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<p>Inom akutsjukvården är en stor del patienterna 65 år och äldre, vilket innebär att en stor del av vården vid en akutmottagning omfattas av bemötande och omhändertagande av äldre patienter. <strong>Syfte: </strong>Syftet med denna studie var att belysa hur äldre personer beskriver att deras behov av omvårdnad blir tillgodosett av omvårdnadspersonal vid akutmottagning. <strong>Metod: </strong>Studien genomfördes som en litteraturstudie där 13 artiklar granskades. <strong>Resultat: </strong>Resultatet visade att många äldre hade en negativ upplevelse av sin vistelse på akutmottagningen. Många fick vänta länge och fick inte sina basala behov tillgodosedda såsom t.ex. mat och dryck. Äldre patienter kände sig oroliga, övergivna och rädda under väntetiden och önskade mer uppmärksamhet och en mer kontinuerlig uppföljning under väntetiden. Resultatet visade också att information till patienten var väldigt viktig. Fick de äldre på akutmottagningen information om vad som skulle hända, hur undersökningar skulle gå till och varför de fick vänta kände de sig nöjda och trygga. Det fanns enligt resultatet en hög respekt för sjuksköterskornas professionella kompetens och omvårdnadspersonalens uppträdande på akutmottagning värderades högre av äldre patienter än av yngre patienter.</p> / <p>In the emergency department a big part of the patients are 65 years old and older, which means that a great deal of the medical care at the emergency department consists of meeting and caring for older patients. <strong>The aim</strong>: The aim with this study was to enlighten how the older patients describe that nurses at the emergency department provide for their need of care. <strong>Method: </strong>The study was done as a study of literature where 13 articles were reviewed. <strong>Result: </strong>The result showed that several older patients had a negative experience of their stay at the emergency department. Many of them had to wait for a long time and did not get their needs provided for. Older patients felt worried, abandon and scared during their time waiting and wished for more attention and more continual checkups during waiting time. The result also showed that information to the patients where very important. If the older patients at the emergency department got information about what was going to happen, how the examinations should proceed and why they had to wait they got more satisfied and secure as patients. There was, according to the result, a high respect for the nurse’s professional competence, and the older patients valued the staff’s behaviour higher than the younger patients.</p>

Inom akutsjukvården är en stor del patienterna 65 år och äldre, vilket innebär att en stor del av vården vid en akutmottagning omfattas av bemötande och omhändertagande av äldre patienter. Syfte: Syftet med denna studie var att belysa hur äldre personer beskriver att deras behov av omvårdnad blir tillgodosett av omvårdnadspersonal vid akutmottagning. Metod: Studien genomfördes som en litteraturstudie där 13 artiklar granskades. Resultat: Resultatet visade att många äldre hade en negativ upplevelse av sin vistelse på akutmottagningen. Många fick vänta länge och fick inte sina basala behov tillgodosedda såsom t.ex. mat och dryck. Äldre patienter kände sig oroliga, övergivna och rädda under väntetiden och önskade mer uppmärksamhet och en mer kontinuerlig uppföljning under väntetiden. Resultatet visade också att information till patienten var väldigt viktig. Fick de äldre på akutmottagningen information om vad som skulle hända, hur undersökningar skulle gå till och varför de fick vänta kände de sig nöjda och trygga. Det fanns enligt resultatet en hög respekt för sjuksköterskornas professionella kompetens och omvårdnadspersonalens uppträdande på akutmottagning värderades högre av äldre patienter än av yngre patienter. / In the emergency department a big part of the patients are 65 years old and older, which means that a great deal of the medical care at the emergency department consists of meeting and caring for older patients. The aim: The aim with this study was to enlighten how the older patients describe that nurses at the emergency department provide for their need of care. Method: The study was done as a study of literature where 13 articles were reviewed. Result: The result showed that several older patients had a negative experience of their stay at the emergency department. Many of them had to wait for a long time and did not get their needs provided for. Older patients felt worried, abandon and scared during their time waiting and wished for more attention and more continual checkups during waiting time. The result also showed that information to the patients where very important. If the older patients at the emergency department got information about what was going to happen, how the examinations should proceed and why they had to wait they got more satisfied and secure as patients. There was, according to the result, a high respect for the nurse’s professional competence, and the older patients valued the staff’s behaviour higher than the younger patients.

