Background: To be able to live independently, older persons can use technology-based health communication (HC) for support, guidance, and contact with health care professionals within their home environment. Informal caregivers who assist in different situations can also find support in their caring role using technology. The study of mobile technologies is an important research area in gerontechnology. Nevertheless, there is a gap of research in technology-based HC utilized by older persons, including preferences related to cognitive impairment (CI) in a home environment. Aim: The overall aim of the thesis was to define the concept and describe experiences of HC within the home environment from a gerontechnological perspective. The aim of Study I was to identify and construct the meaning of HC from the perspective of older persons in need of care in the home environment and their informal caregivers. The aim of Study II was to describe how older persons with CI experienced technology-based HC through the use of a mobile application in order to facilitate a sense of coherence. Method: This thesis has a naturalistic approach. In Study I, the evolutionary model of concept analysis was used, based on a systematic literature review including 29 studies. In Study II, semi-structured interviews were conducted with 16 older persons with CI. The transcripts were analyzed with a deductive thematic analysis. Findings: The defining attributes of the concept HC identified in Study I were: Resources of the recipient, Influence on decisions, and Advantages of tailored information. These attributes led to the following descriptive definition of HC: Tailored information, based on needs and resources of the recipient influence care decisions. The findings of Study II resulted in an overall theme: A technology that supports but creates challenges. Further, the analysis yielded the following three themes, with associated subthemes: Making sense of mobile technologies, Mastering mobile technologies, and Added value to use mobile technologies. Conclusion: Technology-based HC utilized by older persons and their informal caregivers within the home environment emphasizes suiting needs, capacity and preferences to be considered useful. Influences of the context, the home environment also needs to be taken into account when developing technology-based HC and mobile technologies for this purpose.

Bakgrund: När inte längre behandling eller läkemedel finns som kan bota eller bromsa sjukdomen hos en person övergår vårdens fokus till symtomlindring, minskat lidande och livskvalitet. Så kallad palliativ vård.  Idag finns 40 miljoner människor världen över som är i behov av palliativ vård. På grund av människans ökade livslängd kommer behovet av palliativ vård att öka.  Att som sjuksköterska vårda palliativa patienter i hemmiljö handlar om att ha en helhetssyn och arbeta utifrån ett personcentrerat sätt där patientens fysiska, psykiska och existentiella behov sätts i centrum.    Syfte: Syftet var att beskriva sjuksköterskors upplevelse av att vårda palliativa patienter i hemmiljö.   Metod: En kvalitativ litteraturöversikt med induktiv ansats har genomförts, där 12 artiklar har kvalitetsgranskats och analyserats enligt Fribergs fem steg.   Resultat: Vad som framkom i resultatet var fyra teman; Vikten av att skapa en god relation, Vikten av samverkan mellan olika professioner, Det stora ansvaret och Vikten av att arbeta holistiskt, med tillhörande subteman. Temana belyser sjuksköterskans upplevelser av att vårda palliativa patienter i hemmiljö.   Slutsats: Att arbeta personcentrerat, känna stöd från kollegor samt ha kompetens är en stor del av vårdyrket. Strävan efter att tillgodose patientens önskan i livets slutskede var sjuksköterskans fokus i den palliativa vården. / Background: When there’s no longer any treatment or medicine that can cure or slow down a person's disease, the focus of care shifts to symptom relief, reduced suffering and quality of life. So-called palliative care. Today there are 40 million people worldwide who’re in need of palliative care. Due to the increased life expectancy of humans, the need for palliative care will increase. As a nurse, caring for palliative patients in a home environment is about having a holistic view and working from a person-centered way where you put the patient's physical, mental and existential needs at the center.   The aim: The aim was to describe nurse’s experience of palliative care in a home environment   Method: A qualitative literature review with an inductive approach was conducted, 12 articles were quality reviewed and analyzed according to Frieberg’s five steps.   Results: What emerged in the result were four themes; The importance of creating a good relationship, The importance of collaboration between different professions, The great responsibility and The importance of working holistically, with appurtenant subthemes. The themes highlighted the nurse's experiences of caring for palliative patients at home.   Conclusion: Working person-centered, feeling support from colleagues and having competence is a large part of the care profession. The effort to satisfy the patient's desire at the end of life was the nurse's focus in palliative care.

