lena Borell - Academia.edu (original) (raw)
Papers by lena Borell
The Occupational Therapy Journal of Research, 1994
Scandinavian Journal of Occupational Therapy, 1998
ABSTRACT The aim of this study was to explore elderly people's positive experiences of be... more ABSTRACT The aim of this study was to explore elderly people's positive experiences of being occupied and spending time at community-based activity centers. Interviews were conducted with nine elderly persons who attended activity centers. The interviews were analyzed by the empirical, phenomenological, psychological method (EPP method). The constituents that describe the phenomenon of the experience of being occupied and spending time at a community-based activity center were: the center was a safe and familiar setting to attend on a regular basis; doing was absorbing and gave pleasure; it was a challenge to be able to accomplish something; and the activity center was a meeting-place where doing is shared with others. The study suggests that the activity center is experienced as a meeting-place where the social component and the engaging in an occupation are essential for the experience and contribute to the health and well-being of the individual.
Background: Person-centeredness has had substantial uptake in the academic literature on care of ... more Background: Person-centeredness has had substantial uptake in the academic literature on care of older people and people with dementia. However, challenges exist in interpreting and synthesizing the evidence on effects of providing person-centered care, as the person-centered components of some intervention studies are unclear -targeting very different and highly specific aspects of person-centeredness, as well as not providing empirical data to indicate the extent to which care practice was actually perceived to become more person-centered post-intervention.
Aging in place has for many years been a political goal in Sweden. This means that all older adul... more Aging in place has for many years been a political goal in Sweden. This means that all older adults should be supported to stay in their old home as long as they like. Internationally aging in place is what most older adults look forward to (Williams 2002; Tille 1999; Ivarsson 1996,). Also in Slovenia most older adults do live at home instead of institutions, nursing homes or hospitals (Lebar and Tomsic 2006). Community living older adults who experience limitations in their abilities to care for themselves are most at risk to not be able to age at home. Still, a majority of older adults want to remain in the home even if safety and independence are threatened as in the case of disability (Ivarsson 1996). There are a number of issues to solve; for example issues relating to accessibility in the physical environment and also to the need of new services and new products to support the older adult. Overall, the challenge for the welfare state is to enable housing and societal condition...
The name Tuning was chosen for the project to refl ect the idea that universities do not look for... more The name Tuning was chosen for the project to refl ect the idea that universities do not look for uniformity in their degree programmes or any sort of unifi ed, prescriptive or defi nitive European curricula but simply for points of reference, convergence and common understanding. The protection of the rich diversity of European education has been paramount in the Tuning Project from the very start and the project in no way seeks to restrict the independence of academic and subject specialists, or undermine local and national academic authority. The Tuning Project is supported by the European Commission through the Socrates and Tempus programmes (of the Directorate-General for Education and Culture) This publication refl ects the views of the authors only, and the European Commission cannot be held responsible for any use which may be made of the information contained therein.
Qualitative Research, 2021
This article brings methodological insight into in-situ drawings as representations of daily life... more This article brings methodological insight into in-situ drawings as representations of daily life with dementia. As part of ethnographic fieldwork in dementia care units in a nursing home, drawings were made on site by a researcher. We suggest that the ambiguity of in-situ drawings, and the ensuing possibilities to disambiguate them, is valuable. Inspired by Asdal and Moser’s (2012) concept of “contexting,” we experimented with arranging the drawings with fieldnotes, discussing them with staff members, as well as with configuring multiple drawings and fieldnotes in sequences. This led to reflexive engagements with the drawings, creating space for discussing concerns in research practices and care practices. Switching between different forms of contexting produced tensions, revealing that what was cared for through the practices of researchers, staff members, and residents, diverged. In this way, we argue that contexting in-situ drawings may intervene in ways of knowing, caring for, ...
Ageing and Society, 2020
This article was originally published without a statement regarding the financial support of the ... more This article was originally published without a statement regarding the financial support of the Kamprad Family Foundation. This has now been updated and this corrigendum published.
