Balancing family and state care: neither, either or both? The case of Sweden

2006 ◽  
Vol 26 (5) ◽  
pp. 767-782 ◽  
Author(s):  
GERDT SUNDSTRÖM ◽  
BO MALMBERG ◽  
LENNARTH JOHANSSON

Old-age care has frequently been conceptualised as being either family-based or publicly-provided. This article analyses the overlap in provision from the two sources and their relationship in the Swedish welfare state. Many older people and their carers rely on both sources of help rather than on just one, and prefer to do so. The empirical evidence on patterns of care in Sweden supports a joint family-state conceptualisation of care. Its realisation may depend on general coverage rates of public services and the efficient targeting of frail elderly people who live alone. Most older people in need of care rely on help only from their family, but many are helped by both the family and the state, particularly those with the greatest needs. Dynamic concepts like ‘substitution’ and ‘complementarity’ are hard to apply in cross-sectional studies: there may be complementarity in individual cases but long-term substitution or its reversal in successive cohorts. Yet again, both sources of care may increase simultaneously in individual cases. The need for care varies considerably among Swedish municipalities, with implications for the levels of both public services and family support. High coverage rates of the public services may facilitate and support family care.

2017 ◽  
Vol 2 (1) ◽  
pp. 55
Author(s):  
Junaidi Junaidi

The public health center in Darul Kamal has data on under-five children enrolled in 14 integrated service posts of 708 infants in December 2011 with malnutrition rate of 23,0%, short of 41,0% and 25,7% of underweight children. The research aims to determine the influence of the influence of energy and nutrient adequacy and stimulation of family care pattern on the health of intelligence in children. The research is analytical with a cross sectional approach, conducted on September 1 until December 20, 2013. The sample is all children aged 0-24 months registered at 14 integrated service post in Darul Kamal district taken by total sampling method that is 297 child. Types of data are the adequacy of energy and nutrients collected by the method of FFSQ, stimulation of family care patterns and intelligence health of children collected by interview using questionnaires. The results showed that there was no influence of the level of energy sufficiency, carbohydrate, and fat with the health level of intelligence. In that case, the influence of the level of protein adequacy and the level of stimulation of family care pattern with the level of intelligence child health. The conclusion of a child that the level of intelligence health is less influenced by the lack of good stimulation of family parenting and lack of protein adequacy. Suggestion to midwife of it Darul Kamal to be able to increase counseling about the role of stimulation of parenting for the health of child intelligence to a mother of the toddler.Keywords: Energy and nutrients, health intelligence, parentingPuskesmas Darul Kamal memiliki data balita yang terdaftar di 14 Posyandu sebanyak 708 balita pada bulan Desember 2011 dengan angka gizi kurang sebesar 23,0%, pendek sebesar 41,0% dan balita kurus sebesar 25,7%. Penelitian bertujuan untuk mengetahui pengaruh pengaruh kecukupan energi dan zat gizi serta stimulasi pola asuh keluarga terhadap kesehatan intelegensia pada anak baduta. Penelitian bersifat analitik dengan pendekatan cross sectional, dilaksanakan pada tanggal 01 September sampai 20 Desember 2013. Sampel adalah seluruh anak berumur 0-24 bulan yang terdaftar pada 14 Posyandu dalam wilayah Kecamatan Darul Kamal yang diambil dengan metoda total sampling yaitu sebanyak 297 baduta. Jenis data adalah kecukupan energi dan zat  gizi dikumpulkan dengan metode Food Frekuensi Semi Quantitatif (FFSQ), stimulasi pola asuh keluarga dan kesehatan intelegensia anak baduta dikumpulkan dengan cara wawancara menggunakan kuesioner. Hasil penelitian menunjukkan bahwa tidak ada pengaruh tingkat kecukupan energi, karbohidrat dan lemak dengan tingkat kesehatan intelegensia baduta, seain itu terdpat pengaruh tingkat kecukupan protein dan tingkat stimulasi pola asuh keluarga dengan tingkat kesehatan  intelegensia baduta. Kesimpulan baduta yang tingkat kesehatan intelegensia kurang dipengaruhi oleh kurang baik stimulasi pola asuh keluarga dan kurangnya kecukupan protein. Saran kepada para bidan Puskesmas daril Kamal untuk dapat meningkatkan penyuluhan tentang peranan stimulasi pola asuh bagi kesehatan intelegensia anak kepad ibu-ibu balita. Kata kunci: Energi dan zat gizi, kesehatan intelegensia pola asuh 


