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Shand R, Foster A, Baker C, O'Halloran R. Identifying communication difficulty and context-specific communication supports for patient-provider communication in a sub-acute setting: A prospective mixed methods study. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024:1-20. [PMID: 38425157 DOI: 10.1080/17549507.2023.2289350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
PURPOSE To identify the sub-acute rehabilitation inpatients who have communication difficulty and the range of communication supports that can facilitate communicative success. METHOD A prospective cohort mixed methods study was conducted on two inpatient sub-acute rehabilitation wards. Nurses screened all new admissions for communication difficulty using the Inpatient Functional Communication Interview, Screening Questionnaire (IFCI-SQ). Patients identified as having communication difficulty were interviewed by a speech-language pathologist (SLP) using the Inpatient Functional Communication Interview (IFCI). During the interview, the SLP trialled different communication supports. The number of patients who had communication difficulty on the IFCI-SQ was calculated. The number and type of communication supports that improved communication within the patient-SLP interview were calculated. Deductive-dominant qualitative content analysis was conducted on the communication supports used during the IFCI. RESULT Seventy patients were screened. Nurses reported communication difficulty in 45/70 (64%) of patients. A total of 15/45 patients were interviewed by an SLP using the IFCI. The provision of communication supports improved communication for all patients within the context of the patient-SLP interview. CONCLUSION Many sub-acute rehabilitation inpatients have communication difficulty in the hospital setting. A range of communication supports facilitated communication. These insights could inform future communication partner training (CPT) programs.
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Affiliation(s)
- Rosalind Shand
- Monash Health, Melbourne, Australia
- Discipline of Speech Pathology, La Trobe University, Melbourne, Australia
| | - Abby Foster
- Monash Health, Melbourne, Australia
- Discipline of Speech Pathology, La Trobe University, Melbourne, Australia
- NHMRC Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Melbourne, Australia
- School of Primary and Allied Health Care, Monash University, Melbourne, Australia
| | - Caroline Baker
- Monash Health, Melbourne, Australia
- NHMRC Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Melbourne, Australia
| | - Robyn O'Halloran
- Discipline of Speech Pathology, La Trobe University, Melbourne, Australia
- NHMRC Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Melbourne, Australia
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Baker C, Foster AM, D'Souza S, Godecke E, Shiggins C, Lamborn E, Lanyon L, Kneebone I, Rose ML. Management of communication disability in the first 90 days after stroke: a scoping review. Disabil Rehabil 2022; 44:8524-8538. [PMID: 34919449 DOI: 10.1080/09638288.2021.2012843] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
INTRODUCTION People with communication disability after stroke need interventions to optimise healthcare communication and rehabilitation outcomes. Current evidence syntheses do not adequately inform the management of communication disability during the first 90 days post-stroke. PURPOSE To explore the scope of literature for the management of communication disability in the first 90 days after stroke. MATERIALS AND METHODS A scoping review was conducted using a systematic keyword search of six databases. A descriptive synthesis was generated using communication-related domains related to the biopsychosocial framework of the International Classification of Functioning, Disability, and Health (ICF). RESULTS A total of 129 studies met eligibility criteria. Aphasia was the most frequently addressed communication disability after stroke (76/129 studies) with a paucity of evidence investigating other acquired neurogenic communication impairments. Management predominantly focused on communication-related: body functions and structures (62 studies) (e.g., linguistic-behavioural therapies), followed by environmental factors (39 studies) (e.g., communication partner training/support); activities and participation (15 studies) (e.g., augmentative and alternative communication); and personal factors (13 studies) (e.g., assessment of depression after aphasia). CONCLUSION A coordinated, integrated approach to developing and testing acute and subacute interventions for all communication disabilities across all communication-related domains is required.IMPLICATIONS FOR REHABILITATIONInterdisciplinary stroke clinicians need to manage communication disabilities in the first 90 days after stroke to optimise healthcare communication and rehabilitation outcomes.There is some evidence to guide clinicians in aphasia management but less in other disabilities of speech and cognitive functioning.Most interventions to inform clinical practice address communication-related body functions and structures (e.g., linguistic and speech therapies). Clinicians need to address all domains and more evidence is needed to address environmental factors (e.g., communication support); activities and participation (e.g., person-centred goal setting); and personal factors (e.g., psychological care).