Syftet med litteraturöversikten var att beskriva kunskapsläget vad gäller arbetsterapeutiskt hemrehabilitering vid stroke med fokus på klientcentrering. Metoden som använts under litteraturöversiktens gång bygger på 10 artiklar hämtade från fyra databaser inriktade på arbetsterapi och rehabilitering; PubMed, CINAHL, AMED och PsycINFO. Författarna har granskat de valda artiklarna, identifierat likheter och skillnader i resultatet som resulterade i tre kategorier. Resultatets kategorier blev; Hemmiljöns betydelse för den klientcentrerade rehabiliteringen, klientens delaktighet under den klientcentrerade hemrehabiliteringen och det sociala nätverkets påverkan på den klientcentrerade hemrehabiliteringen. Resultatet visar på att hemmiljön vid rehabilitering efter stroke har stor betydelse för klienten och den fortsatta rehabiliteringen i hemmet. Klientens delaktighet vid rehabiliteringen är viktig för att rehabiliteringen ska bli så bra som möjligt och för att få effektiva resultat. Anhöriga och andra personer runt klienten är viktiga för rehabiliteringen efter stroke. Slutsatsen som författarna kom fram till var att det behövs rutiner för att trygga klienter vid hemrehabilitering. Utbildning och information till anhöriga måste säkerställas. Klienters känsla av delaktighet i rehabiliteringen behöver stärkas. Ytterligare forskning på hemrehabilitering och klientcentrering i samband med stroke behövs.

Digitaliseringen av hemmet gör att autonoma enheter blir allt mer vanliga i våra vardagliga liv. Hemmet, som tidigare har varit en privat och personlig plats, blir nu ett centrum för digitala enheter vilket i sig skapar nya teknologiska möjligheter. Det smarta hemmet är en av dessa möjligheter då det erbjuder användaren trygghet och säkerhet samtidigt som enheterna i hemmet kan hjälpa oss med både dagliga problem och långsiktiga utmaningar. En autonom enhet i hemmet kan göra allt ifrån att styra musik till att hålla koll på energiförbrukning. Den gemensamma nämnaren de autonoma enheterna har är att människor tar in dem i sina hem; deras privata sfär, därför blir frågan vi ställer oss följande: Hur bygger en användare tillit mot autonoma enheter i en hemmiljö? / The digitization of the home makes automated systems more common in our everyday lives. The home, which used to be a private and personal place, now becomes a center for digital devices, which in itself creates new technological opportunities. The smart home is one of these opportunities as it offers the user safety and security while the units in the home can help us with both daily problems and long-term challenges. An autonomous unit in a home environment can do everything from controlling music to keeping track of energy consumption. The common denominator the autonomous units have is that people take them into their homes; their private sphere, therefore, the question we ask ourselves becomes the following: How does a user build trust against autonomous units in a home environment?

As the Latino portion of the United States population continues to grow each year, more and more children in the United States leave their Spanish-speaking homes and enter English immersion schools. Throughout their lives, these children are likely to shift language preferences from their home language, to the language of the community. However, maintaining development in their first language would be a benefit to them in multiple ways. Identifying factors within bilingual homes that influence English and Spanish language development in preschool-aged children will help researchers and practitioners encourage families to cultivate the optimal learning environment. This study endeavored to identify some specific social, linguistic, and literacy-related factors within the home that predict Spanish and English language development in 4-year-old children from low-income, predominantly Spanish-speaking families. Extant data from the Bilingual Early Language and Literacy Support Project (BELLS) were analyzed. Data were collected in participants' homes using various measures of the home and family environment. Results indicated children may begin to repress their first language in order to focus on learning a second language as early as 48 months. Maternal use of unique words, in Spanish, was a strong predictor of children's English expressive vocabulary, indicating that continuing to provide a rich language environment in the home language facilitates English language development. Furthermore, current measures of literacy and learning environments may be missing important behaviors present in Latino families that are distinctly different from behaviors in Caucasian families, thus making such measures inapt to predict language-related outcomes in Latino homes.

