Overview of independent variables, number of respondents (N) and mean with standard deviation in parenthesis. Control and intervention group compared at baseline and follow-up. (PDF 172 kb)
Research Interests:
The research reported in this paper is related to an assistive technology that may be used by healthcare services for elderly and disabled people. A system for non-intrusive monitoring of the movements of such persons in their home... more
The research reported in this paper is related to an assistive technology that may be used by healthcare services for elderly and disabled people. A system for non-intrusive monitoring of the movements of such persons in their home environment, based on impulse-radar sensors, is adressed. A large family of new procedures for the estimation of position and walking velocity of a monitored person, on the basis of data acquired in such a system, is presented. These procedures are compared using measurement data acquired in laboratory conditions. A set of Pareto-optimal procedures is selected.
Research Interests:
Research Interests:
The importance of research on new technologies that could be employed in care services for elderly and disabled persons is highlighted. Advantages of radar sensors, when applied for non-invasive monitoring of such persons in their home... more
The importance of research on new technologies that could be employed in care services for elderly and disabled persons is highlighted. Advantages of radar sensors, when applied for non-invasive monitoring of such persons in their home environment, are indicated. A need for comprehensible visualisation of the intermediate results of measurement data processing is justified. Capability of an impulse-radar-based system to provide information, being of crucial importance for medical or healthcare personnel, are investigated. An exemplary software interface, tailored for non-technical users, is proposed, and preliminary results of impulse-radar-based monitoring of human movements are demonstrated.
Research Interests:
Research Interests:
During the outbreak of the COVID-19 pandemic, Norwegian health authorities introduced social distancing measures in nursing homes. The aim was to protect vulnerable residents from contracting the potentially deadly infection. Drawing on... more
During the outbreak of the COVID-19 pandemic, Norwegian health authorities introduced social distancing measures in nursing homes. The aim was to protect vulnerable residents from contracting the potentially deadly infection. Drawing on individual interviews with nursing home managers and physicians, and focus groups with nursing staff, we explore and describe consequences the social distancing measures had on nursing home residents’ health and wellbeing. The analysis indicates that most residents became socially deprived, while some became calmer during the nursing home lockdown. Nursing home staff, physicians and managers witnessed that residents’ health and functional capacity declined when services to maintain health, such as physiotherapy, were put on hold. In conclusion, we argue that although Norwegian health authorities managed to keep the infection rates low in nursing homes, this came at a high price for the residents however, as the social distancing measures also negativ...
Research Interests:
Research Interests:
With the extensive long-term care services for older people, the Nordic countries have been labelled ‘caring states’ as reported (Leira, Welfare state and working mothers: the Scandinavian experience, Cambridge University Press,... more
With the extensive long-term care services for older people, the Nordic countries have been labelled ‘caring states’ as reported (Leira, Welfare state and working mothers: the Scandinavian experience, Cambridge University Press, Cambridge, 1992). The emphasis on services and not cash benefits ensures the Nordics a central place in the public service model (Anttonen and Sipilä, J Eur Soc Policy 6:87–100, 1996). The main feature of this ideal model is public social care services, such as home care and residential care services, which can cover the need for personal and medical care, as well as assistance with household chores. These services are provided within a formally and professionally based long-term care system, where the main responsibility for the organization, provision and financing of care traditionally lays with the public sector. According to the principle of universalism (in: Antonnen et al. (eds), Welfare state, universalism and diversity, Elgar, Cheltenham, 2013), acc...
