Ulrika Söderhamn

• Tomstad, Solveig Thorbjørnsen; Sundsli, Kari; Sævareid, Hans Inge & Söderhamn, Ulrika (2024). Social Contact and Belonging Among Older People Receiving Home Care Nursing. Journal of Multidisciplinary Healthcare. ISSN 1178-2390. 17, s. 1189–1198. doi: 10.2147/JMDH.S452081.
• Guo, Lina; Wei, Miao; Namassevayam, Genoosha; Söderhamn, Ulrika; Liu, Yanjin & Guo, Yuanli (2022). Factor analysis of the Chinese version of the Self-care Ability Scale for the Elderly: A multi-centre cross-cultural validation study. International Journal of Nursing Practice. ISSN 1322-7114. doi: 10.1111/ijn.13060. Vis sammendrag

  Aim:This study aimed to explore and confirm the factor structure and item distribu-tion of the Chinese version of Self-care Ability Scale for the Elderly among olderChinese people.Methods:A cluster random sampling method was used to collect 2856 older peoplefrom five different cities of China from July 2018 to July 2019. A questionnaire com-prised of socio-demographic information and the Chinese version of the Self-careAbility Scale for the Elderly was administered, and SPSS 21.0 and Mplus 7.4 wereused for analyses.Results:Participants were aged 60 to 92 years, with a mean age of 71.52 (SD=7.68)years. In the Exploratory Factor Analysis, the three-factor structure and item distribu-tion of the Chinese version of the Self-care Ability Scale for the Elderly were verifiedto be better than other options. The factor loadings varied from 0.428 to 0.800, andthe communality values ranged from 0.426 to 0.792. The modified model showed agood fit in the Confirmatory Factor Analysis.Conclusion:The Chinese version of the Self-care Ability Scale for the Elderly has aclear three-factor structure and a good item distribution. It serves as a convenientand accurate assessment tool to assess the self-care ability of older Chinese people.

• Haddeland, Kristine; Marthinsen, Gunhild Nordbø; Söderhamn, Ulrika; Flateland, Sylvi Monika & Moi, Ellen Benestad (2022). Experiences of using the ISBAR tool after an intervention: A focus group study among critical care nurses and anaesthesiologists. Intensive & Critical Care Nursing. ISSN 0964-3397. 70. doi: 10.1016/j.iccn.2021.103195. Fulltekst i vitenarkiv Vis sammendrag

  Objective The ISBAR tool is a structured approach to communication between healthcare professionals and refers to Identity, Situation, Background, Assessment, and Recommendation. The objective of this study was to explore how critical care nurses and anaesthesiologists experience using the ISBAR tool in clinical practice. Design Three focus groups were conducted with a total of three anaesthesiologists and 14 critical care nurses from two hospitals in Norway after they had attended an intervention. Setting The intervention consisted of two days at a university, with a four-month interval between, attending resource lectures and simulation exercises focusing on the ISBAR tool. The focus groups were audio-recorded, transcribed and analysed thematically to understand the participants' experiences. Findings Three major themes emerged from the data: (1) predictability and security, (2) usability and (3) recommendations for further use. A feeling of predictability and security was identified through increased awareness of communication and professional roles. Usability included identifying appropriate situations to use the ISBAR tool in clinical practice, the importance of tailoring the use to each situation and some physicians were not interested in using it. Finally, recommendations for further use of the ISBAR tool were identified. Conclusion The findings highlight the importance and need to improve the use of the ISBAR tool to increase patient safety. It is essential that healthcare professionals work together to ensure that everybody has the same situational awareness and that good clinical handover practices are developed and maintained.

• Nilsen, Elin Rogn; Hollister, Brooke Ann; Söderhamn, Ulrika & Dale, Bjørg (2021). What matters to older adults? Exploring person-centred care during and after transitions between hospital and home. Journal of Clinical Nursing (JCN). ISSN 0962-1067. doi: 10.1111/jocn.15914. Fulltekst i vitenarkiv
• Tomstad, Solveig Thorbjørnsen; Sundsli, Kari; Sævareid, Hans Inge & Söderhamn, Ulrika (2021). Loneliness Among Older Home-Dwelling Persons: A Challenge for Home Care Nurses. Journal of Multidisciplinary Healthcare. ISSN 1178-2390. 14, s. 435–445. doi: 10.2147/JMDH.S298548. Fulltekst i vitenarkiv
• Flateland, Sylvi Monika; Pryce-Miller, Maxine; Skisland, Anne Valen -Sendstad; Tønsberg, Anne K. Flaatten & Söderhamn, Ulrika (2019). Exploring the experiences of being an ethnic minority student within undergraduate nurse education: a qualitative study. BMC Nursing. ISSN 1472-6955. 18(1). doi: 10.1186/s12912-019-0389-0. Fulltekst i vitenarkiv
• Robstad, Anja Nastasja; Westergren, Thomas; Siebler, Frank; Söderhamn, Ulrika & Fegran, Liv (2019). Intensive care nurses' implicit and explicit attitudes and their behavioural intentions toward obese intensive care patients. Journal of Advanced Nursing. ISSN 0309-2402. 75(12), s. 3631–3642. doi: 10.1111/jan.14205.
• Nilsen, Elin Rogn; Söderhamn, Ulrika & Dale, Bjørg (2019). Facilitating holistic continuity of care for older patients: Home care nurses’ experiences using checklists. Journal of Clinical Nursing (JCN). ISSN 0962-1067. 28(19-20), s. 3478–3491. doi: 10.1111/jocn.14940.
• Barken, Tina Lien; Söderhamn, Ulrika & Thygesen, Elin (2019). A sense of belonging: A meta-ethnography of the experience of patients with chronic obstructive pulmonary disease receiving care through telemedicine. Journal of Advanced Nursing. ISSN 0309-2402. s. 1–12. doi: 10.1111/jan.14117. Vis sammendrag

  Abstract Aim To synthesize the qualitative research in the literature addressing how patients with chronic obstructive pulmonary disease experience care received by telemedicine. Design Meta‐ethnography. Data Sources Twelve studies, published from 2013 – 2018, were identified by a search of relevant systematic databases in June 2017, including updated searches performed in June 2018. Review Methods The studies were reviewed and critically appraised independently by three researchers. The review followed the seven steps of meta‐ethnography developed by Noblit and Hare, including a line‐of‐argument synthesis. Results The synthesis revealed three second‐order constructs: presence, transparency, and ambivalence. Using a line‐of‐argument synthesis, a model was developed that showed patients’ experience of a sense of belonging when receiving care by telemedicine. Conclusion This meta‐ethnography contributes to the existing and contradictory evidence base of telemedicine to chronic obstructive pulmonary disease patients. It addresses and adds renewed understanding of who would benefit from telemedicine and why, by illustrating the interrelationship between the conditions of telemedicine care, the severity of COPD, and the need for connectedness and emphasizes that the need to belong in telemedicine care increases with the progression of illness burden and severity. Impact The present study endorses the view that the patients with a severe illness burden are likely to benefit the most when receiving care by telemedicine. However, the benefits rely on the fact that the telemedicine interventions involve emotional, social, and clinical support, including regular contact with healthcare professionals, to meet the requirements to belong.

• Rohde, Gudrun E.; Söderhamn, Ulrika & Vistad, Ingvild (2019). Reflections on communication of disease prognosis and life expectancy by patients with colorectal cancer undergoing palliative care: a qualitative study. BMJ Open. ISSN 2044-6055. 9(3). doi: 10.1136/bmjopen-2018-023463. Fulltekst i vitenarkiv Vis sammendrag

  Objectives Patients with colorectal cancer undergoing palliative treatment receive extensive treatment-related information throughout their disease trajectory. We aimed to explore the experiences of patients with incurable colorectal cancer while in palliative care and their reflections on the information provided by physicians and nurses. Our main focus was the patients’ thoughts about how information about disease status and life expectancy was communicated, from the first time that they were informed about the incurable nature of their disease through to postsurgery palliative treatment. Settings Patients with colorectal cancer receiving palliative chemotherapy. Research design We used a qualitative approach, and the data were analysed by qualitative content analysis. Participants 20 patients (34–75 years of age) were included in the study; 12 received first-line chemotherapy and 8 received second-line chemotherapy. Eleven patients were treated by oncologists, and nine were treated by junior physicians. Results Data-driven empirical analysis identified three themes: (1) inadequate information during the initial phase of the disease trajectory; (2) hope and information further into the disease trajectory and (3) personal, professional and organisational factors that influenced information and communication throughout the disease trajectory. Conclusion The participants’ experience of being told for the first time that they had an incurable disease was perceived as inadequate, while postsurgery palliative chemotherapy, physicians and nurses offered hope. The participants preferred customised information about their treatment and likely future prospects and physicians and nurses who took a holistic and compassionate approach focusing on their lifeworld. To be a sensitive, holistic and compassionate physician or nurse requires knowledge and confidence. To achieve this requires training and guidance at universities and in hospitals.

• Moi, Ellen Benestad; Söderhamn, Ulrika; Marthinsen, Gunhild Nordbø & Flateland, Sylvi Monika (2019). Verktøyet ISBAR fører til bevisst og strukturert kommunikasjon for helsepersonell. Sykepleien Forskning. ISSN 1890-2936. 14((74699)(e-74699)). doi: 10.4220/Sykepleienf.2019.74699. Vis sammendrag

  Bakgrunn: ISBAR er en pasientsikker kommunikasjonsstruktur som bidrar til forenklet, effektiv, strukturert og forventet kommunikasjon mellom helsepersonell. Det finnes ingen forskning på masterstudenters erfaringer med å anvende ISBAR i Norge. Tidligere har det blitt etterlyst utdanningsstrategier som sikrer at studenter trener på pasientsikker kommunikasjon. Hensikt: Å belyse spesialstudenters erfaringer med å bruke ISBAR som kommunikasjonsstruktur i klinisk praksis i et masterprogram i spesialsykepleie. Metode: Studien har et kvalitativt beskrivende design med tre fokusgruppeintervjuer. Vi foretok en kvalitativ innholdsanalyse. Resultat: Studentenes kommunikasjon ble mer bevisst, strukturert, oversiktlig og forutsigbar. De formidlet objektive, tydelige og konkrete observasjoner og endringer i stedet for synsinger. Studentene kom oftere med egne løsningsforslag og avklarte medisinske forordninger. Å bruke ISBAR førte til at de følte seg tryggere på sin egen kommunikasjon og kompetanse, ble bedre på teamarbeid og opplevde større pasientsikkerhet. Studentene hadde imidlertid utfordringer med å bruke ISBAR fordi denne kommunikasjonsstrukturen ikke var implementert. Konklusjon: Å anvende ISBAR gir økt bevissthet om egen strukturerte kommunikasjon og kompetanse samt bedre evne til å få raskere oversikt over pasientsituasjoner. Funnene kan synliggjøre betydningen av systematisk opplæring og simulering med ISBARstrukturen for å øke pasientsikkerheten, både i utdanningen av spesialsykepleiere og i spesialisthelsetjenesten.

• Tabrizi, Jafar Sadegh; Behghadami, Mehrdad Amir; Saadati, Mohammad & Söderhamn, Ulrika (2018). Self-care ability of older people living in urban areas of Northwestern Iran. Iranian Journal of Public Health. ISSN 0304-4556. 47(12), s. 1899–1905.
• Sharifi, Farshad; Mirarefin, Mojde; Alizadeh-Khoei, Mahtab; Nazari, Neda; Najafi, Baharak & Fakhrzadeh, Hossien [Vis alle 10 forfattere av denne artikkelen] (2018). Psychometric properties of the Persian version of the nutritional form for the elderly (NUFFE) in nursing home residents . Medical Journal of The Islamic Republic of Iran. ISSN 1016-1430. 32. doi: 10.14196/mjiri.32.105. Vis sammendrag

  Background: The Nutritional Form for the Elderly (NUFFE) is a newly developed tool. This study aimed to carry out a psychometric evaluation of the Persian version of NUFFE (NUFFE-P) among nursing home residents. Methods: Nursing home participant’s aged ≥ 60 years (n=97) were enrolled. The inclusion criteria were residency for at least 6 months in the nursing home, and ability to communicate. Exclusion criteria included cognitive impairment, having depressed mood, severe hearing loss, problems in upper and lower extremities also, history of hospital admission during 6 months before enrollment. Anthropometric measures, laboratory tests, three-day food intake, NUFFE-P version, Mini Nutritional Assessment (MNA), Barthel Index (BI) and Geriatric Depression Scale (GDS-15) were assessed. The relationship between the NUFFE-P and MNA scores was considered as concurrent validity. Results: The Cronbach’s alpha coefficient of NUFFE-P tool was 0.76. The intraclass correlation coefficient for the total score between two raters obtained 0.98 (CI 0.97-0.99). The correlation coefficient between the NUFFE-P and the MNA scores was -0.75 (p<0.01). Four factors were extracted for the NUFFE-P in an exploratory factor analyses. Sensitivity 69.8% and 100% and specificity 75.7% and 85.6% were achieved to detect elderly at medium risk (cutoff=6), and at high risk of under nutrition (cutoff=11) respectively. Conclusion: The NUFFE-P has sufficient psychometric properties in nutritional status screening among the Iranian elderly nursing homes residents.

• Robstad, Anja Nastasja; Siebler, Frank; Söderhamn, Ulrika; Westergren, Thomas & Fegran, Liv (2018). Design and psychometric testing of instruments to measure qualified intensive care nurses' attitudes toward obese intensive care patients. Research in Nursing and Health. ISSN 0160-6891. s. 1–10. doi: 10.1002/nur.21914.
• Skisland, Anne Valen -Sendstad; Flateland, Sylvi Monika; Tønsberg, Anne K. Flaatten & Söderhamn, Ulrika (2018). Praksisveiledning av minoritetsspråklige sykepleierstudenter krever mer tid og tilrettelegging . Sykepleien Forskning. ISSN 1890-2936. 13(73021). doi: 10.4220/sykepleienf.2018.73021. Vis sammendrag

  SAMMENDRAG Bakgrunn: Forskning blant sykepleierstudenter viser at studenter med minoritetsspråklig bakgrunn har et stort behov for veiledning og oppfølging på grunn av manglende språkforståelse. Det tar tid å tilegne seg både lingvistisk og kommunikativ kompetanse, og det er viktig at studentene får et tilpasset opplegg for å gjennomføre utdanningen. Hensikt: Å belyse praksisveilederes erfaringer med å veilede minoritetsspråklige sykepleierstudenter i en sykehuskontekst. Metode: Studien har et kvalitativt design med individuelle intervjuer med ti praksisveiledere fra ulike avdelinger ved et sykehus i et regionalt helseforetak i Helse Sør-Øst. Vi analyserte dataene ved hjelp av manifest innholdsanalyse. Resultat: Praksisveilederne syntes det var utfordrende å veilede minoritetsspråklige studenter på grunn av studentenes språkforståelse. Det er behov for mer tid til veiledning og forbedret samarbeid mellom utdanningsinstitusjonen og praksisfeltet. Konklusjon: Denne studien viser at minoritetsspråklige sykepleierstudenter har språkutfordringer, og at det trengs mer tid til veiledning. Praksisfeltet på sykehus og utdanningsinstitusjoner må samarbeide for å skape en god læresituasjon for de minoritetsspråklige sykepleierstudentene. Det er derfor et stort behov for å legge til rette for individuell oppfølging av minoritetsspråklige studenter i bachelorutdanningen i sykepleie. Sykepleiere har et faglig, etisk og personlig ansvar for pasienter og pårøre

• Guo, Lina; Liu, Yan-Jin; McCallum, Jacqueline; Söderhamn, Ulrika; Ding, Xian-Fei & Yv, Su-Yuan [Vis alle 8 forfattere av denne artikkelen] (2018). Perceived stress and depression amongst older stroke patients: Sense of Coherence as a mediator? Archives of gerontology and geriatrics (Print). ISSN 0167-4943. 79, s. 164–170. doi: 10.1016/j.archger.2018.08.010. Vis sammendrag

  Objective This study aimed to explore the relationship between perceived stress, sense of coherence, and depression among older stroke patients. Methods A demographic questionnaire, the Perceived Stress Scale (PSS), the Sense of Coherence Scale (SOC) and the Center for Epidemiologic Studies Depression Scale (CES-D) were distributed to 3000 older stroke patients from Neurology wards in six large general hospitals, and 2907 individuals completed the survey. Data analysis consisted of correlation, multiple linear regression, and structural equation modeling. Results The total score of the SOC and perceived stress showed a negative correlation (r = −0.80, P ＜ 0.01), the total SOC of coherence and depression also resulted in a negative correlation (r = -0.77, P ＜ 0.01), and the total score of the perceived stress and depression resulted in a positive correlation (r = 0.82, P ＜ 0.01). The results of multiple regression analyses indicated that SOC mediated the association between perceived stress and depression, and the influence of perceived stress on depression was decreased by 16.0%with in the sense of being out of control dimension and was decreased by 12.3% within the feeling of tension dimension when sense of coherence was added to the model. The structural equation model confirmed that the sense of coherence had a partial mediation effect between perceived stress and depression. Conclusion SOC is the mediating variable between perceived stress and depression, and can reduce the influence of perceived stress on depression.

