First Steps towards Evidence-Based Preventive Home Visits: Experiences Gathered in a Swedish Municipality

Table 2

Contents in PHV protocol administrated in the pilot study.

Health area	Assessment	Rationale/source	Structured questions^a (q), 𝑛		Criterion for using in-depth questionnaire
			Basic q	In-depth q
Descriptive questions			5
ADL	ADL Staircase	Items selected from the ADL-staircase [26]. Questions on difficulty were added [28].	5	1	Having difficulties in one or more I-ADL.
Comfort in home	Usability in My Home (UIMH)	[29, 30].	10	0
Activities/interests	Study specific	The relation between meaningful activities and wellbeing is well established [31]. Open ended q on possible changes in pattern of activities and interest were used.	3	0
Exercise	Study specific	Absence of physical exercise has showed to increase the risk for functional decline. Structured q on level of physical activity [32–36].	4	0
Social contacts	Study specific	Used as a predictor of functional decline [22].	4	5	Not having anyone to contact if necessary or expressing feelings of loneliness.
Pain	SF-36	Based on clinical experiences [22], SF-36 were used [37], in combination with one q on pain in the feet.	2	4	Expressing moderate or worse pain.
Depression	GDS4, GDS20	Used as a predictor of functional decline [22].	4	16	Suspected depression (short version; GDS4).
Falls	Study specific	Q for screening of increased fall-risk and in depth assessment of potential causes of falls were based on risk-factors for falls identified by Ganz et al. [38].	4	13	Having had a fall during last year in an everyday situation or having trouble with walking, balance, or moving.
Pain/physical tests	SPPB-S	*Part of SPPB-S, used as a predictor of functional decline and relocation to nursing home [22, 23]. SPPB-S [39] was used as part of the in-depth assessment of potential causes of falls.	*Practical test	Practical test
Environmental barriers	Housing Enabler Screening tool	Used as part of the potential causes of falls [38]. Housing Enabler, entrance, and indoors sections [40].	36	0
Cognition	MMT	The connection between cognitive and functional decline is strong [22]. Short and long version of MMT (Minimental test) were used [41].	9	11	Suspected dementia (short version of MMT).
Medication	75+ health assessments	Selected from an Australian guide for health assessments [42].	5	Open-ended questions	Use of >3 medications in combination with difficulties remembering, lack of a physician contact, or using medication for anxiety, distress, or sleeping disturbance.
Food, diet	MNA	Mininutritional assessment (MNA).	6	9	Risk for malnutrition (MNA).
Health (perceived)	SF-36	Perceived health is a well-established predictor for mortality [22, 43]. One item form the SF-36 was used [37].	2	0
Vision and hearing	Study specific	Used as a predictor of functional decline [22]. Identified as an important health factor in group discussions	2	0
Evaluation q to the informant	Study specific		5	na
Evaluation q to the interviewer	Study specific		10	na

^a Each section starts with an open question introducing the topic, that is, How do you manage everyday activities in your home? or Do you feel comfortable in your home?
na = not applicable.