the adult's power, struggling for control, feeling ashamed, and surrendering. A comprehensive understanding is presented wherein younger children's experiences of NRMPs vary across time and space related to weakening and strengthening their feelings of fear. Conclusions Awareness is needed that adults' power becomes more obvious for children during an NRMP. Children's surrender does not necessarily imply acceptance of the procedure. Providing children with opportunities to control elements of the procedure creates a foundation for active participation, and vice versa.

Coming to a new country involves many challenges. One of them is to approach a new health care system when you have a child with asthma. The aim of this study was to gain a broader understanding of immigrant parents’ experiences of the Swedish health care system. Twelve parents of children with asthma were interviewed and their narratives were analyzed by using qualitative content analysis. The results show that immigrant parents’ experiences of Swedish health care vary and involve both advantages and disadvantages. Advantages of the Swedish health care system are described as Being met with respect and Affordable care, while disadvantages are described as Problems with communication, Being discriminated against and Lack of confidence. The disadvantages are challenges for health care professionals, who are expected to offer care on equal terms to the whole population. Therefore, they need to provide culturally competent care and encourage immigrant parents to voice their expectations and worries.