In recent years, there has been a notable growth in the use of focus groups within occupational therapy. It is important to understand what kind of knowledge focus-group methodology is meant to acquire. The purpose of this article is to create an understanding of the basic assumptions within focus-group methodology from a theory of science perspective in order to elucidate and encourage reflection on the paradigm. This will be done based on a study of contemporary literature. To further the knowledge of basic assumptions the article will focus on the following themes: the focus-group research arena, the foundation and its core components; subjects, the role of the researcher and the participants; activities, the specific tasks and procedures. Focus-group methodology can be regarded as a specific research method within qualitative methodology with its own form of methodological criteria, as well as its own research procedures. Participants construct a framework to make sense of their experiences, and in interaction with others these experiences will be modified, leading to the construction of new knowledge. The role of the group leader is to facilitate a fruitful environment for the meaning to emerge and to ensure that the understanding of the meaning emerges independently of the interpreter. Focus-group methodology thus shares, in the authors' view, some basic assumptions with social constructivism.

The aim of this study was to explore independence in the home as experienced by very old single-living people in Sweden. A grounded theory approach was used and interviews were conducted with 40 men and women aged 80-89. Data analysis revealed the core category "Home as a signification of independence" with two main categories: "Struggle for independence" and "Governing daily life". The findings showed that home is strongly linked to independence, and being independent is extremely valued. Explicit descriptions of the ageing process as an individual process of changing living conditions within the home emerged from the findings. Hence, the ageing process influences the participants' perception of themselves as independent persons. Along the ageing process the participants' view of independence changed from being independent in activity performance without help from others to experiencing independence in being able to make autonomous decisions concerning daily life at home. Consequently, there is a need to develop strategies to support very old people in staying as active and independent as possible in their own homes. In addition, since the findings highlight that independence is a complex construct, there is a need for conceptual differentiation between independence and a construct often used synonymously, namely autonomy.

In this study we have received an understanding of the complex situation of being on sickness absence due to work related strain. We have learned the importance of recognizing the context of the individual and understanding the interplay between the person and the environment. As professionals in rehabilitation we can use this knowledge to create a rehabilitation programme supporting people back to work.

The aim was to explore health in relation to the home as experienced by very old, singleliving Swedish people. Applying a grounded theory approach, 40 men and women aged 80-89 were interviewed in their own homes. Data analysis revealed the main theme "The home is the hub of health", comprising two categories, "The home as support for health", and "Having an inner driving force to maintain health". Health was described as being active and participating, and during the aging process the home became an increasingly important source of support. The older people were aware of their vulnerability, and knew that their life situation could change rapidly. Thus, health was always interpreted in relation to this. They had a strong inner driving force to maintain health, and within the home they challenged their capacity, and used different adaptive strategies targeting person-environment-activity transactions. Our findings imply the need for focusing on the opportunities for activity and participation in all interventions. They also challenge current national and international housing policy emphasizing the benefits of staying put, thus contributing to a more diverse view of what kind of housing arrangements are optimal for very old people.

BackgroundAs more people reach older age, there is a growing interest in improving old person’s health, activity, independence and social participation, thereby adding quality to the extended years. Preventive home visits (PHV) programs for old people have received much attention in recent decades. A large body of research shows mixed effects, and argues that a home visit is a complex social process influenced by numerous factors. To evaluate the impact of PHV, as well as making decisions on whether, how, and to whom the service should be provided, requires a deeper understanding of PHV than we have now. Consequently, the aim of the study was to describe the variations in older people’s (80+) experiences of a single preventive home visit and its consequences for health.MethodsSeventeen participants between 80 and 92 years of age who had all received a structured PHV were interviewed in their own homes. The interviews were analyzed using the phenomenographic method, looking at the variations in the participants’ experiences.ResultsThe interviews revealed four categories: “The PHV made me visible and proved my human value”; “The PHV brought a feeling of security”; “The PHV gave an incentive to action”; and “The PHV was not for me”.ConclusionsThe experiences of a PHV were twofold. On one hand, the positive experiences indicate that one structured PHV was able to empower the participants and strengthen their self-esteem, making them feel in control over their situation and more aware of the importance of keeping several steps ahead. Together this could motivate them to take measures and engage in health-promoting activities. On the other hand, the PHV was experienced as being of no value by a few. These findings may partly explain the positive results from PHV interventions and emphasize that one challenge for health care professionals is to motivate older people who are healthy and independent to engage in health-promoting and disease-preventive activities.

