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  • 1.
    Cuijpers, Pim
    et al.
    Vrije University Amsterdam.
    van Straten, Annemieke
    Vrije University Amsterdam.
    Smit, Filip
    Vrije University Amsterdam.
    Andersson, Gerhard
    Linköpings universitet, Institutionen för beteendevetenskap och lärande, Avdelningen för klinisk och socialpsykologi (CS). Linköpings universitet, Filosofiska fakulteten.
    Is psychotherapy for depression equally effective in younger and older adults? A meta-regression analysis2009Ingår i: International psychogeriatrics, ISSN 1041-6102, E-ISSN 1741-203X, Vol. 21, nr 1, s. 16-24Artikel, forskningsöversikt (Refereegranskat)
    Abstract [en]

    Background: It is well established that psychotherapy is effective in the treatment of depression in younger as well as in older adults. Whether these psychotherapies are equally effective in younger and older age groups has not been examined in meta-analytic research.

    Methods: We conducted a systematic literature search and included 112 studies with 170 comparisons between a psychotherapy and a control group (with a total of 7,845 participants). Twenty studies with 26 comparisons were aimed at older adults.

    Results: We found no indication that psychotherapies were more or less effective for older adults compared to younger adults. The effect sizes of both groups of comparisons did not differ significantly from each other (older adults: d = 0.74; 95% CI: 0.49 similar to 0.99; younger adults: d = 0.67; 95% CI: 0.58 similar to 0.76). In a multivariate metaregression analysis, in which we controlled for major characteristics of the participants, the interventions and the study designs, no indication of a difference between psychotherapy in younger and older adults was found.

    Conclusions: There appears to be no significant difference between psychotherapy in younger and older adults, although it is not clear whether this is also true for clinical samples, patients with more severe depression, and the older old.

  • 2.
    Johansson, Maria
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap.
    Marcusson, Jan
    Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Geriatriska kliniken. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap.
    Wressle, Ewa
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i centrala Östergötland, Geriatriska kliniken.
    Cognitive impairment and its consequences in everyday life: experiences of people with mild cognitive impairment or mild dementia and their relatives2015Ingår i: International psychogeriatrics, ISSN 1041-6102, E-ISSN 1741-203X, Vol. 27, nr 6, s. 949-958Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The aim of this study was to explore experiences of cognitive impairment, its consequences in everyday life and need for support in people with mild cognitive impairment (MCI) or mild dementia and their relatives.

    Methods: A qualitative approach with an explorative design with interviews was chosen. The participants included five people with MCI and eight people with mild dementia and their relatives. All participants were recruited at a geriatric memory clinic in Sweden. The Grounded Theory method was used.

    Results: The following categories emerged: noticing cognitive changes; changed activity patterns; coping strategies; uncertainty about own ability and environmental reactions; support in everyday life; support from the healthcare system; consequences in everyday life for relatives; and support for relatives. The main findings were that people with MCI and dementia experienced cognitive changes that could be burdensome and changed activity patterns. Most of them, however, considered themselves capable of coping on their own. The relatives noticed cognitive changes and activity disruptions to a greater extent and tried to be supportive in everyday life. Degree of awareness varied and lack of awareness could lead to many problems in everyday life.

    Conclusions: Perceived cognitive impairment and its consequences in everyday life were individual and differed among people with MCI or dementia and their relatives. Thus, healthcare professionals must listen to both people with cognitive impairment and their relatives for optimal individual care planning. Support such as education groups and day care could be more tailored towards the early stages of dementia.