BMC Health Services Research, 2018
Background: Older persons with cognitive impairment (CI) risk social isolation. Strong evidence s... more Background: Older persons with cognitive impairment (CI) risk social isolation. Strong evidence shows that perceived loneliness, or inadequate social networks, triggers and increases health problems. How homecare systems address social participation remains unknown; anecdotal data suggests there are significant gaps. This study's objective was to identify and describe how the assessors of homecare needs document social participation among persons with CI and how their documentation corresponds with the services actually provided to meet social needs. The research questions were: How and what kinds of social participation needs are documented on need assessment forms? What types of homecare services (with a social focus) are documented and approved? How are specified needs in social participation profiles addressed by a homecare service? Methods: Descriptive data from need assessment forms and their attached care plans for all applicants aged 65+ were collected during a 2 month period from a large homecare agency serving a municipality in Sweden. Persons with documented CI (n = 43) in the group were identified. Qualitative data analysis was conducted to examine the research questions. Results: Social participation factors were not documented consistently. The relationship between recognition of limitations to social participation and approval of service eligibility was not consistent. Social participation was designated by references to social status, sometimes by social network size, and occasionally by limitations to social participation. The range of approved homecare services (with social focus) covered services such as day care center visits or companionship. Three profiles of social participation were identified: clients with, (a) no participation limitations; (b) potential limitations; and (c) marked limitations. Conclusion: Given the known health harms from social isolation and the high risk of isolation among older persons with CI, this novel study's documentation of inadequate and inconsistent information in homecare social need assessments and services is sobering. The findings suggest a pressing need for initiatives to formulate best practices and standards to ensure alignment of care service systems to the health needs of the growing group of aging individuals with CI.
BMJ Open, 2019
IntroductionOlder persons with functional limitations often need assistance from home care staff ... more IntroductionOlder persons with functional limitations often need assistance from home care staff to thrive and continue to live in their home environments. Reablement, a proactive, preventative approach administered by home care staff, stimulating active engagement of the older person, is often recommended. Even though reablement has a potential to become a new rehabilitation model and has been implemented in different countries in various degrees, there is a lack of knowledge regarding the process of establishing reablement, the theoretical underpinnings and the conditionality and outcomes in different contexts. This knowledge is needed before full-scale recommendations can be made for implementation in specific contexts.AimThis study protocol aims to present a feasibility study of the intervention, ASSIST 1.0, a theory-based reablement programme, which includes coaching of home care staff and digitally based smart products, in a Swedish context.Methods and analysisThis feasibility...
OTJR Occupation Participation Health
International Psychogeriatrics, 2014
ABSTRACTBackground:Systematic evaluations of knowledge translation interventions in nursing homes... more ABSTRACTBackground:Systematic evaluations of knowledge translation interventions in nursing homes to improve practice are scarce. There is also a lack of studies focusing on creating sustainable evidence-based practice in the setting of residential dementia care.Methods:The aim of this paper is to describe a model for implementing national evidence-based guidelines for care of persons with dementia in nursing homes. The secondary aim is to outline the nursing home staff experiences during the first year of the implementation process. The intervention had a participatory action research approach. This included educational activities such as: (i) thematic seminars introducing national guidelines for dementia care, (ii) regular unit-based seminars; and (iii) later dissemination of information in reflective seminars and several days of poster-exhibitions. Areas of practice development were selected on each of the 24 units, based on unit-specific needs, and a quality improvement strategy...
Scandinavian Journal of Occupational Therapy, 1997
Scandinavian Journal of Occupational Therapy, 2012
Objective: Development of research in occupational therapy requires a continuous critical discuss... more Objective: Development of research in occupational therapy requires a continuous critical discussion concerning methodological approaches. In this paper the authors wish to contribute to such a discussion by introducing the Formal Data-Structure Analysis approach (FDSA) as a method for understanding people's experiences. Methods and results: A review of selected publications from occupational therapy journals between 2003 and 2005 illustrated that qualitative articles within occupational therapy publications were mainly descriptive in nature. This finding raises questions about how to develop new knowledge that contributes to occupational therapy. Conclusions: In this paper the authors suggest that it is possible to apply the FDSA approach not only when describing and categorizing qualitative phenomena, but also when aiming to reach an in-depth understanding of issues related to human meaning-making; for example, how we understand engagement in occupations or living with a disability. Examples of the application of the FDSA approach are included and discussed.