Research Interests:
Research Interests:
Research Interests:
Background There is a knowledge gap regarding factors that may influence the access to different devices for home-dwelling people with dementia (PwD). The aim of this study was to identify different assistive technology and telecare (ATT)... more
Background There is a knowledge gap regarding factors that may influence the access to different devices for home-dwelling people with dementia (PwD). The aim of this study was to identify different assistive technology and telecare (ATT) devices installed in the home and key factors associated with access to such technology. Methods The baseline data came from the LIVE@Home.Path trial, a 24-month multi-component intervention including PwDs and their informal caregivers (dyads) and were collected through semi-quantitative questionnaires in three Norwegian municipalities between May and November of 2019. Regression models were applied to detect demographic and clinical factors associated with access to ATT. Results Of 438 screened dyads, 276 were included at baseline. The mean ages of the PwDs and caregivers were 82 ± 7.0 and 66 ± 12 years, respectively, and 62.8% of the PwD were female and 73.5% had access to any type of ATT. The majority had traditional equipment such as stove guar...
Research Interests:
Background The global health challenge of dementia is exceptional in size, cost and impact. It is the only top ten cause of death that cannot be prevented, cured or substantially slowed, leaving disease management, caregiver support and... more
Background The global health challenge of dementia is exceptional in size, cost and impact. It is the only top ten cause of death that cannot be prevented, cured or substantially slowed, leaving disease management, caregiver support and service innovation as the main targets for reduction of disease burden. Institutionalization of persons with dementia is common in western countries, despite patients preferring to live longer at home, supported by caregivers. Such complex health challenges warrant multicomponent interventions thoroughly implemented in daily clinical practice. This article describes the rationale, development, feasibility testing and implementation process of the LIVE@Home.Path trial. Methods The LIVE@Home.Path trial is a 2-year, multicenter, mixed-method, stepped-wedge randomized controlled trial, aiming to include 315 dyads of home-dwelling people with dementia and their caregivers, recruited from 3 municipalities in Norway. The stepped-wedge randomization implies ...
Research Interests:
This study was part of a major evaluation project with focus on various models for and effects of reablement. The aim was to get an extended understanding of how Norwegian municipalities organize and conduct reablement. Seven focus group... more
This study was part of a major evaluation project with focus on various models for and effects of reablement. The aim was to get an extended understanding of how Norwegian municipalities organize and conduct reablement. Seven focus group interviews were conducted in seven municipalities including a total of 33 participants representing different health professions. The interviews were transcribed, and a hermeneutical approach was used in the analyses. Four main themes were derived: "The team as an organizational and professional center", "Collaboration around assessment of applications”, "Different understanding of rehabilitation affected the organization", and "Goal – oriented and intensive training in everyday activities". The focus group interviews revealed different strength and weaknesses with specialized or integrated organization of reablement, but nevertheless they emphasized the importance of having interdisciplinary teams that can coordin...
Research Interests: Norwegian, Medicine, Focus Group, Organizing, Team, and 3 moreIntegrated, Specialized, and Home Care Services
Research Interests:
Research Interests:
Research Interests:
Aim: The aim is to identify important factors for immigrants’ health and well-being and for their use (or non-use) of primary health care (PHC) and other non-specialised services, and for possible ways that PHC can support healthy ageing... more
Aim: The aim is to identify important factors for immigrants’ health and well-being and for their use (or non-use) of primary health care (PHC) and other non-specialised services, and for possible ways that PHC can support healthy ageing of immigrants. Background: Older persons are an increasing share of the immigrant population in the global north, frequently in contact with various forms of health services, (PHC services most of all. Consequently, PHC services are in a particularly unique position to support healthy ageing of immigrants. Methods: The position paper builds on five international, multi-professional and cross-disciplinary small group discussions as well as an international workshop early summer. During the discussions and the workshop, topics were arrived at as to factors related to the health situation of older immigrants, their needs, and health-seeking behaviour, and to how PHC professionals could support healthy ageing in immigrants. Those main topics in turn gui...
Research Interests:
The COVID-19 pandemic was declared as such in March 2020 [...]