The purpose was to determine the velocity during strength and power training, with elastic resistance bands, in older adults. Nine older patients, who attended the day hospital rehabilitation program at Riverview Health Centre, were trained for power and strength of the ankle muscles using elastic resistance bands for 4 to 6 weeks. Training sessions were filmed to assess the velocity of training using Proanalyst software. Power training occurred at faster peak velocities as compared to strength training (p<0.001) for both muscle groups, however there were significant differences for average velocity only during training of plantar flexors (p<0.001). There was no significant difference between strength and power training in terms of within individual variability. However, a wide variability was observed between subjects in velocities they trained at and overlap was found between velocities for strength and power training. Hence, researchers should monitor velocity during different types of training in older adults.

The purpose was to determine the velocity during strength and power training, with elastic resistance bands, in older adults. Nine older patients, who attended the day hospital rehabilitation program at Riverview Health Centre, were trained for power and strength of the ankle muscles using elastic resistance bands for 4 to 6 weeks. Training sessions were filmed to assess the velocity of training using Proanalyst software. Power training occurred at faster peak velocities as compared to strength training (p<0.001) for both muscle groups, however there were significant differences for average velocity only during training of plantar flexors (p<0.001). There was no significant difference between strength and power training in terms of within individual variability. However, a wide variability was observed between subjects in velocities they trained at and overlap was found between velocities for strength and power training. Hence, researchers should monitor velocity during different types of training in older adults.

Aim: The overall aim is to examine how a patient perspective, grounded in caring science, can be preserved and developed in the context of hospital care.   Methods: The first study examines attitudes towards caring science in a clinical practice. Data were collected through focus group interviews with seven nurses, three head nurses and four senior preceptors. An interpretive approach guided the study. The results called for collaboration between clinical praxis and the academy, according to how caring science can be preserved and developed. Study II–III functioned in accordance with this goal and were conducted in collaboration with a hospital ward for people over seventy-five years of age. In an attempt to develop care the patients were invited to attend a team meeting. The data in these studies were collected using interviews and observations. Fifteen patients (study II) and nine nurses (study III) who had experienced patient participation in a team meeting participated. In these studies, a reflective lifeworld approach guided the research process. Study IV is presented as a general structure and philosophical examination in the light of Heidegger and Merleau-Ponty’s philosophies.   Main Findings: To preserve and develop a patient perspective is strongly connected to existential issues, such as lived time, intersubjectivity and a meaningful existence. For the patients, vulnerability is exposed and increased when the need for hospital care arises. The team meeting is experienced as an emotional situation where existential dimensions need to be recognized. The nurses desire to develop caring is challenged by organizational and economic demands. Time presents both a possibility for an encounter as well as a threat to excellent care.   Conclusions: There is a need to challenge narrow processes in modern health care that value the staffs’ work and the patients’ vulnerability in quantifiable measures of efficiency. The challenge is to take into account something that is invaluable - human existence.

Older adults make up a significant and increasing proportion of the U.S. population and are frequent users of healthcare services. Ageism in healthcare, driven by an incomplete and narrowly biomedical perspective on aging, has been linked to various problematic outcomes for older patients, including under- and over-treatment. The purpose of this study was to use the theory of relational ageism to explore the relationship between personal aging anxiety among healthcare professionals and their attitudes to older patients, considering the potentially moderating factors of job role and work setting. Using convenience sampling, clinical healthcare professionals working for a mid-sized, regional healthcare system in the Mid-Atlantic region of the United States were invited to participate in an online survey, resulting in a sample of N = 145. Independent variables in this study included the sociodemographic variables of gender, age, race, ethnicity, level of education, formal geriatric or gerontological education, and years of expression, plus job role, work setting, and aging anxiety scores as measured by the Aging Anxiety Scale. The dependent variable was attitudes to older patients as measured by the Geriatric Attitudes Scale. Regression analysis findings suggest that while having formal geriatric or gerontological education was associated with more negative attitudes to older patients, other sociodemographic variables including gender, age, race, ethnicity, level of education, and years of experience were not predictive of attitudes to older patients. While physicians had more negative attitudes toward older patients than did nurses, therapists, and other types of clinicians, work setting was not predictive of attitudes toward older patients. Study findings also indicate that higher levels of personal aging anxiety of healthcare professionals were correlated with more negative attitudes to older patients. This study provides information that can inform diversity training for healthcare professionals in order to improve attitudes toward older patients and reduce age discrimination in healthcare. A key recommendation is the inclusion of an exploration of healthcare professionals’ internalized attitudes to aging in any diversity training in order to increase awareness that these internalized attitudes about aging may influence their attitudes to older patients.