Scandinavian Journal of Occupational Therapy, 1998
Scandinavian Journal of Occupational Therapy, 2000
Dementia is a neurological disease, causing behavioral and cognitive symptoms, that progressively... more Dementia is a neurological disease, causing behavioral and cognitive symptoms, that progressively impairs an individual's ability to engage in meaningful activities. Progressive deterioration associated with dementia impacts occupational performance and independence and quality of life. Sensory based interventions, such as drumming groups, have been hypothesized to be a non-pharmacological intervention for individuals with dementia. The purpose of this study was to analyze the effects of a sensory based intervention program, in this case participation in a drumming group, on functional engagement during self-feeding for individuals with dementia. Researchers gathered data over the course of two days using the Functional Behavior Profile, Self-Feeding Questionnaire, Visual Analog Scale, and the Agitated Behavior Scale as outcome measures. The first day was a baseline day, during which participants did not participate in the drumming group. Researchers completed observational questionnaires measuring the participant's agitation and mood prior to lunch, and during lunch. On the second day, the participants engaged in the drumming group. Agitation, mood, and function was observed before and after the drumming group, and during lunch. Mood was elevated and increased engagement was observed during the drumming group. The effect of the drumming group did not carry over into self-feeding. There was a 20-minute wait period in between the drumming group and lunch time, which may have affected the results. Recommendations for future research include the evaluation of arousal and engagement during the drumming group and its effect on occupational performance.
Scandinavian Journal of Occupational Therapy, 1995
... LENA BORELL, MARGARETA LILJA, SIV CARLSSON-ALM, KRISTINA TORNQUIST, and EVA STAHL ... that ex... more ... LENA BORELL, MARGARETA LILJA, SIV CARLSSON-ALM, KRISTINA TORNQUIST, and EVA STAHL ... that existed in the population, and (d) the dimensions of performance of the ADL, which it is important to assess in order to understand the elderly person's performance pro ...
Scandinavian Journal of Occupational Therapy, 1995
... To observe Ben and Axel performing daily living tasks might also have been helpful to this st... more ... To observe Ben and Axel performing daily living tasks might also have been helpful to this study. ... 3. Yerxa E. Research in occupational therapy. In Hopkins, H & Smith H. (Eds), Willar and Spackman's Ocuptional Therapy (7th ed.) Philadelphia: JB Lippincott 1988. ...
Scandinavian Journal of Occupational Therapy, 1995
ABSTRACT
Scandinavian Journal of Occupational Therapy, 2009
Home modifications are part of the occupational therapy interventions provided to persons with fu... more Home modifications are part of the occupational therapy interventions provided to persons with functional limitations in the home environment. Home modification services often involve many different actors, and persons experiencing a need for home modifications have to navigate through a network of service organizations and professional actors. The aim of this study was to explore and describe how older adults in one Swedish municipality tried to find their way and navigate through the service system in order to receive home modification services that could meet their experienced needs. A case study design was used, including four older adults with different experiences and expectations of home modification services. The relationship between the participants' expectations, experiences, and their ways to navigate through the service system was described through the metaphor of a ''geographical map''. Satisfaction with the service process was found when there was a match in understandings of responsibilities and eligibility between what could be read from the older persons' map and the professionals' perspective. The findings have implications for client-centred occupational therapy practice, indicating that this match can be achieved when professionals translate clients' experienced problems in everyday life into a terminology that fits into the service system.
Scandinavian Journal of Occupational Therapy, 2006
The aim of this paper is to advance our understanding of participation and its relation to occupa... more The aim of this paper is to advance our understanding of participation and its relation to occupation, by analysing the daily occupational experiences of six men and women living with chronic pain. Open-ended interviews are used in conjunction with a constant comparative method of analysis. The findings are thematically presented as: "taking initiative and making choices", doing something physical", "doing something social", and "doing something for others". Furthermore, a short vignette is presented in which the authors attempt to juxtapose theoretical constructs with individual experiences in order to illustrate another level of contextual richness of the data. Methodological implications are discussed in relation to the findings, analytic presentation, and previous research.
