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Olai, Lena
Publications (10 of 11) Show all publications
Hägglund, P., Olai, L., Ståhlnacke, K., Persenius, M., Hägg, M., Andersson, M., . . . Carlsson, E. (2017). Study protocol for the SOFIA project: Swallowing function, Oral health, and Food Intake in old Age: a descriptive study with a cluster randomized trial. BMC Geriatrics, 17, Article ID 78.
Open this publication in new window or tab >>Study protocol for the SOFIA project: Swallowing function, Oral health, and Food Intake in old Age: a descriptive study with a cluster randomized trial
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2017 (English)In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 17, article id 78Article in journal (Refereed) Published
Abstract [en]

Background: Extensive studies have shown that older people are negatively impacted by impaired eating and nutrition. The abilities to eat, enjoy food, and participate in social activities associated with meals are important aspects of health-related quality of life (HRQoL) and recovery after illness. This project aims to (i) describe and analyze relationships between oral health and oral HRQoL, swallowing ability, eating ability, and nutritional risk among older individuals admitted to short-term care; (ii) compare the perceptions that older individuals and staff report on care quality related to oral hygiene and eating; and (iii) study the feasibility and effects of a training program for people with impaired swallowing (i.e., dysphagia). Methods/Design: This project consists of two parts, which will be performed in five Swedish counties. It will include approximately 400 older individuals and 200 healthcare professionals. Part 1 is a cross-sectional, descriptive study of older people admitted to short-term care. Subjects will be assessed by trained professionals regarding oral health status, oral HRQoL, eating and nutritional risk, and swallowing ability. Swallowing ability will be measured with a teaspoon test and a swallowing capacity test (SCT). Furthermore, subjects and staff will complete a questionnaire regarding their perceptions of care quality. Part 2 is a cluster randomized intervention trial with controls. Older participants with dysphagia (i.e., SCT < 10 ml/s, measured in part 1) will be recruited consecutively to either the intervention or control group, depending on where they were admitted for short-term care. At baseline, all subjects will be assessed for oral health status, oral HRQoL, eating and nutritional risk, swallowing ability, and swallowing-related QoL. Then, the intervention group will receive 5 weeks of training with an oral screen for neuromuscular training focused on orofacial and pharyngeal muscles. After completing the intervention, and at six months post-intervention, all assessments will be repeated in both study groups. Discussion: The results will make important contributions to rehabilitation knowledge, including approaches for improving swallowing function, oral health, and food intake and for improving the quality of oral care for older people.

Place, publisher, year, edition, pages
BIOMED CENTRAL LTD, 2017
Keywords
Aged, Deglutition, Eating, Oral health, Quality of health care, Quality of life, Oral screen, Short-term care, Swallowing disorders
National Category
Geriatrics
Identifiers
urn:nbn:se:uu:diva-320201 (URN)10.1186/s12877-017-0466-8 (DOI)000397463200003 ()28335729 (PubMedID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare
Available from: 2017-04-18 Created: 2017-04-18 Last updated: 2017-11-29Bibliographically approved
Eldh, A. C., Olai, L., Jönsson, B., Wallin, L., Denti, L. & Elf, M. (2017). Supporting first-line managers in implementing oral care guidelines in nursing homes. Nordic journal of nursing research
Open this publication in new window or tab >>Supporting first-line managers in implementing oral care guidelines in nursing homes
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2017 (English)In: Nordic journal of nursing research, ISSN 2057-1585, E-ISSN 2057-1593Article in journal (Refereed) Epub ahead of print
Abstract [en]

This study investigated first-line managers’ experience of and responses to a concise leadership intervention to facilitate the implementation of oral care clinical practice guidelines (CPGs) in nursing homes. Leadership is known to be an important element in knowledge implementation but little is known as to what supports managers to facilitate the process. By means of a process evaluation with mixed methods, the context and a three-month leadership program was explored, including activities during and in relation to the program, and the effects in terms of oral care CPG implementation plans. While the managers appreciated the intervention and considered improved oral care to be a priority, their implementation plans mainly focused the dissemination of an oral care checklist. The findings suggest that extended implementation interventions engaging both managers and clinical staff are needed, and that a concise intervention does not facilitate first-line managers to adopt behaviors known to facilitate knowledge implementation.