Using a grounded theory perspective, this article focuses on experiences of participation in relation to home among very old people who are living alone. Eight people selected from the larger ENABLE-AGE Project were interviewed. Data analysis identified the core category as "home as the locus and origin for participation" with two main categories ("performance-oriented participation" and "togetherness-oriented participation"). The findings indicate that the home is the origin for participation both out of the home and within the home. However, as older people's health declines, the home becomes the explicit locus for participation. Participation successively changes from taking part in more physically demanding activities out of the home to participation by means of watching others from within the home (i.e., by being a spectator). In appreciating self-defined goals for a meaningful life, thus enabling the experience of participation in very old age (age 80 to 89 years), this study contributes to the knowledge about relationships between participation and home in very old age.

ObjectiveThe aim of this study was to investigate whether the acute care of frail elderly patients in a comprehensive geriatric assessment (CGA) unit is superior to the care in a conventional acute medical care unit.DesignThis is a clinical, prospective, randomized, controlled, one-center intervention study.SettingThis study was conducted in a large county hospital in western Sweden.ParticipantsThe study included 408 frail elderly patients, aged ≥75 years, in need of acute in-hospital treatment. The patients were allocated to the intervention group (n=206) or control group (n=202). Mean age of the patients was 85.7 years, and 56% were female.InterventionThis organizational form of care is characterized by a structured, systematic interdisciplinary CGA-based care at an acute elderly care unit.MeasurementsThe primary outcome was the change in health-related quality of life (HRQoL) 3 months after discharge from hospital, measured by the Health Utilities Index-3 (HUI-3). Secondary outcomes were all-cause mortality, rehospitalizations, and hospital care costs.ResultsAfter adjustment by regression analysis, patients in the intervention group were less likely to present with decline in HRQoL after 3 months for the following dimensions: vision (odds ratio [OR] =0.33, 95% confidence interval [CI] =0.14–0.79), ambulation (OR =0.19, 95% CI =0.1–0.37), dexterity (OR =0.38, 95% CI =0.19–0.75), emotion (OR =0.43, 95% CI =0.22–0.84), cognition (OR = 0.076, 95% CI =0.033–0.18) and pain (OR =0.28, 95% CI =0.15–0.50). Treatment in a CGA unit was independently associated with lower 3-month mortality adjusted by Cox regression analysis (hazard ratio [HR] =0.55, 95% CI =0.32–0.96), and the two groups did not differ significantly in terms of hospital care costs (P>0.05).ConclusionPatients in an acute CGA unit were less likely to present with decline in HRQoL after 3 months, and the care in a CGA unit was also independently associated with lower mortality, at no higher cost.

Focus group methodology was used with the aim of learning how persons with the diagnosis of age-related macular degeneration perceived and described their disease, and how the disease had changed their activities of daily living (ADL). This information is seen as critical in designing a health education programme. The focus group participants described problems in performing ADL. Factors contributing to the ADL problems were categorized as functional limitations in, and feelings about performing, ADL. The participants used a number of ADL strategies to adapt to new situations. The participants expressed uncertainty regarding whether senile macular degeneration, age-related macular degeneration and 'yellow spot' were the same disease. They expressed a desire to know more about the disease and its consequences. They particularly requested time for receiving information, and the opportunity to discuss it, as in the focus groups. This target group need a health education programme based on their own perceptions. The main issues in such a programme should be to convey information, teach ADL strategies, provide support and foster problem-solving.