Ulrika Westerling

About Ulrika Westerling

About Ulrika Westerling

Ulrika Westerling is a registered district nurse at Region Örebro County with 50 % clinical duty at the department “Nära vård” as process coordinator in care of older adults in primary care. Remaining 50 % is dedicated to doctoral studies at Örebro University with an affiliation to the University Health Care Research Center. Ulrika's research interest is frail older adults in primary health care.

Research

In December 2017 the primary care in Kumla opened a tailored primary health care unit at the health center, with the aim of optimizing the care of older adults in need of medical or health-promoting interventions. Adults aged 75 or older are offered the opportunity to register with the unit. The tailored unit focuses on the health, quality of life, and needs of older individuals, as well as the opportunity to receive continuous and secure care.

The overall aim of the PhD project is to evaluate the care of older adults with declining health in Kumla municipality through the implementation of a tailored primary health care unit.

The specific research questions are:

How do frail older adults and informal caregivers experience the care?
What effect does the implementation of a Safe homecoming team have on patients’ morbidity and mortality after discharge from hospital?
Is home-based care by an interprofessional primary care team after hospital discharge cost-effective?

Study 1: A qualitative study on older patient's experiences of a tailored primary health care unit. Individual interviews were conducted, and the data was analyzed inductively using qualitative content analysis. The results show that older patients feel they are in safe hands when seeking care at the tailored unit and that they receive the care they need. They view the care as an improvement compared to the one provided at the regular health center. In addition, there is a desire for more health-promoting visits and for the unit to be linked with social services.
The manuscript has been published.

Study 2: A qualitative study of informal caregivers need for support from a tailored primary health care unit.
Focus groups were conducted, and the data was analyzed abductively using qualitative content analysis, based on the framework "Patient and Family Centred Care."
The results show that informal caregivers need additional support from the tailored unit and they strive to build a relationship with healthcare professionals. Professionals should request and meet informal caregivers individual needs of support and information exchange.

Study 3:  A quantitative retrospective cohort study with intervention and control groups evaluating whether the tailored transitional care intervention Safe homecoming was associated with decreased risk of death or readmission after a one-year follow-up. The study was conducted in Örebro County, Sweden, from 2016 till 2020. The cohort consisted of 38.338 patients 75 years or older admitted at least one day to any of the three hospitals in Örebro county. From this cohort, patients that had received the intervention Safe homecoming (n=128), and propensity score matched controls (n=596) that received care as usual were included. Analyses are being finalized.

Study 4: A quantitative study with a descriptive design.
The plan is to describe the health economic effects of interprofessional teamwork in primary care in the care of older adults at home following hospital discharge.

Pedagogical assignment:
Supervisor in the course OM313G, bachelor’s program for nurses.