• Barken, Tina Lien; Thygesen, Elin & Söderhamn, Ulrika (2017). Advancing beyond the system: telemedicine nurses’ clinical reasoning using a computerised decision support system for patients with COPD – an ethnographic study. BMC Medical Informatics and Decision Making. ISSN 1472-6947. 17(1). doi: 10.1186/s12911-017-0573-7. Fulltekst i vitenarkiv Vis sammendrag

  Background: Telemedicine is changing traditional nursing care, and entails nurses performing advanced and complex care within a new clinical environment, and monitoring patients at a distance. Telemedicine practice requires complex disease management, advocating that the nurses’ reasoning and decision-making processes are supported. Computerised decision support systems are being used increasingly to assist reasoning and decision-making in different situations. However, little research has focused on the clinical reasoning of nurses using a computerised decision support system in a telemedicine setting. Therefore, the objective of the study is to explore the process of telemedicine nurses’ clinical reasoning when using a computerised decision support system for the management of patients with chronic obstructive pulmonary disease. The factors influencing the reasoning and decision-making processes were investigated. Methods: In this ethnographic study, a combination of data collection methods, including participatory observations, the think-aloud technique, and a focus group interview was employed. Collected data were analysed using qualitative content analysis. Results: When telemedicine nurses used a computerised decision support system for the management of patients with complex, unstable chronic obstructive pulmonary disease, two categories emerged: “the process of telemedicine nurses’ reasoning to assess health change” and “the influence of the telemedicine setting on nurses’ reasoning and decision-making processes”. An overall theme, termed “advancing beyond the system”, represented the connection between the reasoning processes and the telemedicine work and setting, where being familiar with the patient functioned as a foundation for the nurses’ clinical reasoning process.Conclusion: In the telemedicine setting, when supported by a computerised decision support system, nurses’ reasoning was enabled by the continuous flow of digital clinical data, regular video-mediated contact and shared decision-making with the patient. These factors fostered an in-depth knowledge of the patients and acted as a foundation for the nurses’ reasoning process. Nurses’ reasoning frequently advanced beyond the computerised decision support system recommendations. Future studies are warranted to develop more accurate algorithms, increase system maturity, and improve the integration of the digital clinical information with clinical experiences, to support telemedicine nurses’ reasoning process.

• Fensli, Marthe M. Fosse; Söderhamn, Ulrika; Flateland, Sylvi Monika & Skaar, Ragnhild (2017). Alvorlig sykes erfaringer med å delta i støttegruppe ledet av frivillige. Tidsskrift for omsorgsforskning. ISSN 2387-5976. 3(3), s. 186–193. doi: 10.18261/ISSN.2387-5984-2017-03-04. Vis sammendrag

  Bakgrunn og hensikt: Å leve med en uhelbredelig alvorlig sykdom vil medføre komplekse fysiske og psykiske utfordringer som fører til et krevende sykdomsforløp. Hensikten med denne studien var å belyse alvorlig syke personers erfaringer med å delta i støttegruppe ledet av frivillige. Metode: Studien har en kvalitativ tilnærming. Individuelle intervju ble gjennomført med hjemmeboende alvorlig syke personer. Funn: Å være alvorlig syk og delta i støttegruppe ledet av frivillige var en positiv opplevelse for informantene. De frivillige ble opplevd som trygge, tillitsfulle og egnete personer. Det var viktig med gjensidig fortrolighet. Å dele egne og andres erfaringer ga en følelse av fellesskap som bidro til at det ble lettere å mestre problemer og utfordringer som sykdommen medførte. Konklusjon: En støttegruppe ledet av frivillige kan gi viktig støtte til personer med alvorlig sykdom. Etablering av et fortrolig fellesskap hvor medlemmene føler trygghet ved utlevering av personlige forhold og problemstillinger, og den forståelse og empatien som kan oppleves av likemenn i støttegruppen og frivillige, kan bidra til egenmestring av sykdommen. Nøkkelord Erfaringsutveksling, Kvalitativ metode, Palliativ omsorg, Samtalepartner, Taushetsavtale

• Guo, Lina; Söderhamn, Ulrika; McCallum, Jacqueline; Ding, Xianfei; Gao, Han & Guo, Qiyun [Vis alle 8 forfattere av denne artikkelen] (2017). Testing and comparing two self-care-related instruments among older Chinese adults. PLOS ONE. ISSN 1932-6203. 12(8). doi: 10.1371/journal.pone.0182792. Fulltekst i vitenarkiv Vis sammendrag

  Objectives The study aimed to test and compare the reliability and validity, including sensitivity and specificity of the two self-care-related instruments, the Self-care Ability Scale for the Elderly (SASE), and the Appraisal of Self-care Agency Scale-Revised (ASAS-R), among older adults in the Chinese context. Methods A cross-sectional design was used to conduct this study. The sample consisted of 1152 older adults. Data were collected by a questionnaire including the Chinese version of SASE (SASE-CHI), the Chinese version of ASAS-R (ASAS-R-CHI) and the Exercise of Self-Care Agency scale (ESCA). Homogeneity and stability, content, construct and concurrent validity, and sensitivity and specificity were assessed. Results The Cronbach's alpha (α) of SASE-CHI was 0.89, the item-to-total correlations ranged from r = 0.15 to r = 0.81, and the test-retest correlation coefficient (intra-class correlation coefficient, ICC) was 0.99 (95% CI, 0.99±1.00; P<0.001). The Cronbach's α of ASAS-R-CHI was 0.78, the item-to-total correlations ranged from r = 0.20 to r = 0.65, and the test-retest ICC was 0.95 (95% CI, 0.92±0.96; P<0.001). The content validity index (CVI) of SASE-CHI and ASAS-R-CHI was 0.96 and 0.97, respectively. The findings of exploratory and confirmatory factor analyses (EFA and CFA) confirmed a good construct validity of SASE-CHI and ASAS-R-CHI. The Pearson's rank correlation coefficients, as a measure of concurrent validity, between total score of SASE-CHI and ESCA and ASAS-R-CHI and ESCA were assessed to 0.65 (P<0.001) and 0.62 (P<0.001), respectively. Regarding ESCA as the criterion, the area under the receiver operator characteristic (ROC) curve for the cut-point of SASE-CHI and ASAS-R-CHI were 0.93 (95% CI, 0.91±0.94) and 0.83 (95% CI, 0.80±0.86), respectively. Conclusion There is no significant difference between the two instruments. Each has its own characteristics, but SASE-CHI is more suitable for older adults. The key point is that the users can choose the most appropriate scale according to the specific situation.

• Tomstad, Solveig Thorbjørnsen; Dale, Bjørg; Sundsli, Kari; Sævareid, Hans Inge & Söderhamn, Ulrika (2017). Who often feels lonely? A cross-sectional study about loneliness and its related factors among older home-dwelling people. International Journal of Older People Nursing. ISSN 1748-3735. 12(4). doi: 10.1111/opn.12162. Vis sammendrag

  Aim and objectives: To investigate the prevalence of individuals who often feel lonely among a sample of Norwegian older home-dwelling people aged ≥65 years old, as well as to identify any possible factors explaining their loneliness. Background: Loneliness is known to be common among older people. To identify those older adults who are lonely, and to acquire knowledge about the complexity of their loneliness, is important to provide them with adequate help and support. Design: This study employed a cross-sectional design. Method: A questionnaire was mailed to a randomised sample of 6,033 older home-dwelling persons aged ≥65 years. A total of 2,052 persons returned the questionnaire and were included in the study. The questionnaire consisted of questions asking whether the subjects often felt lonely or not, as well as health-related and background questions and instruments to measure the participants’ sense of coherence, mental problems, nutritional screening and self-care ability. The data were analysed using univariate and multivariate statistical methods. Results: A total of 11.6% of the participants reported often feeling lonely. Six factors emerged to be independently associated with often feeling lonely among the respondents: Living alone, not being satisfied with life, having mental problems, a weak sense of coherence, not having contact with neighbours and being at risk for undernutrition. Conclusions: The study shows that often feeling lonely among older home-dwelling persons is a health-related problem that includes social, psychological and physical aspects. Moreover, these persons have limited resources to overcome feelings of loneliness. Implications for practice: Lasting loneliness among older home-dwelling persons requires an overall, person-centred and time-consuming approach by nurses. Nurses with advanced knowledge on geriatric nursing may be required to offer appropriate care and support. Healthcare leaders and politicians should offer possibilities for adequate assessment, support and help.

• Robstad, Anja Nastasja; Söderhamn, Ulrika & Fegran, Liv (2017). Intensive care nurses’ experiences of caring for obese intensive care patients: a hermeneutic study. Journal of Clinical Nursing (JCN). ISSN 0962-1067. 27(1-2), s. 386–395. doi: 10.1111/jocn.13937. Vis sammendrag

  Aim and objectives: To obtain a deeper understanding of qualified intensive care nurses’ experiences of caring for obese patients in intensive care. Background: Admission of obese patients with complex health care needs to intensive care units is increasing. Caring for obese critically ill patients can be challenging and demanding for the intensive care nurse because of the patients’ weight, critical situation, and physical challenges. There is a gap in knowledge at present about qualified intensive care nurses’ experiences of caring for obese patients in intensive care units. Design: A qualitative hermeneutic approach. Accepted Article This article is protected by copyright. All rights reserved. Method: The study took place in 2016 at intensive care units of two different hospitals. Semi-structured individual interviews were conducted with 13 qualified intensive care nurses. The interviews were analysed according to a Gadamerian-inspired research method. Results: Intensive care nurses perceived caring for obese intensive care patients as emotionally demanding owing to these patients’ vulnerability, dissimilarity and physical challenges compared to normal weight patients. They experienced ambivalent feelings caring for these patients: while they endeavoured to provide good and equal care to all patients, they simultaneously held negative beliefs and attitudes towards obese patients. Furthermore, frustration arose among the intensive care nurses relating to the physically demanding care situations and an unwillingness to care for such patients among some colleagues. Conclusion: The qualified intensive care nurses’ experiences of caring for obese patients revealed ambivalent feelings, attitudes, and beliefs towards these patients, which must be considered in intensive care unit practice as well as in the education of these nurses. Relevance to clinical practice: The results have implications for clinical practice with respect to increasing intensive care nurses’ awareness of their attitudes and beliefs towards obese intensive care patients and to improve the education of these nurses.

• Moe, Karen; Skisland, Anne Valen -Sendstad & Söderhamn, Ulrika (2017). Encountering parents of a sick newborn child. When nurses encounter parents with a sick newborn child, it is vital that they see them as individuals and establish a relationship based on empathy. Sykepleien Forskning. ISSN 1890-2936. 12. doi: 10.4220/Sykepleienf.2017.62155. Vis sammendrag

  Bakgrunn: For mange foreldre er det stressende å oppleve at det nyfødte barnet deres innlegges på neonatalavdeling. Sykepleiere som møter foreldrene, trenger kunnskap om kommunikasjon og relasjonskompetanse for å gi støtte i henhold til foreldrenes erfaringer og behov. Hensikt: Å beskrive sykepleieres erfaringer med hva som er viktig i møtet og samtalen med foreldre til et nyfødt, sykt barn.  Metode: Studien har en kvalitativ design med fenomenologisk tilnærming, som innebærer en nøyaktig beskrivelse av informantenes opplevelse av et fenomen. Vi gjennomførte individuelle intervjuer med fem sykepleiere fra en neonatalavdeling. Intervjuene ble analysert ved hjelp av en deskriptiv fenomenologisk forskningsmetode. Resultat: I møtet med foreldrene beskrev informantene det som avgjørende å etablere en relasjon basert på empati, der den enkelte forelderen ble sett, der det ble gitt rom for gjensidig informasjonsutveksling, og der foreldrenes opplevelse av mestring ble fremmet. Når disse aspektene var til stede, opplevde informantene at det ble et godt møte og en god samtale. Uten disse aspektene ble møtene og samtalene beskrevet som mindre vellykkete. Konklusjon: Resultatene understreker at sykepleiere har ansvar for å etablere en empatisk relasjon og møte hver enkelt forelder der de er i prosessen for å hjelpe dem å mestre den sårbare livssituasjonen de befinner seg i.

• Barken, Tina Lien; Thygesen, Elin & Söderhamn, Ulrika (2017). Unlocking the limitations: living with chronic obstructive pulmonary disease and receiving care through telemedicine – a phenomenological study. Journal of Clinical Nursing (JCN). ISSN 0962-1067. 27(1-2), s. 132–142. doi: 10.1111/jocn.1385. Vis sammendrag

  Aims and objectives: The aim of this study was to describe the lived experiences of quality of life among a group of patients living with chronic obstructive pulmonary disease (COPD) who were included in a telemedical intervention after hospitalization for disease exacerbation. Background: Patients with COPD have high symptom burden, poor control of symptoms, and a need for greater requirements in care. Telemedicine (TM) can provide benefits for patients with COPD by improving self-management. Design: Descriptive phenomenological approach. Methods: Ten in-depth interviews were conducted with COPD patients participating in a telemedical intervention. The collected data were analysed using a descriptive phenomenological research method. Results: Living with COPD was experienced as creating physical and mental limitations of the diseased body and an increasing identity as a patient, which led to impaired quality of life. Being included in the TM intervention increased accessibility to health care services and support from TM nurses. Self-measurement of health data increased participants’ clinical insight and created a mutual clinical language in dialog with TM nurses, which led to increased quality of life. However, receiving care through TM was also experienced as a dual chore. Accepted Article This article is protected by copyright. All rights reserved. Conclusions: TM can reduce the perceived limitations imposed by COPD through four key elements: 1) improving accessibility to health care services, 2) increasing support from health professionals, 3) strengthening clinical insight, and 4) developing a mutual clinical language; thus, increasing quality of life. The transparency facilitated through TM in this health care context encourages open decision-making, where the participants can increase their knowledge and improve acknowledgement of and collaboration with TM nurses. Relevance to clinical practice: TM can be beneficial when rethinking care for COPD by providing knowledge on how living with COPD can affect the experience of receiving care through TM and further determine for whom TM is useful. Keywords: chronic obstructive pulmonary disease, nursing, patient experience, phenomenology, quality of life, self-management, telemedicine

• Gao, Han; Söderhamn, Ulrika; Cliffordson, Christina; Guo, Lina; Guo, Qiyun & Liu, Kun (2017). Reliability and validity of the Chinese version of the Self-care Ability Scale for the Elderly. Journal of Clinical Nursing (JCN). ISSN 0962-1067. 26(23-24), s. 4489–4497. doi: 10.1111/jocn.13779. Vis sammendrag

  Aims and objectives: To translate the Self-care Ability Scale for the Elderly into Simplified Chinese and to test the Chinese version of the scale regarding its reliability and validity among older people. Background: Self-care is an important topic in nursing. When assessing older people’s self-care ability, it is essential that a reliable and valid instrument is used. Design: This study employed a cross-sectional design. Methods: We translated the English version of the Self-care Ability Scale for the Elderly into Simplified Chinese according to Brislin’s translation guidelines and carried out a questionnaire survey among 610 older people, including both communitydwelling people and hospital patients, in Jinzhou City, People’s Republic of China. Eighty participants completed the instrument twice for test–retest reliability. Data analyses were performed using SPSS 17.0 and Mplus, version 5, to assess reliability and validity. Results: A Cronbach’s alpha coefficient of .89 and statistically significant item-tototal correlations showed evidence of homogeneity. An intraclass correlation coefficient of .99 for the test–retest between total scores and intraclass correlation coefficients between .87–.99 for the test–retest scores of each item explained the almost perfect test–retest reliability noted in this study. Content validity was found to be good, and a three-factor model was obtained in an exploratory factor analysis (explaining a variance of 57%) and modified in a confirmatory factor analysis (v2 = 261.559, df = 98, root mean square error of approximation = 0.074; standardised root mean square residual = 0.059), which reflected an acceptable construct validity. Conclusions: This study shows that the Chinese version of the Self-care Ability Scale for the Elderly has sufficient psychometric properties for assessing self-care ability among older people in China. Relevance to clinical practice: A reliable and valid instrument is available to assess the self-care ability of older Chinese people. KEYWORDS instrument testing, older people, self-car

• Flateland, Sylvi Monika; Skaar, Ragnhild; Fensli, Marthe M. Fosse & Söderhamn, Ulrika (2017). Pårørendes erfaringer med bruk av frivillige ved alvorlig sykdom i hjemmet. Nordisk tidsskrift for helseforskning. ISSN 1504-3614. 13(1), s. 1–13. doi: 10.7557/14.4106. Fulltekst i vitenarkiv Vis sammendrag

  The aim of this study was to illuminate next-of-kins’ experiences when using volunteers supplementing community health care services for palliative patients living at home. The study has a qualitative approach. Nine individual interviews were conducted with next of kin from a municipality in Southern Norway. Use of volunteers for palliative care in the home was a relief for next-of-kin, especially prominent for families who had limited social network. Planned volunteering resulted in the best results. Use of volunteer was also found helpful for families as they were given a "breathing space" and a certain normalization of everyday life. The volunteers followed up activities related to the patient that the next-ofkin to a limited extent managed to attend. This affected the next-of-kin’s conscience in a positive way. The next-of-kin experienced the volunteers to be empathetic, they could inspire confidence and showed good characteristics to assist ill people and their next-of-kin. The next-of-kin needed regular relief from volunteers as a supplement to the community health care services. The volunteers were well suited to meet people, who were in a difficult situation, and with their approach they had strong confidence in the next-of-kin and gave them relief in a challenging environment. The coordinator for palliative care was a key person in relation to the link between families, patients in palliative care and the volunteers.