2021 ◽  
pp. 1-19
Author(s):  
Albert Julià ◽  
Sandra Escapa ◽  
Pedro Gallo

Abstract Care strategies for older dependants are determined by not only individuals or network characteristics, but also contextual factors. The objective of this study is to determine whether urban contexts (neighbourhoods) are linked to the use of family care (informal), public services or private care at home (formal). We applied logistic regression analysis to data from the Survey of People in a Situation of Dependence 2018. The sample was composed of 530 older people (55 years old and over) living in two types of socio-economic groups of neighbourhoods in Barcelona, Spain. The type of neighbourhood is relevant in explaining the home care that older dependants receive. In neighbourhoods with a high socio-economic level, dependants are more likely to use private services and less likely to use informal care services and public services, even after controlling for household income, degree of dependency, sex, age and the number of people in the household. Understanding the factors that determine the use of public care services, private care services or family care-giving is important due to the increment in the number of older people in the population. Our results suggest that differences in urban socio-economic contexts determine some inequalities in the use of services even after controlling for socio-economic individual differences. The characteristics of neighbourhoods should be considered to adjust care policies for older dependants.


2021 ◽  
Author(s):  
Jianlan Ren ◽  
Yu Zheng ◽  
Yue Luo ◽  
Mei Li ◽  
Rendie Xie ◽  
...  

Abstract Background:Vaccination is one of the most effective and low-cost health measures to prevent COVID-19. Vaccine hesitancy is an obstacle to COVID-19 vaccination. Objective:This study aims to inform the vaccine hesitancy and analyze related factors towards COVID-19 vaccination among elderly in Luzhou, so as to provide suggestions for increasing vaccines uptake. Methods:A face-to-face questionnaire cross-sectional survey was conducted among the elderly people over 60 years old in Luzhou City in April 2021 by multi-stage sampling method. Results: A total of 1047 valid questionnaires were received. 42.0%(440/1047)vaccine hesitancy was reported among elderly in total. Female (OR=1.282, 95%CI:1.003-1.649), live in the rural (OR=3.659, 95%CI:2.813-4.758), poor health (OR=2.318, 95%CI:1.473-3.649), individuals not having regular medical check-ups (OR=2.669, 95%CI:2.072-3.437) and no history of self-funded influenza vaccination ( OR=2.408, 95% CI:1.656-3.502) reported slightly higher vaccine hesitancy. Being in low-risk areas and no need to get vaccinated (OR=16.877, 95%CI:11.750-24.242), being considered that the current protective measures had been able to avoid infection (OR=5.539, 95%CI:3.596-8.532), being considered that the natural immunity get from the disease was better than getting COVID-19 vaccine (OR=5.297, 95%CI:3.666-7.653), being concerned about side effects (OR=5.155, 95%CI:3.655-7.270) and being concerned that the vaccine was ineffective (OR=10.244, 95%CI:6.831-15.362) had higher prevalence of vaccine hesitancy. Those who believing the COVID-19 vaccine was safe and reliable (OR=0.075, 95%CI:0.044-0.130), the vaccine was free (OR=0.466, 95%CI:0.312-0.697) and individuals with higher education (OR=0.189, 95%CI:0.126-0.284) were more willing to get vaccinated. Conclusion: Confidence in vaccines and perceptions of benefits and risk are associated with vaccine hesitancy. It’s very important to strengthen vaccine health literacy education for older people and enhance vaccine confidence. Countries need to supervise the public opinions in social media, television broadcasting and other media, so as to ensure the correct orientation of public opinion. Open and transparent evidence-based information is also needed which can help improve the vaccination coverage rate of the public.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 350-350
Author(s):  
Zachary Baker ◽  
Eric Jutkowitz ◽  
Joseph Gaugler

