Embodied navigation: the influence of lived experience on physical activity and sedentary behavior among older adults.

PURPOSE: The impact of a sedentary lifestyle on health and well-being is well recognized. However, there is limited understanding of how a lifetime of physical activity and sedentary behaviour influences an active lifestyle in older adults. The aim of this study was to describe how lived experience of physical activity and sedentary behaviour impacts daily activities among older adults, from a life course perspective. METHODS: Qualitative content analysis was used; individual telephone interviews were conducted with fourteen older adults aged 71 to 92 years. The participants received initial support from community care and lived in ordinary housing in southern Sweden. RESULTS: The interviews yielded one theme, "Navigating with an embodied activity compass," and two sub-themes: "Being guided by the past" and "Unveiling pathways through body awareness." CONCLUSIONS: Our study highlights how older adults' lived experiences of physical activity, with their connections to body awareness and acceptance, impact daily physical activity. These findings offer new knowledge for clinical practitioners balancing recommendations of sedentary behaviour and physical activity, to promote healthy daily physical activity among older adults. Future research and policies should consider the lived experiences of older adults when addressing public health matters related to sedentary behaviour and physical activity.

Relative's suggestions for improvements in support from health professionals before and after a patient's death in general palliative care at home: A qualitative register study.

INTRODUCTION: The efforts of relatives in providing palliative care (PC) at home are important. Relatives take great responsibility, face many challenges and are at increased risk of poor physical and mental health. Support for these relatives is important, but they often do not receive the support they need. When PC is provided at home, the support for relatives before and after a patient's death must be improved. This study aimed to describe relatives' suggestions to improve the support from health professionals (HPs) before and after a patient's death in general PC at home. METHODS: This study had a qualitative descriptive design based on the data from open-ended questions in a survey collected from the Swedish Register of Palliative Care. The respondents were adult relatives involved in general PC at home across Sweden. The textual data were analysed using thematic analysis. RESULTS: The analysis identified four themes: (1) seeking increased access to HPs, (2) needing enhanced information, (3) desiring improved communication and (4) requesting individual support. CONCLUSIONS: It is important to understand and address how the support to relatives may be improved to reduce the unmet needs of relatives. The findings of this study offer some concrete suggestions for improvement on ways to support relatives. Further research should focus on tailored support interventions so that HPs can provide optimal support for relatives before and after a patient's death when PC is provided at home.

Daily activity patterns in older adults receiving initial support: the association between daily steps and sitting in bouts of at least 60 min.

BACKGROUND: Aging has a significant impact on health, underlining the importance of maintaining physical function and reducing time spent sitting among older adults. To understand how to reduce prolonged sitting or increase physical activity, factors related to the daily living and observed daily activity patterns should be explored. This study aimed to investigate the association between daily steps, self-rated health, physical activity, sedentary behavior, motivation to exercise and fear of falling among older adults receiving initial support. METHOD: Cross-sectional design with total population questionnaire data from adults aged ≥ 60 years (n = 917), living at home with initial support from municipal care in southern Sweden. The older adults were offered to participate in a follow-up study measuring daily activity patterns with accelerometers (n = 72). Linear regression was used to analyze associations between daily steps and possible predictors. RESULTS: The linear model ([Formula: see text]0.478) showed that sitting in unbroken bouts of > 60 min (ß = -0.313, p < 0.05), walking independently outdoors (ß = 0.301, p < 0.05), intending to increase physical activity (ß = -0.294, p < 0.05), sex (ß = 0.279, p < 0.05), relative autonomy index (ß = 0.258, p < 0.05), fear of falling (ß = -0.238, p < 0.05), and self-rated health (ß = 0.213, p < 0.05) predicted daily steps. CONCLUSION: The model of predictors brings new understanding regarding daily steps among community-dwelling older adults. The association between sitting in bouts of > 60 min and daily steps is interesting as 35% of participants had a number of sitting bouts that on average, showed 30% less steps taken. Minimizing long sitting bouts and maintaining physical functioning to promote independence when walking outdoors can be tools for clinical practitioners devising interventions to break prolonged sitting among community-dwelling older adults. Future research should prioritize studying older adults' outdoor walking independence, including its relation to walking with or without assistive devices and its impact on physical activity and sedentary behavior.