Place, publisher, year, edition, pages
Sage Publications, 2017
National Category
Nursing
Research subject
Caring Sciences
Identifiers
urn:nbn:se:uu:diva-342433 (URN)10.1177/2057158517713379 (DOI)
Available from: 2018-02-20 Created: 2018-02-20 Last updated: 2018-02-21Bibliographically approved
Olai, L., Hägg, M., Ståhlnacke, K., Carlsson, E. & Persenius, M. (2015). Effects of swallowing training on eating, oral health and quality of care among elderly people in short-term care units: preliminary findings. In: : . Paper presented at The 21st IAGG European Congress of Gerontology and Geriatrics, Dublin.
Open this publication in new window or tab >>Effects of swallowing training on eating, oral health and quality of care among elderly people in short-term care units: preliminary findings
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2015 (English)Conference paper, Published paper (Other academic)
National Category
Geriatrics
Identifiers
urn:nbn:se:uu:diva-268163 (URN)
Conference
The 21st IAGG European Congress of Gerontology and Geriatrics, Dublin
Available from: 2015-12-02 Created: 2015-12-02 Last updated: 2015-12-02
Olai, L., Elf, M., Eldh, A., Wallin, L. & Jönsson, B. (2015). Implementing oral health-care guidelines in long-term-care: the role and support of managers. In: : . Paper presented at 20th European Association of Dental Public Health, Istanbul.
Open this publication in new window or tab >>Implementing oral health-care guidelines in long-term-care: the role and support of managers
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2015 (English)Conference paper, Published paper (Other academic)
National Category
Geriatrics
Identifiers
urn:nbn:se:uu:diva-268169 (URN)
Conference
20th European Association of Dental Public Health, Istanbul
Available from: 2015-12-02 Created: 2015-12-02 Last updated: 2015-12-02
Olai, L., Borgquist, L. & Svärdsudd, K. (2015). Life situations and the care burden for stroke patients and their informal caregivers in a prospective cohort study. Upsala Journal of Medical Sciences, 120(4), 290-298
Open this publication in new window or tab >>Life situations and the care burden for stroke patients and their informal caregivers in a prospective cohort study
2015 (English)In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 120, no 4, p. 290-298Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: The purpose of this study was to analyse whether the parallel life situation between stroke patients and their informal caregivers (dyads) shown in cross-sectional studies prevails also in a longitudinal perspective.

METHODS: A total of 377 Swedish stroke patients, aged ≥65 years, and their 268 informal caregivers were followed from hospital admission and one year on. Analyses were based on patient interviews, functional ability (MMSE) score, Nottingham Health Profile (NHP) score, Hospital Anxiety and Depression (HAD) score, self-rated health score, and the Gothenburg Quality of Life (GQL) activity score. Similar information was obtained by postal questionnaires from informal caregivers, also including information on the nature and amount of assistance provided and on Caregiver Burden (CB) score.

RESULTS: Before index admission informal caregivers provided care on average 5 h per week and after discharge 11 h per week (P < 0.0001). Support volume was associated with patient sex (more for men), low patient's functional ability, low received municipal social service support, closeness of patient-caregiver relation, and short distance to patient's home. Significant positive associations within the dyads were found for HAD anxiety score (P < 0.0001), total NHP score (P < 0.0001), and GQL activity score (P < 0.0001) after adjustment for patient's age, sex, functional ability, and patient-caregiver relationship. CB score increased with amount of informal caregiver support, patient's age, and with low functional ability and low amount of municipal social service support. All these associations were constant across time.

CONCLUSIONS: There was an association within the dyads regarding anxiety score, NHP score, and activity score. CB score was generally high.

Keywords
Caregiver burden; dyad; elderly; informal caregiver; stroke
National Category
Health Sciences
Identifiers
urn:nbn:se:uu:diva-264933 (URN)10.3109/03009734.2015.1049388 (DOI)000365684900009 ()26074171 (PubMedID)
Funder
Vårdal Foundation, V98-401
Available from: 2015-10-19 Created: 2015-10-19 Last updated: 2017-12-01Bibliographically approved
Österlund Efraimsson, E., Klang, B., Ehrenberg, A., Larsson, K., Fossum, B. & Olai, L. (2015). Nurses’ and patients’ communication in smoking cessation at nurse-led COPD clinics in primary health care. European Clinical Respiratory Journal, 2, Article ID 27915.
Open this publication in new window or tab >>Nurses’ and patients’ communication in smoking cessation at nurse-led COPD clinics in primary health care
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2015 (English)In: European Clinical Respiratory Journal, ISSN 2001-8525, Vol. 2, article id 27915Article in journal (Refereed) Published
Abstract [en]

Background: Smokers with chronic obstructive pulmonary disease (COPD) have high nicotine dependence making it difficult to quit smoking. Motivational interviewing (MI) is a method that is used in stimulating motivation and behavioral changes.

