No abstract

In this study we explored frail elders' experiences with and perceptions of the phenomenon of health so as to develop a deeper understanding of living with diseases and disorders in old age. Frail elders participated in qualitative interviews that explored the meaning of the phenomenon of health for them. Eleven men and 11 women, who had diverse ratings of self-perceived health ranging from poor to excellent, were selected by means of a purposeful strategic sampling of frail elders taken from a broader sample that participated in a larger quantitative study on health. In total, 22 individual interviews were analyzed using Giorgi's descriptive phenomenology. We found that frail elders described health as being in harmony and balance in everyday life, and this occurred when participants were able to adjust to the demands of their daily lives in the context of their resources and capabilities.

BackgroundMedication overuse headache (MOH) is a chronic headache disorder, caused by overuse of acute medication. To date, it remains unclear why some people overuse these medications. The aim of this qualitative study was to explore how individuals with MOH use medications and other strategies to manage headaches in their daily lives, and their thoughts about their own use of acute medication. Our intention was to develop a theoretical model about the development of MOH, from the perspective of those with MOH.MethodsData collection and analysis were conducted according to grounded theory methodology. The participants were recruited via newspaper advertisements. Fourteen persons with MOH were interviewed in individual qualitative interviews.ResultsThe basic process leading to medication overuse was holding on to the indispensable medication. The acute medication was indispensable to the participants because they perceived it as the only thing that could prevent headaches from ruining their lives. The participants perceived headaches as something that threatened to ruin their lives. As a result, they went to great lengths trying to find ways to manage it. They tried numerous strategies. However, the only strategy actually perceived as effective was the use of acute medication and they eventually became resigned to the idea that it was the only effective aid. The acute medication thus became indispensable. Their general intention was to use as little medication as possible but they found themselves compelled to medicate frequently to cope with their headaches. They did not like to think about their medication use and sometimes avoided keeping track of the amount used.ConclusionsThis qualitative study adds understanding to the process via which MOH develops from the perspective of those having MOH. Such knowledge may help bridge the gap between the perspectives of patients and health-care professionals.

The processes that precede treatment-seeking were highly complex, and both internal and external factors promoted and hindered treatment entry. The social significance of alcohol and the grief related to thoughts of abstaining were the most striking hindering factors. Such feelings need to be considered when motivating people to seek treatment for alcohol problems.

The aim of this study was to explore the inducements for treatment-seeking for alcohol problems in women and men. Specifically we wanted to identify what promoted or hindered treatment-seeking in women and men, respectively, and to what extent femininity and masculinity was reflected in the context of treatment seeking. Data was obtained from open interviews with five women and seven men within a month after their first entry into alcohol treatment. A content analysis was performed using gender as the sorting factor. Promoting factors for treatment seeking in men were characterized by belief in their own capability, and looking to the future; whereas the women placed importance on pressure from someone significant, and sharing the problem with others. Hindrances for both women and men were feelings of shame and the significant role alcohol had in their lives. The women perceived alcohol problems as incompatible with femininity, and this made them avoid talking openly about their problems, which hence hindered treatment seeking. These findings showed that the value of alcohol as a gendered symbol still exists, which could be perceptible in promoting and hindering factors for treatment seeking in women and men. These factors could be useful to consider by professionals both in the primary healthcare system and in the social services. Future research should address treatment seeking in relation to both cultural and gendered constructions and their influence on the perceptions and behaviour of women and men with alcohol problems.

We aimed to evaluate effects of the intervention on self-rated health, experiences of security/safety and symptoms. A nonblinded controlled trial was performed with participants randomised to either the intervention group or a control group, with follow-ups at 3, 6 and 12 months. The intervention involved collaboration between a nurse with geriatric competence at the emergency department, the hospital wards and a multi-professional team for care and rehabilitation of older adults, with a case manager from the municipality as the hub. Older people who sought care at the emergency department at Sahlgrenska University Hospital/Mö lndal and who were discharged to their own homes in the Mö lndal municipality were asked to participate. Inclusion criteria were age 80 years and older, or 65 to 79 years with at least one chronic disease and dependency in at least one activity of daily living. Analyses were conducted on the basis of the intention-to-treat principle. Outcome measures were self-rated health, experiences of security/safety and symptoms. These were analysed using Svensson's method. Of 161 participants, 76 were allocated to the control group and 85 to the intervention group. Positive effects of the intervention were observed for frail older adult's symptoms and self-rated health.

Hope has been identified as an important component for individuals coping with stress in life-threatening situations. The purpose of this study was to establish a Swedish instrument measuring hope. The instrument is based on an American hope scale developed by J.F. Miller to measure hope in adults. The Miller Hope Scale (MHS) is a 40-item 5-point Likert-type scale with a score range of 40-200. The MHS was translated into Swedish and examined in three stages before it was tested on a group of nursing students (n = 120). The test results in the Swedish sample were in accordance with Miller's evaluation of the psychometric properties of the MHS. The mean hope score was 170.4 (SD = 16.52) and the internal alpha coefficient was 0.88. The factor analysis on the Swedish sample resulted in the factors: I. Satisfaction with self, others and life; II. Avoidance of hope threats; III. Ability, capacity to influence the outcome in life.

The results indicate that a multi-disciplinary approach is desirable, where the focus should not only be on medical problems but also on providing supportive services to older people to maintain their independence and experiences of health despite frailty.