Support given by health professionals before and after a patient's death to relatives involved in general palliative care at home in Sweden: Findings from the Swedish Register of Palliative Care.

OBJECTIVES: General palliative care (PC) is provided more at home, leading to increased involvement of relatives. Although support for relatives is a fundamental component of PC, there are deficiencies in the support provided to relatives when general PC is provided at home. This study aimed to describe the support provided by health professionals before and after a patient's death to relatives involved in general PC at home. METHODS: A cross-sectional register study was implemented, with data from the Swedish Register of Palliative care. The sample consisted of 160 completed surveys from relatives who had been involved in general PC at home, with 160 related surveys answered by health professionals. Only the questions about support to relatives were used from the surveys. RESULTS: The findings showed that although many relatives appear to receive support in general PC at home, not all relatives receive optimal support before or after a patient's death. The findings also indicated differences in whether relatives received some support before and after a patient's death depending on the type of relative. There were also differences in responses between health professionals and relatives regarding if relatives received counseling from a doctor about whether the patient was dying. SIGNIFICANCE OF RESULTS: There is potential for improvements regarding support for relatives, especially after a patient's death, which has been confirmed in previous studies. The differences in whether relatives received support before and after a patient's death depending on the type of relative highlight the need for future research on how to support different types of relatives before and after a patient's death when general PC is provided at home.

The meaning of sedentary behavior among older adults: a phenomenological hermeneutic study.

BACKGROUND: A sedentary lifestyle has implications for health and well-being. For healthy ageing, it is recommended to interrupt prolonged sitting; however, little is known about the meaning of sedentary behavior among older adults. The aim of this study was to understand the meaning of sedentary behavior among older adults with initial support from community care. METHODS: A phenomenological hermeneutics approach was used, and individual interviews were conducted with sixteen older adults aged 70 to 97 years, by phone and face to face. The older adults lived in ordinary housing in southern Sweden and received initial support from community care. RESULTS: The interviews yielded three key themes: Being sedentary is an unnatural part of life, having an ageing body means unwanted frailty, and having a sedentary lifestyle is based on conscious choices. CONCLUSION: Being sedentary means having a lack of physical activity and social interactions, resulting in wanting to be more physically active than sometimes possible. Clinical practitioners should bear in mind that becoming more sedentary is inevitable with an ageing body, but that older adults may have an innate desire to be as physically active as possible. A lifelong exposure to physical activity, the possibility of well-being found in sedentary activities and the impact of social networks should not be overlooked when creating clinical interventions to break unhealthy sedentary behavior among older adults. To increase the understanding of sedentary behavior among older adults, future research could focus on the impact of physical impairment on sedentary behavior and the relationship between sedentary behavior and physical activity throughout life.

Cross-Sectional Study of Sexual Activity and Satisfaction Among Older Adult's ≥60 Years of Age.

INTRODUCTION: Despite the rapidly increasing population of older adults, little is currently known about sexual activity and sexual satisfaction among the oldest people. AIM: The present study aimed to investigate sexual activity and sexual satisfaction among people of ≥60 years of age. We also examined whether sexual activity and sexual satisfaction were influenced by age, gender, cohabiting, socioeconomic factors, education, functional ability, and self-reported health. METHODS: We performed a descriptive analysis of self-stated sexual activity and sexual satisfaction among 1680 participants who were 60 years and older from the Swedish National Study on Aging and Care. Chi-square tests and logistic regression were used to analyze relationships between factors. MAIN OUTCOME MEASURE: Sexual activity and sexual satisfaction. RESULTS: Among participants aged ≥90 years, about 10% were sexually active. Within the total study population, 46% (654/1680) were sexually active. Overall, sexually activity was more commonly reported by men (55%) than women (40%). However, men in all age cohorts reported sexual dissatisfaction more commonly than women. In the total sample, 24% (246/1680) reported dissatisfaction with their sex life. Sexual activity and sexual satisfaction were positively associated with self-reported health and cohabitation. CONCLUSION: The present results suggest that sexual activity is present throughout life. For persons older than 90 years, about 10% of participants were sexually active, regardless of gender. Every third man reported dissatisfaction with his sex life. Women were more satisfied with their sex lives than men, and this difference varies more widely among age cohorts. These findings confirm that it is important that health professional take sexuality into account during caring encounters with older persons. M Stentagg, L Skär, JS Berglund, et al. Cross-Sectional Study of Sexual Activity and Satisfaction Among Older Adult's ≥60 Years of Age. Sex Med 2021;9:100316.

