Biomedical subjects

Ulf Jakobsson

Publications and source records attributed to Ulf Jakobsson.

12 recordsLinked to original sources

PubMed2006

Older people in Sweden with various degrees of present quality of life: their health, social support, everyday activities and sense of coherence.

Public health policies in most European countries are concerned with how to keep older people living independently with a qualitatively good life in the community as long as possible. However, knowledge about what may characterise those seemingly 'healthy' older people is sparse. The aim of the study was to investigate the characteristics of a sample of people (75+) reporting various degrees of Quality of Life (QoL) with respect to QoL in different areas, as well as self-rated health, health problems, social support, everyday activities and sense of coherence. A postal questionnaire was sent out in spring 2001 to a randomly selected population-based sample (n= 600) in the southern parts of Sweden. A two-step cluster analysis was performed (n= 385, mean age 84.6, SD = 5.7) with 'present QoL' as clustering attribute. Three groups were disclosed, classified as high, intermediate and low present QoL, of which 33.8% could be regarded being at risk of low QoL. Those with low present QoL (18.4%) were the oldest and most vulnerable, a majority were women with 'poor or bad' self-rated health, high frequencies of health problems, low total QoL, low social support and sense of coherence and less physically active. Those with high present QoL (47.8%) reported more 'excellent or good' self-rated health, physical activity, satisfactory social support and higher sense of coherence and total QoL than the other two groups. Those with intermediate present QoL (33.8%) had more of 'poor or bad' self-rated health, more health problems were less physically active, had lower total QoL and sense of coherence, and less social support than those with high present QoL. The sample seemed to reflect the ageing process in that the respondents were at different stages of ageing. However, the fact that the level of social support, sense of coherence and self-rated health followed the same curve as QoL may indicate that some are more vulnerable to low present QoL given the same health and these should be targeted in preventive programmes since they report low QoL.

Activities of Daily Living↗

PubMed2006

Quality of life among older adults with osteoarthritis: an explorative study.

Factors that explain the variance in quality of life among older adults with osteoarthritis were investigated. Individuals with osteoarthritis (n = 168) had more pain, functional limitations, and lower quality of life (physical component) than those without osteoarthritis (n = 246). No significant differences between the groups were found related to depressed mood and mental components of quality of life. Quality of life was associated with pain, functional limitations, and depressed mood in both groups. It is important to identify these problems when caring for older adults, and special attention should be given to individuals with osteoarthritis because of their higher degree of pain and functional limitations.

Activities of Daily Living↗

PubMed2005

Psychometric evaluation of multidimensional pain inventory (Swedish version) in a sample of elderly people.

OBJECTIVES: The aim was to psychometrically evaluate the Swedish version of the Multidimensional Pain Inventory (MPI-S) and the "brief screening version of MPI-S" for use in an elderly sample. METHODS: This study comprised 175 people aged 76-99 years reporting pain and in need of help to manage daily living. The instrument's factor structures were investigated through factor analyses, convergent and discriminant validity were assessed through inter-scale correlations and correlations with items from SF-12. Reliability was assessed by Cronbach's alpha. RESULTS: The full-length version of MPI-S did not, in general, show any satisfactory validity and reliability when used among elderly. It had acceptable convergent and discriminant validity, but the factor analysis did not show a good model fit. Low alpha values were found for most of the sub-scales. However, the brief screening version of MPI showed acceptable validity and reliability, except for rather low alpha values in sections 3 and 4. CONCLUSION: The MPI-S instrument may not be very useful for measuring pain among frail elderly. The brief screening version may instead be a better alternative to the full version of the MPI-S. However, the small number of observations may be the reason to the lack of fit, and further studies are warranted.

Activities of Daily Living↗

PubMed2005

Loneliness, fear, and quality of life among elderly in Sweden: a gender perspective.

BACKGROUND AND AIMS: The aim of this work was to study feelings of loneliness and fear among elderly people (75+) in a gender perspective, and to explore their causes. METHODS: A cross-sectional study (postal questionnaire) with a randomised and age-stratified sample (n = 4277) was used to study the variables of interest. Because the variables were compared between men and women, weighted values for means, standard deviations, and ratios were used. Multiple logistic regression analysis was used to identify the causes of loneliness and fear. RESULTS: Findings showed that loneliness and fear were both more frequently reported by women than men. Loneliness was significantly associated with gender, marital status, living in special accommodation, fear, and need of help with activities of daily living (IADL). Fear was significantly associated with gender, number of children, having someone to trust, loneliness, and being in need of help with IADL. Those who reported loneliness and/or fear had significantly lower health-related quality of life than those who did not. Many of the elderly feared violence/crime, but only a few had been exposed to violence/crime. CONCLUSIONS: Loneliness and fear are common among elderly people. Both variables seem to be related to each other and were both found to be "threats" to a good life in old age. However, to minimize these "threats" and perhaps improve these people's quality of life, action can be taken in the care for elderly people such as involving the social network and reducing the need of help with IADL.