<p>Syfte med litteraturstudien var att beskriva bemötande av äldre människor inom vården utifrån de äldre vårdtagarnas, vårdgivarnas, observatörernas/anhörigas perspektiv. I en av dessa tre perspektiv representerade anhöriga tillsammans med observatörerna ett gemensamt perspektiv. En litteraturstudie gjordes och sexton vetenskapliga artiklar granskades och analyserades. Joyce Travelbee’s omsorgsteori (Interaktionsteori) var den teoretiska referensramen för studien. Resultatet visade att vårdgivarnas tillvaratagande av den äldre vårdtagarens autonomi bidrog påtagligt till upplevelsen av bemötandet, vårdtagarna uttryckte denna aspekt tydligast. Personalbrist var ett inbyggt fel i organisationen som påverkade bemötande. Alla tre perspektiv uttryckte detta problem tydligt. Vårdgivarnas egen förmåga att organisera och prioritera var av betydelse för upplevelsen av bemötande. Bemötandet påverkades när den äldre vårdtagarens önskemål nedprioriterades för rutiner. Nivån på vårdgivarnas empatiska förmåga påverkade upplevelsen av bemötandets kvalitet på olika sätt. Vården upplevdes som trygg när vårdgivare hade hög empatisk förmåga. Sammanfattningsvis var upplevelsen av bemötande att det var en förmåga till lyhördhet och en vilja att kommunicera, utförandet av dessa var i sin tur beroende av tid, personliga värderingar och invant beteende.</p>

Syfte med litteraturstudien var att beskriva bemötande av äldre människor inom vården utifrån de äldre vårdtagarnas, vårdgivarnas, observatörernas/anhörigas perspektiv. I en av dessa tre perspektiv representerade anhöriga tillsammans med observatörerna ett gemensamt perspektiv. En litteraturstudie gjordes och sexton vetenskapliga artiklar granskades och analyserades. Joyce Travelbee’s omsorgsteori (Interaktionsteori) var den teoretiska referensramen för studien. Resultatet visade att vårdgivarnas tillvaratagande av den äldre vårdtagarens autonomi bidrog påtagligt till upplevelsen av bemötandet, vårdtagarna uttryckte denna aspekt tydligast. Personalbrist var ett inbyggt fel i organisationen som påverkade bemötande. Alla tre perspektiv uttryckte detta problem tydligt. Vårdgivarnas egen förmåga att organisera och prioritera var av betydelse för upplevelsen av bemötande. Bemötandet påverkades när den äldre vårdtagarens önskemål nedprioriterades för rutiner. Nivån på vårdgivarnas empatiska förmåga påverkade upplevelsen av bemötandets kvalitet på olika sätt. Vården upplevdes som trygg när vårdgivare hade hög empatisk förmåga. Sammanfattningsvis var upplevelsen av bemötande att det var en förmåga till lyhördhet och en vilja att kommunicera, utförandet av dessa var i sin tur beroende av tid, personliga värderingar och invant beteende.

Older patients comprise a large portion of patients in the acute care setting. Registered Nurses (RNs) are the main care providers in the hospital setting. RNs caring for older hospitalized patients are affected by many factors including workload pressures, issues related to the acute care environment and attitudes toward older patients. However, a literature review identified a limited number of studies exploring the RNs experience of caring for older patients in the acute care setting. This study explored the RNs experience of caring for older patients (age 65 and older) on an orthopedic unit in an acute care hospital. Saturation was reached with a purposive sample of nine RNs working on the orthopedic unit, including eight females and 1 male. Participants were interviewed using broad open-ended questions, followed by questions more specific to emerging themes. All interviews were audio-taped and transcribed verbatim. Data were analyzed using Glasers (1992) grounded theory approach. Participants described the basic social problem as dealing with the complexity of older patients. The basic social process identified was the concept of looking beyond. Looking beyond was described as looking at the big picture to find what lies outside the scope of the ordinary. Three sub-processes of looking beyond were identified as connecting, searching, and knowing. Connecting was described as getting to know patients as a person by taking time, respecting and understanding the individual. Searching was described as digging deeper, searching for the unknown by looking for clues and mining everywhere for information. Knowing was described as intuitively knowing what is going to happen and what the older patient needs by pulling it all together and knowing what to expect. These dynamic sub-processes provided the RN with the relationship and information required to look beyond to manage the older patients complexity. The results of this study have implications for nursing practice, education and research. These findings may provide RNs with a process to manage the complex care of a large portion of our population.