Världshälsoorganisationen definierar palliativ vård som ett förhållningssätt som syftar till att förbättra livskvaliteten hos patienter och deras familjer som står inför problem som följer med en livshotande sjukdom. Den palliativa vården ska bygga på ett förhållningssätt som kännetecknas av en helhetssyn på människan. Detta sker genom att stödja individen så att den kan leva med värdighet och med största möjliga välbefinnande till livets slut oavsett ålder och diagnos. Socialstyrelsen skriver att såväl internationella som svenska studier visar att många vill dö i sina hem. I Sverige utgörs omvårdnadspersonalen i hemtjänst och på särskilda boenden av undersköterskor och vårdbiträden. Syftet med studien var att beskriva omvårdnadspersonalens erfarenheter av att vårda personer i livets slutskede i hemmiljö utifrån begreppet KASAM. En forskningsöversikt gjordes och till grund ligger 14 stycken vetenskapliga artiklar. En deduktiv ansats användes i denna forskningsöversikt med KASAM som ett teoretiskt ramverk. Resultatet visade att det fanns faktorer som gör tillvaron strukturerad och hanterbar för omvårdnadspersonalen. Dessa faktorer var: att det fanns en upplevelse av tydliga mål och arbetsuppgifter, att det fanns stöd från chefer och kollegor samt att det fanns en känsla av att tillhöra en grupp. Resurser som finns eller behöver finnas hos omvårdnadspersonalen framkom också. Dessa var: kollegor, organisationen, att kunna hantera känslor och sorg, närstående samt kunskap och kompetensutveckling. Det fanns en stark vilja att hjälpa patienten och en nöjdhet över vården som omvårdnadspersonalen gav och många gånger kände de sig som en del av familjen. Omvårdnadspersonalen som arbetar med vård i livets slut har stort engagemang och vilja att ge högkvalitativ vård. Nära relationer till både patient och närstående skapas, vilket är en förutsättning för att ge personcentrerad vård, men som även leder till svåra känslor av sorg och förlust när patienten avlider. De hamnar också i situationer där de förväntas bemöta svåra, emotionella och existentiella frågor, vilket de saknar kompetens för och är något som upplevs orsaka obehag hos omvårdnadspersonalen. / World Health Organization define palliative care as in an approach that improves the quality of life of patients and their families who are facing problems associated with life-threatening illness. Palliative care should be based on an approach that is characterized by a holistic view of humans. This is done by supporting the individual so that it can live with dignity and with the best possible well-being to end of life regardless of age and diagnosis. The National Board of Health and Welfare writes that both international and Swedish studies show that many want to die in their homes. In Sweden, the nursing staff in homecare and long-term facilities constitutes of enrolled nurses and healthcare assistants. The purpose of the study was to describe nursing staff's experience of caring for patients in the end of life in the home environment based on the concept Sense of Coherence (SOC). A research overview was made, based on 14 scientific articles. A combination of deductive and inductive approach was used in this research overview, with KASAM as a theoretical framework. The results showed that there were factors that make life structured and manageable for nursing staff. These factors were that there was an experience of clear goals and tasks, that there was support from managers and colleagues and that there was a sense of belonging to a group. Resources that exist or need to exist at nursing staff also emerged; these were colleagues, the organization, being able to handle emotions and grief, close relationships, as well as knowledge and skills development. There was a strong will to help the patient and satisfaction with the care that nursing staff gave and many times they felt a part of the family. Nursing staff who work with care at the end of life have great commitment and willingness to provide high quality care. Close relationships with both patient and relatives are created, which is a prerequisite for providing person-centered care, but also leads to severe feelings of sadness and loss when the patient dies. They also end up in situations where they are expected to respond to difficult, emotional and existential issues, which they lack competence for, and which is perceived to cause discomfort to nursing staff

Bakgrund: Stroke är en vanlig orsak till bestående skador och funktionsnedsättningar. Inom slutenvården finns det betydligt mer stöd och forskning om återhämtning av stroke till skillnad från i hemmet. Det är därför av vikt att lyfta detta område för att ge sjuksköterskan en djupareförståelse för de utmaningar och upplevelser som strokedrabbade upplever i hemmet samt för att kunna främja en effektiv återhämtning och livskvalitet.Syfte: Syftet var att belysa personers upplevelse av återhämtning i hemmet efter stroke. Metod: En allmän litteraturstudie med induktiv ansats där elva artiklar analyserats och deras resultat sammanställs för att beskriva kunskapsläget inom det valda ämnet. Resultat: Litteratursökningen resulterade i två kategorier; Att känna sig begränsad med underkategoriernaPsykisk belastning: En kamp inombords, Förändrat livsmönster, Hemmiljön och dess utmaningar och andra kategorin var Behov av stöd. Konklusion: Upplevelserna av återhämtningen i hemmet beskrevs i form av ökad psykisk, fysisk och social påverkan. Ett gott stöd både socialt och professionellt med kontinuitet ledde till en god återhämtning. Mer forskning inom området kan resultera i bredare kunskaper om personers upplevelser i hemmet. Detta kan ge sjuksköterskan fler verktyg och en ökad förståelse för att skapa en god holistisk vårdmiljö. / Background: Stroke is a common cause of permanent injuries and disabilities. Within inpantient care there is significally more support and research on recovering from a stroke in contrast to at home. It is therefore important to highlight this area in order to give the nurse a deeper understanding of the challenges and experiences of suffering from a stroke at home in order to promote an effective recovery and quality of life. Aim: The aim of this study was to highlight the experience of recovery at home after a stroke. Method: This litterature study had an inductive approach where eleven articles were analyzed. The results of the articles were then compiled to describe the state of knowledge within the chosen subject. Results: The litterature search resulted in two categories: Feeling limitedwith the subcategories of mental burden: A struggle within, Changed lifestyle, Home environment and its challenges and the second category was Need for support. Conclusion: The results reflect an increased psychological, physical and social impact. Continuous support socially and professionally increases the recovery process. More research in the area may result in a broader knowledge about the experience of recovering at home. This can give nurses more tools and an increased understanding to create agood holistic care environment.