• Söderhamn, Ulrika; Flateland, Sylvi Monika; Fensli, Marthe M. Fosse & Skaar, Ragnhild (2017). To be a trained and supported volunteer in palliative care – a phenomenological study. BMC Palliative Care. ISSN 1472-684X. 16(1). doi: 10.1186/s12904-017-0193-0. Fulltekst i vitenarkiv Vis sammendrag

  Background: It has been found that including volunteers in palliative care is a positive contribution to seriously ill patients. It is, however, recommended that the volunteers are trained and supported. The aim of this study was to describe a group of trained and supported volunteers’ lived experiences as volunteers in palliative care within the community health care services. Methods: This study adopted a descriptive phenomenological approach featuring individual interviews with nine volunteers. The interviews were analysed using the descriptive phenomenological research method according to Giorgi. Results: Being a volunteer in palliative care was both a positive and meaningful experience. It was a privilege being able to help those in need, which yielded positive returns. As a volunteer, it was important to be present for the ill persons and to follow them in their various physical and psychical states, which also implied that the volunteer had to face and deal with challenging situations. However, volunteers stated it was crucial to possess knowledge and life experience, as well as a clarified role, and they stressed the importance of being followed up by a mentor. Conclusions: The findings showed that trained and supported volunteers among seriously ill or dying people within the realm of community health care services play an independent and important role in the palliative care team. A coordinator in palliative care is especially suitable for training and supporting the volunteers. Keywords: Benefits, Challenges, Clarified role, Community health care services, Followed-up, Meaningful experience, Phenomenology, Presence in volunteering, Qualitative research, Seriously ill

• Skaar, Ragnhild; Fensli, Marthe M. Fosse; Flateland, Sylvi Monika & Söderhamn, Ulrika (2017). Helsepersonells erfaringer og tanker om bruk av frivillige i palliativ omsorg. Nordisk tidsskrift for helseforskning. ISSN 1504-3614. 13(1), s. 1–17. doi: 10.7557/14.4075. Fulltekst i vitenarkiv Vis sammendrag

  The government of Norway is planning for the municipalities’ health care resources, including volunteering. The purpose of this study was to shed light on the experiences and thoughts of a group of health care personnel on the use of volunteers in palliative care in the community health care services, and to discuss the findings in a social perspective. Individual interviews were conducted with seven nurses and three nursing assistants. Using a qualitative content analysis three categories emerged: "The importance of organization, clarification and responsibility," "Qualifications" and "Different types of tasks," with the overarching theme: “Close monitoring and good clarification of roles can contribute to suitable volunteers functioning as an appropriate supplement for patients in palliative care in the community health care services”. The informants stated that trained health care personnel must perform the nursing tasks in palliative care while volunteers can be a positive supplement for the patient.

• Barken, Tina Lien; Thygesen, Elin & Söderhamn, Ulrika (2016). Living with chronic obstructive pulmonary disease and being followed up through telemedicine-A phenomenological approach. Studies in Health Technology and Informatics. ISSN 0926-9630. 225, s. 926–927. doi: 10.3233/978-1-61499-658-3-926. Vis sammendrag

  Abstract. Chronic obstructive pulmonary disease (COPD) provides substantially reduced health related quality of life (HQoL). Telemonitoring on COPD patients appears to have a positive effect on improving HQoL. This study has a phenomenological approach, and ten informants, who were followed-up between 1 and 3 months in their own homes through telemonitoring of COPD symptoms, narrated their lived experiences of HQoL. The results show that the informants experienced safety and increased knowledge through the digital dialog (telemedicine) with expertise nurses, which indirectly improved their HQoL, and in term lead to increased mastery and control in managing their disease. Several studies show an increased HQoL, but the benefits are still limited and there is a need for further research.

• Lyngroth, Anne Liv; Hernes, Susanne M S; Madsen, Bengt-Ove; Söderhamn, Ulrika & Grov, Ellen Karine (2016). Nutritional screening of patients at a memory clinic - association between patients' and their relatives' self-reports. Journal of Clinical Nursing (JCN). ISSN 0962-1067. 25(5-6), s. 760–768. doi: 10.1111/jocn.13093.
• Flateland, Sylvi Monika; Nesheim, Trine Marie; Riiser, Anne-Brit & Söderhamn, Ulrika (2015). Sykepleiestudenters erfaringer knyttet til overføring av pasient fra spesialist- til kommunehelsetjeneste. Tidsskrift for omsorgsforskning. ISSN 2387-5976. 1(2), s. 145–153. Vis sammendrag

  SAMMENDRAG Bakgrunn: Forskning som fokuserer på overflytting av pasient fra spesialist- til kommunehelsetjenesten er viktig for den videre sykepleieoppfølgingen i kommunen. Hensikt: Å belyse sykepleiestudenters erfaringer med hvordan sykepleiere praktiserer informasjonsutveksling mellom spesialist- og kommunehelsetjeneste ved overflytting av pasienter, og hvordan utskrevne sykehuspasienter blir tatt imot og fulgt opp av sykepleier i kommunehelsetjenesten de første dagene etter ankomst. Metode: Studien har et kvalitativt design, med individuelle intervju med ti studenter fra en bachelorutdanning i sykepleie i Sør-Norge. Datamaterialet ble analysert ved hjelp av manifest og latent innholdsanalyse. Funn: Den skriftligesykepleiesammenfatningen fra sykehuset kunne være mangelfull. Tidspunktet for pasientens ankomst til kommunen var uforutsigbart, både for pasient og for sykepleier i kommune. Mottak og oppfølging av pasienten i kommune kunne være preget av sykepleiere som signaliserte tidspress, men også av sykepleiere som tok seg god tid. Konklusjon: Koordinering mellom spesialist- og kommunehelsetjeneste trenger større fokus. De to ulike kontekstene må få større forståelse for hverandres organisatoriske betingelser, og det må utarbeides retningslinjer for å sikre gode pasientforløp.

• Wergeland, Jon Normann; Selbæk, Geir; Bergh, Sverre; Söderhamn, Ulrika & Kirkevold, Øyvind (2015). Predictors for Nursing Home Admission and Death among Community-Dwelling People 70 Years and Older Who Receive Domiciliary Care. Dementia and Geriatric Cognitive Disorders Extra. ISSN 1664-5464. 5(3), s. 320–329. doi: 10.1159/000437382. Fulltekst i vitenarkiv Vis sammendrag

  Aim: The aim of this study was to analyze which variables predicted nursing home admission (NHA) and death. Methods: 1,001 recipients of domiciliary care were assessed three times in a 3-year period. Through bivariate and multivariate Cox proportional hazards regression models, associations between a covariate and the outcomes were analyzed. Results: Participants with dementia had a higher risk of NHA (odds ratio 3.88, 95% confidence interval 2.92-5.16) compared to participants without dementia. The Neuropsychiatric Inventory sub-syndrome psychosis, poorer functional impairment and age were associated with NHA. Female sex, age, worse medical health and functional impairment were associated with death. Conclusion: Support to the caregiver and education on how to meet and cope with behavioral disturbance, depressive mood and sub-syndrome psychosis will probably enable the family to better adapt to late life changes.

• Söderhamn, Ulrika; Sundsli, Kari; Cliffordson, Christina & Dale, Bjørg (2015). Psychometric properties of Antonovsky’s 29-item Sense of Coherence scale in research on older home-dwelling Norwegians. Scandinavian Journal of Public Health. ISSN 1403-4948. 43(8), s. 867–874. doi: 10.1177/1403494815598863. Vis sammendrag

  Aim: The aim of this study was to test the homogeneity and construct validity of the Sense of Coherence 29-item scale (SOC-29) among older home-dwelling Norwegians. Methods: A postal questionnaire, consisting of background variables, five health-related questions, the SOC-29, and three other instruments measuring mental health, self-care ability, and risk for undernutrition, was sent to 6033 home-dwelling older people (65+ years) in southern Norway. A total of 2069 participants were included. Homogeneity was assessed with Cronbach’s alpha coefficient and item-to-total correlations. The construct validity was assessed with “the known-groups technique,” a linear stepwise regression analysis with SOC score serving as the dependent variable and with confirmatory factor analysis. Results: With a Cronbach’s alpha coefficient of 0.91 and statistically significant item-to-total correlations, the SOC-29 was found to be homogeneous. Construct validity was supported because the SOC-29 could separate known groups with expected high and low scores. The factors that could predict SOC were mental health, self-care ability, feeling lonely, being active, and chronic disease or handicap. Evidence of construct validity was displayed in a confirmatory factor analysis that confirmed SOC-29 as one theoretical construct with the three dimensions, comprehensibility, manageability, and meaningfulness. Conclusions: The Norwegian version of the SOC-29 is a reliable and valid instrument for use in research among older people. The results confirm that SOC has a particularly strong relationship with mental health and self-care ability.

• Ilje Tveit, Gry Nina & Söderhamn, Ulrika (2015). Hva gjør førstegangsmødre for å mestre barnestellet i tidlig barseltid? Nordisk sygeplejeforskning. ISSN 1892-2678. 5(2), s. 151–164. Vis sammendrag

  Innledning: Umiddelbart etter fødsel må førstegangsmødre tilegne seg nye ferdigheter om barnestell på kort tid. Det er et gap mellom utskrivelse fra barselavdelingen og helsestasjonens mulighet til å gi tilpasset oppfølging av mor og barn. Hensikten med studien var å undersøke hva førstegangsmødre gjør for å mestre barnestellet de første to ukene etter fødsel. Metode: Et kvalitativt design med hermeneutisk tilnærming ble valgt. Syv førstegangsmødre ble intervjuet individuelt. Intervjuene ble analysert etter en Gadamer-basert hermeneutisk metode. Resultat: Analysen viste at det var tre måter å mestre barnestellet: «å være forberedt», «å søke hjelp og støtte» og «å bli kjent med barnet». Nærhet til barnet var viktig for å få kontroll. Å mestre ammingen hadde størst betydning for mestringsfølelsen. Konklusjon: Førstgangsmødre bør få hensiktsmessig hjelp og støtte til å mestre barnestellet fra jordmor respektive helsesøster. Denne innsatsen bør starte før barnet blir født, blant annet ved å tilrettelegge for å knytte relasjoner mellom førstegangsmødre og flergangsmødre i nærmiljøet og mellom fastlege/jordmor og helsesøster. Barselomsorgen må organiseres med tidlig kontakt med jordmor eller helsesøster etter utskrivelse fra barselavdelingen.

• Dale, Bjørg & Söderhamn, Ulrika (2015). Nutritional self-care among a group of older home-living people in rural Southern Norway. Journal of Multidisciplinary Healthcare. ISSN 1178-2390. 8, s. 67–74. doi: 10.2147/JMDH.S75521. Fulltekst i vitenarkiv Vis sammendrag

  Background: Older home-living people are an at-risk group for undernutrition, particularly those who are living alone. Lack of knowledge about healthy dietary habits, altered taste sensation, and declined health status are shown to be some of the factors related to undernutrition. The aims of this study were to explore how a small group of older people in Southern Norway perceived their nutritional self-care. Methods: An exploratory qualitative approach, combined with a simple self-report questionnaire, was used. Five persons living in rural areas in Southern Norway, who in a former study were screened and found to be at risk for undernutrition, participated. Qualitative data assessed by means of individual self-care talks in the persons’ own homes were analyzed using directed content analysis. A simple self-report questionnaire containing demographic variables, two health-related questions, and the Nutritional Form For the Elderly (NUFFE-NO) instrument was filled out at baseline and 6 months after the self-care talks. Results: The qualitative data showed that the participants had adequate knowledge about healthy and nutritious diets. They were aware of and motivated to adapt their diet to their current state of health and to perform the necessary actions to maintain an optimal nutritional status and nutritional self-care. Conclusion: Older people living at home are a diverse group. However, this study showed that they may have sufficient knowledge, willingness, and ability to perform nutritional self-care, even if they live alone and have several chronic illnesses and impaired health. Keywords: adapting, decision-making, knowledge, self-care talks

• Gao, Han; Söderhamn, Ulrika; Zhang, Lin; Cui, Hui-Xia & Liu, Kun (2015). Reliability and validity of the Chinese version of the Nutritional Form For the Elderly. Public Health Nutrition (PHN). ISSN 1368-9800. 18(14), s. 2559–2564. doi: 10.1017/S1368980014003267. Vis sammendrag

  Objective: The present study aimed to translate the English version of the Nutritional Form For the Elderly into Simplified Chinese, as well as to test the reliability (homogeneity and stability) and validity (content and construct validity) of the Chinese version of the Nutritional Form For the Elderly (NUFFE-CHI). Design: The study adopted a cross-sectional design. The English version of the NUFFE was translated into Simplified Chinese and a questionnaire survey was conducted. The data were analysed with statistical methods to estimate the homogeneity, stability, content and construct validity. Setting: Jinzhou City, China. Subjects: A total number of 701 community-dwelling older adults answered the questionnaire, including background variables and the NUFFE-CHI. A small group of the participants (n 50) completed the NUFFE-CHI twice for test–retest reliability. Results: Cronbach’s α was 0·65 and the split-half reliability was 0·67. Item-to-total correlation analyses showed that the scale has sufficient internal consistency. The test–retest reliability regarding the total scores of NUFFE-CHI was reflected in an intra-class correlation coefficient of 0·88. The intra-class correlation coefficients between the test and retest of the NUFFE-CHI items varied between 0·43 and 0·98. A content validity index of 0·83 explained good content validity. Construct validity was demonstrated in an exploratory factor analysis with a six-factor solution, explaining 57·65 % of the variance. Conclusions: This first testing of the NUFFE-CHI indicates sufficient evidence for reliability, content and construct validity. Further testing studies regarding homogeneity, concurrent validity, sensitivity and specificity are required before the NUFFE-CHI can be used as a screening instrument in clinical settings and in research. Keywords: Instrument testing, Nutrition, Older people, Screening instrument

• Söderhamn, Ulrika; Aasgaard, Live & Landmark , Bjørg Thomassen (2014). Attending an activity center: positive experiences of a group of home-dwelling persons with early-stage dementia. Clinical Interventions in Aging. ISSN 1176-9092. 9, s. 1923–1931. doi: 10.2147/CIA.S73615. Vis sammendrag

  Background: In Norway, there is a focus on home-dwelling people with dementia receiving the opportunity to participate in organized meaningful activities. The aim of this study was to elucidate the experiences of home-dwelling persons with early-stage dementia who attend an activity center and participate in adapted physical and social activities delivered by nurses and volunteers. Methods: The study adopted a qualitative approach, with individual interviews conducted among eight people diagnosed with early-stage dementia. The interview texts were analyzed using manifest and latent content analysis. Results: Four categories, ie, “appreciated activities”, “praised nurses and volunteers”, “being more active”, and “being included in a fellowship”, as well as the overall theme “participation in appreciated activities and a sense of feeling included in a fellowship may have a positive influence on health and well-being” emerged in the analysis. The informants appreciated the adapted physical and social activities and expressed their enjoyment and gratitude. They found the physical activities useful, and they felt themselves to be included in a fellowship through cheerful nurses and volunteers. The nurses were able to create a good atmosphere and spread joy in the center together with the volunteers. The informants felt themselves valued as the persons they were. These findings indicated that such activities may have had a positive influence on the informants’ health and well-being. Conclusion: In order to succeed with this kind of activity center, it is decisive that the nurses are able to tailor meaningful activities and create an environment where the persons with dementia can feel that they are respected and valued. The municipality health care service should implement such activity centers with specialist nurses in dementia care together with volunteers. Keywords: activity center, content analysis, experiences, physical and social activities, qualitative research

• Söderhamn, Ulrika; Kjøstvedt, Helga Tofte & Slettebø, Åshild (2014). Evaluation of ethical reflections in community healthcare: A mixed-methods study. Nursing Ethics. ISSN 0969-7330. doi: 10.1177/0969733014524762. Vis sammendrag

  Background: Ethical reflections over care practices are important. In order to be able to perform such reflections, health care professionals must learn to think critically about their care practice. Aim: The aim of this study was to evaluate whether an introduction to and practice in ethical reflections in community health care have consequences for the health care personnel’s practice. Research design: A mixed methods design was adopted with five focus group interviews and an electronic questionnaire based on results from the interviews. Participants and research context: Twenty nine community health care personnel with experience in ethical reflections participated in the interviews. The electronic questionnaire was sent via e-mail to 2,382 employees in community health care services in 13 municipalities in southern part of Norway. Ethical considerations: The study was guided by the intentions of the Declaration of Helsinki and ethical standard principles and approved by the Norwegian Social Science Data Services. Results: An introduction to and practice in performing ethical reflections brought about an ethical awareness with understanding and respect for both colleagues and patients. The leader had a key role. Lack of time was a hindrance for ethical reflections. Three factors could predict meaningful ethical reflections: higher age of personnel, higher percentage of employment and longer experience with ethical reflections. Discussion: According to other studies, ethical reflections may enhance moral development of colleagues and their actions as advocates for the patients. A deepened ethical awareness, professional competency and sufficient time resources will guarantee proper caregiving. Conclusion: A supportive environment that prioritizes participation in reflection meetings is decisive. To practice ethical reflections will provide better care for patients. A challenge for the community health care system is to offer adequate positions that provide the personnel an opportunity to be involved as caregivers and to participate in ethical reflections.