Objective: To describe smoking cessation communication between patients and registered nurses trained in MI in COPD nurse-led clinics in Swedish primary health care.

Methods: A prospective observational study with structured quantitative content analyses of the communication between six nurses with basic education in MI and 13 patients in non-smoking consultations.

Results: Only to a small extent did nurses’ evoke patients’ reasons for change, stimulate collaboration, and support patients’ autonomy. Nurses provided information, asked closed questions, and made simple reflections. Patients’ communication was mainly neutral and focusing on reasons for and against smoking. It was uncommon for patients to be committed and take steps toward smoking cessation.

Conclusion: The nurses did not adhere to the principles of MI in smoking cessation, and the patients focused to a limited extent on how to quit smoking.

Practice implications: To make patients more active, the nurses need more education and continuous training in motivational communication.

National Category
Respiratory Medicine and Allergy
Identifiers
urn:nbn:se:uu:diva-268154 (URN)10.3402/ecrj.v2.27915 (DOI)
Available from: 2015-12-02 Created: 2015-12-02 Last updated: 2015-12-04Bibliographically approved
Stålnacke, K., Carlsson, E., Olai, L., Hägg, M. & Persenius, M. (2015). OHRQoL, oral-health/care, eating and swallowing among elderly people in short-term accommodations in Sweden. In: : . Paper presented at 20th European Association of Dental Public Health, Istanbul.
Open this publication in new window or tab >>OHRQoL, oral-health/care, eating and swallowing among elderly people in short-term accommodations in Sweden
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2015 (English)Conference paper, Published paper (Other academic)
National Category
Geriatrics
Identifiers
urn:nbn:se:uu:diva-268168 (URN)
Conference
20th European Association of Dental Public Health, Istanbul
Available from: 2015-12-02 Created: 2015-12-02 Last updated: 2015-12-02
Olai, L., Borgquist, L. & Svärdsudd, K. (2012). Health problems in elderly patients during the first post-stroke year. Upsala Journal of Medical Sciences, 117(3), 318-327
Open this publication in new window or tab >>Health problems in elderly patients during the first post-stroke year
2012 (English)In: Upsala Journal of Medical Sciences, ISSN 0300-9734, E-ISSN 2000-1967, Vol. 117, no 3, p. 318-327Article in journal (Refereed) Published
Abstract [en]

Background. A wide range of health problems has been reported in elderly post-stroke patients. Aim. The aim of this study was to analyse the prevalence and timing of health problems identified by patient interviews and scrutiny of primary health care and municipality elderly health care records during the first post-stroke year.

Methods. A total of 390 consecutive patients, >= 65 years, discharged alive from hospital after a stroke event, were followed for 1 year post-admission. Information on the health care situation during the first post-stroke year was obtained from primary health care and municipal elderly health care records and through interviews with the stroke survivors, at 1 week after discharge, and 3 and 12 months after hospital admission.

Results. More than 90% had some health problem at some time during the year, while based on patient record data only 4-8% had problems during a given week. The prevalence of interview-based health problems was generally higher than record-based prevalence, and the ranking order was moderately different. The most frequently interview-reported problems were associated with perception, activity, and tiredness, while the most common record-based findings indicated pain, bladder and bowel function, and breathing and circulation problems. There was co-occurrence between some problems, such as those relating to cognition, activity, and tiredness.

Conclusions. Almost all patients had a health problem during the year, but few occurred in a given week. Cognitive and communication problems were more common in interview data than record data. Co-occurrence may be used to identify subtle health problems.

Keywords
stroke, elderly, health problems, outcome
National Category
General Practice
Research subject
Caring Sciences
Identifiers
urn:nbn:se:uu:diva-112871 (URN)10.3109/03009734.2012.674572 (DOI)000307186800009 ()
Available from: 2010-01-21 Created: 2010-01-21 Last updated: 2018-01-12Bibliographically approved
Olai, L. (2010). Life After a Stroke Event: With Special Reference to Aspects on Prognosis, Health and Municipality Care Utilization, and Life Satisfaction Among Patients and Their Informal Caregivers. (Doctoral dissertation). Uppsala: Acta Universitatis Upsaliensis
Open this publication in new window or tab >>Life After a Stroke Event: With Special Reference to Aspects on Prognosis, Health and Municipality Care Utilization, and Life Satisfaction Among Patients and Their Informal Caregivers
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Objectives. The aim of this thesis was to study the prognosis, health care utilization and health situation in stroke patients, and informal caregiver burden during the first post-stroke year.