Aged↗

PubMed2005

Self-reported health complaints and their prediction of overall and health-related quality of life among elderly people.

OBJECTIVE: To describe and compare self-reported health complaints, overall and health-related quality of life and to investigate how health complaints, age, gender, marital status, living and dwelling conditions and socio-economy predicted overall and health-related quality of life. DATA AND METHOD: A sample of 469 persons (aged 75-99) responded to a postal questionnaire. Multiple linear regression analysis was used to examine possible predictors. RESULT: Self-reported health complaints such as pain, fatigue and mobility impairment significantly predicted low overall and health-related quality life. Women had significantly lower overall and health-related quality of life than men, and a significantly higher degree of self-reported health complaints. The regression models had more similarities than differences, implying that the overall quality of life instrument were sensitive to physical influences only supposed to be detected by health-related quality of life instruments. Several of the health complaints predicting low quality of life are amenable for being relieved by nursing care. In the care of older people nurses need to assess for several health complaints simultaneously and be aware of their possible interaction when outlining interventions. Nurses are able to facilitate early detection of health complaints negatively affecting quality of life by implementing more pro-active preventive work as well as a higher degree of thorough and systematic assessments. It also seems important to consider that older woman's and men's needs for high quality of life may differ.

Activities of Daily Living↗

PubMed2005

Statistical methods for assessing agreement for ordinal data.

Evaluation of various methods in clinical practice is often based on interpretations by two or more observers. Such data need to be analysed with correct statistics, or the results and conclusions may be misleading. In this study, the use of measures of agreement for ordinal data in five international nursing journals is reviewed and various methods for measuring agreement are presented and discussed. Analyses of agreement did not seem to be very common in nursing research, but a great variation was found regarding the choice of method for analysing agreement. Both acceptable and unacceptable methods were found in the articles reviewed. When choosing among various methods for agreement the weighted kappa-coefficient is probably the most useful for ordinal data, but several issues of concern arise and need to be taken into consideration when using these types of analyses.

Humans↗

PubMed2004

Pain management in elderly persons who require assistance with activities of daily living: a comparison of those living at home with those in special accommodations.

OBJECTIVES: To describe and compare the methods of pain management used by elderly individuals with chronic pain and requiring assistance with activities of daily living, depending on whether they live alone, with someone, at home or in special accommodations. METHODS: This study comprised 294 people aged 76-100 years, identified as having chronic pain and requiring assistance with activities of daily living. Pain and pain management methods were compared using the Multidimensional Pain Inventory, Swedish version, and the Pain Management Inventory. RESULTS: Those living in special accommodations reported more pain than those living at home. Those living with someone reported more pain and interference in daily life than those living alone, despite using more pain-relief methods and having greater social support. The median number of pain-relieving methods used was 3.0 (75th-25th percentile: 5-2). Some (3.8%) did not use any method to relieve their pain. The most frequently used methods were prescribed medicine (20%), rest (20%) and distraction (15%). The methods rated most effective were using cold, exercise, hot bath/shower and consuming alcohol. CONCLUSION: Participants had only a small repertoire of pain management methods and these were mostly conventional in nature. Few non-pharmacological methods were used. The findings suggest the importance of thorough assessment, and the need to fully discuss pain management options with the elderly.

Activities of Daily Living↗

PubMed2004

Pain management among older people in need of help with activities of daily living.

The aim of this study was to investigate the use of various pain relief methods among older people in chronic pain and in need of help to manage activities of daily living. People who reported pain and were in need of help to manage activities of daily living were included in the study. The Multidimensional Pain Inventory-Swedish version and a modified version of the Pain Management Inventory were used to study pain and methods of pain relief. The respondents used a variety of methods (median = 3) to relieve their pain; pharmacologic methods, rest, and distraction were the predominant strategies employed. A cluster analysis identified 2 main groups of people: people who used a few well-known methods and were significantly older and people who used a larger repertoire of methods to relieve their pain and reported higher pain severity and interference with daily life. About a third of older people reported inadequate pain relief. These findings stress the need for nurses to inform older people about available methods for pain relief and to do systematic pain assessments to evaluate the effectiveness of various pain relief methods.