Older persons' experience of eHealth services in home health care: A meta-ethnography eHealth services in home health care.

This study aimed to describe older persons' experiences of eHealth services in home health care. A meta-ethnographic approach was applied, and a systematic literature search was conducted in three databases. In total, 11 articles were included and analysed, which resulted in two themes and six sub-themes. The results show that for older persons to use the eHealth services, they must provide some additional value compared to current contacts with healthcare professionals. Those with regular healthcare contact do not experience the eHealth service as adding anything to the care they already receive. The introduction of eHealth services involves learning how to use the new technology, and some older persons experience the technology as motivating and inspiring. The eHealth service makes some feel safer while some do not trust the technology. In order to make the best use of eHealth services, it is important that the services are adjusted not only to each person's needs but also to their personal capabilities and resources, while the older person must feel valued as an active partner in the care process. Thus, when using eHealth services, the older person's perspective needs to be given priority and decisions should not only be based on organizational considerations.

Nonpharmacological methods: frequency of use and follow-up actions among healthcare staff in the care of older people.

Older people are at risk of developing multi-comorbidity and thus being exposed to multiple treatments and drugs to manage the emerging health complaints. More focus has been put on nonpharmacological alternatives. However, studies revealing the healthcare staff perspective on using nonpharmacological methods (NPMs) in the care of older people are still lacking. Thus, the aim of this study was to map the use of NPMs in daily practices and the follow-up thereof. A population-based survey with questionnaires was performed, included all healthcare professionals (n = 163; nurses and paramedical professionals) working in one district of elderly care in Sweden. The older person's anxiety and worry (76.1%), sleeping problems (53.1%) and pain (41.1%) were the health problems in daily life most likely to trigger use of NPMs. To manage the emerging health problems, interactions (87.1%), diet and nutrition supplements (63.2%) and physical activity were commonly used, particularly by nurses. One third (n = 54) stated that they did not evaluate the NPMs used, with no statistical differences between nurses and paramedical professionals. The present study indicated that NPMs were used in care of older people among nurses and paramedical professionals, but not in a systematic way and often without follow-up.

Prevalence and Incidence of Atrial Fibrillation and Other Arrhythmias in the General Older Population: Findings From the Swedish National Study on Aging and Care.

Aim: To study the prevalence and cumulative incidence of arrhythmias in the general population of adults aged 60 and older over a 6-year period. Study Design and Setting: Data were taken from the Swedish National Study on Aging and Care (SNAC), a national, longitudinal, multidisciplinary study of the general elderly population (defined as 60 years of age or older). A 12-lead resting electrocardiography (ECG) was performed at baseline and 6-year follow-up. Results: The baseline prevalence of atrial fibrillation (AF) was 4.9% (95% confidence interval [CI] = [4.5%, 5.5%]), and other arrhythmias including ventricular premature complexes (VPCs), supraventricular tachycardia (SVT), and supraventricular extrasystole (SVES) were seen in 8.4% (7.7%, 9.0%) of the population. A first- or second-degree atrioventricular (AV) block was found in 7.1% of the population (95% CI = [6.5%, 7.7%]), and there were no significant differences between men and women in baseline arrhythmia prevalence. The 6-year cumulative incidence of AF was 4.1% (95% CI = [3.5%, 4.9%]), or 6.9/1,000 person-years (py; 95% CI = [5.7, 8.0]). The incidence of AF, other arrhythmias, AV block, and pacemaker-induced rhythm was significantly higher in men in all cohorts except for the oldest. Conclusion: Our data highlight the prevalence and incidence of arrhythmias, which rapidly increase with advancing age in the general population.