• Sundsli, Kari; Söderhamn, Ulrika; Espnes, Geir Arild & Söderhamn, Olle (2014). Self-care telephone talks as a health-promotion intervention in urban home-living persons 75+ years of age: a randomized controlled study. Clinical Interventions in Aging. ISSN 1176-9092. 9, s. 95–103. doi: 10.2147/CIA.S55925. Fulltekst i vitenarkiv Vis sammendrag

  Aim: The aim of this study was to evaluate the effects of a telephone-based self-care intervention among urban living individuals 75+ years of age by comparing self-reported perceived health, mental health, sense of coherence, self-care ability, and self-care agency before and after the intervention. Materials and methods: In a randomized controlled study, 15 persons answered a questionnaire about perceived health, mental health, sense of coherence, self-care ability, and self-care agency. In a sex- and age-matched control group (n=15), the same questions were answered. Data were collected before and after intervention. An open-ended question about experiences of the intervention was included in the last questionnaire. The intervention consisted of a first meeting with health professionals and additional five self-care telephone calls. The control group did not receive any intervention or attention except for the questionnaires. Descriptive statistics were used to describe the study group. To compare the intervention group and control group on nominal and ordinal levels, the McNemar test and the Wilcoxon signed-rank test, respectively, were chosen. Results: Thirty individuals (14 females and 16 males) participated in the study, ranging in age between 75 and 93 years. A significant difference was obtained in the intervention group regarding mental health. Mental health improved significantly in the intervention group (P=0.037). In the control group, mental health, sense of coherence, self-care ability, and self-care agency showed worse outcome results after the intervention (19 weeks). Conclusion: Self-care telephone talks improved mental health significantly in our sample, and mental health focus could be understood as a possible condition for health promotion to take place. Structured self-care telephone talks have proved to be successful and a relevant method to use in practice. Keywords: case-control study, changes, mental health, older people

• Wergeland, Jon Normann; Selbæk, Geir; Høgset, Lisbeth Dyrendal; Söderhamn, Ulrika & Kirkevold, Øyvind (2013). Dementia, neuropsychiatric symptoms and the use of psychotropic drugs among older people who receive domiciliary care: a cross-sectional study. International Psychogeriatrics. ISSN 1041-6102. 26(03), s. 383–391. doi: 10.1017/S1041610213002032. Vis sammendrag

  The objective of this study was to a) determine the prevalence of cognitive impairment, dementia and neuropsychiatric symptoms (NPSs) among home-dwelling people, 70 years and older (70+ years), who receive domiciliary care and b) describe their use of psychotropic drugs. Few studies have investigated dementia among people receiving in-home care. Methods A sample (N=1000) representative of people aged 70+ years receiving domiciliary care was randomly recruited for participation. A standardized interview with the participants and their next of kin were performed using well established assessment scales. Two clinical experts independently diagnosed dementia according to ICD-10 criteria. Results Of the 415 participants (41.5%) with dementia according to ICD-10 criteria, 19.5% had a dementia diagnosis known to the patient themselves, their caregiver or health workers in the domiciliary care service. In the previous month, 72.1% exhibited NPSs (21.1% rated as clinically significant), with depression (47.5%), apathy (33.7%), anxiety (33.0%) and irritability (31.1%) being the most common. Psychotropic drugs were regularly used by 40.1% of the sample. Antidepressants (p=0.001) and cognitive enhancers (p<0.001) were more often given to people with dementia than to those without dementia. Conclusions Dementia and NPSs are highly prevalent among people who receive domiciliary care and diagnostic disclosure is low. People with dementia constitute a distinct group with respect to NPSs and psychotropic drug use. Early detection and correct diagnosis might increase the understanding of their everyday challenges and enable families to alleviate consequences of dementia and NPSs.

• Söderhamn, Ulrika; Landmark , Bjørg ; Eriksen, Sissel & Söderhamn, Olle (2013). Participation in physical and social activities among home-dwelling persons with dementia - experiences of next of kin. Psychology Research and Behavior Management. ISSN 1179-1578. 6, s. 29–36. doi: 10.2147/PRBM.S46334. Fulltekst i vitenarkiv Vis sammendrag

  Introduction: To be next of kin to a home-dwelling person with dementia is known to be a heavy burden, especially early in the process. Studies have revealed a need for information and support during the disease process. Likewise, there is support for the positive impacts of physical and social activities for wellbeing in home-dwelling people with dementia. It is important to obtain experiences from next of kin whose spouses or parents participate in such physical and social activities. Aim: The aim of this study was to elucidate experiences of next of kin to home-dwelling persons in an early stage of dementia who had an opportunity to participate in organized physical and social activities. Method: The study has a qualitative design. Focus group interviews were conducted with ten next of kin to home-dwelling dementia sufferers, who participated in physical and social activities in an activity center. The interview texts were analyzed using qualitative content analysis. Findings: In the analysis, two categories emerged: “a break in the everyday” and “being attended and cared about.” Two sub-categories identified in each of the two main categories were: “need of relief” and “meaningful activities;” and “being confirmed” and “sharing experiences and getting advice and help,” respectively. These categories were interpreted in an overall theme: “contentment with adapted activities and group meetings provided with a person-centered approach.” Conclusion: Adapted physical and social activities led by highly qualified personnel can provide a needed relief and support to the next of kin and meaningful activities to the dementia sufferers. However, it is crucial that the personnel provide person-centered care and are able to meet the needs of the dementia sufferers and their next of kin, to help to give them a new everyday life. Key words: activity center, content analysis, parent, qualitative design, spouse

• Tomstad, Solveig Thorbjørnsen; Söderhamn, Ulrika; Espnes, Geir Arild & Söderhamn, Olle (2013). Nutritional self-care in two older Norwegian males - A case study. Clinical Interventions in Aging. ISSN 1176-9092. 8, s. 609–620. doi: 10.2147/CIA.S45458. Fulltekst i vitenarkiv Vis sammendrag

  Introduction: How to support nutritional self-care among older vulnerable individuals living in their own homes can be considered important knowledge for health care professionals. Aim: The aim of this case study was to evaluate the effects of a nutritional intervention by comparing self-reported perceived health, sense of coherence, self-care ability and nutritional risk in two older home-dwelling individuals before, during and after the intervention and also to describe experiences of nutritional self-care before and after the intervention. Methods: A study circle was established to support nutritional self-care in two older home-dwelling individuals (65+ years of age), who participated in three gatherings, arranged by health professionals, during a period of six months. The effects were evaluated with the instruments the Nutritional Form For the Elderly (NUFFE), the Self-care Ability Scale for the Elderly (SASE), the Appraisal of Self-care Agency (ASA) scale and the Sense of Coherence (SOC) scale and responses on a number of health related questions. Qualitative interviews were performed before and after the intervention to interpret changes that occurred during the intervention. Results: Reduced risk of undernutrition was obtained for both participants. Higher total score on SASE was obtained for one of the participants, and a slightly stronger preference to use the potential for self-care to maintain sufficient food intake and meals appeared. For the other participant, total score on SASE decreased, but SOC was stronger after the intervention. Decreased mobility was experienced, but did not influence the food intake. The study circle was an opportunity to bring in personal views and opinions about food intake and meals. Conclusion: An organized meeting place between older home-dwelling individuals and health care professionals, based upon dialogues, can stimulate the older person’s engagement, consciousness and learning about nutritional self-care, and be of importance to reduce risk of undernutrition. Key words: health, health promotion, intervention, study circle

• Söderhamn, Ulrika; Dale, Bjørg & Söderhamn, Olle (2013). The meaning of actualization of self-care resources among a group of older home-dwelling people - A hermeneutic study. International Journal of Qualitative Studies on Health and Well-being. ISSN 1748-2623. 8. doi: 10.3402/qhw.v8i0.20592. Vis sammendrag

  Self-care is an activity of mature persons who have developed their abilities to take care of themselves. Individuals can choose to actualise their self-care abilities into self-care activities to maintain, restore or improve health and well-being. It is of importance to understand the meaning of the actualisation of self-care resources among older people. The aim of this study was to investigate the meaning of the actualisation of self-care resources, i.e. actions taken to improve, maintain or restore health and well-being, among a group of older home-dwelling individuals with a high sense of coherence. The design of this study was to reanalyse narratives revealing self-care activities from 11 (five females and six males) Norwegian older home-dwelling people (65 years or older) identified as having a high sense of coherence. In order to reveal the meaning and get an understanding of why these self-care resources were realised or actualised, a Gadamerian-based research method was chosen. The analysis revealed four themes that showed the meaning of actualisation of self-care resources in the study group: “Desire to carry on”, “Be of use to others”, “Self-realisation” and “Confidence to manage in the future”. The findings showed what older people found meaningful to strive for and this information can be used as a guide for health professionals when supporting older people in their self-care. Older people with self-care resources can also be an important resource for others in need of social contact and practical help. These resources have to be asked for in voluntary work among older people in need of help and, thereby, can be a valuable supplement to the community health care system.

• Haddeland, Kristine & Söderhamn, Ulrika (2013). Sykepleierstudenters opplevelse av veiledningssituasjoner med sykepleiere i sykehuspraksis - En fenomenologisk studie. Nordisk sygeplejeforskning. ISSN 1892-2678. 3(1), s. 18–32. Vis sammendrag

  Tilnærmet halve bachelorstudiet i sykepleie i Norge foregår i klinisk praksis under veiledning av sykepleiere. Sykepleierstudenter opplever at sykepleiere ikke er oppmerksomme nok på betydningen av deres veilederrolle, og det reduserer sykepleierstudenters læringsmuligheter i klinisk praksis. Hensikten med studien var å belyse en gruppe sykepleierstudenters opplevelse av veiledning i sykehuspraksis. Et kvalitativt design med gjennomførelse av individuelle intervju ble valgt. Utvalget bestod av åtte tredjeårssykepleierstudenter i alderen 21–48 år, som hadde hatt praksis på totalt 10 ulike sykehusavdelinger på to sykehus i Norge. Intervjuene ble analysert ifølge Giorgis fenomenologiske forskningsmetode. Informantene beskrev veiledningen som positiv for egen læring når de følte seg sett og hørt, og opplevde forutsigbarhet og mestring. Samtidig opplevde de veiledningen positiv når de fikk lov til å være til stede i og reflektere rundt reelle læresituasjoner, for å kunne opparbeide seg kompetanse. Når disse aspektene ved veiledningen ikke var til stede, beskrev informantene veiledningen som negativ for egen læring. Det er ønskelig at studien kan føre til økt bevissthet, refleksjon og verdsetting av sykepleieres rolle og funksjon som praksisveiledere. Nøkkelord: Giorgis fenomenologi, klinisk praksis, læringserfaringer, student-veileder forhold, sykepleierutdanning

• Tomstad, Solveig Thorbjørnsen; Söderhamn, Ulrika; Espnes, Geir Arild & Söderhamn, Olle (2012). Lived experiences of self-care among older, home-dwelling individulas identified to be at risk of undernutrition. Journal of Multidisciplinary Healthcare. ISSN 1178-2390. 5, s. 319–327. doi: 10.2147/JMDH.S38474. Fulltekst i vitenarkiv Vis sammendrag

  Introduction: In a society where most older people live in their own homes, it may be expected of older individuals to exercise their potential to take care of themselves in daily life. Nutrition is a central aspect of self-care, and groups of older home-dwelling people are at risk of undernutrition. Aim: The aim of this study was to describe the lived experiences of self-care and features that influence health and self-care among older home-dwelling individuals identified to be at risk of undernutrition. Methods: Qualitative interviews were performed in eleven home-dwelling individuals who had been identified as being at risk of undernutrition. The interviews were recorded, transcribed verbatim and analyzed with a descriptive phenomenological method. Findings: Self-care as lived experience among older home-dwelling individuals at risk of undernutrition is to be aware of food choices, and make decisions about making healthy steps or not. When having health problems, the appetite often decreases. Being able to take care of oneself in daily life is important as well as receiving help when needing it. To work at being physically and socially active and engaged may stimulate the appetite. Having company at meals is important and missed when living alone. To be present and taking each day by day, as well as considering oneself in the light of past time and previous experiences and looking ahead, is central, even though having fears for the future and the end of life. Conclusion: Healthcare professionals should be aware of these findings in order to support self-care in older people, and they should pay attention to the social aspects at meals. Keywords: aged, health promotion, phenomenology, qualitative interviews

• Dale, Bjørg; Söderhamn, Ulrika & Söderhamn, Olle (2012). Psychometric properties of the Norwegian version of the General Health Questionnaire (GHQ-30) among older people living at home. Psychology Research and Behavior Management. ISSN 1179-1578. 5, s. 151–157. doi: 10.2147/PRBM.S37502. Vis sammendrag

  Introduction: The incidence and prevalence of mental problems among older people are difficult to map because the causes are often complex and the symptoms manifest in a range of ways. Therefore, there is a need for robust and useful instruments for screening mental problems in this group. One instrument used in Norway and around the world is the 30-item version of the General Health Questionnaire (GHQ-30). Nevertheless, studies testing reliability and validity of the Norwegian version are scarce. Aim: The aim of this study was to test the psychometric properties, by means of reliability and construct validity, of the Norwegian version of the GHQ-30 in a sample of older people living at home. Methods: A cross-sectional design was used. A postal questionnaire including background variables and a range of health related questions, including the GHQ-30, was mailed to 6033 older people (age 65 years or more) who lived in their own homes in southern Norway. A final sample of 2106 persons (34.9%) responded to and returned the questionnaire. Data were analyzed statistically regarding reliability and construct validity of the GHQ-30. Results: The reliability of the instrument, reflecting its homogeneity, was shown in a Cronbach’s alpha coefficient of 0.93 and in significant item-to-total correlations. Construct validity was supported as the GHQ-30 demonstrated robustness in separating groups with known mental problems. Construct validity was also demonstrated in a logical four factor solution, which accounted for 50.0% of the variance in the study group. The factor structure supported previous testing studies of the instrument. Conclusion: The GHQ-30 showed satisfactory psychometric properties regarding reliability and construct validity in this study group, which may indicate that the instrument is suitable for use in screening mental problems in older people living at home. Keywords: factor analysis, mental problems, psychological screening, reliability, validity

• Fossum, Mariann; Söderhamn, Olle; Cliffordson, Christina & Söderhamn, Ulrika (2012). Translation and testing of the Risk Assessment Pressure Ulcer Sore scale used among residents in Norwegian nursing homes. BMJ Open. ISSN 2044-6055. 2(5). doi: 10.1136/bmjopen-2012-001575. Vis sammendrag

  Objective. The purpose of this study was to translate and test the psychometric properties of the Norwegian-language version of the Risk Assessment Pressure Sore scale. Background. Risk assessment scales for pressure ulcer prevention have become an aspect of quality improvement in healthcare, but their effectiveness depends on the reliability and validity of the scale. Methods. A convenience sample of 481 residents in 15 nursing homes in rural Norway was included between January and June 2007. The English-language version of the Risk Assessment Pressure Sore scale was translated into Norwegian, and this scale was used to collect the data, including a skin examination. The number of pressure ulcers and grades were documented. Reliability was assessed in a small group of 26 residents and construct validity in the total study group. Results. Equivalence between two assessments regarding total scores of the Risk Assessment Pressure Sore scale was reflected in an intraclass correlation coefficient of 0.95. Construct validity was supported, and the Risk Assessment Pressure Sore scale could define groups with expected low and high scores. Further evidence of construct validity was shown in a confirmatory factor analysis. Conclusion. The Norwegian version of the Risk Assessment Pressure Sore scale has shown sufficient psychometric properties to be considered a reliable and valid scale for identifying risk of pressure ulcers among nursing home residents. However, further testing is needed.

