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  • 1.
    Algilani, Samal
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Östlund-Lagerström, Lina
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Kihlgren, Annica
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Blomberg, Karin
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Brummer, Robert Jan
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Örebro University Hospital.
    Schoultz, Ida
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Exploring the concept of optimal functionality in old age2014In: Journal of Multidisciplinary Healthcare, ISSN 1178-2390, E-ISSN 1178-2390, Vol. 7, p. 69-79Article, review/survey (Refereed)
    Abstract [en]

    BACKGROUND: Aging is characterized by loss of function and represents a perspective that puts the focus on the negative aspects of aging. Thus, it is fundamental to shift the focus from loss of function to maintaining good health and personal satisfaction through life; in other words, to promote optimal functionality at a level appropriate for older adults. However, it is not yet known what constitutes optimal functionality from the older adult's own perspective.

    OBJECTIVE: To explore the concept of optimal functionality in old age from the older adult's perspective (ie, people over 65 years of age) in industrialized Western countries.

    METHODS: We undertook a scoping review and searched two electronic databases (PubMed and the Cumulative Index to Nursing and Allied Health Literature [CINAHL]) from January 2002 to July 2013 for scientific studies, using the key search term personal satisfaction. In total, 25 scientific studies were analyzed.

    RESULTS: Only six of the included articles applied a qualitative methodology. By analyzing the results of these articles, three major themes were identified as cornerstones in the concept of optimal functionality at old age: 1) self-related factors (eg, mental well-being); 2) body-related factors (eg, physical well-being); and 3) external factors equal to demographic and environmental factors.

    CONCLUSION: There is a lack of qualitative studies in the current literature, and hence of what constitutes optimal functionality from the older adult's perspective. The results outlined in this review identify three cornerstones (self-related factors, body-related factors, and external factors) of what constitutes optimal functionality at old age. However, it is vital that these findings are taken further and are evaluated through qualitative studies to reflect older adults' opinions.

  • 2.
    Callio, Carina
    et al.
    University Health Care Research Center, Region Örebro County, Örebro, Sweden; Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Gustafsson, Sanna Aila
    Örebro University, School of Medical Sciences.
    Living with a sibling who suffers from an eating disorder: a pilot interview study2016In: Journal of Multidisciplinary Healthcare, ISSN 1178-2390, E-ISSN 1178-2390, Vol. 9, p. 615-622Article in journal (Refereed)
    Abstract [en]

    Background and objective: Having a sibling who suffers from an eating disorder (ED) has a profound effect on healthy siblings' own health, quality of life and family relationships, yet siblings have been an excluded group within health care, and there is a lack of knowledge regarding healthy siblings' needs and wishes for information and support. Thus, the aim of this study was to examine adolescents' experiences of living with a sibling who suffers from an ED.

    Method: In this small-scale pilot study, three boys and two girls aged 15-20 years were interviewed, and the interviews were analyzed by qualitative content analysis.

    Results: This study confirms prior knowledge of adolescents' experiences of living with a sibling who is suffering from an ED. The adolescents were concerned about their siblings and lacked information about their siblings' illness and treatment progress. The girls described that their everyday life had been heavily influenced by their sisters' illness, while the boys described that their everyday life with friends and activities were not affected to such a great extent. One new result that emerged as something positive was that some informants described that although the ED was a source of conflict in the family, it had led to greater awareness of the importance of gaining sufficient energy and had contributed to better meal situations in the family.

    Conclusion: Having a sibling with an ED had a profound and negative effect on family relationships, and was often a source of conflict, especially around mealtime. However, it appeared that if parents were able to organize family meals and create an open and supportive climate, the negative effects for the family could be reduced. The health care professionals need to acknowledge the siblings' need for information and support, and support parents in their important role of caring for well siblings.

  • 3.
    Grundberg, Åke
    et al.
    Division of Neurogeriatrics, Karolinska Institutet, Stockholm, Sweden.
    Ebbeskog, Britt
    Division of Nursing, Department of Neurobiology, Care sciences and society, Karolinska Institutet, Stockholm, Sweden.
    Gustafsson, Sanna Aila
    Örebro University Hospital. Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Psychiatric Research Centre, Örebro University Hospital, Örebro, Sweden.
    Religa, Dorota
    Division of Neurogeriatrics, Karolinska Institutet, Stockholm, Sweden.
    Mental health-promoting dialogues from the perspective of community-dwelling seniors with multimorbidity.2014In: Journal of Multidisciplinary Healthcare, ISSN 1178-2390, E-ISSN 1178-2390, Vol. 7, p. 189-199Article in journal (Refereed)
    Abstract [en]

    Mental health promotion needs to be studied more deeply within the context of primary care, because persons with multiple chronic conditions are at risk of developing poor mental health. In order to make progress in the understanding of mental health promotion, the aim of this study was to describe the experiences of health-promoting dialogues from the perspective of community-dwelling seniors with multimorbidity - what these seniors believe is important for achieving a dialogue that may promote their mental health. Seven interviews with six women and one man, aged 83-96 years, were analyzed using qualitative content analysis. The results were summarized into nine subcategories and three categories. The underlying meaning of the text was formulated into an overarching theme that embraced every category, "perceived and well-managed as a unique individual". These seniors with multimorbidity missed someone to talk to about their mental health, and needed partners that were accessible for health dialogues that could promote mental health. The participants missed friends and relatives to talk to and they (crucially) lacked health care or social service providers for health-promoting dialogues that may promote mental health. An optimal level of care can be achieved through involvement, continuity, and by providing a health-promoting dialogue based on seniors' needs and wishes, with the remembrance that general health promotion also may promote mental health. Implications for clinical practice and further research are discussed.