Research Interests:
Background: Nursing homes are under strong pressure to provide good care to the residents. In Norway, municipalities have applied the ‘Joy-of-Life-Nursing-Home’ strategy to increase a health-promoting perception that focuses on the older... more
Background: Nursing homes are under strong pressure to provide good care to the residents. In Norway, municipalities have applied the ‘Joy-of-Life-Nursing-Home’ strategy to increase a health-promoting perception that focuses on the older persons` resources. Implementations represent introducing changes to the healthcare personnel; however, changing one’s working approaches, routines and working culture may be demanding. On this background, we explored how the ‘Joy-of-Life-Nursing-Home’ strategy is perceived by the employees in retrospective, over a period after the implementation and which challenges the employees experience with this implementation.Method: We used a qualitative approach and interviewed 14 healthcare personnel working in nursing homes in one Norwegian municipality, which had implemented the ‘Joy-of-Life-Nursing-Home’ strategy. The analysis was conducted following Kvale’s approach to qualitative content analysis.Results: The main categories were: (a) the characterist...
Research Interests:
There is a knowledge gap about nurses’ use of social media in relation to and during the COVID-19 pandemic, which demands the upholding of a physical distance to other people, including patients and their relatives. The study aims to... more
There is a knowledge gap about nurses’ use of social media in relation to and during the COVID-19 pandemic, which demands the upholding of a physical distance to other people, including patients and their relatives. The study aims to explore how nurses in the Scandinavian countries used social media for professional purposes in relation to the first 15 months of the COVID-19 pandemic. Qualitative, semi-structured interviews with 30 nurses in three Scandinavian countries (Denmark, Norway, and Sweden) were conducted. Thematic analyses were made, methodically inspired by Braun and Clarke, and theoretically inspired by Berger and Luckmann’s theory about the construction of social reality. The Standards for Reporting Qualitative Research (SRQR) checklist was used. The results showed that social media was a socialisation tool for establishing new routines in clinical practice. Virtual meeting places supported collective understandings of a specific COVID-19 ‘reality’ and ‘knowledge’ among...
Research Interests:
Background Nursing homes are under strong pressure to provide good care to the patients. In Norway, municipalities have applied the ‘Joy-of-Life-Nursing-Homes’ (JoLNH) strategy which is based on a health-promoting approach building on the... more
Background Nursing homes are under strong pressure to provide good care to the patients. In Norway, municipalities have applied the ‘Joy-of-Life-Nursing-Homes’ (JoLNH) strategy which is based on a health-promoting approach building on the older persons’ resources. Meanwhile job satisfaction is closely related to less intention to leave, less turnover and reduced sick leave. The knowledge about adjustable influences related with job satisfaction might help nursing home leaders to minimize turnover and preserve high quality of care. This study explores leadership in Norwegian nursing homes with and without implementation of JoLNH: How does leadership influence the work environment and how is leadership experienced in JoLNH compared to ordinary Nursing Homes? Method We used a qualitative approach and interviewed 19 health care personnel working in nursing homes in two Norwegian municipalities. The analysis was conducted following Kvale’s approach to qualitative analysis. Results The ma...
Research Interests:
Background During the COVID-19 pandemic, nurses stand in an unknown situation while facing continuous news feeds. Social media is a ubiquitous tool to gain and share reliable knowledge and experiences regarding COVID-19. The article aims... more
Background During the COVID-19 pandemic, nurses stand in an unknown situation while facing continuous news feeds. Social media is a ubiquitous tool to gain and share reliable knowledge and experiences regarding COVID-19. The article aims to explore how nurses use social media in relation to the COVID-19 pandemic. Method A scoping review inspired by Arksey and O’Mally was conducted by searches in Medline, CINAHL, Academic Search Complete and Web of Sciences. Empirical research studies investigating nurses’ use of social media in relation to COVID-19 were included. Exclusion criteria were: Literature reviews, articles in languages other than English, articles about E-health, and articles investigating healthcare professionals without specification of nurses included. Articles, published in January-November 2020, were included and analysed through a thematic analysis. The PRISMA-ScR checklist was used. Results Most of the eleven included studies were cross-sectional surveys, conducted ...