• Söderhamn, Ulrika; Dale, Bjørg; Sundsli, Kari & Söderhamn, Olle (2012). Nutritional screening of older home-dwelling Norwegians: a comparison between two instruments. Clinical Interventions in Aging. ISSN 1176-9092. 7, s. 383–391. doi: 10.2147/CIA.S35986. Vis sammendrag

  Background: It is important to obtain knowledge about the prevalence of nutritional risk and associated factors among older home-dwelling people in order to be able to meet nutritional challenges in this group in the future and to plan appropriate interventions. The aim of this survey was to investigate the prevalence of home-dwelling older people at nutritional risk and to identify associated factors using two different nutritional screening instruments as self-report instruments. Methods: This study had a cross-sectional design. A postal questionnaire, including the Norwegian versions of the Nutritional Form for the Elderly (NUFFE-NO) and Mini Nutritional Assessment – Short Form (MNA-SF), background variables, and health-related questions was sent to a randomized sample of 6033 home-dwelling older people in southern Norway. A total of 2106 (34.9%) subjects were included in the study. Data were analyzed using descriptive statistics and logistic regression analyses. Results: When using the NUFFE-NO and MNA-SF, 426 (22.3%) and 258 (13.5%) older persons, respectively, were identified to be at nutritional risk. The risk of undernutrition increased with age. Several predictors for being at risk of undernutrition, including chronic disease/handicap and receiving family help, as well as protective factors, including sufficient food intake and having social contacts, were identified. Conclusion: Health professionals must be aware of older people’s vulnerability to risk of undernutrition, perform screening, and have a plan for preventing undernutrition. For that purpose, MNA-SF and NUFFE-NO can be suggested for screening older people living at home. Keywords: aged, risk factors, undernutrition, screening

• Dale, Bjørg; Söderhamn, Ulrika & Söderhamn, Olle (2012). Life situation and identity among single older home-living people: A phenomenological-hermeneutic study. International Journal of Qualitative Studies on Health and Well-being. ISSN 1748-2623. 7. doi: 10.3402/qhw.v7i0.18456. Vis sammendrag

  Being able to continue living in their own home as long as possible is the general preference for many older people, and this is also in line with the public policy in the Nordic countries. The aim of this study was to elucidate the meaning of self-care and health for perception of life situation and identity among single-living older individuals in rural areas in southern Norway. Eleven older persons with a mean age of 78 years were interviewed and encouraged to narrate their self-care and health experiences. The interviews were audio taped, transcribed verbatim and analysed using a phenomenological hermeneutic method inspired by the philosophy of Ricoeur. The findings are presented as a na ̈ıve reading, an in- ductive structural analysis characterized by two main themes; i.e., ‘‘being able to do’’ and ‘‘being able to be’’, and a comprehensive interpretation. The life situation of the interviewed single-living older individuals in rural areas in southern Norway was interpreted as inevitable, appropriate and meaningful. Their identity was constituted by their freedom and self-chosen actions in their personal contexts. The overall impression was that independence and the ability to control and govern their own life in accordance with needs and preferences were ultimate goals for the study participants. Key words: Activity, adaptedness, freedom, health, independence, self-care actions

• Söderhamn, Ulrika; Dale, Bjørg; Sundsli, Kari; Tomstad, Solveig Thorbjørnsen & Söderhamn, Olle (2012). Psychometric testing of the Norwegian version of the Nutritional Form For the Elderly among older home-dwelling people. Journal of Multidisciplinary Healthcare. ISSN 1178-2390. 5, s. 121–128. doi: 10.2147/JMDH.S32502. Vis sammendrag

  Background: Nutritional screening instruments need to be evaluated in terms of reliability and validity and being able to demonstrate sensitivity and specificity for use in clinical practice and research. The aims of this study were to test the reliability and validity of the Norwegian version of the Nutritional Form For the Elderly (NUFFE-NO) in a sample of older home-dwelling people, and to use the short form of the Mini Nutritional Assessment (MNA-SF) as a standard. Methods: A postal questionnaire, including the two instruments, background variables, and health-related questions, was sent to 6033 home-dwelling older people (65+ years) in southern Norway. In total, 2106 persons responded and were included. Data were analyzed statistically regarding homogeneity, concurrent and construct validity, sensitivity, and specificity of NUFFE-NO. Results: A Cronbach’s alpha coefficient of 0.71 and significant item-to-total correlations were obtained as measures of homogeneity. Concurrent validity was assessed by a correlation coefficient of –0.37 (P , 0.001) between NUFFE-NO and MNA-SF. NUFFE-NO could separate known nutritional at-risk groups as a measure of construct validity. A cut-off point of ≥4 for identification of older people at nutritional risk was found for NUFFE-NO with MNA-SF as a standard. Conclusion: NUFFE-NO shows adequate psychometric properties regarding homogeneity and construct validity. MNA-SF was not found to be the most suitable standard to use, because a low correlation coefficient was obtained as a measure of concurrent validity and a lower cut-off point was found compared with another study using the Mini Nutritional Assessment (MNA®) as a standard for NUFFE-NO. The obtained cut-off point of ≥4 is not recommended for use in practice or research, because many false positive nutritional at-risk persons would then be identified. Further studies with suitable design have to be performed among older home-dwelling people using the MNA as a standard. Keywords: nutritional screening instrument, reliability, sensitivity, specificity, validity

• Skaar, Ragnhild & Söderhamn, Ulrika (2012). Feriereise kan ha positiv innvirkning på pasienter med demenslidelse. Vård i Norden. ISSN 0107-4083. 32(1 = 103), s. 22–26. Vis sammendrag

  Aim. To gain knowledge about how a holiday trip to Spain with adapted cultural activities may affect a group of patients with dementia disorder. Background. With the increasing number of people suffering from dementia, it will be important to focus on activities that may affect well-beeing in this group. Method. A focus group interview was conducted with six healthcare workers, who participated in a trip to Spain together with six patients suffering from dementia. A qualitative content analysis was used. Findings. The findings were interpreted in one main theme: Close follow-up in unfamiliar environment and participation in adapted cultural activities may contribute to that a holiday will be a positive experience. The theme was based on three categories: Increased social competence, Increased stamina and coping ability and Good balance between activity and rest. The patients got improved language, ADL-functions and were calmer during the holyday trip. Conclusion. The study showed that patients who suffer from dementia have hidden resources that can be made visible through close monitoring by healthcare workers with good knowledge of people with a dementia disorder. A holiday trip can be considered as a positive experience for the target group. KEYWORDS: Dementia care, focus group interview, nursing home, qualitative content analysis, qualitative design.

• Sundsli, Kari; Söderhamn, Ulrika; Espnes, Geir Arild & Söderhamn, Olle (2012). Ability for self-care in urban living older people in southern Norway. Journal of Multidisciplinary Healthcare. ISSN 1178-2390. 5, s. 85–95. doi: 10.2147/JMDH.S29388. Fulltekst i vitenarkiv Vis sammendrag

  Background: The number of older people living in urban environments throughout the world will increase in the coming years. There is a trend in most European countries towards improved health among older people, and increased life expectancy for both women and men. Norway has experienced less increase in life expectancy than some other European countries, and it is therefore important to investigate older urban Norwegian people’s health and ways of living in a self-care environment, with special regard to health promotion. Aim: The aim of this study was to describe self-care ability among home-dwelling older (65+ years) individuals living in urban areas in southern Norway in relation to general living conditions, sense of coherence (SOC), screened nutritional state, physical activity, perceived self-reported health, mental health, and perceived life situation. Methods: In 2010, a randomized sample of 1044 men and women aged 65+ years who were living in urban areas in southern Norway answered a postal questionnaire consisting of five instruments, some background variables, and 17 health-related questions. Univariate and multivariate statistical methods were used in the analyses of the data. Results: The mean age of the participants was 74.8 years (SD = 7.1). Eighty-three percent of the participants had higher abilities to care for themselves. Self-care agency, perceived good health,being active, being frequently active, good mental health, not being at risk of undernutrition, and satisfaction with life were all positively related to self-care ability. Negative factors were perceived helplessness, receiving home nursing, being anxious, and being at a more advanced age. People aged 85+ years had worse mental health, were less physically active, and more at risk of undernutrition. Conclusion: Health professionals should focus on the health-promoting factors that reinforce older people’s ability to care for themselves, and be aware of important symptoms and signs associated with a reduction in a person’s self-care ability. Politicians should assume responsibility for health care with a special regard to senior citizens. Keywords: activity, aged, health promotion, mental health, perceived health, undernutrition

• Tomstad, Solveig Thorbjørnsen; Söderhamn, Ulrika; Espnes, Geir Arild & Söderhamn, Olle (2012). Living alone, receiving help, helplessness, and inactivity are strongly related to risk of undernutrition among older home-dwelling people. International Journal of General Medicine. ISSN 1178-7074. 5, s. 231–240. doi: 10.2147/IJGM.S28507. Fulltekst i vitenarkiv Vis sammendrag

  Background: Being at risk of undernutrition is a global problem among older people. Undernutrition can be considered inadequate nutritional status, characterized by insufficient food intake and weight loss. There is a lack of Norwegian studies focusing on being at risk of undernutrition and self-care ability, sense of coherence, and health-related issues among older home-dwelling people. Aim: To describe the prevalence of being at risk of undernutrition among a group of older home-dwelling individuals in Norway, and to relate the results to reported self-care ability, sense of coherence, perceived health and other health-related issues. Methods: A cross-sectional design was applied. A questionnaire with instruments for nutritional screening, self-care ability, and sense of coherence, and health-related questions was sent to a randomized sample of 450 persons (aged 65+ years) in southern Norway. The study group included 158 (35.1%) participants. Data were analysed using statistical methods. Results: The results showed that 19% of the participants were at medium risk of undernutrition and 1.3% at high risk. Due to the low response rate it can be expected that the nonparticipants can be at risk of undernutrition. The nutritional at-risk group had lower self-care ability and weaker sense of coherence. Living alone, receiving help regularly to manage daily life, not being active and perceived helplessness emerged as predictors for being at risk of undernutrition. The results indicate difficulties in identifying people at nutritional risk and supporting self-care activities to maintain a good nutritional status. Conclusion: Health care professionals have to be able to identify older home-dwelling people at risk of undernutrition, support self-care activities to enable people at risk to maintain a sufficient nutritional status, and be aware that older people living alone, who receive help, feel helpless, and are inactive are especially vulnerable. Keywords: health, nutrition, self-care, sense of coherence

• Tomstad, Solveig Thorbjørnsen; Söderhamn, Ulrika; Espnes, Geir Arild & Söderhamn, Olle (2012). Testing two self-care-related instruments among older home-dwelling people in Norway. International Journal of Older People Nursing. ISSN 1748-3735. 8, s. 189–198. doi: 10.1111/j.1748-3743.2011.00307.x. Vis sammendrag

  Aim and objective. To test reliability and validity of the Norwegian versions of the two self-care-related instruments, the Self-care Ability Scale for the Elderly (SASE) and the Nutritional Form For the Elderly (NUFFE) among older home-dwelling individuals.Background. Older persons’ ability and agency for self-care is an important issue.Therefore, the development of reliable and valid instruments to measure self-care with regard to both clinical nursing practice and personal health is important for nursing research and practice. Methods. A postal questionnaire that contained these instruments, background variables, health-related questions and two other self-care-related instruments was completed by a randomised sample of 158 older persons in southern Norway. Reliability was assessed as internal consistency and validity as concurrent and construct validity. Results. SASE reached a Cronbach’s alpha coefficient of 0.85 and significant Spearman’s rank correlations for 16 of 17 items. For NUFFE, a Cronbach’s alpha coefficient of 0.64 was obtained and significant correlations for 13 of 15 items. Validity was supported for both instruments. An appropriate cut-off was found for SASE. For NUFFE, a low cut-off point was obtained. Conclusions. SASE was shown to have sufficient psychometric properties and can be used in research and clinical practice among older persons. Implications for practice. The psychometric properties of NUFFE can be assessed as sufficient, but further studies are needed regarding the cut-off point. Key words: nursing, reliability, sensitivity, specificity, undernutrition, validity

• Söderhamn, Ulrika; Landmark , Bjørg ; Aasgaard, Live; Eide, Hilde & Söderhamn, Olle (2012). Volunteering in dementia care - A Norwegian phenomenological study. Journal of Multidisciplinary Healthcare. ISSN 1178-2390. 5, s. 61–67. doi: 10.2147/JMDH.S28240. Vis sammendrag

  Introduction: The number of people suffering from dementia will increase dramatically in the future, and this will be a great challenge and concern for health care services. It is assumed that volunteers will strengthen community health care services more in the future than they do today. Aim: The aim of this study was to elucidate lived experiences of working as a volunteer in an activity center with adapted activities for home-dwelling people with early stage dementia. Methods: Qualitative interviews were implemented in a group of nine female volunteers from an activity center in southern Norway. The interviews were recorded, transcribed verbatim, and analyzed with a descriptive phenomenological method. Results: Volunteering in an activity center for home-dwelling people with early stage dementia was reported to provide experiences of being useful and feeling satisfied with performing a good job. It was an advantage for the volunteers to have had experiences from life in general, but also as a health professional or as being the next of kin of a dementia sufferer. It was important for the volunteers to focus on the dementia sufferer and show caring behavior, and interaction with and the appreciation of the health care professionals were also important. The volunteers were motivated by being able to have influence and participate in the planning of the work, to be a part of the social setting, and to learn. However, for some volunteers it was difficult to adjust to an appropriate role. Conclusion: In order to promote volunteering in a caring context, mutual trust and freedom should be emphasized. Being conscious of important volunteer characteristics like their experiences, knowledge, and caring behavior, as well as a focus on the staff showing appreciation and providing feedback, may be the difference between success and failure. Keywords: activity, early stage dementia, phenomenology, voluntary work

• Dale, Bjørg; Söderhamn, Ulrika & Söderhamn, Olle (2012). Self-care ability among home-dwelling older people in rural areas in southern Norway. Scandinavian Journal of Caring Sciences. ISSN 0283-9318. 26(1), s. 113–122. doi: 10.1111/j.1471-6712.2011.00917.x. Vis sammendrag

  Introduction: The growing number of older people is assumed to represent many challenges in the future. Selfcare ability is a crucial health resource in older people and may be a decisive factor for older people managing daily life in their own homes. Studies have shown that self-care ability is closely related to perceived health, sense of coherence and nutritional risk. Aim: The aim of this study was to describe self-care ability among home-dwelling older individuals living in rural areas in southern Norway and to relate the results to general living conditions, sense of coherence, screened nutritional state, perceived health, mental health and perceived life situation. Methods: A cross-sectional survey was carried out in rural areas in five counties in 2010. A mailed questionnaire, containing background variables, health-related questions and five instruments, was sent to a randomly selected sample of 3017 older people (65+ years), and 1050 respondents were included in the study. Data were analysed with statistical methods. Results: A total of 780 persons were found to have higher self-care ability and 240 to have lower self-care ability using the Self-care Ability Scale for the Elderly. Self-care ability was found to be closely related to health-related issues, self-care agency, sense of coherence, nutritional state and mental health, former profession, and type of dwelling. Predictors for high self-care ability were to have higher self-care agency, not receiving family help, having low risk for undernutrition, not perceiving helplessness, being able to prepare food, being active and having lower age. Conclusions: When self-care ability is reduced in older people, caregivers have to be aware about how this can be expressed and also be aware of their responsibility for identifying and mapping needs for appropriate support and help, and preventing unnecessary and unwanted dependency. Keywords: mental health, nutritional status, perceived health, self-care agency, sense of coherence

• Söderhamn, Ulrika; Christensson, Lennart; Idvall, Ewa; Johansson, AnnaKarin & Bachrach-Lindström, Margareta (2012). Factors associated with nutritional risk in 75-year-old community living people. International Journal of Older People Nursing. ISSN 1748-3735. 7(1), s. 3–10. doi: 10.1111/j.1748-3743.2010.00242.x. Vis sammendrag

  Background. Undernutrition in older people is known to contribute to poor health. The instrument Nutritional Form For the Elderly helps to identify those at nutritional risk. Aim. To identify risk factors for being at nutritional risk, by means of a nutritional screening, in a population based sample of 75-year old people living in three county councils in Sweden. Method. The screening instrument Nutritional Form For the Elderly, background variables and health related questions were mail distributed. A total of 1461 persons (75 years old) were included in the study. Statistical methods were used in the analyses. Results. One percent of the participants had high risk, 21.3 % medium and 77.7 % low risk for undernutrition. Medium or high risk was predicted by: living alone, receiving help and impaired perceived health. Low Body Mass Index was associated with low risk for undernutrition. Conclusion. By using a simple nutritional screening instrument, significant risk factors were highlighted. Relevance to practice: This instrument can identify older people at nutritional risk and is easy to use. Older people living alone have an increased risk for undernutrition. Body Mass Index should be used with caution as one and only indicator of nutritional risk in older people.