Material and methods. 390 patients, 65 years or older, discharged from hospital after a stroke, were followed with repeated patient interviews, patient record and register data, and hospital staff and informal caregiver questionnaires.

Results. Prognosis assessments performed by hospital staff at discharge regarding the course of events during the following year were highly accurate and were mainly influenced by the patient’s pre- and post-morbid state. The risk of dying or having a new stroke decreased rapidly during the early post-morbid phase. Health care utilization, in hospitals as well as in primary health care, and municipal social service support was considerably higher after the stroke than before, but the utilization of services was lower than previously reported. Health problem prevalence according to interview and record scrutiny was modest, peaked early after discharge and then declined. Support from informal caregivers increased significantly after discharge and remained high during the first post-stroke year. The support given was mainly determined by patient functional ability, distance to patient, relation to patient, municipal social service support provided, and patient sex. The informal caregivers reported considerable strain and burden, with significantly higher levels of anxiety and depression than the stroke patients. Moreover, there was a parallel between the patient’s and the caregiver’s situation regarding anxiety, emotional and social situation, and home, social and outdoor activities.

Conclusion. Hospital staff prognosis assessments of patient outcomes during the next year were highly accurate. Risk of recurrence and mortality, and health problem prevalence was high in the early post-stroke period, and than declined. Health care utilization and municipality social support increased over time. Informal caregivers reported considerable strain and burden.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2010. p. 78
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 517
Keywords
stroke, older age, prognosis, care utilization, life situation, informal caregiver, health problems, survival, hazard, nursing
National Category
General Practice
Research subject
Caring Sciences
Identifiers
urn:nbn:se:uu:diva-112875 (URN)978-91-554-7711-0 (ISBN)
Public defence
2010-03-06, Föreläsningssalen, Falu lasarett, Falun, 13:15 (Swedish)
Opponent
Supervisors
Available from: 2010-02-12 Created: 2010-01-21 Last updated: 2018-01-12Bibliographically approved
Olai, L., Omne-Pontén, M., Borgquist, L. & Svärdsudd, K. (2009). Survival, hazard function for a new event, and healthcare utilization among stroke patents ≥65 Years. Stroke, 40(11), 3585-3590
Open this publication in new window or tab >>Survival, hazard function for a new event, and healthcare utilization among stroke patents ≥65 Years
2009 (English)In: Stroke, ISSN 0039-2499, E-ISSN 1524-4628, Vol. 40, no 11, p. 3585-3590Article in journal (Refereed) Published
Abstract [en]

Background and Purpose — The natural history of stroke is still incompletely understood. The aim of this study was to present detailed data on survival, recurrence, and all types of healthcare utilization before and after a stroke event in patients with stroke.

Methods — Three hundred ninety stroke survivors constituted the study population. Information on survival data during 5 years of follow-up, all hospital admissions since 1971, all outpatient and primary care consultations, and all municipal social service support during the year before and after the index stroke admission and patient interviews 1 week after discharge were obtained.

Results — The risk of death or a new stroke was high in the early phase after admission but then decreased rapidly during the next few months. Mortality during the first 5 years was influenced by age and functional ability, whereas the risk of stroke recurrence was influenced by number of previous strokes, hypertension diagnosis, and sex. On a day-by-day basis, 35% were dependent on municipal support before and 65% after the stroke. The corresponding proportions in outpatient care were 6% and 10%, and for hospital inpatient care 1% to 2% and 2% to 3%. Of the health care provided, nursing care dominated.

Conclusions — The risk of dying or having a new stroke event decreased sharply during the early postmorbid phase. Healthcare utilization increased after discharge but was still moderate on a day-by-day basis, except for municipal social service support, which was substantial.

Keywords
epidemiology, hazard function, health care utilization, municipal support, recurrence
National Category
Medical and Health Sciences
Research subject
Caring Sciences
Identifiers
urn:nbn:se:uu:diva-112848 (URN)10.1161/STROKEAHA.109.556720 (DOI)000271160300030 ()
Available from: 2010-01-21 Created: 2010-01-21 Last updated: 2017-12-12Bibliographically approved
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