Research Interests:
This article sets out to analyze written stories of nursing students focusing on challenging situations from clinical practice The analysis involves looking at how the stories present various versions of being and becoming a nurse. On the... more
This article sets out to analyze written stories of nursing students focusing on challenging situations from clinical practice The analysis involves looking at how the stories present various versions of being and becoming a nurse. On the one hand, this calls for an examination of what is found in the stories, narrative structures, linguistic devices, word choice and so on. On the other hand, it implies looking at what is not found by reflecting on notable absences from the stories. The analysis underscores that vulnerability is a prominent feature of these stories. The article stresses the importance of honouring the stories while at the same time advocating the use of narrative pedagogy to put the stories in a larger context and thus develop the student nurses’ narrative resources.
Research Interests:
Findings from an empirical, qualitative study conducted by the first author regarding cancer patients' perceptions of good nursing care have previously been published. In this article, the entire research process of the study is... more
Findings from an empirical, qualitative study conducted by the first author regarding cancer patients' perceptions of good nursing care have previously been published. In this article, the entire research process of the study is analyzed and discussed in light of the social theories of Erving Goffman (1959, 1986), arriving at some complementary interpretations of the findings. Reflections are made specifically based on his theories concerning the interactional frames and the presentation of self in everyday life. The interviewer and the informants entered the interview situation from very different standpoints, with different expectations and objectives, social roles, theoretical backgrounds, and positions within the power structure of the clinical setting. Those differences naturally influence the interaction in the interview situation, not the least of which includes the self-presentation of the patients. The complementary insight dealt with in this article provides an importa...
Research Interests:
Background Nursing homes are under strong pressure to provide good care to the residents. In Norway, municipalities have applied the ‘Joy-of-Life-Nursing-Home’ strategy to increase a health-promoting perception that focuses on the older... more
Background Nursing homes are under strong pressure to provide good care to the residents. In Norway, municipalities have applied the ‘Joy-of-Life-Nursing-Home’ strategy to increase a health-promoting perception that focuses on the older persons` resources. Implementations represent introducing changes to the healthcare personnel; however, changing one’s working approaches, routines and working culture may be demanding. On this background, we explored how the ‘Joy-of-Life-Nursing-Home’ strategy is perceived by the employees in retrospective, over a period after the implementation and which challenges the employees experience with this implementation. Method We used a qualitative approach and interviewed 14 healthcare personnel working in nursing homes in one Norwegian municipality, which had implemented the ‘Joy-of-Life-Nursing-Home’ strategy. The analysis was conducted following Kvale’s approach to qualitative content analysis. Results The main categories were: (a) the characteristi...
Research Interests:
Research Interests:
Background: Nursing homes are under strong pressure to provide good care to the patients. In Norway, municipalities have applied the ‘Joy-of-Life-Nursing-Homes’ strategy to increase a health-promoting perception that focuses on the older... more
Background: Nursing homes are under strong pressure to provide good care to the patients. In Norway, municipalities have applied the ‘Joy-of-Life-Nursing-Homes’ strategy to increase a health-promoting perception that focuses on the older persons` resources. Implementations represent introducing changes to the health professionals; however, changing one’s working approaches, routines and working culture may be demanding. On this background we explored how the ‘Joy-of-Life-Nursing-Homes’ strategy is perceived by the employees, before and after the implementation and which challenges the employees experience with this implementation.Method: We used a qualitative approach and interviewed 14 healthcare personnel working in nursing homes in one Norwegian municipality which had implemented the ‘Joy-of-Life-Nursing-Homes’ strategy. The analysis was conducted following Kvale’s approach to qualitative analysis.Results: The main categories after the data condensing were (a) the characteristics...