  • 3.
    Ludvigsson, Mikael
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i centrala Östergötland, Psykiatriska kliniken inkl beroendekliniken.
    Marcusson, Jan
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i centrala Östergötland, Medicinska och geriatriska akutkliniken.
    Wressle, Ewa
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Avdelningen för neuro- och inflammationsvetenskap. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i centrala Östergötland, Medicinska och geriatriska akutkliniken.
    Milberg, Anna
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten. Region Östergötland, Närsjukvården i östra Östergötland, LAH i Norrköping.
    Morbidity and mortality in very old individuals with subsyndromal depression: an 8-year prospective study2019Ingår i: International psychogeriatrics, ISSN 1041-6102, E-ISSN 1741-203X, Vol. 31, nr 11, s. 1569-1579, artikel-id PII S1041610219001480Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objectives: Both morbidity and mortality are elevated for individuals with subsyndromal depression (SSD) compared to non-depression (ND) in those of younger ages, but scientific studies are scarce for very old individuals. The aim of this study was therefore to compare the morbidity and mortality in very old individuals with SSD and ND. Design and setting: An 8-year prospective population-based study was undertaken on 85-year-old individuals in Sweden. Measurements: Data were collected from postal questionnaires and clinical assessments at baseline, after 1, 5, and 8 years. Depressive symptoms were measured with Geriatric Depression Scale and the results were classified into ND, SSD, and syndromal depression. Mortality was investigated using multivariable cox regressions, and variables of morbidity were investigated using linear mixed models. Results: Compared to ND, in people with SSD, mortality was elevated in the univariate regression, but this association vanished when controlling for relevant covariates. Morbidity was elevated with regard to basic activities of daily living (ADLs), instrumental ADLs, loneliness, self-perceived health, and depressive symptoms for individuals with SSD compared to ND, whereas cognitive speed, executive functions, and global cognitive function were not significantly impaired when adjusting for covariates. Conclusions: SSD among very old individuals is longitudinally associated with elevated morbidity but not mortality, when controlling for relevant covariates. Considering the high prevalence of SSD and the demographic development of increasing numbers of very old people, the findings highlight the need to develop clinical and societal strategies to prevent SSD and associated negative outcomes.

  • 4.
    Midlov, Patrik
    et al.
    Lund University, Sweden .
    Andersson, Martin
    Lund University, Sweden .
    Östgren, Carl Johan
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i västra Östergötland, Primärvården i västra länsdelen.
    Molstad, Sigvard
    Lund University, Sweden .
    Depression and use of antidepressants in Swedish nursing homes: a 12-month follow-up study2014Ingår i: International psychogeriatrics, ISSN 1041-6102, E-ISSN 1741-203X, Vol. 26, nr 4, s. 669-675Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND:

    The prescription of antidepressants in nursing homes has increased markedly since the introduction of SSRIs, while at the same time depressive symptoms often go unrecognized and untreated. The aim of this study was to examine whether depression among residents in nursing homes is treated adequately.

    METHODS:

    A sample of 429 participants from 11 Swedish nursing homes was selected and was assessed with the Cornell Scale for Depression in Dementia (CSDD) and using medical records and drug prescription data. For 256 participants a follow-up assessment was performed after 12 months.

    RESULTS:

    The prevalence of depression, according to medical records, was 9.1%, and the prevalence of CSDD score of ≥8 was 7.5%. Depression persisted in more than 50% of cases at the 12-month follow-up. Antidepressants were prescribed to 33% of the participants without a depression diagnosis or with a CSDD score of <8. 46.2% of all participants were prescribed antidepressants. 14% of the participants without a depression diagnosis or with a CSDD score of <8 had psychotropic polypharmacy. 15.2% of all participants had psychotropic polypharmacy, which persisted at the 12-month follow-up in three-quarters of cases.

    CONCLUSION:

    The prescription of antidepressants in frail elderly individuals is extensive and may be without clear indication. The clinical implication is that there is a need for systematic drug reviews at nursing homes, paying special attention to the subjects which are on antidepressants.

  • 5.
    Mårdh, Selina
    et al.
    Linköpings universitet, Institutionen för beteendevetenskap och lärande. Linköpings universitet, Filosofiska fakulteten.
    Karlsson, Thomas
    Linköpings universitet, Institutionen för beteendevetenskap och lärande. Linköpings universitet, Filosofiska fakulteten. Linnaeus Centre HEAD, Linköping University, Linköping, Sweden.
    Marcusson, Jan
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Geriatrik. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Närsjukvården i centrala Östergötland, Geriatriska kliniken.
    Aspects of awareness in patients with Alzheimer's disease2013Ingår i: International psychogeriatrics, ISSN 1041-6102, E-ISSN 1741-203X, Vol. 25, nr 7, s. 1167-1179Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The purpose of the present study was to gain insight into Alzheimer's disease (AD) patients' perception of the world through the study of a few aspects of awareness. The aspects in focus of the study were disease awareness, metacognition, managing of everyday life, and as a complement, the agreement (calibration) between patients and their spouses on the studied aspects was considered.

    Method: A mixed-method evaluation design was used involving 15 AD patients, their spouses, and 15 elderly healthy control subjects. The study comprised both a semistructured interview (AD patients and spouse) and a neuropsychological assessment (AD patients and control subjects).

    Results: The patients were aware of their disease and able to report on their illness. Despite this awareness, they were unable to realize and manage the practical and cognitive implications of their impairment. The results also indicate that patients and spouses were not well calibrated regarding thoughts about the disease and problems in handling the cognitive deterioration.