• Söderhamn, Ulrika; Dale, Bjørg & Söderhamn, Olle (2011). Narrated lived experiences of self-care and health among rural-living older persons with a strong sense of coherence. Psychology Research and Behavior Management. ISSN 1179-1578. 4, s. 151–158. doi: 10.2147/PRBM.S27228. Vis sammendrag

  Sense of coherence (SOC), with its components comprehensibility, manageability, and meaningfulness, is a major factor in the ability to cope successfully with stressors and is closely related to health. Qualitative studies related to SOC are scarce, and in this phenomenological interview study, self-care is investigated in relation to SOC. The aim of this study was to describe the lived experiences of self-care and features that may influence health and self-care among older home-dwelling individuals living in rural areas and who have a strong SOC. Eleven persons with a mean age of 73.5 years and a SOC value in the range of 153–188, measured by Antonovsky’s 29-item SOC scale, were interviewed. The interviews were recorded, transcribed verbatim, and analyzed with a phenomenological descriptive method. The findings showed that successful self-care involves having, when needed, contact with the health care system, being conscious of a sound lifestyle, being physically and mentally active, being engaged, having social contacts with family and/or others, and being satisfied and positive and looking forward. Formal and informal caregivers should be conscious of the importance of motivating and supporting older individuals with respect to these dimensions of self-care. Keywords: aged, activity, contacts, phenomenology, well-being

• Skaar, Ragnhild & Söderhamn, Ulrika (2011). Deltakelse i tilpasset kulturaktivitet : en mulighet for velvære for pasienter med demenslidelse. Nordisk sygeplejeforskning. ISSN 1892-2678. 1(3), s. 192–205. Vis sammendrag

  Bakgrunn. Med det økende antall personer som lider av demens vil det være betydningsfullt å fokusere på kulturelle aktiviteter som kan gi gode opplevelser og velvære for personer med demenslidelse. Hensikt. Å få innsikt og kunnskap om hvordan tilpassede kulturaktiviteter kunne innvirke på velvære for en gruppe pasienter med demenslidelse. Metode. Kvalitativ tilnærming ble valgt. Data ble innsamlet gjennom ikke-deltakende observasjon av seks pasienter med demenslidelse på et bo- og omsorgssenter samt intervju av deres pårørende i forbindelse med tilpassede kulturaktiviteter, inkludert en reise til Spania. En hermeneutisk analysemetode ble benyttet. Funn. Gjennom analysene fremkom tre temaer som tegn på velvære, ut fra observasjonene og intervjuene: god opplevelse i nuet, tilhørighet og gjenkjennelse. Konklusjon. Det kan hevdes ut fra studiens funn at tilpassede kulturaktiviteter, inkludert en feriereise til Spania, kan bidra til velvære for pasienter med demenslidelse på bo- og omsorgssenter. Utdannet helsepersonell med interesse og engasjement samt god kjennskap til målgruppen er også sentralt.

• Flateland, Sylvi Monika; Kristiansen, Aslaug & Söderhamn, Ulrika (2011). Sykepleiestudenters læring - Læring i praksis gjennom deltakelse i refleksjonsgruppe. Nordisk sygeplejeforskning. ISSN 1892-2678. 1(1), s. 5–18. Vis sammendrag

  Hensikten med studien var å belyse en gruppe sykepleiestudenters opplevelse av læring og det å være en del av en refleksjonsgruppe hvor også ferdigutdannede sykepleiere deltok. Ti sykepleiestudenter fra et universitet i Norge deltok i studien. Fire refleksjonsgrupper ble avholdt i to kirurgiske sykehusavdelinger. Hver gruppe bestod av to eller tre sykepleiestudenter, to sykepleiere fra de respektive avdelingene, en fagutviklingssykepleier og to lærere. Fokus for refleksjonsgruppene var kjente pasientsituasjoner. Fire fokusgruppeintervju ble foretatt etter at refleksjonsgruppene var avsluttet. Datamaterialet ble analysert kvalitativt. Tre kategorier ble identifisert: «Konteksten som utgangspunkt for læring», «Å lære gjennom å utfylle hverandre» og «Å være en del av et fellesskap». Studentenes læring var basert på kulturen i de to avdelingene. Studentene og sykepleierne utfylte hverandre. Relasjonen mellom gruppemedlemmene var sentral i forhold til læring og følelsen av trygghet og tillit var i den sammenheng avgjørende. Funnene viste at refleksjonsmodellen, med utgangspunkt i refleksjon over en kjent pasientsituasjon, var en god metode for å øke sykepleiestudenters læring i praksis.

• Söderhamn, Ulrika (2011). The Nutritional Form For the Elderly - A Short Scale Development Report. Nordisk sygeplejeforskning. ISSN 1892-2678. 1(1), s. 75–81. Vis sammendrag

  Background: Screening is recommended as the first step in the process for assessing nutritional status in order to identify nutritional at-risk patients and should be performed with reliable and valid instruments. The nutritional screening instrument Nutritional Form For the Elderly is especially developed for screening of older people. Objectives: The aim of this paper was to describe the development and psychometrical testing procedures of the nutritional screening instrument Nutritional Form For the Elderly. Development: The instrument was constructed after studies about important nutritional issues, found in the scientific literature, regarding older people and contains 15 items without anthropometrical measurements. It is developed in the Swedish context and has been translated into several languages. Psychometrical testing procedures: Homogeneity and stability, as measures of reliability, and face validity, criterion-related, concurrent and construct validity as well as sensitivity and specificity have been assessed. Conclusion: The Nutritional Form For the Elderly is reflecting factors of importance for the nutritional status of older people, and the testing procedures have shown that the instrument has sufficient psychometric properties in order to be used as a screening instrument in clinical practice and research.

• Söderhamn, Ulrika; Flateland, Sylvi Monika; Jessen, Liss & Söderhamn, Olle (2011). Perceived health and risk of undernutrition: a comparison of different nutritional screening results in older patients. Journal of Clinical Nursing (JCN). ISSN 0962-1067. 20(15-16), s. 2162–2171. doi: 10.1111/j.1365-2702.2010.03677.x. Vis sammendrag

  Aims and objectives: To compare screening results by using different nutritional screening instruments with respect to nutritional risk and associations with perceived health and health-related issues in a group of older hospital patients. Background: The association between lower perceived health and nutritional risk in older people is widely known. It is advised to use a screening instrument in order to identify nutritional at-risk patients. Design: A cross-sectional study-design was used. Methods: One hundred fifty-eight older patients, in three medical hospital wards in two hospitals in southern Norway, were interviewed using a questionnaire containing questions about background variables, perceived health and health-related issues and the nutritional screening instruments Nutritional Form For the Elderly and Mini Nutritional Assessment (including Mini Nutritional Assessment-Short Form). Data were also collected regarding the screening instrument Nutrition Risk Screening 2002. All data were analysed utilising statistical methods. Results: Many patients were at nutritional risk independent of used instrument. Nutrition Risk Screening 2002 identified fewer nutritional at-risk patients than the other instruments did. Perceived ill health was significantly associated with nutritional risk utilising instruments specifically designed for older people. Feeling satisfied with life and lower risk for undernutrition were two important predictors for perceived good health. Conclusions: Nutritional Form For the Elderly, Mini Nutritional Assessment and Mini Nutritional Assessment-Short Form could identify approximately the same number of nutritional at-risk patients. Being at nutritional risk had a negative impact on older patients’ perceived health.

• Söderhamn, Olle & Söderhamn, Ulrika (2010). Sense of coherence and health among home-dwelling older people. British Journal of Community Nursing. ISSN 1462-4753. 15(8), s. 376– 380 . Vis sammendrag

  Sense of coherence (SOC) is important for maintaining health. The aim of this study was to investigate if the SOC experience among home-dwelling physically active older people differs from that of hospital patients with the same age and sex. Data were collected with questionnaires and structured interviews containing Antonovsky's SOC scale in an age- and sex-matched study group (n=160). Non-parametric statistical analyses were performed. No differences were found in SOC between home-dwelling individuals and patients. Ninety-five percent of the home-dwelling individuals perceived themselves as being in good health and 42.5% among the patients (p<0.001). SOC and disease were predictors for health in the total study group. Among the home-dwelling individuals, SOC, disease and being single were predictors for health and among the patients solely SOC. When using the components of the SOC concept, comprehensibility and disease predicted health for the home-dwelling individuals and meaningfulness predicted health for the patients.

• Skaar, Ragnhild; Söderhamn, Ulrika & Fensli, Marthe M. Fosse (2010). Behov for praktisk hjelp og sosial kontakt - En intervjustudie blant hjemmeboende eldre i Norge. Vård i Norden. ISSN 0107-4083. 30(2), s. 33–37. Vis sammendrag

  Aim. The aim of this study was to elucidate a group of older home-dwelling people?s perception of needs of care and services that were not met by home care services, and how these needs could be met. Background. As a result of a higher number of older people in the future there will be increased needs of care and services. Method. Nine older persons were interviewed. A qualitative content analysis was used. Findings. The findings were interpreted in one main theme: Informal networks important to meet requirements for practical help and social contact. The theme was based on two categories: Practical help (subcategories: getting help with snow shovelling/gardening, house work, transportation, being accompanied to the doctor and assisted there, and shopping) and social contact (subcategories: having someone to talk to, participating in a fellowship, meeting someone of the same age and background with similar interests, and activities). Conclusion. The needs for practical help and social contact were not satisfied for all informants. To meet these needs, co-operation between formal and informal caregivers is necessary. This will contribute to enabling older people to live in their own home as long as possible.

• Söderhamn, Ulrika; Flateland, Sylvi; Jessen, Liss & Söderhamn, Olle (2009). Norwegian version of the Nutritional Form for the Elderly: sufficient psychometric properties for performing institutional screening of elderly patients. Nutrition Research. ISSN 0271-5317. 29(11), s. 761–767. doi: 10.1016/j.nutres.2009.10.010. Vis sammendrag

  The objective of this study was to test if the Norwegian version of the nutritional screening instrument entitled Nutritional Form for the Elderly (NUFFE-NO) demonstrates sufficient evidence of reliability and validity, including sensitivity and specificity, when applied to a select group of elderly hospital patients. The hypothesis was that NUFFE-NO has sufficient psychometric properties to be used as a screening instrument. The model used for the testing procedure was designed to test reliability (homogeneity and stability) and validity (criterion-related, concurrent validity and construct validity) including sensitivity and specificity in a cross-sectional study. One-hundred and fifty eight patients were interviewed using the nutritional screening instruments NUFFE-NO and Mini Nutritional Assessment (MNA). They were interviewed once again (utilizing NUFFE-NO) two to four days afterwards. Background variables were collected. Data from the patients? records were collected regarding the nutritional screening instrument Nutrition Risk Screening-2002 (NRS-2002). Anthropometric measurements were performed. A Cronbach?s alpha coefficient of 0.77 was obtained. A majority of the items showed good or very good agreement in a test-retest. A high correlation coefficient (as a measurement of concurrent validity) was estimated between NUFFE-NO and MNA. NUFFE-NO could separate groups with expected high and low scores, which supported construct validity. Calculated sensitivity and specificity values for NUFFE-NO, with MNA as a criterion and ROC-curves with areas 0.79 and 0.80, showed appropriate cut-off points for measuring low, medium and high risk for undernutrition. In conclusion, NUFFE-NO was shown to have sufficient psychometric properties for performing an institutional screening of elderly hospital patients.

• Söderhamn, Ulrika & Söderhamn, Olle (2009). A successful way for performing nutritional nursing assessment in older patients. Journal of Clinical Nursing (JCN). ISSN 0962-1067. 18(3), s. 431–439. doi: 10.1111/j.1365-2702.2008.02378.x. Vis sammendrag

  These results highlight that nurses have an important role in identifying eating problems in older patients, which has to be a prioritised issue in the care of older people.

Se alle arbeider i Cristin

• Nilsen, Elin Rogn; Söderhamn, Ulrika & Dale, Bjørg (2018). Helhetlige pasientforløp for eldre i kommunene - sykepleieres erfaringer med sjekklister .
• Sundsli, Kari & Söderhamn, Ulrika (2018). Self-care telephone talks as a health-promotion intervention in urban home-living persons 75+ years of age: a randomized controlled study.
• Skisland, Anne Valen -Sendstad; Flateland, Sylvi Monika; Tønsberg, Anne K. Flaatten & Söderhamn, Ulrika (2018). Minority language-speaking students' challenges in the Bachelor's programmes.
• Barken, Tina Lien; Thygesen, Elin & Söderhamn, Ulrika (2018). Å leve med KOLS og få oppfølging med telemedisin. BestPractice. Lungemedisin. 8, s. 13–15.
• Robstad, Anja Nastasja; Söderhamn, Ulrika & Fegran, Liv (2017). Intensive care nurses’ experiences of caring for obese intensive care patients: a hermeneutic study.
• Barken, Tina Lien; Thygesen, Elin & Söderhamn, Ulrika (2016). Nursing practice with triage decision making for COPD patients of a telemedicine centre – An ethnographic approach. International Journal of Integrated Care (IJIC). ISSN 1568-4156. 16(5). doi: 10.5334/ijic.2547. Vis sammendrag

  Introduction: The collaboration reform has increased the responsibility of Norwegian municipalities for health care services for patients with chronic diseases; whereas chronic obstructive pulmonary disease (COPD) represents a large group [1]. This change, associated to the reform, requires establishing new clinical pathways. Telemedicine (TM) has demonstrated potential in advanced nursing practice in terms of efficacy and quality of care [2]. Through TM, nurses can determine patient’s health status and follow-up supported by a decision aid software program. To date, there is little research investigating how nurses working in municipal health care services make clinical decisions based on a triage to assess COPD patient’s health status. This research presents an ethnographic study with three nurses working in a telemedicine center (TMC) in Southern Norway as part of a European project, namely United4Health. Patients used a tablet at home with video camera for video consultations and a pulse oximeter device for transference of clinical measurements (oxygen saturation and heart rate). The aim of the study was to investigate how nurses in a TMC using video consultations made decisions on COPD patient’s health status using triage as part of the decision making process. Methods: The data collection was made through participatory observations, field notes and focus group interview including three nurses working in a TMC from October 2015 to February 2016 in southern Norway. The collected data is currently being analysed using qualitative content analysis [3]. Results and discussion: Preliminary results showed that nurses working in the TMC found the triage useful as part of the decision making process that allowed identifying health problems and prioritising the patients need for help. However, the nurses often used workarounds and made decisions according to their own knowledge and experience when interpreting the software recommendation; in these cases, the triage model was seen just as guidance. In addition, this interpretation was not only based on the daily triage assigned to each patient, but also on the content of past triaging and earlier nurses’ documentation for each patient. This indicated that triaging a chronic patient is complex, time consuming and relies on the nurses’ previous knowledge concerning both patients’ medical history and life. Furthermore, video consultation was important for the nurses as a visualisation of the patient, and it was a significant additional component to the triage recommendation and nurses’ own decision. Video consultation follow-up was often replaced by telephone calls because of frequent technical problems. This led to important visual information for the decision making process was not possible to be observed by nurses, which could have negatively influenced the decision outcome. References: [1] Report No. 47. The Coordination Reform: Proper treatment – at the right place and right time 2008-2009: Oslo: Ministry of Health and Care Services. [2] Reed K. Telemedicine: Benefits to Advanced Practice Nursing and the Communities They Serve. Journal of the American academy of nurse practitioners 2005: 17(5) 176-180. [3] Graneheim UH and Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Education Today 2003: 24: 105112.

• Barken, Tina Lien; Thygesen, Elin & Söderhamn, Ulrika (2016). Nursing practice with triage decision making for COPD patients of a telemedicine centre – An ethnographic approach. Vis sammendrag

  Introduction: The collaboration reform has increased the responsibility of Norwegian municipalities for health care services for patients with chronic diseases; whereas chronic obstructive pulmonary disease (COPD) represents a large group [1]. This change, associated to the reform, requires establishing new clinical pathways. Telemedicine (TM) has demonstrated potential in advanced nursing practice in terms of efficacy and quality of care [2]. Through TM, nurses can determine patient’s health status and follow-up supported by a decision aid software program. To date, there is little research investigating how nurses working in municipal health care services make clinical decisions based on a triage to assess COPD patient’s health status. This research presents an ethnographic study with three nurses working in a telemedicine center (TMC) in Southern Norway as part of a European project, namely United4Health. Patients used a tablet at home with video camera for video consultations and a pulse oximeter device for transference of clinical measurements (oxygen saturation and heart rate). The aim of the study was to investigate how nurses in a TMC using video consultations made decisions on COPD patient’s health status using triage as part of the decision making process. Methods: The data collection was made through participatory observations, field notes and focus group interview including three nurses working in a TMC from October 2015 to February 2016 in southern Norway. The collected data is currently being analysed using qualitative content analysis [3]. Results and discussion: Preliminary results showed that nurses working in the TMC found the triage useful as part of the decision making process that allowed identifying health problems and prioritising the patients need for help. However, the nurses often used workarounds and made decisions according to their own knowledge and experience when interpreting the software recommendation; in these cases, the triage model was seen just as guidance. In addition, this interpretation was not only based on the daily triage assigned to each patient, but also on the content of past triaging and earlier nurses’ documentation for each patient. This indicated that triaging a chronic patient is complex, time consuming and relies on the nurses’ previous knowledge concerning both patients’ medical history and life. Furthermore, video consultation was important for the nurses as a visualisation of the patient, and it was a significant additional component to the triage recommendation and nurses’ own decision. Video consultation follow-up was often replaced by telephone calls because of frequent technical problems. This led to important visual information for the decision making process was not possible to be observed by nurses, which could have negatively influenced the decision outcome. References: [1] Report No. 47. The Coordination Reform: Proper treatment – at the right place and right time 2008-2009: Oslo: Ministry of Health and Care Services. [2] Reed K. Telemedicine: Benefits to Advanced Practice Nursing and the Communities They Serve. Journal of the American academy of nurse practitioners 2005: 17(5) 176-180. [3] Graneheim UH and Lundman B. Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Education Today 2003: 24: 105112.