Depression is recognized as a disabling and impairing condition, impacting mood, cognitions, and daily functioning (APA, 2013; WHO, 2017). Women are more likely to develop depression than men (Gutierrez-Lobos et al., 2002; Noble, 2005). The perinatal period is a sensitive time when mothers are vulnerable to developing depression (Noble, 2005; Schiller et al., 2015). Further, postpartum depression is a risk factor for negative outcomes for both mother and child (Goodman & Gotlib, 1999), including child cognitive development (Grace et al., 2003). The onset and course of depression involves a variety of biopsychosocial components that are often accounted for in research on maternal depression (Billings & Moos, 1993; Cummings & Davies, 1994; Nobel, 2005). Examining the severity, chronicity, and time of onset of maternal depression reveals specific patterns or trajectories for the mother’s experience; these trajectories can provide better understanding of maternal depression and its impact on child development (Brennan et al., 2000). Maternal depression is prevalent yet under-studied and under-identified in low-middle income countries (LMICs), with most research of postpartum depression centering Western and English-speaking families (Gelaye et al.,2016; Halbreich &Karkun, 2006). To better understand and treat maternal depression across cultures, research is needed in diverse locations with culturally sensitive methods. The purpose of the present study is to identify trajectories of maternal depression in diverse, international locations including LMICs. The MAL-ED Study involves eight study sites (Dhaka, Bangladesh (BGD); Fortaleza, Brazil (BRF); Vellore, India; (INV), Bhaktapur, Nepal (NEB); Loreto, Peru (PEL); Naushahro Feroze, Pakistan (PKN); Venda, South Africa (Dzimauli Community, SAV); and Haydom, Tanzania (TZH)) and incorporates several health-related factors pertaining to mothers and children (Murray-Kolb et al., 2014). The present study included five of the eight international sites. Maternal depression, as measured by the Self-Report Questionnaire (SRQ; Beusenberg & Orley, 1994), was assessed across the first two years postpartum, allowing for longitudinal analysis of trajectory using latent class growth analysis (LCGA). Maternal depression trajectories differed across the five sites, but demonstrated a general pattern of high, moderate, and low symptoms for the total sample. Path models were used to determine if there was a relationship between maternal depression trajectories and child cognitive development as measured by the Bayley Scales for Infant and Toddler Development, 3rd Edition (BSID-III, Bayley, 2009) for the total sample. To address the influence of contextual factors, the Home Observation for the Measurement of the Environment (HOME; Caldwell & Bradley, 1984, 2003) was incorporated in analysis as a mediator. However, the mediation analysis was not statistically significant and maternal depression trajectory was not a strong predictor of child cognitive development with the total sample. The results indicated that better home environment predicted improved cognitive scores, regardless of maternal depression trajectories. The present study provided evidence that maternal depression trajectories varied based on cultural group. Although maternal depression trajectories did not predict child cognitive development with the total sample, future research can explore trajectories in each location and relationships with other variables. Additionally, further investigation of how the home environment impacts child cognitive development in the five different locations can be informative for providing services to children and their families. / School Psychology

Healthy eating in childhood and adolescence is important for proper growth and development and to help prevent chronic diseases. Many factors contribute to healthy eating patterns, and one of the most influential factors is the home and school environment. Both settings have role models who may affect a child’s eating behaviors. This study consisted of 54 home school and 21 public school participants who lived in northeast Mississippi and were between 6-12 years old. Public school children consumed significantly more total calories, net carbohydrates, vitamin C, and calcium compared to the home school children. Also, the public school children consumed more calories in the form of carbohydrates after 3pm compared to home school children. Nevertheless, there was no difference in BMI percentiles in public school and home school children 8-12 years of age. For 6 and 7-year-old children, the home school children had significantly lower BMI percentiles compared to the public school children.

No description available.