Abstract The decreasing number of family/friend caregivers available to help the rising number of older adults is creating a critical family care gap. For this reason, there is a growing need for interventions that reduce family/friend caregiving time. We systematically reviewed five electronic databases to identify randomized trials, case control, quasi-experimental, and cross-sectional studies that evaluated a modifiable element that could be targeted for interventions with care recipients 65+ and/or their family/friend caregivers and reported on an outcome of time spent caregiving. We excluded studies without a comparison, broadly defined. The initial search included 1,812 unique records. Following abstract and title screening 311 full-texts were reviewed. Fifty-five studies published between the years of 1990 and 2019 met inclusion criteria. Studies predominantly focused on care recipients with dementia (58%) and were largely conducted in western countries (91%). The categories of interventions reviewed included pharmaceuticals (25%), public long-term care financing (7%), case management (7%), care setting (16%), technology (7%), multi-component interventions (9%), skills building (15%), additional formal expertise/care (9%), and other (5%), with one study falling into multiple categories. Pharmaceuticals, case management, care setting, and multi-component interventions demonstrated promising evidence to reduce family/friend caregiving time. Methodologically, studies were inconsistent in measurement and ascertainment of caregiving time. Given the public health concerns of reduced availability of family/friend caregivers for older persons in the upcoming decades, caregiving interventions should consider measurements of caregiving time as key outcomes.


Author(s):  
Tamás Szabó

Demand concentrates space and vice versa with regard to the principle of rational public services: concentrated space broadens the needs in relation to task fulfilment and the possibilities of organizing public services. The theoretical question concerning the goodness of decentralised and centralised task fulfilment gets exciting when we compare the level of the provision of public services to social trends, and we examine the unintended functions of the applied practice and the latent impacts of these functions. Based on cross-sectional data, present study examines – with public education and health care focus – how access to public goods influences the social competitiveness of the resident population of each district in space. Furthermore, the study also addresses the direction in which the differentiated level of provision of each regions of the country exerts its migration and demographic impact.


2021 ◽  
pp. 205715852110443
Author(s):  
Helena Larsson ◽  
Kerstin Blomqvist ◽  
Anna-Karin Edberg ◽  
Christine Kumlien

The number of older people needing care is increasing, and care is often provided by informal caregivers. The mission of family care advisors (FCAs) is to provide them with support; however, whether and how support in existential matters such as existential loneliness is provided is unclear. Therefore, the aim of this study was to describe FCAs’ views on existential loneliness, and existential support provided to relatives who act as informal caregivers to older people. A national survey was distributed to 349 FCAs in Sweden, response rate n = 120 (36%). The STROBE checklist was followed when presenting the study. Existential loneliness was viewed as thoughts about life and meaning (78%). Existential support was provided by dialogues (87%), visits (75%) and support groups (73%); 45% of FCAs stated that they had time to provide existential support and 27% reported having knowledge of how to encounter existential loneliness. FCAs provide existential support, but often lack experience, knowledge and time. Time and knowledge are important prerequisites for acknowledging existential needs.


2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii1-iii16
Author(s):  
Deirdre O'Donnell

Abstract Background Family carers are critical to supporting older people to live well in their homes and demand for care at home is projected to increase dramatically into the future.1 The Irish state and health system, therefore, are dependent upon the supply of family care now and into the future. The health and well-being of older family carers, and carers providing care to older people in the community, is under-researched. Methods A combination of online and postal survey distribution achieved a convenience sample (N=1102) of carers from the membership and network reach of Ireland’s largest family carer support and advocacy agency. Results Of those carers providing care to an older adult (n=341), 30% were aged over 64 and 28% reported mild to moderate carer burden. A further 36% reported moderate to severe burden. The average Zarit burden score for carers caring for an older adult was 44 (CI 42:45) and was 39 (CI 36:43) for family carers aged over 64. Among family carers of older adults, 72% reported diagnosis or treatment for physical illness and 42% reported diagnosis or treatment for mental illness. The most frequently cited source of worry for this group was their own health and wellbeing (73%) followed by lack of appropriate supports/services (68%). GPs were the most frequently cited source of support (64%) followed by a PHN (50%). Conclusion The study findings indicate that the lack of appropriate state supports and services for family carers is negatively impacting carer health and well-being. Family carers, including those providing care to older people and those who are themselves aged over 64, need to be consistently identified for intervention by health professionals, particularly GPs and PHNs.