• Barken, Tina Lien; Thygesen, Elin & Söderhamn, Ulrika (2016). Living with chronic obstructive pulmonary disease and being followed up through telemedicine – a phenomenological approach. Vis sammendrag

  Abstract. Chronic obstructive pulmonary disease (COPD) provides substantially reduced health related quality of life (HQoL). Telemonitoring on COPD patients appears to have a positive effect on improving HQoL. This study has a phenomenological approach, and ten informants, who were followed-up between 1 and 3 months in their own homes through telemonitoring of COPD symptoms, narrated their lived experiences of HQoL. The results show that the informants experienced safety and increased knowledge through the digital dialog (telemedicine) with expertise nurses, which indirectly improved their HQoL, and in term lead to increased mastery and control in managing their disease. Several studies show an increased HQoL, but the benefits are still limited and there is a need for further research.

• Skaar, Ragnhild; Fensli, Marthe M. Fosse; Flateland, Sylvi Monika & Söderhamn, Ulrika (2016). FRIPO-Frivillighet i palliativ omsorg.
• Lyngroth, Anne Liv; Hernes, Susanne; Madsen, Bengt-Ove; Söderhamn, Ulrika & Grov, Ellen Karine (2015). Nutritional screening of patients at a memory clinic - association between patients’ and their relatives’ self-reports . European Geriatric Medicine. ISSN 1878-7649. 6, s. 136–137. Vis sammendrag

  Aims and objectives. To increase knowledge of nutritional screening in cognitive impaired by comparing individual reports by patients and relatives of the Nutritional Form For the Elderly (NUFFE). Background. Undernutrition is a significant problem among people with dementia. Design. A cross sectional prospective study. Method. Application of the NUFFE-NO in addition to cognitive tests in a memory clinic. Results. A total of 213 patients, mean age 73 years, 53% females, 32% single home-dwellers and 15% below the age of 65 were included in the study. The mean MMSE score was 23.2 and 50% failed the five-point Clock Drawing Test. Patients’ and relatives’ NUFFE-scores yielded comparative results, however the patients were inclined to report higher nutritional state compared to their relative’ scores. By self-reported NUFFE-scores, 32% were at medium to high risk of undernutrition. NUFFE-scores from their closest relatives revealed 43% of the patients at medium to high risk. Involuntary weight loss was reported by 42% of the patients, and in 26% of the sample BMI-values were below 22 kg/m2. Conclusion. The study demonstrates that a significant proportion of patients at the memory clinic were at nutritional risk. Corresponding results exist between patients’ and their relatives’ NUFFE-scores, however patient assessed scores were somewhat more well-nourished than their relatives. The discrepancies seem to increase with more severe cognitive impairment. In our sample, females and single dwelling individuals are at a higher risk of undernutrition compared to males and cohabitants. Scores from the MMSE-test and CDT might predict the probability of weight loss.

• Lyngroth, Anne Liv; Hernes, Susanne; Madsen, Bengt-Ove; Söderhamn, Ulrika & Grov, Ellen Karine (2015). Nutritional screening of patients at a memory clinic - association between patient's and their relative's self-report. Vis sammendrag

  Aims and objectives. To increase knowledge of nutritional screening in cognitive impaired by comparing individual reports by patients and relatives of the Nutritional Form For the Elderly (NUFFE). Background. Undernutrition is a significant problem among people with dementia. Design. A cross sectional prospective study. Method. Application of the NUFFE-NO in addition to cognitive tests in a memory clinic. Results. A total of 213 patients, mean age 73 years, 53% females, 32% single home-dwellers and 15% below the age of 65 were included in the study. The mean MMSE score was 23.2 and 50% failed the five-point Clock Drawing Test. Patients’ and relatives’ NUFFE-scores yielded comparative results, however the patients were inclined to report higher nutritional state compared to their relative’ scores. By self-reported NUFFE-scores, 32% were at medium to high risk of undernutrition. NUFFE-scores from their closest relatives revealed 43% of the patients at medium to high risk. Involuntary weight loss was reported by 42% of the patients, and in 26% of the sample BMI-values were below 22 kg/m2. Conclusion. The study demonstrates that a significant proportion of patients at the memory clinic were at nutritional risk. Corresponding results exist between patients’ and their relatives’ NUFFE-scores, however patient assessed scores were somewhat more well-nourished than their relatives. The discrepancies seem to increase with more severe cognitive impairment. In our sample, females and single dwelling individuals are at a higher risk of undernutrition compared to males and cohabitants. Scores from the MMSE-test and CDT might predict the probability of weight loss.

• Söderhamn, Ulrika; Dale, Bjørg; Sundsli, Kari & Tomstad, Solveig Thorbjørnsen (2015). Ernæring, egenomsorg og helse hos eldre.
• Söderhamn, Ulrika (2015). Villa med lav terskel - Villa Fredrikke er et lavterskeltilbud rettet mot personer med tidlig demens. Forskning viser at det fungerer. [Tidsskrift]. Sykepleien Forskning.
• Skaar, Ragnhild; Fensli, Marthe M. Fosse & Söderhamn, Ulrika (2015). Frivilligsentral og offentlig sektor.
• Söderhamn, Ulrika; Eriksen, Sissel & Landmark , Bjørg Thomassen (2014). Fysiske og sosiale aktiviteter for hjemmeboende personer med demens - erfaringer fra pårørende. Vis sammendrag

  Bakgrunn: Å være pårørende til en hjemmeboende person med demens er kjent å være en tung byrde. I Drammen kommune er det startet et aktivitetssenter, Villa Fredrikke, med sykepleiere og frivillige som tilbyr hjemmeboende personer med demenssykdom, i tidlig fase, deltakelse i fysiske og sosiale aktiviteter og støtte til pårørende. Hensikt: Å belyse erfaringer fra pårørende til personer med demens i tidlig fase som har deltatt i organiserte fysiske og sosiale aktiviteter ved Villa Fredrikke. Materiale og Metode: Studien har en kvalitativ design. Ti pårørende, barn eller ektefelle, ble inkludert i studien. To fokusgruppeintervju med fem deltaker i hvert intervju ble gjennomført. Intervjuteksten ble analysert med manifest og latent innholdsanalyse. Resultater: To kategorier fremkom i den manifeste analysen: «Avbrudd i hverdagen» og «Bli sett og passet på». To subkategorier til hver kategori ble identifisert: «Behov av avlastning» og «Meningsfulle aktiviteter» respektive «Bli bekreftet» og «Dele erfaringer og få råd og hjelp». Kategoriene ble fortolket (latent analyse) i et overordnet tema: «Fornøydhet med tilpassede aktiviteter og gruppemøter formidlet med en person-sentrert omsorg». Pårørende opplevde økt velvære da de fikk avlastning og da de så at personene med demens fikk en ny hverdag gjennom Villa Fredrikke. Personene med demens ble gladere og mer oppmerksomme og kjente de seg inkludert i en felleskap og fikk økt verdi som menneske. De pårørende fikk mulighet til å delta i gruppemøter sammen med andre pårørende. Dette opplevdes som en god støtte i en vanskelig situasjon og de følte seg alltid sett og velkommen når de kom til Villa Fredrikke. Konklusjon: For at et aktivitetssenter for personer med demens i tidlig fase skal kunne gi personene med demens en ny hverdag og støtte til de pårørende er det helt avgjørende at personalet har høy kompetanse innen demens og kan gi en personsentrert omsorg.

• Söderhamn, Ulrika (2013). Kartlegging av ernæringstilstand hos eldre.
• Söderhamn, Ulrika (2012). Tools to identify nutritional risk for older people in the home. British Journal of Community Nursing. ISSN 1462-4753. 17(11), s. S26–S29. Vis sammendrag

  Community nurses are in an ideal position to identify older home-dwelling people at nutritional risk and thereby to prevent undernutrition. The aim of this paper is to present some nutritional screening instruments for older home-dwelling people and to discuss nutritional issues of importance for community nurses in order to assess nutritional risk and prevent undernutrition. The screening instruments Nutritional Form For the Elderly(NUFFE)and Mini Nutritional Assessment MNA)are especially developed for screening older people. The Malnutrition Universal Screening Tool(MUST)is recommended for screening community-living people. Identifying nutritional at-risk persons by means of a screening instrument and being aware of risk factors and protective factors for undernutrition can guide nurses in their nutritional assessment and help them to find tailored interventions in order to prevent undernutrition.

• Sundsli, Kari; Söderhamn, Ulrika; Espnes, Geir Arild & Söderhamn, Olle (2012). Egenomsorgsevne blant de eldste eldre i bystrøk i Sør-Norge. Vis sammendrag

  Bakgrunn: Antall eldre i bystrøk vil øke i årene som kommer, og mange eldre vil fortsette å bo i egne hjem. Derfor er det viktig å få økt kunnskap om hvordan personene selv opplever sin situasjon i forhold til helse og egenomsorg. Hensikten: Undersøke faktorer som bidrar til å vedlikeholde, gjenopprette eller øke egenomsorgsevnen blant hjemmeboende personer fra 85+ i bystrøk i Sør-Norge. Egenomsorgsevne i denne studien er individets evne til å utføre tiltak for å opprettholde, gjenvinne eller øke helse og velvære. Materiale og metode: Et spørreskjema med helserelaterte spørsmål og instrumenter, ble i 2010 sendt til et tilfeldig utvalg av hjemmeboende eldre over 65 år, i bystrøk i Sør-Norge. Totalt 1044, (34.6%), personer ble inkludert, og data fra personer over 85 år (n=133), ble brukt i denne undersøkelsen. Univariate og multivariate statistiske metoder ble benyttet i analysen. Resultater: Blant hjemmeboende eldre over 85 år, var fysisk aktivitet den viktigste positive faktor som fremmet egenomsorgsevnen. Samtidig var det å motta hjemmesykepleie den mest negative faktor. Andre viktige faktorer som hadde betydning for helse og egenomsorg blant de eldste eldre var egenomsorgskapasitet, tilfredshet med livet og god psykisk helse. Eldre over 85 år er de mest sårbare personer blant hjemmeboende eldre og krever oppmerksomhet fra helsepersonell og politikere. Konklusjon: Fysisk aktivitet er den viktigste positive faktor som bidrar til økt egenomsorgsevne blant deltakerne i denne studien. Samtidig synes det som om fysisk aktivitet virker gunstig inn slik at de eldste eldre kan fortsette å bo i eget hjem. Derfor må helsepersonell som møter de eldste eldre i deres hjem fokusere på og fremme fysisk aktivitet, samt avdekke symptomer og tegn på nedsatt psykisk helse for slik å kunne vedlikeholde, gjenopprette eller øke helse og velvære blant de eldste eldre.

• Söderhamn, Olle; Dale, Bjørg; Sundsli, Kari & Söderhamn, Ulrika (2012). Health among very old people. Vis sammendrag

  Due to increase in the older population, self-care and health promotion have become important in countries like Norway. Health is a state of expanding consciousness, where the individual perceives life as comprehensible, manageable and meaningful. This sense of coherence (SOC) experience is fundamental in our lives and significant when health promotion among very old people is studied. The aim of this study was to investigate factors that may influence health among home-dwelling people 80+ years of age. A questionnaire, with health related questions and instruments, was sent to a randomized sample of home-dwelling people, 65+ years, in southern Norway. A total of 2106 (34.9%) persons were included, and data from individuals aged 80+ years (n=518) were used in this study. Univariate and multivariate statistical methods were used in the analyses. There was no difference in SOC scores between males and females. More males than females were in good health (p=0.005). Health was explained by self-care ability and not being helpless among the males (R2=0.49), and by not being helpless, satisfaction with life, not having chronic disease/handicap, and good nutritional state among the females (R2=0.65). Different factors influence health among older males and females. Health promotion among these groups should, therefore, have an individual and gendered focus. Key words: gender, helplessness, self-care

• Dale, Bjørg; Söderhamn, Ulrika & Söderhamn, Olle (2012). Perceived life situation and identity among older home-living people. Vis sammendrag

  The public policy in the Norway is that older people should live a good life in their own homes as long as possible, even with functional declines. Managing daily life independently in own home is also found to be important for the older persons themselves. The aim of this study was to explore the meaning of self-care and health for perceived life situation and identity among single living older individuals in rural areas in southern Norway. Eleven older persons with an age ranging from 69 to 85 years were interviewed and asked to narrate experiences related to own self-care and health. The narrated text was analyzed using a phenomenological-hermeneutic method including an initial naïve reading, an inductive structural analysis and a final comprehensive interpretation. Two main themes emerged from the structural analysis: “being able to do” and “being able to be”. The life situation of the interviewed persons was interpreted as inevitable, appropriate and meaningful. Their identity was constituted by their freedom and self-chosen actions in their personal contexts. The overall impression was that independence and the ability to control and govern own life in accordance with preferences were ultimate goals for the study participants.

• Fensli, Marthe M. Fosse; Skaar, Ragnhild & Söderhamn, Ulrika (2012). Frivilligsentral og offentlig omsorg - Samhandling til brukers beste. Nordisk sygeplejeforskning. ISSN 1892-2678. 2(1), s. 74–86. Vis sammendrag

  Bakgrunn: Hjemmeboende eldre med oppfølging fra hjemmetjenesten opplever begrensninger med å få dekket sitt behov for praktisk hjelp og sosial kontakt. For disse kan frivillige tjenester være et viktig supplement. Det er derfor behov for å øke samarbeidet mellom offentlig helsetjeneste og frivillige tjenester. Hensikt: Å beskrive erfaringer med utvikling og utprøving av arbeidsformer mellom helse og omsorgstjenesten og frivilligsentral i et distrikt i en kommune i Sør-Norge. Metode: Et kvalitativt design ble valgt. Det ble gjennomført ett fokusgruppeintervju med en gruppe ansatte i hjemmetjenesten og frivilligsentralen for å få deres erfaringer med å utvikle og utprøve arbeidsformer for formidling og koordinering av frivillige tjenester for praktisk hjelp og sosial kontakt. Intervjuteksten ble analysert ved hjelp av kvalitativ innholdsanalyse. Funn: Gjennom analysen fremkom to hovedkategorier «Samhandling» og «Nytteverdi» med et felles overordnet tema «Supplere hverandre til brukers beste». Konklusjon: Et enkelt kartleggingsskjema og en samarbeidsprosedyre førte til økt samhandling mellom personalet i hjemmetjenesten og frivilligsentralen og bidro til en positiv holdning om å arbeide sammen til brukers beste. Nøkkelord: arbeidsformer, frivillighet, hjemmetjeneste, samarbeid, sykepleie

• Skaar, Ragnhild & Söderhamn, Ulrika (2011). En feriereise som en kulturaktivitet for personer med demenslidelse på bo- og omsorgssenter. Vis sammendrag

  Bakgrunn. Med det økende antall mennesker som lider av demens, vil det være viktig å fokusere på kulturaktiviteter for å stimulere og gi personer med demenslidelse opplevelse av livskvalitet, trygghet og mening i hverdagen.Hensikten. Hensikten med studien var å få kunnskap om hvordan en feriereise til Spania kunne innvirke på en gruppe pasienter med demenslidelse. Metode. Forskningsprosjektet ble gjennomført i tilknytning til et bo- og omsorgssenter, i Sør-Norge våren 2009. En kvalitativ tilnærming ble valgt. Data ble samlet inn gjennom et fokusgruppeintervju med seks helsearbeidere, som deltok på reisen til Spania som ledsagere for seks pasienter med demenslidelse. En kvalitativ innholdsanalyse ble benyttet.Funn. Gjennom analysene fremkom ett hovedtema: Tett oppfølging i ukjent miljø kan bidra til at en feriereise blir en positiv opplevelse for personer som lider av demens. Temaet var basert på tre kategorier: “Sosial kompetanse”, “Utholdenhet og mestringsevne”, “Balanse mellom aktivitet og hvile”. Funnene viste at pasientene hadde en potensiell sosial kompetanse og kommunikasjonsevne, som ble mobilisert gjennom stimuli, slik at de kunne delta i et fellesskap og gi uttrykk for trivsel. Videre var ADL-funksjonene forbedret på feriereisen. Konklusjon. Studien viste at pasienter som lider av demens har skjulte ressurser som kan gjøres synlig gjennom tett oppfølging av helsepersonell med god kunnskap om mennesker med en demenslidelse. En ferietur kan betraktes som en positiv opplevelse for målgruppen.