Activities of Daily Living↗

PubMed2004

Overall and health related quality of life among the oldest old in pain.

OBJECTIVES: To compare the oldest old (85 years and above) in pain with those with no pain across gender, regarding demographic data, living conditions, social network/support, walking/mobility problems, fatigue, sleeping problems, depressed mood and quality of life (QoL). The aim was also to test how these variables were related to QoL among the oldest old in pain. METHODS: The study comprised 1622 people aged 85-105 years, of whom 47% reported pain. SF-12 and the LGC questionnaire were used to measure QoL. Multiple linear regression analysis was used to identify factors associated with QoL. RESULTS: Functional limitations, fatigue, sleeping problem and depressed mood were significantly more prevalent and QoL was significantly lower among those in pain than those not in pain, and among women compared to men. These complaints, along with financial problems, living in sheltered housing and living alone, were associated with low QoL among those in pain. CONCLUSION: Pain is common among the oldest old and coexists with several other complaints that together negatively affect QoL. By identifying those in pain and coexisting factors, actions can be taken to contribute to QoL, also in late life.

Activities of Daily Living↗

PubMed2004

Statistical presentation and analysis of ordinal data in nursing research.

OBJECTIVES: The aim of this study was to review the presentation and analysis of ordinal data in three international nursing journals in 2003. METHOD: In total, 166 full-length articles from the 2003 editions of Cancer Nursing, Scandinavian Journal of Caring Sciences and Nursing Research were reviewed for their use of ordinal data. RESULTS: This review showed that ordinal scales were used in about a third of the articles. However, only about half of the articles that used ordinal data had appropriate data presentation and only about half of the analyses of the ordinal data were performed properly. CONCLUSIONS: Ordinal data are rather common in nursing research, but a large share of the studies do not present/analyse the result properly. Incorrect presentation and analysis of the data may lead to bias and reduced ability to detect statistical differences or effects, resulting in misleading information. This highlights the importance of knowledge about data level, and underlying assumptions for the statistical tests must be considered to ensure correct presentation and analyses of data.

Bibliometrics↗

PubMed2003

Old people in pain: a comparative study.

To investigate the prevalence of pain in older people (75+), compare those in pain to those without regarding demographics, social network, functional limitations, fatigue, sleeping problems, depressed mood and quality of life (QOL), and identify variables associated with pain, a cross-sectional, prospective survey was conducted in an age-stratified sample of 4,093 people aged 75-105 years old. Those reporting pain (n=1,654) were compared with those who did not (n=2,439). Pain was more common with higher age, as were all complaints among those in pain and among those without, except sleeping problems. Lower QOL was found with higher age, as well as with pain. Pain was found to be associated with functional limitations, fatigue, sleeping problems, depressed mood, and QOL. These data highlight the importance of identifying old people in pain. Those who are older and those affected by pain are at greater risk of also being troubled by other problems, such as functional limitations and lowered QOL.

Activities of Daily Living↗

PubMed2002

Pain and quality of life among older people with rheumatoid arthritis and/or osteoarthritis: a literature review.

The aim of this study was to review the research literature on pain and quality of life (QoL) and the relationship between these variables among people aged 75 years and above with rheumatoid arthritis and/or osteoarthritis. A Medline and CINAHL search was carried out using MeSH terms rheumatoid arthritis, osteoarthritis, QoL and pain in various combinations. Seventeen articles were identified that met the requirements for methodological quality and inclusion criteria. No study focused only on respondents aged 75 years or over. The studies had varying representation of this age group. Pain was common in both groups and was found to increase with age and disease duration among those with rheumatoid arthritis but not among those with osteoarthritis. Increased pain could lead to depression. Pain, functional limitation and increased age were found to decrease QoL among those with rheumatoid arthritis and osteoarthritis alike. Social support was found to buffer against negative effects on QoL among those with osteoarthritis while no moderating effects were found in rheumatoid arthritis. Increased age was found to relate to pain (rheumatoid arthritis) and decrease QoL (both rheumatoid arthritis and osteoarthritis). It is, however, hard to draw any firm conclusions about older people's pain and QoL because of the lack of studies including respondents aged 75 years or over. Thus, research about pain and QoL, especially focusing on the old and the very elderly with rheumatoid arthritis/osteoarthritis, is needed. It also seems justified to say that nursing care should especially focus on older people and that these people should be assessed for their level of pain, functional limitations and QoL especially in the case of having rheumatoid arthritis and/or osteoarthritis.

Age Factors↗