The Occupational Therapy Journal of Research, 1994
Scandinavian Journal of Occupational Therapy, 1998
ABSTRACT The aim of this study was to explore elderly people's positive experiences of be... more ABSTRACT The aim of this study was to explore elderly people's positive experiences of being occupied and spending time at community-based activity centers. Interviews were conducted with nine elderly persons who attended activity centers. The interviews were analyzed by the empirical, phenomenological, psychological method (EPP method). The constituents that describe the phenomenon of the experience of being occupied and spending time at a community-based activity center were: the center was a safe and familiar setting to attend on a regular basis; doing was absorbing and gave pleasure; it was a challenge to be able to accomplish something; and the activity center was a meeting-place where doing is shared with others. The study suggests that the activity center is experienced as a meeting-place where the social component and the engaging in an occupation are essential for the experience and contribute to the health and well-being of the individual.
Background: Person-centeredness has had substantial uptake in the academic literature on care of ... more Background: Person-centeredness has had substantial uptake in the academic literature on care of older people and people with dementia. However, challenges exist in interpreting and synthesizing the evidence on effects of providing person-centered care, as the person-centered components of some intervention studies are unclear -targeting very different and highly specific aspects of person-centeredness, as well as not providing empirical data to indicate the extent to which care practice was actually perceived to become more person-centered post-intervention.
Aging in place has for many years been a political goal in Sweden. This means that all older adul... more Aging in place has for many years been a political goal in Sweden. This means that all older adults should be supported to stay in their old home as long as they like. Internationally aging in place is what most older adults look forward to (Williams 2002; Tille 1999; Ivarsson 1996,). Also in Slovenia most older adults do live at home instead of institutions, nursing homes or hospitals (Lebar and Tomsic 2006). Community living older adults who experience limitations in their abilities to care for themselves are most at risk to not be able to age at home. Still, a majority of older adults want to remain in the home even if safety and independence are threatened as in the case of disability (Ivarsson 1996). There are a number of issues to solve; for example issues relating to accessibility in the physical environment and also to the need of new services and new products to support the older adult. Overall, the challenge for the welfare state is to enable housing and societal condition...
The name Tuning was chosen for the project to refl ect the idea that universities do not look for... more The name Tuning was chosen for the project to refl ect the idea that universities do not look for uniformity in their degree programmes or any sort of unifi ed, prescriptive or defi nitive European curricula but simply for points of reference, convergence and common understanding. The protection of the rich diversity of European education has been paramount in the Tuning Project from the very start and the project in no way seeks to restrict the independence of academic and subject specialists, or undermine local and national academic authority. The Tuning Project is supported by the European Commission through the Socrates and Tempus programmes (of the Directorate-General for Education and Culture) This publication refl ects the views of the authors only, and the European Commission cannot be held responsible for any use which may be made of the information contained therein.
Qualitative Research, 2021
This article brings methodological insight into in-situ drawings as representations of daily life... more This article brings methodological insight into in-situ drawings as representations of daily life with dementia. As part of ethnographic fieldwork in dementia care units in a nursing home, drawings were made on site by a researcher. We suggest that the ambiguity of in-situ drawings, and the ensuing possibilities to disambiguate them, is valuable. Inspired by Asdal and Moser’s (2012) concept of “contexting,” we experimented with arranging the drawings with fieldnotes, discussing them with staff members, as well as with configuring multiple drawings and fieldnotes in sequences. This led to reflexive engagements with the drawings, creating space for discussing concerns in research practices and care practices. Switching between different forms of contexting produced tensions, revealing that what was cared for through the practices of researchers, staff members, and residents, diverged. In this way, we argue that contexting in-situ drawings may intervene in ways of knowing, caring for, ...
Ageing and Society, 2020
This article was originally published without a statement regarding the financial support of the ... more This article was originally published without a statement regarding the financial support of the Kamprad Family Foundation. This has now been updated and this corrigendum published.