Research Interests:
Use of restraint in nursing homes is highly controversial and fundamentally transgresses human rights and freedom of movement and choice. While different forms of formal restraint use in nursing homes are broadly delineated, the use of... more
Use of restraint in nursing homes is highly controversial and fundamentally transgresses human rights and freedom of movement and choice. While different forms of formal restraint use in nursing homes are broadly delineated, the use of informal restraint is less understood. The aim of this article is to identify different kinds of informal restraint, and how staff use informal restraint under which circumstances. This article illuminates informal restraint use based on an ethnographic study in four nursing homes in the Western part of Norway. We have identified five different forms of informal restraint use which are as follows: (1) diversion of residents' attention; (2) white lies; (3) persuasion and interpersonal pressure; (4) offers and finally (5) threats. These different forms of informal restraint are actions by staff against residents' will, limiting residents' freedom of movement and their personal preferences. In addition, we have identified 'grey-zone restr...
Research Interests:
This paper examines the tension between macro level regulation and the rule breaking and rule following that happens at the workplace level. Using a comparative study of Canada, Norway, and Germany, the paper documents how long-term... more
This paper examines the tension between macro level regulation and the rule breaking and rule following that happens at the workplace level. Using a comparative study of Canada, Norway, and Germany, the paper documents how long-term residential care work is regulated and organized differently depending on country, regional, and organizational contexts. We ask where each jurisdiction's staffing regulations fall on a prescription-interpretation continuum; we define prescription as a regulatory tendency to identify what to do and when and how to do it, and interpretation as a tendency to delineate what to do but not when and how to do it. In examining frontline care workers' strategies for accomplishing everyday social, health, and dining care tasks we explore how a policy-level prescriptive or interpretive regulatory approach affects the potential for promising practices to emerge on the frontlines of care work. Overall, we note the following associations: prescriptive regulat...
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Research Interests: Anthropology and Africa
This article presents cross-country comparisons of trends in for-profit nursing home chains in Canada, Norway, Sweden, United Kingdom, and the United States. Using public and private industry reports, the study describes ownership,... more
This article presents cross-country comparisons of trends in for-profit nursing home chains in Canada, Norway, Sweden, United Kingdom, and the United States. Using public and private industry reports, the study describes ownership, corporate strategies, costs, and quality of the 5 largest for-profit chains in each country. The findings show that large for-profit nursing home chains are increasingly owned by private equity investors, have had many ownership changes over time, and have complex organizational structures. Large for-profit nursing home chains increasingly dominate the market and their strategies include the separation of property from operations, diversification, the expansion to many locations, and the use of tax havens. Generally, the chains have large revenues with high profit margins with some documented quality problems. The lack of adequate public information about the ownership, costs, and quality of services provided by nursing home chains is problematic in all t...
Research Interests:
To investigate (1) what kind of restraint is used in three nursing homes in Norway and (2) how staff use restraint under what organisational conditions. Restraint use in residents living with dementia in nursing homes is controversial,... more
To investigate (1) what kind of restraint is used in three nursing homes in Norway and (2) how staff use restraint under what organisational conditions. Restraint use in residents living with dementia in nursing homes is controversial, and at odds with fundamental human rights. Restraint is a matter of hindering residents' free movement and will by applying either interactional, physical, medical, surveillance or environmental restraint. Previous research has identified use of restraint related to individual resident characteristics such as agitation, aggressiveness and wandering. This model is embedded in an overall mixed-method education intervention design study called Modelling and evaluating evidence-based continuing education program in dementia care (MEDCED), applying ethnography postintervention to examine the use of restraint in 24 nursing homes in Norway. Based on restraint diversity measured in the trial, ethnographic investigation was carried out in three different nursing homes in Norway over a 10-month period to examine restraint use in relation to organisational constraints. Several forms of restraint were observed; among them, interactional restraint was used most frequently. We identified that use of restraint relates to the characteristics of individual residents, such as agitation, aggressiveness and wandering. However, restraint use should also be explained in relation to organisational conditions such as resident mix, staff culture and available human resources. A fluctuating and dynamic interplay between different individual and contextual factors determines whether restraint is used - or not in particular situations with residents living with dementia. Educational initiatives targeting staff to reduce restraint must be sensitive towards fluctuating organisational constraints.