2018 ◽  
Vol 7 (1) ◽  
pp. 157-164
Author(s):  
Rubiane Inara Wagner ◽  
Patrícia Molz ◽  
Camila Schreiner Pereira

O objetivo deste estudo foi comparar a frequência do consumo de alimentos processados e ultraprocessados e verificar a associação entre estado nutricional por adolescentes do ensino público e privado do município de Arroio do Tigre, RS. Trata-se de um estudo transversal realizado com adolescentes, com idade entre 10 e 15 anos, de uma escola pública e uma privada de Arroio do Tigre, RS. O estado nutricional foi avaliado pelo índice de massa corporal. Aplicou-se um questionário de frequência alimentar contendo alimentos processados e ultraprocessados. A amostra foi composta por 64 adolescentes com idade média de 12,03±1,15 anos, sendo 53,1% da escola pública. A maioria dos adolescentes encontravam-se eutróficos (p=0,343), e quando comparado com o consumo de alimentos processados e ultraprocessados, a maioria dos escolares eutróficos relataram maior frequência no consumo de balas e chicletes (50,0%) e barra de cereais (51,0%), de 1 a 3 vezes por semana (p=0,004; p=0,029, respectivamente). Houve também uma maior frequência de consumo de alimentos processados e ultraprocessados como pizza (73,5%; p0,001), refrigerante (58,8%; p=0,036) e biscoito recheado (58,8%; p=0,008) entre 1 a 3 vezes por semana na escola pública em comparação a escola privada. O consumo de suco de pacote (p=0,013) foi relatado não ser consumido pela maioria dos alunos da escola particular em comparação a escola pública. Os dados encontrados evidenciam um consumo expressivo de alimentos processados e ultraprocessados pelos adolescentes de ambas as escolas, destacando alimentos com alto teor de açúcar e sódio.Palavras-chave: Hábitos alimentares. Adolescentes. Alimentos industrializados. ABSTRACT: The objective of this study was to compare the frequency of consumption of processed and ultraprocessed foods and to verify the association between nutritional status by adolescents from public and private schools in the municipality of Arroio do Tigre, RS. This was a cross-sectional study conducted with adolescents, aged 10 to 15 years, from a public school and a private school in Arroio do Tigre, RS. Nutritional status was assessed by body mass index. A food frequency questionnaire containing processed and ultraprocessed foods was applied. The sample consisted of 64 adolescents with a mean age of 12.03±1.15 years, 53.1% of the public school. Most of the adolescents were eutrophic (p=0.343), and when compared to the consumption of processed and ultraprocessed foods, most eutrophic schoolchildren reported a higher frequency of bullets and chewing gum (50.0%) and cereal bars (51.0%), 1 to 3 times per week (p=0.004, p=0.029, respectively). There was also a higher frequency of consumption of processed and ultraprocessed foods such as pizza (73.5%, p0.001), refrigerant (58.8%, p=0.036) and stuffed biscuit (58.8%, p=0.008) between 1 to 3 times a week in public school compared to private school. Consumption of packet juice (p=0.013) was reported not to be consumed by the majority of private school students compared to public school. Conclusion: The data found evidenced an expressive consumption of processed and ultraprocessed foods by the adolescents of both schools, highlighting foods with high sugar and sodium content.Keywords: Food Habits. Adolescents. Industrialized Foods.


2020 ◽  
Vol 2 (CSI) ◽  
pp. 12-18
Author(s):  
Ali Al-Rubaye ◽  
Dhurgham Abdulwahid ◽  
Aymen Albadran ◽  
Abbas Ejbary ◽  
Laith Alrubaiy

Background: There has been a rapid rise in cases of COVID-19 infection and its mortality rate since the first case reported in February 2020. This led to the rampant dissemination of misinformation and rumors about the disease among the public. Objectives: To investigate the scale of public misinformation about COVID-19 in Basrah, Iraq. Methods: A cross-sectional study based on a 22-item questionnaire to assess public knowledge and understanding of information related to the COVID-19 infection. Results: A total of 483 individuals completed the questionnaire. The most frequent age group was 26–35 years (28.2%); there were 280 (58%) males and 203 (42%) females. Of the participants, 282 (58.4%) were with an education level below the Bachelor’s degree, 342 (70.8%) were married, and 311 (64%) were living in districts in Basra other than the central district. Overall, 50.8% (11.8/ 22 * 100%) of individuals had the correct information regarding COVID-19. There was a significant association between the level of COVID-19 related misinformation and participants’ educational levels and occupation (p <0.05). However, there was no significant difference found across sex, age group, marital state, and area of residence. Conclusions: Misinformation related to COVID-19 is widely spread and has to be addressed in order to control the pandemic. Keywords: COVID-19, misinformation, knowledge, Iraq


2001 ◽  
Author(s):  
Jorge Calmon Moniz de Bittencourt Filho ◽  
Elizabeth R. Loiola

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