BMC Health Services Research, 2018
Background: Older persons with cognitive impairment (CI) risk social isolation. Strong evidence s... more Background: Older persons with cognitive impairment (CI) risk social isolation. Strong evidence shows that perceived loneliness, or inadequate social networks, triggers and increases health problems. How homecare systems address social participation remains unknown; anecdotal data suggests there are significant gaps. This study's objective was to identify and describe how the assessors of homecare needs document social participation among persons with CI and how their documentation corresponds with the services actually provided to meet social needs. The research questions were: How and what kinds of social participation needs are documented on need assessment forms? What types of homecare services (with a social focus) are documented and approved? How are specified needs in social participation profiles addressed by a homecare service? Methods: Descriptive data from need assessment forms and their attached care plans for all applicants aged 65+ were collected during a 2 month period from a large homecare agency serving a municipality in Sweden. Persons with documented CI (n = 43) in the group were identified. Qualitative data analysis was conducted to examine the research questions. Results: Social participation factors were not documented consistently. The relationship between recognition of limitations to social participation and approval of service eligibility was not consistent. Social participation was designated by references to social status, sometimes by social network size, and occasionally by limitations to social participation. The range of approved homecare services (with social focus) covered services such as day care center visits or companionship. Three profiles of social participation were identified: clients with, (a) no participation limitations; (b) potential limitations; and (c) marked limitations. Conclusion: Given the known health harms from social isolation and the high risk of isolation among older persons with CI, this novel study's documentation of inadequate and inconsistent information in homecare social need assessments and services is sobering. The findings suggest a pressing need for initiatives to formulate best practices and standards to ensure alignment of care service systems to the health needs of the growing group of aging individuals with CI.
BMJ Open, 2019
IntroductionOlder persons with functional limitations often need assistance from home care staff ... more IntroductionOlder persons with functional limitations often need assistance from home care staff to thrive and continue to live in their home environments. Reablement, a proactive, preventative approach administered by home care staff, stimulating active engagement of the older person, is often recommended. Even though reablement has a potential to become a new rehabilitation model and has been implemented in different countries in various degrees, there is a lack of knowledge regarding the process of establishing reablement, the theoretical underpinnings and the conditionality and outcomes in different contexts. This knowledge is needed before full-scale recommendations can be made for implementation in specific contexts.AimThis study protocol aims to present a feasibility study of the intervention, ASSIST 1.0, a theory-based reablement programme, which includes coaching of home care staff and digitally based smart products, in a Swedish context.Methods and analysisThis feasibility...
OTJR Occupation Participation Health
International Psychogeriatrics, 2014
ABSTRACTBackground:Systematic evaluations of knowledge translation interventions in nursing homes... more ABSTRACTBackground:Systematic evaluations of knowledge translation interventions in nursing homes to improve practice are scarce. There is also a lack of studies focusing on creating sustainable evidence-based practice in the setting of residential dementia care.Methods:The aim of this paper is to describe a model for implementing national evidence-based guidelines for care of persons with dementia in nursing homes. The secondary aim is to outline the nursing home staff experiences during the first year of the implementation process. The intervention had a participatory action research approach. This included educational activities such as: (i) thematic seminars introducing national guidelines for dementia care, (ii) regular unit-based seminars; and (iii) later dissemination of information in reflective seminars and several days of poster-exhibitions. Areas of practice development were selected on each of the 24 units, based on unit-specific needs, and a quality improvement strategy...
Scandinavian Journal of Occupational Therapy, 1997
Scandinavian Journal of Occupational Therapy, 2012
Objective: Development of research in occupational therapy requires a continuous critical discuss... more Objective: Development of research in occupational therapy requires a continuous critical discussion concerning methodological approaches. In this paper the authors wish to contribute to such a discussion by introducing the Formal Data-Structure Analysis approach (FDSA) as a method for understanding people's experiences. Methods and results: A review of selected publications from occupational therapy journals between 2003 and 2005 illustrated that qualitative articles within occupational therapy publications were mainly descriptive in nature. This finding raises questions about how to develop new knowledge that contributes to occupational therapy. Conclusions: In this paper the authors suggest that it is possible to apply the FDSA approach not only when describing and categorizing qualitative phenomena, but also when aiming to reach an in-depth understanding of issues related to human meaning-making; for example, how we understand engagement in occupations or living with a disability. Examples of the application of the FDSA approach are included and discussed.