• Dale, Bjørg; Söderhamn, Ulrika & Söderhamn, Olle (2011). Viktige faktorer for opplevelse av egenomsorg blant hjemmeboende eldre i Sør-Norge. Vis sammendrag

  Bakgrunn: Det er en generell oppfatning og et mål hos norske helsemyndigheter at eldre skal bo i sine hjem så lenge som mulig. For å kunne realisere dette målet kan deres evne til egenomsorg være helt avgjørende. Hensikten med denne studien var derfor å undersøke mulige faktorer relatert til egenomsorgsevne blant eldre som bodde i eget hjem i landdistrikt i Sør-Norge. Metode: Et tilfeldig utvalg av 1050 personer over 65 år, som bodde i eget hjem i landlige strøk i fem fylker i Sør-Norge, besvarte et tilsendt spørreskjema. Skjemaet inneholdt blant annet spørsmål om leveforhold, opplevelse av sammenheng, ernæringstilstand, opplevd helse og oppfattelse av egen livssituasjon, i tillegg til egenomsorgsevne. Datamaterialet ble analysert ved hjelp av statistiske metoder. Resultater: De fleste av respondentene hadde god egenomsorgsevne. Prediktorer for høy egenomsorgsevne var blant annet å ha lav risiko for underernæring og det å lage sin egen mat, å ha egenomsorgskapasitet, å være aktiv, å ikke oppleve hjelpeløshet, å ikke motta hjelp fra familien. Yngre alder var relatert til høyere egenomsorgsevne. Konklusjon: Det er viktig at helse- og omsorgspersonell er oppmerksomme på faktorer som er relatert til eldre menneskers egenomsorgsevne. De har også et viktig ansvar når det gjelder å identifisere og fremme eldres ressurser så vel som behov for støtte, slik at uønsket hjelpeavhengighet kan unngås. Nøkkelord: aktivitet, egenomsorgskapasitet, ernæringsstatus

• Söderhamn, Ulrika; Dale, Bjørg & Söderhamn, Olle (2011). Helse og egenomsorg hos en gruppe eldre personer med sterk opplevelse av sammenheng og som bor i landstrøk i Sør-Norge. Vis sammendrag

  Helse kan ses på som det å nå vitale mål i livet, og egenomsorg er de tiltak individet gjør selv for seg selv i den hensikt å opprettholde, gjenvinne eller øke helse og velvære. En betydningsfull faktor for helse og det å mestre livet er opplevelse av sammenheng (OAS). En person med sterk OAS ser tilværelsen som begripelig, håndterbar og meningsfull, og studier har vist at sterk OAS bidrar til økt livskvalitet hos eldre. Det finnes også studier som viser at egenomsorgsevne er positivt assosiert til OAS og at begge disse faktorer bidrar til økt bedre helse hos eldre personer. OAS har oftest blitt undersøkt som en deskriptiv kvantitativ variabel, men det er også behov for å studere betydningen av det å ha en sterk OAS med andre vitenskapelige tilnærminger. Hensikten med denne studien var å beskrive levd erfaring av egenomsorg og hva som kan ha innflytelse på helse og egenomsorg blant eldre hjemmeboende personer i landlige strøk og som har en sterk opplevelse av sammenheng. Et utvalg av 11 eldre personer (67-89 år) som bodde i landlige strøk i tre fylker i Sør-Norge, og som i en annen studie var kartlagt å ha en sterk OAS, ble intervjuet med en fenomenologisk tilnærming. Intervjuene ble skrevet ordrett ned og analysert med en deskriptiv fenomenologisk metode. Funnene viste at egenomsorg, slik det ble fortalt av disse personene med en sterk opplevelse av sammenheng, var det å ha kontakt med helsevesenet, være fysisk og mentalt aktiv, være engasjert, ha sosial kontakt med familie og andre, være bevisst på en sunn livsstil, samt å være tilfreds, positiv og se fremover i livet. Funnene er i samsvar med både egenomsorgsteori og andre studier av eldre personer. Nøkkelord: aktivitet, aldring, livskvalitet, salutogenese

• Kjøstvedt, Helga Tofte; Söderhamn, Ulrika & Slettebø, Åshild (2011). Ethical reflection and experience - A literature review. Vis sammendrag

  The aim of the study was to report the results of a systematically conducted literature review of studies about ethical reflection and ethical experience in healthcare settings. Searches in electronical databases Medline and Cinahl yielded a number of different studies. After excluding studies irrelevant to this project, 27 fulltext studies were included. One large research program and six litterature reviews was identified. The rest of the studies used mainly surveys and interviews in collecting data. About half of these studies was conducted in nursing homes or in home service, the rest in different hospital settings. The studies focused on ethical dilemmas, challenges, problems, questions, development, values, encounters or in educating ethics to nursing students. Study sample consisted of mostly of healthcare practitioners. Most of the studies were descriptive and cross-sectional. The result of this study is ment to serv as a background for the "EEKAVAproject": Evaluationproject of work on Ethics in Communities in Aust- and Vest Agder(Norway). The focus in the EEKAVAproject are on: which kind of experience healthcare workers have got, after participation in ethical reflectiongroups? And what does it mean to healthcare receivers and quality of practical work?

• Sundsli, Kari; Söderhamn, Ulrika; Espnes, Geir Arild & Söderhamn, Olle (2011). Health promotion and self-care ability among older urban people. Vis sammendrag

  Background: Health promotion is one important dimension of self-care that is recognized as a key factor to active ageing internationally. Purpose: To describe self-care ability among home dwelling older (65+ years) individuals living in urban areas in southern Norway in relation to perceived health, activity, nutritional state and place of residence. Methods: A randomized sample of 1044 men and women aged 65+ years, living in urban areas in southern Norway, answered in 2010 a mailed questionnaire consisted of five instruments, some background variables and 17 health-related questions. Results: The majority of the participants reported perceived good health and they also found themselves as active persons. Seventy-five percent of the respondents were physically active every day, and eighty-nine percent found comfort in being physically active. Self-care ability was high among the participants, but lower for those living in smaller towns. Self-care ability was positively related to the following health promotion factors: self-care agency, perceived good health, being physically active, good mental health and lower risk for undernutrition. Conclusion: Health promotion among older urban people should focus on general health promoting behavior and motivation, including physical, mental and social activities. Key words: activity, aged, mental health, undernutrition

• Söderhamn, Ulrika; Dale, Bjørg; Sundsli, Kari & Söderhamn, Olle (2011). Rett mat og fysisk aktivitet bidrar til økt helse hos eldre.
• Söderhamn, Ulrika; Flateland, Sylvi; Jessen, Liss & Söderhamn, Olle (2010). Low risk for undernutrition is a predictor for perceived good health in older patients. Journal of Clinical Nursing (JCN). ISSN 0962-1067. 19, s. 42–43. Vis sammendrag

  Introduction: A nutritional screening is recommended after admission to hospital in order to detect undernutrition or risk for undernutrition. An association between lower perceived health and being at nutritional risk in older people is also known. The aim was to perform a nutritional screening using different screening instruments in a group of older hospital patients and relate the results to the patients´ perceived health. A further aim was to identify possible predictors for perceived good health. Methods and Materials: A convenience sample of 158 newly admitted older (>65 years) medical hospital patients in southern Norway were interviewed using a questionnaire, the Mini Nutritional Assessment (MNA) and the Nutritional Form For the Elderly (NUFFE-NO). Body Mass Index (BMI) was calculated, as a part of MNA. Results: According to MNA, 39% had no risk for undernutrition, 44% were at risk for undernutrition and 17% were undernourished. Using NUFFE-NO, 38% were at low risk, 29% at mediumrisk and 33% at high risk for undernutrition. The both screening results were significantly associated to perceived health, i.e. patients who were at nutritional risk or undernourished were more likely to perceive ill health than those screened to be at no or low risk for undernutrition. A lower BMI, being satisfied with life and lower risk for undernutrition, screened by MNA, were found to be predictors for perceived good health in the first regression analysis. In the second analysis more advanced age, being satisfied with life and lower risk for undernutrition, screened by NUFFE-NO, emerged as predictors for perceived health. Conclusion: The results showed that a large amount of older patients were at nutritional risk or undernourished using two nutritional screening instruments developed for older people. In order to be able to prevent and treat undernutrition and to use such screening instruments for identifying older nutritional at-risk patients and thereby enhance older patients´ perceived health.

• Söderhamn, Ulrika; Flateland, Sylvi; Jessen, Liss & Söderhamn, Olle (2010). Low risk for undernutrition is a predictor for perceived good health in older patients. Vis sammendrag

  Introduction: It is well-known that many older patients are at risk for undernutrition or already undernourished at hospital admission. A nutritional screening is therefore recommended after admission to hospital in order to detect undernutrition or risk for undernutrition. An association between lower perceived health and being at nutritional risk in older people is also known. The aim was to perform a nutritional screening using different screening instruments in a group of older hospital patients and relate the results to the patients´ perceived health. A further aim was to identify possible predictors for perceived good health. Methods and materials: A convenience sample of 158 newly admitted older (>65 years) medical hospital patients in southern Norway were interviewed using a questionnaire containing background variables (age, sex, civil status, type of dwelling, former profession, main medical diagnosis), a question about perceived health, health related issues (having regularly help, perceived helplessness, being active and feeling satisfied) and the Norwegian versions of the nutritional screening instruments Mini Nutritional Assessment (MNA®) and the Nutritional Form For the Elderly (NUFFE-NO). Body Mass Index (BMI) was calculated, as a part of MNA®. The nutritional screening instruments were chosen because they are especially designed for older people and tested regarding reliability and validity. The question about perceived health and the health related issues could be answered with yes or no. The data were analysed with statistical methods. Two multiple forward stepwise logistic regression analyses were performed in order to identify predictors for perceived good health. Dependent variable was perceived health. In the first regression, background variables, health related issues, BMI and screenings scores from the instruments were independent variables. The second analysis had the same independent variables without BMI, since BMI is a variable in MNA®. The study was carried out in concordance with important ethical principles and was approved by the regional committee for medical research ethics in southern Norway. Results: According to MNA®, 39% had no risk for undernutrition, 44% were at risk for undernutrition and 17% were undernourished. Using NUFFE-NO, 38% were at low risk, 29% at medium risk and 33% at high risk for undernutrition. The both screening results were significantly associated to perceived health, i.e. patients who were at nutritional risk or undernourished were more likely to perceive ill health than those screened to be at no or low risk for undernutrition. A lower BMI, being satisfied with life and lower risk for undernutrition, screened by MNA®, were found to be predictors for perceived good health in the first regression analysis. In the second analysis more advanced age, being satisfied with life and lower risk for undernutrition, screened by NUFFE-NO, emerged as predictors for perceived health. Conclusion: The results showed that a large amount of older patients were at nutritional risk or undernourished using two nutritional screening instruments developed for older people. In order to be able to prevent and treat undernutrition, it is important to use such screening instruments for identifying older nutritional at-risk patients and thereby enhance older patients´ perceived health.

• Söderhamn, Ulrika (2010). Screening - en hjelp til å identifisere eldre i fare for underernæring. Demens og alderspsykiatri. 14(1), s. 19–21. Vis sammendrag

  Underernæring eller risiko for underernæring er et stort problem blant eldre pasienter. Eldre med demenssykdom er en risikogruppe for underernæring. Hensikten med artikkelen var å vise at ernæringsscreening kan være en hjelp for helsepersonell i arbeidet med å identifisere eldre personer i fare for underernæring. Screning er det første steget i vurdering og behandling av underernæring. Screeningsinstrumentet Mini Nutritional Assessment (MNA) er anbefalt av europeiske og nasjonale retningslinjer angående forebygging og behandling av underernæring hos eldre. Dette instrumentet, som består av en kominasjon av antropometriske målinger og spørsmål, bør være førstevalget. Men det kan være vanskelig å gjennomføre antropometriske målinger. Da kan screeningsinstrumentet Nutritional Form For the Elderly (NUFFE) være et alternativ ettersom det er spesielt utviklet for eldre og å være enkelt å bruke og uten antropometriske målinger.

• Söderhamn, Ulrika (2009). Helse, opplevelse av sammenheng og egenomsorgsevne hos eldre i fare for underernæring. Vis sammendrag

  Eldre er en risikogruppe for underernæring, dvs. en sykdomsrelatert underernæring. Alle eldre pasienter i fare for underernæring identifiseres ikke. Å bruke et enkelt screeningsinstrument er en vei å gå for å identifisere de i fare for underernæring. The Nutritional Form For the Elderly (NUFFE) er et enkelt screeningsinstrument utviklet, testet angående reliabilitet og validitet, for å hjelpe helsepersonell å identifisere eldre risikopasienter. I en studie blant eldre rehabiliteringspasienter hadde 69 % middels eller høy risiko for underernæring målt med NUFFE. Disse pasientene hadde også lavere egenomsorgsevne, målt med The Self-care Ability Scale for the Elderly (SASE), og lavere følelse av sammenheng, målt med Sense of Coherence scale. Videre opplevde risikopasientene dårligere helse i større utstrekning enn de med lav risiko for underernæring. Dette indikerer at eldre pasienter med lav risiko for underernæring har større kapasitet å ta hånd oms eg selv mens de med middels eller høy risiko for underernæring er i behov av hjelp.

• Söderhamn, Ulrika (2009). Ernæring, mat og måltider. Vis sammendrag

  Ernæring ses som et overordnet begrep som står for ulike aspekter på mat og spising. For å få en god ernæringstilstand behøver man mat og drikke i passende mengder og få energi- og væskebehovet dekket. Sykdom, trauma eller infeksjon øker kroppens energi- og væskebehov. Sykdom, høy alder og farmaka bidrar til at eldre syke personer er en risikogruppe for underernæring. Omtrent halvparten av pasienter på sykehus eller sykehjem kan være underernærte. Dette medfører lidelse og redusert livskvalitet for den enkelte pasienten. Helsepersonell har en meget viktig oppgave i å identifisere risikopasientene gjennom å ha kunnskap om problematikken, samtale med pasientene/screene pasientene, observere spiseadferd og ev. spiseproblemer, gjennomføre antropometriske målinger, gjennomføre mat- og væskeregistrering. Matens innhold og måltidenes fordeling er av stor betydning. Rett kost (energitett- og næringsrik kost) med rett konsistens, fint servert er viktige tiltak. Videre å støtte pasientene etter behov med mating, spisehjelpemidler og riktig sittestilling ved måltider er andre viktige tiltak ved siden av jevnlig veiing, fortløpende observasjoner, aktivisering og god sykepleiedokumentasjon for å forebygge underernæring.

• Söderhamn, Olle & Söderhamn, Ulrika (2009). Self-care as a condition for health change among older home-dwelling persons and older in-patients. Vis sammendrag

  Background: Self-care ability is a necessary condition for self-care and crucial for changing a perception of ill health into good health. Objective: The objective of this study was to investigate if self-care ability among older home-dwelling persons differs from that of older in-patients with the same age and sex. Methods: An age stratified randomly chosen group of older home-dwelling persons and another group of consecutively older in-patients were originally recruited for two different research studies. An age and sex matched study group (n=150), where the respondents had a mean age of 75.8 years participated. Data were collected by means of questionnaires and interviews. Demographic data, self-reported perceived health, a few health related questions and scores from the Self-care Ability Scale for the Elderly (SASE) were used and analysed with statistical methods. Results: A significant lower self-care ability (p<0.001) was found among the home-dwelling persons than among the in-patients. Seventy-six percent of the home-dwelling persons perceived themselves as being in good health and 29% among the patients (p<0.001). Perceived helplessness was a negative predictor for health in the total study group. Among the home-dwelling persons, perceived helplessness was a negative predictor and self-care ability a positive predictor for health and among the patients solely self-care ability. Conclusion: Capacity for health change was higher among the older in-patients than among the home-dwelling persons. The importance of perceived helplessness as a hindrance for health change among older people should be important for nurses to focus on when caring for, about and with older people.

• Barken, Tina Lien; Söderhamn, Ulrika & Thygesen, Elin (2019). The humanistic perspective of telemedicine care - COPD patient' and nurses' expereiences of receiving/providing telemedicine care . Universitetet i Agder. ISSN 978-82-7117-942-7. Fulltekst i vitenarkiv
• Slettebø, Åshild; Kjøstvedt, Helga Tofte & Söderhamn, Ulrika (2014). Evalueringsprosjekt av etikkarbeid i kommunene i Aust- og Vest-Agder (EEKAVA). Senter for omsorgsforskning. ISSN 978-82-93269-65-6.

Se alle arbeider i Cristin