Older individuals' need for knowledge and follow-up about their chronic atrial fibrillation, lifelong medical treatment and medical controls.

Older individuals with chronic atrial fibrillation (AF) often experience physical symptoms and feel psychologically unwell. In addition, these persons are prescribed lifelong medical treatment that requires regular monitoring. Through 11 individual interviews, this interpretive description study aimed to explore and describe lifelong medical treatment and the need for medical controls as experienced from the perspective of older individuals living with chronic AF. The interviews were performed during 2014-2015; furthermore, they were recorded, transcribed verbatim and analysed for thematic patterns using thematic analysis inspired by Braun and Clarke. Ethical standards were followed throughout the study. The findings revealed one main theme: 'ambivalence in the need of knowledge' showing that lifelong medical treatment and the need for medical controls, in general, meant experiencing feelings of 'it doesn't matter, but it does matter' and 'being in the hands of the healthcare system'. The older persons lacked knowledge about their condition, which generated poor insight into their medical treatment and this in turn affected their daily life. They had thoughts and questions about their medication, but did not have an opportunity to ask the questions because of lack of follow-up from the healthcare system. The findings underscore the negative impact chronic AF has on older people's life and emphasises the need for follow-up and providing information from health care to these individuals.

Prevalence of unknown and untreated arrhythmias in an older outpatient population screened by wireless long-term recording ECG.

PURPOSE: With longer life expectancies, the prevalence of arrhythmias is increasing; thus, there is a need for new methods to screen the older outpatient population. This population-based study describes the prevalence of arrhythmias in 200 outpatients aged ≥66 years. We also investigated the feasibility of wireless long-term recording (LTR) using the ECG-BodyKom(®). METHODS: Two hundred elderly persons aged 66-93 years were recruited from the Swedish National Study on Aging and Care in 2010-2013, and data were collected via wireless LTR ECG-BodyKom. RESULTS: Screening with the LTR ECG revealed that persistent atrial fibrillation (AF) occurred in 10% of the outpatient population aged ≥66 years. Paroxysmal AF occurred in 5.5% of the population, with no difference between younger (60-80 years) and older (>80 years) elderly participants. Furthermore, all patients with paroxysmal AF had a CHA2DS2VASc score of ≥2 and were therefore potential candidates for follow-up and medical examination. LTR ECG-BodyKom can be considered a feasible method to screen for arrhythmias in older outpatient populations. This simple method requires little of the user, and there was high satisfaction with the equipment and a good overall experience wearing it. CONCLUSION: The increasing occurrence of arrhythmias in the older population, as well as the high number of untreated cases of arrhythmias such as persistent AF and paroxysmal AF, poses a challenge for health care. Therefore, it is essential to develop effective strategies for their prevention and treatment.

A systematic review and meta-analysis of dressings used for wound healing: the efficiency of honey compared to silver on burns.

BACKGROUND: Honey has the antibacterial effect of silver without the toxic effect of silver on the skin. Even so, silver is the dominant antibacterial dressing used in wound healing. OBJECTIVES: To evaluate the healing effects of honey dressings compared to silver dressings for acute or chronic wounds. DESIGN: A systematic review with meta-analysis. METHOD: The search, conducted in seven databases, resulted in six randomised controlled trial studies from South Asia focusing on antibacterial properties and healing times of honey and silver. RESULT: Honey was more efficacious for wound healing than silver, as measured in the number of days needed for wounds to heal (pooled risk difference -20, 95% CI -0.29 to -0.11, p < .001). Honey turned out to have more antibacterial qualities than silver. CONCLUSION: All the included studies based on burns showed the unequivocal result that honey had an even more positive effect than silver on wound healing.