The aim of the study is to evaluate the effects of the Comprehensive Geriatric Assessment (CGA) for frail older people in Swedish acute hospital settings – the CGA-Swed study. In this study protocol, we present the study design, the intervention and the outcome measures as well as the baseline characteristics of the study participants. The study is a randomised controlled trial with an intervention group receiving the CGA and a control group receiving medical assessment without the CGA. Follow-ups were conducted after 1, 6 and 12 months, with dependence in activities of daily living (ADL) as the primary outcome measure. The study group consisted of frail older people (75 years and older) in need of acute medical hospital care. The study design, randomisation and process evaluation carried out were intended to ensure the quality of the study. Baseline data show that the randomisation was successful and that the sample included frail older people with high dependence in ADL and with a high comorbidity. The CGA contributed to early recognition of frail older people’s needs and ensured a care plan and follow-up. This study is expected to show positive effects on frail older people’s dependence in ADL, life satisfaction and satisfaction with health and social care.

Background: The comprehensive geriatric assessment (CGA) designed to manage frail older people requiring acute medical care, is responsible for diagnostics, assessment, treatment, and planning while addressing a person’s medical, psychological, social, and functional capabilities. The aim was to investigate if CGA had an impact on frail older people’s activities of daily living (ADL) status, self-rated health, and satisfaction with hospital care. Methods: A two-armed design with frail people aged 75 or older who required an unplanned hospital admission were randomized to either the CGA ward or to an acute medical ward. Analyses were made based on the intention-to-treat principle (ITT). The primary outcome was ADL. Data were analyzed using Chi-square and odds ratio. A subgroup analysis was performed due to non-adherence and contamination. Results: One-hundred and fifty-five people participated in the study; 78 in the intervention and 77 in the control. Participants in the intervention group had a higher odds ratio of reporting having received written information and felt that care met their needs during their hospital stay. No additional statistically significant results for the primary or secondary outcomes in the ITT analysis were achieved. Conclusion: Participants felt that the care they received with the CGA ward met their needs. The lack of additional results supporting the CGA could be due to difficulties performing pragmatic intervention trials in clinical hospital settings, and because a CGA during one hospital stay is probably not enough to have long-term effects.

Background: Self-determination in old age is essential for people’s experiences of good subjective health and quality of life. The knowledge concerning how frail older people with decreased cognition perceive their ability to be self-determined in the different dimension in daily life is, however, limited. The aim of this study was therefore to explore the relationship of self-determination and cognition in frail older people. Methods: This study was a cross-sectional secondary data analysis using baseline data with 119 frail people 75 ≥ from a larger randomized control trial. Self-determination was measured with the statements from the Impact on Participation and Autonomy-Older persons (IPA-O). Cognition was measured using the Mini Mental State Examination (MMSE), where decreased cognition was broadly defined as a score below 25 points. Fisher’s exact test was used to test differences in proportions of perceiving self-determination in relation to cognition. The Relative Risk (RR) with a 95% Confidence Interval (CI) was used to explore the risk of perceiving reduced self-determination in relation to cognitive functioning. Results: Nearly the entire study population, regardless of cognitive functioning, perceived self-determination in Financial situation. For people with decreased cognition, the relative risk for perceiving reduced self-determination was statistically significant higher in activities related to Self-care and in Social relationships when comparing with the participants with intact cognition. Conclusion: Perceiving self-determination when being old, frail and having decreased cognition is possible but is dependent upon which activities that are involved. Organizing healthcare needs according to the older people’s wants and wishes is crucial regardless of people having a cognitive decline or not when the effort is to enable the people to be as self-determined as they want. The frail older people with decreased cognition should be treated as being experts in their own lives, and healthcare professionals should navigate the older people to get to their desired direction. Trial registration: ClinicalTrials.gov, NCT02773914. Retrospectively registered 16 May 2016.

Background: Trait emotional intelligence (EI) is often assessed using the 30-item Trait Emotional Intelligence Questionnaire-Short Form (TEIQue-SF). However, previous research using item response theory (IRT) modelling has identified several underperforming items. This study aimed to psychometrically evaluate, refine, and optimize the TEIQue-SF using IRT, with the goals of identifying and eliminating underperforming items, and examining whether items in the refined version function differently across sexes. Furthermore, the study sought to further validate the Swedish version of the TEIQue-SF. Methods: This cross-sectional study surveyed 845 first-year students aged 19–59 (87% women) from seven healthcare and social work programs across six universities in southern Sweden. Participants completed the TEIQue-SF and health-related measures for convergent validity. IRT modeling employed the Graded Response Model (GRM) using the 2-Parameter Logistic Model in IRT for Patient-Reported Outcomes (IRTPRO). Marginal reliability and differential item functioning (DIF) were assessed with IRT, internal consistency with Cronbach’s alpha and mean inter-item correlations, and validity through evaluating Direct Discrepancy Dynamic fit index (DDDFI) and bivariate correlations. Results: The IRT modeling identified underperforming items, leading to a refined 12-item TEIQue-SF that effectively captures trait EI with high-quality items. The item selection process is detailed and supplemented. The shortened measure showed a strong correlation with the original (r = .94), demonstrated good reliability, and exhibited uniform DIF for only one item (Item 15). A comparison of confirmatory factor analysis (CFA) model fit statistics using the DDDFI indicated a fair fit for the TEIQue-SF. Consistent with previous research on the TEIQue-SF, both 30-item and 12 item versions demonstrated strong convergent validity with health-related measures within the Swedish context. Conclusions: The 12-item TEIQue-SF is a brief, precise, and valid measure for assessing trait EI while preserving its global conceptual structure. IRT modeling and validity testing against health-related measures confirm that 12-item TEIQue-SF effectively captures trait EI.

Introduction: Research has shown that older people experienced mental and physical health issues due to isolation during the Covid-19 pandemic. However, more in-depth knowledge is needed regarding the consequences for frail older people. Aim: To explore frail older people’s experiences of managing everyday life in quarantine during the first year of the Covid-19 pandemic. Material and Methods: Twenty people were interviewed, and the data were analyzed using qualitative content analysis. Results: The people experienced powerlessness under the restrictions and limitations in everyday life beyond control. To cope with these experiences, they accepted and trusted the restrictions and strived for meaningfulness in everyday life. Conclusions: Frail older people experienced managing everyday life in double exposure during the pandemic, where personal vulnerabilities and external restrictions intersected, limiting their ability to adapt and maintain autonomy in everyday life. Supporting meaningful routines and enabling participation are therefore central, underscoring the important role of occupational therapy in mitigating the impact of disrupted everyday life. Significance: These findings contribute to a more nuanced understanding of the needs of frail older people. This approach is essential to sustaining leisure activities, fostering social connections, and promoting health and well-being during future disruptive events.