Research Interests:
To examine the influence of leadership when facilitating change in nursing homes. The study is a part of an education intervention for care staff to prevent the use of restraint in nursing home residents with dementia in 24 nursing homes... more
To examine the influence of leadership when facilitating change in nursing homes. The study is a part of an education intervention for care staff to prevent the use of restraint in nursing home residents with dementia in 24 nursing homes (NHs) in Norway. Leadership is known to be a fundamental factor for success of evidence-based practice (EBP) implementation in health services. However, the type of leadership that strengthens the processes of change remains to be clarified. A multi-site comparative ethnography was performed in four nursing homes to investigate how contextual factors influenced the implementation. The analysis was informed by the Promoting Action on Research Implementation in Health Services (PARIHS) framework, and in particular the sub-element of leadership. Different leadership styles to facilitate change were identified. Paradoxically, a strong collective and collaborative leadership style was found to hamper change in one particular home, whereas a remote leader...
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Research Interests:
How the general public in Norway conceives being an older adult and the meaning of chronological age has changed over the last few decades. As narratives of aging may be identified in the Norwegian mass media and in the population at... more
How the general public in Norway conceives being an older adult and the meaning of chronological age has changed over the last few decades. As narratives of aging may be identified in the Norwegian mass media and in the population at large, dominant narratives may also be identified in policy documents, such as government health policy papers. This article explores a narrative analytical framework based on stories, subtexts, and counterstories; it argues that such narratives are characterized as much by what is unsaid as by what is said, and as much by choice of words and word combinations as by explicit messages. Culture strongly influences the conception of a likely future (what will be) and an envisioned future (what ought to be) regarding aging and geriatric care in Norway, as expressed in the public policy papers. The public policy story is discussed as both a story continuously developing, where later health policy papers relate to and comment on earlier documents, and as a story characterized by a measure of cultural incoherence. Some recent government documents dealing with professional geriatric care will serve as material for a narrative analysis.
Research Interests:
ABSTRACT
Research Interests:
The aim of this study was to evaluate the effectiveness of a tailored 7-month training intervention "Trust Before Restraint," in reducing use of restraint, agitation, and antipsychotic medications in care home residents with... more
The aim of this study was to evaluate the effectiveness of a tailored 7-month training intervention "Trust Before Restraint," in reducing use of restraint, agitation, and antipsychotic medications in care home residents with dementia. This is a single-blind cluster randomized controlled trial in 24 care homes within the Western Norway Regional Health Authority 2011-2013. From 24 care homes, 274 residents were included in the study, with 118 in the intervention group and 156 in the control group. Use of restraint was significantly reduced in both the intervention group and the control group despite unexpected low baseline, with a tendency to a greater reduction in the control group. There was a significant reduction in Cohen-Mansfield Agitation Inventory score in both the intervention group and the follow-up group with a slightly higher reduction in the control group, although this did not reach significance and a small nonsignificant increase in use of antipsychotics (14.1...
Research Interests:
Assistive Personnel are central to a health system, caring for the vulnerable elderly in industrialized countries. The literature suggests that higher levels of job autonomy may make for healthier, happier, and more productive employees... more
Assistive Personnel are central to a health system, caring for the vulnerable elderly in industrialized countries. The literature suggests that higher levels of job autonomy may make for healthier, happier, and more productive employees at all levels in the workplace. In this article we examine the job autonomy of nursing home assistive personnel in six industrialized countries: U. and the U.S.A. Worker autonomy -defined broadly as including job control, job flexibility, enhanced responsibility, and consultation in decision-making – is an important social determinant of health. We also examine differences in education, certification, unionization, pay scale, and job benefits of assistive personnel across these countries because these variables may influence job autonomy. Several methodologies are employed including consultations with knowledgeable scholars in each country; on-site case study observations; consultation of nursing home records; interviews with nursing home executive o...