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  • 1.
    Djukanovic, Ingrid
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Depression in late life-prevalence and preventive intervention2017Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Background

    Depression in older people often goes undetected but has severe consequences on physical health, functioning and quality of life. As the aging population is growing, mental ill-health already is and will continue to be an important public health problem. There is a need for adequate strategies to meet this challenge.

    Aims

    (1) To investigate the prevalence of and the association between depressive symptoms and loneliness in relation to age and sex in a random Swedish sample in the age group 65-80 years, and to investigate to what extent those scoring ≥ 8 in the depression dimension of the Hospital Anxiety and Depression Scale (HAD) had visited health care professionals and/ or used antidepressive medication.

    (2) To evaluate the effect of group discussions, in which structured reminiscence and a Problem Based Method (PBM) were used, on depressive symptoms, Quality of Life (QoL) and Self-Rated Health (SRH) among older people.

    (3) To describe the individual´s experiences of the year before and the time after retirement.

    (4) To evaluate the factorial structure of the HAD in a general older population 65-80 years and to examine the possible presence of differential item functioning (DIF) related to sex.

    Result

    More men than women reported depressive symptoms, few were offered psychological treatment and a quarter used antidepressant medication. Depressive symptoms were associated with loneliness and this association decreased with increasing age.  

    Participation in group discussions resulted in a decrease in depressive symptoms and an increase in QoL and SRH. Both expectations and fears were experienced the year before and the time after retirement.

    The psychometric evaluation of the HAD showed a two-factorial structure and invariance regarding sex.

    Conclusion

    The result highlights the importance of detecting depressive symptoms and loneliness in older people and offer adequate treatment. Transition into retirement should receive more attention both from a health care and organizational perspective. Group discussions with structured reminiscence and PBM as a nursing intervention, seem to be a promising method to prevent depressive symptoms in older people, but further research is needed. The HAD can be recommended to assess anxiety and depression among a general population 65-80 years old.  

  • 2.
    Djukanovic, Ingrid
    et al.
    Kalmar County Hospital.
    Brudin, Lars
    Kalmar County Hospital.
    Hagberg, Margaretha
    Linnaeus University, Faculty of Health, Social Work and Behavioural Sciences, School of Health and Caring Sciences.
    Tillander, Bo
    University Hospital of Linköping.
    Cöster, Maria
    Kalmar County Hospital.
    Health-related quality of life in patients before and after planned orthopedic surgery: a prospective follow-up study2011In: International Journal of Orthopaedic and Trauma Nursing, ISSN 1878-1241, E-ISSN 1878-1292, Vol. 15, no 4, p. 185-195Article in journal (Refereed)
    Abstract [en]

    Background

    There are increasing demands on health care for both results and quality. Treatment outcome from the patient’s perspective is essential but not often demanded. The aim of the study was to assess Health Related Quality of Life (HRQoL) prior to and one year after an elective orthopedic intervention.

    Methods

    HRQoL was evaluated by the 5-dimensional scale of the EuroQoL (EQ5D) with two additional scales, EQVAS and PainVAS in 676 consecutive patients undergoing 120 different elective orthopedic interventions. Descriptive statistics were used.

    Results

    Results showed patients treated for arthrosis with total hip and knee replacement had the greatest improvement in HRQoL. Patients that underwent spinal, upper arm and arthroscopic knee surgery showed considerable improvement. All patients experienced pain relief one year after surgery. Changes in the three effect variables EQ5D, EQVAS and PainVAS correlated significantly with each other.

    Conclusions

    The study provides an overview of patient assessment of HRQoL before and after some of the most common elective orthopedic interventions. Knowledge obtained from patient groups should help improve and individualize care both from a nursing and surgical perspective.

  • 3.
    Djukanovic, Ingrid
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Carlsson, Jörg
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Peterson, Ulla
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Group discussions with structured reminiscence and a problem-based method as an intervention to prevent depressive symptoms in older people2016In: Journal of Clinical Nursing, ISSN 0962-1067, E-ISSN 1365-2702, Vol. 25, no 7-8, p. 992-1000Article in journal (Refereed)
    Abstract [en]

    Aims and objectives: To evaluate the effect of group discussions, in which structured reminiscence and a problem-based method were used, on depressive symptoms, quality of life and self-rated health among older people. Background: Depressive symptoms in older people have a considerable impact on self-rated health and quality of life, with a high rate of co-morbidity and mortality. As the ageing population is growing, late-life depression is becoming an important public health problem and there is a need to find preventive interventions to avert unnecessary suffering. Design: The study was quasi-experimental, with a one-group pretest-post-test design and follow-up after one year. Methods: Initially, a questionnaire was sent to the total population of 55-80-year-old retirees in a community in the northeast of Sweden, (n=679). The questionnaire concerned demographics and covered areas such as health, depression and quality of life. The intervention consisted of group discussions where structured reminiscence and a problem-based method were used. The participants (n=18) met 10 times under the guidance of a group-leader, a registered nurse educated in the method. Each session had different themes with a focus on positive memories but also on the present situation and the future. Parametric, nonparametric tests and content analysis were used.Results: Participants evaluated the intervention positively, showed a decrease in depressive symptoms, an increase in self-rated health and experienced an increased autonomy. No long- lasting effect was seen. Conclusion: Group discussions where structured reminiscence and a problem-based method are used might be an option to prevent depressive symptoms in older people. Relevance to clinical practice: This method might provide an opportunity for older people with depressive symptoms to improve their quality of life, however, to maintain the positive outcome the intervention should probably be continuous.