    Conclusions: The findings of our study have relevance to patients' well being and how they manage everyday life. An open dialogue on these issues between spouses and in the care for AD patients would hopefully enhance quality of life for all parties involved.

  • 6.
    Taghizadeh Larsson, Annika
    et al.
    Linköpings universitet, Filosofiska fakulteten. Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, NISAL - Nationella institutet för forskning om äldre och åldrande.
    H. Österholm, Johannes
    Linköpings universitet, Filosofiska fakulteten. Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, NISAL - Nationella institutet för forskning om äldre och åldrande.
    How are decisions on care services for people with dementia made and experienced?: A systematic review and qualitative synthesis of recent empirical findings2014Ingår i: International psychogeriatrics, ISSN 1041-6102, E-ISSN 1741-203X, Vol. 26, nr 11, s. 1849-1862Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: During recent decades, there has been a growing recognition that people cannot be assumed incapable of making decisions about their own care solely on the basis of a dementia diagnosis and international agreements and legislative changes have strengthened the formal right for people with dementia to participate in decisions on care services. This raises important questions about how these decisions are currently made and experienced in practice. In this review, we address this question and highlight directions for further research.

    METHODS:

    We searched CINAHL, PsycINFO, ASSIA, Social Services Abstracts, Science Direct, Academic Search Premier, and PubMed. Twenty-four pertinent articles were identified, all representing qualitative studies. Relevant findings were extracted and synthesized along dimensions of involvement of the person with dementia in decisions on care services, using an integrative approach to qualitative synthesis.

    RESULTS:

    We identified three overarching ways in which people with dementia are involved, primarily, in the informal part of a process of decisions: excluded, prior preferences taken into account, and current preferences respected. Several (10) articles seemed to be based on the assumption that decisions on care services are invariably and solely made within the family and without participation of the person with dementia.

    CONCLUSIONS:

    The review emphasizes the need for more updated research about international debates and agreements concerning capabilities and rights of people with dementia and about the (potential) formal contexts of care decisions in the country concerned. This, we argue, is vital for future knowledge production in the area.

     

  • 7.
    Ward, Richard
    et al.
    Faculty of Social Science, University of Stirling, UK of Great Britain and Northern Ireland.
    Clark, Andrew
    School of Nursing, Midwifery, Social Work and Social Sciences, University of Salford, Salford, Greater Manchester, UK of Great Britain and Northern Ireland..
    Campbell, Sarah
    School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK of Great Britain and Northern Ireland..
    Graham, Barbara
    Faculty of Social Science, University of Stirling, UK of Great Britain and Northern Ireland.
    Kullberg, Agneta
    Linköpings universitet, Institutionen för medicin och hälsa, Avdelningen för samhällsmedicin. Linköpings universitet, Medicinska fakulteten.
    Manji, Kainde
    Faculty of Social Science, University of Stirling, UK of Great Britain and Northern Ireland.
    Rummery, Kirstein
    Faculty of Social Science, University of Stirling, UK of Great Britain and Northern Ireland.
    Keady, John
    School of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK of Great Britain and Northern Ireland..
    The lived neighborhood: understanding how people with dementia engage with their local environment.2018Ingår i: International psychogeriatrics, ISSN 1041-6102, E-ISSN 1741-203X, Vol. 30, nr 6, s. 867-880Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: In this paper, we report progress on "Neighborhoods: our people, our places" an international study about how people living with dementia interact with their neighborhoods. The ideas of social health and citizenship are drawn upon to contextualize the data and make a case for recognizing and understanding the strengths and agency of people with dementia. In particular, we address the lived experience of the environment as a route to better understanding the capabilities, capacities, and competencies of people living with dementia. In doing this, our aim is to demonstrate the contribution of social engagement and environmental support to social health.

    METHODS: The study aims to "map" local spaces and networks across three field sites (Manchester, Central Scotland and Linkoping, Sweden). It employs a mix of qualitative and participatory approaches that include mobile and visual methods intended to create knowledge that will inform the design and piloting of a neighborhood-based intervention.

    RESULTS: Our research shows that the neighborhood plays an active role in the lives of people with dementia, setting limits, and constraints but also offering significant opportunities, encompassing forms of help and support as yet rarely discussed in the field of dementia studies. The paper presents new and distinctive insights into the relationship between neighborhoods and everyday life for people with dementia that have important implications for the debate on social health and policy concerning dementia friendly communities.

    CONCLUSION: We end by reflecting on the messages for policy and practice that are beginning to emerge from this on-going study.

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