  • 4.
    Gustafsson, Sanna Aila
    et al.
    Örebro University, School of Health and Medical Sciences.
    Edlund, Birgitta
    Institutionen för folkhälso- och vårdvetenskap, Uppsala universitet, Uppsala, Sweden.
    Davén, Josefine
    Kjellin, Lars
    Örebro University, School of Health and Medical Sciences.
    Norring, Claes
    Centrum för psykiatriforskning, Karolinska Institute, Stockholm, Sweden.
    How to deal with sociocultural pressures in daily life: reflections of adolescent girls suffering from eating disorders2011In: Journal of Multidisciplinary Healthcare, ISSN 1178-2390, E-ISSN 1178-2390, Vol. 18, no 4, p. 103-110Article in journal (Refereed)
    Abstract [en]

    Adolescent girls with eating disorders experience unattainable and contradictory expectations in daily life, which create stress and negatively affect their self-evaluation. Disordered eating may function as a way of seeking control and consistency. In order to make progress in the understanding of eating disorders, the aim of this study was to describe how adolescent girls with eating disorders reflect upon ways of dealing with sociocultural pressures in daily life. Eighteen interviews with girls aged 15-19 years were analyzed using a phenomenographic approach. The results were summarized into three conceptions: "Striving to be oneself " (conception A) was described as the most desirable, but also the hardest. "Adapting to various situations" (conception B) was used without much reflection, as long as it worked, but when this way of dealing with everyday expectations was unsuccessful it was evaluated negatively. "Presenting oneself in a positive light" (conception C) was described negatively even when it was successful. Within these conceptions, the participants described various strategies that could be used more or less effectively depending on the circumstances. A common theme was their difficulties in finding a balance between trying harder to live up to perceived expectations from others on one hand, and trying to accept the situation as it was, without trying to change themselves or the situation, on the other hand. The participants believed that their eating disorder was partly a result of being unable to deal with sociocultural pressures in an effective way, and they experienced a conflict between societal values of being assertive and values of being interpersonally oriented. Implications for treatment are discussed.

  • 5.
    Lindstedt, Katarina
    et al.
    Örebro University, School of Medical Sciences. University Health Care Research Center.
    Neander, Kerstin
    Örebro University, School of Medical Sciences. Örebro University Hospital. University Health Care Research Center.
    Kjellin, Lars
    University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
    Gustafsson, Sanna Aila
    Örebro University, School of Medical Sciences. Örebro University Hospital. University Health Care Research Center.
    A life put on hold: adolescents' experiences of having an eating disorder in relation to social contexts outside the family2018In: Journal of Multidisciplinary Healthcare, ISSN 1178-2390, E-ISSN 1178-2390, Vol. 11, p. 425-437Article in journal (Refereed)
    Abstract [en]

    Background: As suffering from an eating disorder often entails restrictions on a person's everyday life, one can imagine that it is an important aspect of recovery to help young people learn to balance stressful demands and expectations in areas like the school environment and spare-time activities that include different forms of interpersonal relationships.

    Purpose: The aim of the present study was to investigate how adolescents with experience from a restrictive eating disorder describe their illness and their time in treatment in relation to social contexts outside the family.

    Patients and methods: This qualitative study is based on narratives of 15 adolescents with experience from outpatient treatment for eating disorders with a predominately restrictive symptomatology, recruited in collaboration with four specialized eating-disorder units. Data were explored through inductive thematic analysis.

    Results: The adolescents' descriptions of their illness in relation to their social contexts outside the family follow a clear timeline that includes narratives about when and how the problem arose, time in treatment, and the process that led to recovery. Three main themes were found: 1) the problems emerging in everyday life (outside the family); 2) a life put on hold and 3) creating a new life context.

    Conclusion: Young people with eating disorders need to learn how to balance demands and stressful situations in life, and to grasp the confusion that often preceded their illness. How recovery progresses, and how the young people experience their life contexts after recovery, depends largely on the magnitude and quality of peer support and on how school and sports activities affect and are affected by the eating disorder.

  • 6.
    Paulson-Karlsson, Gunilla
    et al.
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden. Anorexia-Bulimia Unit, Child and Adolescent Psychiatry Centre, Queen Silvia Children’s Hospital, Göteborg, Sweden.
    Nevonen, Lauri
    Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.
    Anorexia nervosa: treatment expectations – a qualitative study2012In: Journal of Multidisciplinary Healthcare, ISSN 1178-2390, E-ISSN 1178-2390, Vol. 5, p. 169-177Article in journal (Refereed)
    Abstract [en]

    Background: Anorexia nervosa is a serious illness with a high mortality rate, a poor outcome, and no empirically supported treatment of choice for adults. Patients with anorexia nervosa strive for thinness in order to obtain self-control and are ambivalent toward change and toward treatment. In order to achieve a greater understanding of patients’ own understanding of their situation, the aim of this study was to examine the expectations of potential anorexic patients seeking treatment at a specialized eating-disorder unit.

    Methods: A qualitative study design was used. It comprised 15 women between 18 and 25 years of age waiting to be assessed before treatment. The initial question was, “What do you expect, now that you are on the waiting list for a specialized eating-disorder unit?” A content analysis was used, and the text was coded, categorized according to its content, and further interpreted into a theme. Results: From the results emerged three main categories of what participants expected: “treatment content,” “treatment professionals,” and “treatment focus.” The overall theme, “receiving adequate therapy in a collaborative therapeutic relationship and recovering,” described how the participants perceived that their expectations could be fulfilled./p>

    Discussion: Patients’ expectations concerning distorted thoughts, eating behaviors, a normal, healthy life, and meeting with a professional with knowledge and experience of eating disorders should be discussed before treatment starts. In the process of the therapeutic relationship, it is essential to continually address patients’ motivations, in order to understand their personal motives behind what drives their expectations and their desire to recover.

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