  • 4.
    Djukanovic, Ingrid
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Carlsson, Jörg
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Peterson, Ulla
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Reminiscence and problem-based method as an intervention to prevent depressive symptoms in elderly2016In: Journal of Advanced Nursing, ISSN 0309-2402, E-ISSN 1365-2648, Vol. 72, p. 67-68Article in journal (Other academic)
  • 5.
    Djukanovic, Ingrid
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Carlsson, Jörg
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Årestedt, Kristofer
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Kalmar County Hospital ; Linköping University.
    Is the Hospital Anxiety and Depression Scale (HADS) a valid measure in a general population 65-80 years old?: A psychometric evaluation study2017In: Health and Quality of Life Outcomes, ISSN 1477-7525, E-ISSN 1477-7525, Vol. 15, p. 1-10, article id 193Article in journal (Refereed)
    Abstract [en]

    Background: The HADS (Hospital Anxiety and Depression Scale) aims to measure symptoms of anxiety (HADS Anxiety) and depression (HADS Depression). The HADS is widely used but has shown ambiguous results both regarding the factor structure and sex differences in the prevalence of depressive symptoms. There is also a lack of psychometric evaluations of the HADS in non-clinical samples of older people. The aim of the study was to evaluate the factor structure of the HADS in a general population 65-80 years old and to exam possible presence of differential item functioning (DIF) with respect to sex. Methods: This study was based on data from a Swedish sample, randomized from the total population in the age group 65-80 years (n = 6659). Confirmatory factor analyses (CFA) were performed to examine the factor structure. Ordinal regression analyses were conducted to detect DIF for sex. Reliability was examined by both ordinal as well as traditional Cronbach's alpha. Results: The CFA showed a two-factor model with cross-loadings for two items (7 and 8) had excellent model fit. Internal consistency was good in both subscales, measured with ordinal and traditional alpha. Floor effects were presented for all items. No indication for meaningful DIF regarding sex was found for any of the subscales. Conclusions: HADS Anxiety and HADS Depression are unidimensional measures with acceptable internal consistency and are invariant with regard to sex. Despite pronounced ceiling effects and cross-loadings for item 7 and 8, the hypothesized two-factor model of HADS can be recommended to assess psychological distress among a general population 65-80 years old.

  • 6.
    Djukanovic, Ingrid
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Peterson, Ulla
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Experiences of the transition intoretirement: An interview study2016In: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593, Vol. 36, no 4, p. 224-232Article in journal (Refereed)
    Abstract [en]

    Retirement is one of the most important transitions in a person's life, which also might affect health and well-being. Adjustment to a life as retiree does not follow a uniform pattern, which emphasizes the importance of an individual perspective. This article uses transition theory as a theoretical perspective. In-depth interviews were conducted with 13 individuals newly retired, focusing on experiences from the last year of work and the time after retirement. Content analysis was used to analyze data. Two themes emerged: ‘become aware of’ and ‘become adapted to’. Nine subthemes describe the individual experiences reflecting positive expectations and outcomes but also feelings of grief and disconnectedness and fears about loss of social network and identity. Transition into retirement should receive more attention from a nursing perspective since experiences such as, for example, grief, disconnectedness and loss of identity if unaddressed could lead to an unhealthy transition.

  • 7.
    Djukanovic, Ingrid
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Sorjonen, Kimmo
    Karolinska Institutet.
    Peterson, Ulla
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Association between depressive symptoms and age, sex, loneliness and treatment among older people in Sweden2015In: Aging & Mental Health, ISSN 1360-7863, E-ISSN 1364-6915, Vol. 19, no 6, p. 560-568Article in journal (Refereed)
    Abstract [en]

    Objectives: The objective of this study was to examine the prevalence of and the association between depressive symptoms and loneliness in relation to age and sex among older people (65–80 years) and to investigate to what extent those who report depressive symptoms had visited a health care professional and/or used antidepressant medication.

    Method: A cross-sectional study was conducted in a Swedish sample randomized from the total population in the age group 65–80 years (n = 6659). Chi square tests and logistic regression analyses were conducted.

    Results: The data showed that 9.8% (n = 653) reported depressive symptoms and 27.5% reported feelings of loneliness. More men than women reported depressive symptoms, and the largest proportion was found among men in the age group 75–80 years. An association between the odds to have a depressive disorder and loneliness was found which, however, decreased with increasing age. Of those with depressive symptoms a low proportion had visited a psychologist (2.9%) or a welfare officer (4.2%), and one in four reported that they use antidepressant medication. Of those who reported depressive symptoms, 29% considered that they had needed medical care during the last three months but had refrained from seeking, and the most common reason for that was negative experience from previous visits.

    Conclusion: Contrary to findings in most of the studies, depressive symptoms were not more prevalent among women. The result highlights the importance of detecting depressive symptoms and loneliness in older people and to offer adequate treatment in order to increase their well-being.

  • 8.
    Årestedt, Kristofer
    et al.
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Kalmar County Council, Sweden.
    Allert, Camilla
    Blekinge Institute of Technology, Sweden.
    Djukanovic, Ingrid
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Israelsson, Johan
    Linnaeus University, Faculty of Technology, Kalmar Maritime Academy. Kalmar County Council, Sweden.
    Schildmeijer, Kristina
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Agerström, Jens
    Linnaeus University, Faculty of Health and Life Sciences, Department of Psychology.
    Herlitz, Johan
    University of Borås, Sweden.
    Årestedt, Liselott
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences.
    Bremer, Anders
    Linnaeus University, Faculty of Health and Life Sciences, Department of Health and Caring Sciences. Kalmar County Council, Sweden.
    Health-related quality of life among in-hospital cardiac arrest survivors in working age2018In: Resuscitation, ISSN 0300-9572, E-ISSN 1873-1570, Vol. 130, no s1, article id e18Article in journal (Refereed)
1 - 8 of 8
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