Scandinavian Journal of Occupational Therapy, 1998
Scandinavian Journal of Occupational Therapy, 2000
Dementia is a neurological disease, causing behavioral and cognitive symptoms, that progressively... more Dementia is a neurological disease, causing behavioral and cognitive symptoms, that progressively impairs an individual's ability to engage in meaningful activities. Progressive deterioration associated with dementia impacts occupational performance and independence and quality of life. Sensory based interventions, such as drumming groups, have been hypothesized to be a non-pharmacological intervention for individuals with dementia. The purpose of this study was to analyze the effects of a sensory based intervention program, in this case participation in a drumming group, on functional engagement during self-feeding for individuals with dementia. Researchers gathered data over the course of two days using the Functional Behavior Profile, Self-Feeding Questionnaire, Visual Analog Scale, and the Agitated Behavior Scale as outcome measures. The first day was a baseline day, during which participants did not participate in the drumming group. Researchers completed observational questionnaires measuring the participant's agitation and mood prior to lunch, and during lunch. On the second day, the participants engaged in the drumming group. Agitation, mood, and function was observed before and after the drumming group, and during lunch. Mood was elevated and increased engagement was observed during the drumming group. The effect of the drumming group did not carry over into self-feeding. There was a 20-minute wait period in between the drumming group and lunch time, which may have affected the results. Recommendations for future research include the evaluation of arousal and engagement during the drumming group and its effect on occupational performance.
Scandinavian Journal of Occupational Therapy, 1995
... LENA BORELL, MARGARETA LILJA, SIV CARLSSON-ALM, KRISTINA TORNQUIST, and EVA STAHL ... that ex... more ... LENA BORELL, MARGARETA LILJA, SIV CARLSSON-ALM, KRISTINA TORNQUIST, and EVA STAHL ... that existed in the population, and (d) the dimensions of performance of the ADL, which it is important to assess in order to understand the elderly person's performance pro ...
Scandinavian Journal of Occupational Therapy, 1995
... To observe Ben and Axel performing daily living tasks might also have been helpful to this st... more ... To observe Ben and Axel performing daily living tasks might also have been helpful to this study. ... 3. Yerxa E. Research in occupational therapy. In Hopkins, H & Smith H. (Eds), Willar and Spackman's Ocuptional Therapy (7th ed.) Philadelphia: JB Lippincott 1988. ...
Scandinavian Journal of Occupational Therapy, 1995
ABSTRACT
Scandinavian Journal of Occupational Therapy, 2009
Home modifications are part of the occupational therapy interventions provided to persons with fu... more Home modifications are part of the occupational therapy interventions provided to persons with functional limitations in the home environment. Home modification services often involve many different actors, and persons experiencing a need for home modifications have to navigate through a network of service organizations and professional actors. The aim of this study was to explore and describe how older adults in one Swedish municipality tried to find their way and navigate through the service system in order to receive home modification services that could meet their experienced needs. A case study design was used, including four older adults with different experiences and expectations of home modification services. The relationship between the participants' expectations, experiences, and their ways to navigate through the service system was described through the metaphor of a ''geographical map''. Satisfaction with the service process was found when there was a match in understandings of responsibilities and eligibility between what could be read from the older persons' map and the professionals' perspective. The findings have implications for client-centred occupational therapy practice, indicating that this match can be achieved when professionals translate clients' experienced problems in everyday life into a terminology that fits into the service system.
Scandinavian Journal of Occupational Therapy, 2006
The aim of this paper is to advance our understanding of participation and its relation to occupa... more The aim of this paper is to advance our understanding of participation and its relation to occupation, by analysing the daily occupational experiences of six men and women living with chronic pain. Open-ended interviews are used in conjunction with a constant comparative method of analysis. The findings are thematically presented as: "taking initiative and making choices", doing something physical", "doing something social", and "doing something for others". Furthermore, a short vignette is presented in which the authors attempt to juxtapose theoretical constructs with individual experiences in order to illustrate another level of contextual richness of the data. Methodological implications are discussed in relation to the findings, analytic presentation, and previous research.