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A person-centred approach to health promotion for persons 70+ who have migrated to Sweden: promoting aging migrants' capabilities implementation and RCT study protocol.

ABSTRACT: BACKGROUND:There are inequities in health status associated with ethnicity, which may limit older foreign-born persons' ability to age optimally. Health promotion for older persons who have experienced migration is thus an area of public health importance. However, since research related to this issue is very limited, the study 'Promoting Aging Migrants' Capabilities' was initiated to improve our understanding. The study aims to implement and evaluate a linguistically adapted, evidence-based, health-promoting intervention with a person-centred approach for two of the largest groups of aging persons who have migrated to Sweden: persons from Finland and persons from the Balkan Peninsula. METHODS/DESIGN:This study has a descriptive, analytical, and experimental design. It is both a randomised controlled trial and an implementation study, containing the collection and analysis of both qualitative and quantitative data. The setting is an urban district in a medium-sized Swedish city with a high proportion of persons who were born abroad and whose socio-economic status is low. The intervention comprises four group meetings ('senior meetings') and one follow-up home visit made by a multi-professional team. For the randomised controlled trial, the plan is to recruit at least 130 community-dwelling persons 70 years or older from the target group. Additional persons from involved organisations will participate in the study of the implementation. Both the intervention effects in the target group (outcome) and the results of the implementation process (output) will be evaluated. DISCUSSION:The results of this forthcoming randomised controlled trial and implementation study may be useful for optimising implementation of person-centred, health-promoting initiatives for older persons who have experienced migration. It is also hoped that this combined study will show that the capabilities for optimal aging among older persons born in Finland and the Balkan countries can be improved in the Swedish healthcare context. TRIAL REGISTRATION:The trial was registered at ClinicalTrials.gov April 10, 2013, identifier: NCT01841853.

SUBMITTER: Gustafsson S

PROVIDER: S-EPMC4333269 | biostudies-literature | 2015 Feb

REPOSITORIES: biostudies-literature

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A person-centred approach to health promotion for persons 70+ who have migrated to Sweden: promoting aging migrants' capabilities implementation and RCT study protocol.

Gustafsson Susanne S Lood Qarin Q Wilhelmson Katarina K Häggblom-Kronlöf Greta G Landahl Sten S Dahlin-Ivanoff Synneve S

BMC geriatrics 20150214

<h4>Background</h4>There are inequities in health status associated with ethnicity, which may limit older foreign-born persons' ability to age optimally. Health promotion for older persons who have experienced migration is thus an area of public health importance. However, since research related to this issue is very limited, the study 'Promoting Aging Migrants' Capabilities' was initiated to improve our understanding. The study aims to implement and evaluate a linguistically adapted, evidence-b ...[more]

PMID: 25887506

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Project description:IntroductionMealtime is a critical daily activity to ensure nutrition, hydration, function and socialisation. Interactions between staff and residents during mealtimes are complex and dynamic processes including verbal and/or nonverbal communication that can be positive/neutral or challenging. This study examined characteristics of and relationships between person-centred and task-centred care and positive/neutral and challenging mealtime behaviours in persons with dementia.MethodsThis study was a secondary behavioural analyses of videotaped mealtime observations (n = 110) involving 42 unique staff-resident dyads (29 staff and 25 residents with dementia) in nine nursing homes. The refined Cue Utilization and Engagement in Dementia mealtime video-coding scheme was used to code videos during 2019-2020. Dependent variables representing resident mealtime behaviours included positive verbal behaviours, positive/neutral nonverbal behaviours, functional impairments (nonverbal) and resistive behaviours (verbal and nonverbal). Independent variables were staff person-centred and task-centred approaches (verbal and nonverbal). Relationships between resident mealtime behaviours and staff approaches were examined using bivariate analysis and logistic regression.ResultsStaff person-centred verbal approaches were associated with resident positive verbal behaviours (OR = 1.38, 95% CI = 1.09-1.76), functional impairments (OR = 0.81, 95% CI = 0.66-1.00) and resistive behaviours (OR = 1.65, 95% CI = 1.18-2.31). Staff person-centred nonverbal approaches were associated with resident functional impairments (OR = 1.33, 95% CI = 1.02-1.74). Staff task-centred approaches were not associated with resident positive/neutral or challenging mealtime behaviours.ConclusionThis study characterised staff approaches and resident behaviours during mealtime care and provided preliminary support on associations between staff person-centred approaches and resident positive and challenging behaviours. Person-centred mealtime care practice is recommended by focusing on support of common, challenging behaviours and reinforcement of positive behaviours with adequate consideration of individual needs and preferences.

Project description:BackgroundEstablishing more substantial patient involvement in the health care has become fundamental to Western health care services. Person-centred care (PCC) has been developed as a way of working that involve the patients and family members. However, the implementation of PCC in clinical practice has proven to be challenging. The aim of this study was to explore the congruence of managers' perceptions and understanding of various aspects of PCC across three organisational levels in one health care region in Sweden in terms of coupling, decoupling and recoupling.MethodsA policy on increased patient participation in health care was adopted in one health care region in Sweden. This policy was embodied in the form of PCC and a support strategy for the implementation was put in place. Participants representing three organisational levels (senders: politicians, n = 3; messengers: senior management, n = 7; and receivers: middle- and frontline managers, n = 13) were interviewed and documents collected. A deductive qualitative content analysis was performed and findings from the three organisational levels compared.ResultsDescriptions of PCC at all the three organisational levels included health care provided in partnership between provider and patient. However, messengers and receivers also included aspects of how work was organised as part of the concept. Representatives at all levels expected high-quality care while reducing health care costs as an outcome, however, messengers and receivers also anticipated improvements in the work environment and reduced staff turnover. Strategies to support implementation included continuation and enhancement of existing routines that were considered person-centred and development of new ones. A need to make PCC less 'fuzzy' and ambiguous and instead communicate a more tangible care process was described. Representatives among messengers and receivers also suggested that no actions were needed because the practice was already considered person-centred.ConclusionThe findings indicated that congruence between organisational levels existed in some aspects, suggesting coupling between policy and practice. However, also incongruences were identified that might be due to the fuzziness of definitions and the application of PCC in practice, and the difficulty in assessing the level of patient-centredness in clinical practice.

Dataset Information

A person-centred approach to health promotion for persons 70+ who have migrated to Sweden: promoting aging migrants' capabilities implementation and RCT study protocol.

Publications

A person-centred approach to health promotion for persons 70+ who have migrated to Sweden: promoting aging migrants' capabilities implementation and RCT study protocol.

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