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Affiliation(s)
- Caroline Baker
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Australia.,School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia.,Speech Pathology Department, Monash Health, Melbourne, Australia
| | - Abby M Foster
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Australia.,School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia.,Speech Pathology Department, Monash Health, Melbourne, Australia.,School of Primary & Allied Health Care, Monash University, Melbourne, Australia
| | - Sarah D'Souza
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Australia.,School of Medical and Health Science, Edith Cowan University, Joondalup, Australia
| | - Erin Godecke
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Australia.,School of Medical and Health Science, Edith Cowan University, Joondalup, Australia
| | - Ciara Shiggins
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Australia.,School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia.,School of Health Sciences, University of East Anglia, Norwich, UK
| | - Edwina Lamborn
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Australia.,School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia
| | - Lucette Lanyon
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Australia.,School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia
| | - Ian Kneebone
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Australia.,Discipline of Clinical Psychology, Graduate School of Health, University of Technology Sydney, Broadlands, Australia
| | - Miranda L Rose
- Centre of Research Excellence in Aphasia Recovery and Rehabilitation, Australia.,School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Australia
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Knowing-in-action that centres humanising relationships on stroke units: an appreciative action research study. BRAIN IMPAIR 2022. [DOI: 10.1017/brimp.2021.34] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Background:
Equal, collaborative and therapeutic relationships centred on the person affected by stroke are important for supporting recovery and adjustment. However, realising these relationships in hospital practice is challenging when there is increasing focus on biomedical needs and organisational pressures. Despite a body of evidence advocating for quality relationships, there remains limited research describing how to achieve this in clinical practice. This appreciative action research (AAR) study aimed to describe the processes involved in co-creating meaningful relationships on stroke units.
Design and methods:
An AAR approach was used to develop humanising relationship-centred care (RCC) within two hospital stroke units. Participants were staff (n = 65), patients (n = 17) and relatives (n = 7). Data generation comprised of interviews, observations and discussion groups. Data were analysed collaboratively with participants using sense-making as part of the AAR cyclical process. Further in-depth analysis using immersion crystallisation confirmed and broadened the original themes.
Findings:
All participants valued similar relational experiences around human connections to support existential well-being. The AAR process supported changes in self, and the culture on the stroke units, towards increased value being placed on human relationships. The processes supporting human connections in practice were: (i) sensitising to humanising relational knowing; (ii) valuing, reflecting and sharing relational experiences with others that co-created a relational discourse; and (iii) having the freedom to act, enabling human connections. The outcomes from this study build on existing lifeworld-led care theories through developing orientations for practice that support relational knowing and propose the development of RCC to include humanising values.
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Abstract
BACKGROUND: Within nursing, the concepts of home and homelike have been used indiscriminately to describe characteristics of healthcare settings that resemble a home more than an institution. OBJECTIVES: The aim of this study was to investigate the concept of home ( hem in Swedish). The main questions were as follows: What does the concept of home entail etymologically and semantically? Of what significance is the meaning of the concept to caring science and nursing? DESIGN AND METHODS: This study had a qualitative design with a hermeneutical approach guided by Gadamer. Eriksson's model of concept determination was partly used to determine the etymology and semantics, the essence and epistemic category of the concept of home. In this study, etymological dictionaries and 17 Swedish language dictionaries published between 1850 and 2001 were investigated. ETHICAL CONSIDERATION: In all parts of this study, ethical guidelines have been followed concerning both gathering data from dictionaries and other sources and during the interpretation of these sources. FINDINGS: The home, framed as the ethos of caring, can be drawn as a three-dimensional picture where the three dimensions have a common core, enclosed and inviolable. Symbolically, the picture of home can be seen as the ethos of the human being's innermost room, the human being's manner of being and the tone expressed in the external or abstract room where the human being lives and interacts with others. CONCLUSION: Based on the findings in this study, we conclude that home as ethos is an inner ethical dimension within the human being. Human beings who are in contact with their ethos, the self, feel at home and dare to follow the voice of their heart. Nurses who experience at-homeness have an ability to invite the patient into a caring relationship. The home and the feeling of being at home have significant meaning in terms of human beings' health and well-being.
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Affiliation(s)
- Yvonne Hilli
- University of Borås, Sweden; Åbo Akademi University, Finland
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Sørensen RB, Uhrenfeldt L. Stroke survivors' experiences of communication with healthcare providers in long-term care settings: a systematic review protocol. JBI DATABASE OF SYSTEMATIC REVIEWS AND IMPLEMENTATION REPORTS 2016; 14:85-92. [PMID: 27755320 DOI: 10.11124/jbisrir-2016-003080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The objective of this review is to identify, appraise and synthesize the best available evidence exploring how adult stroke survivors experience communication with healthcare providers (HCPs) in long-term care settings. More specifically, the review questions are.
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Affiliation(s)
- Rikke Brændgaard Sørensen
- 1Department of Nursing, University College Northern Denmark, Hjørring, Denmark 2Department of Health Science and Technology, Aalborg University, Aalborg, Denmark 3Danish Center of Systematic Reviews: a Joanna Briggs Institute Centre of Excellence, the Center of Clinical Guidelines-Clearing House, Aalborg University, Aalborg, Denmark
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Dorell Å, Sundin K. Becoming visible - Experiences from families participating in Family Health Conversations at residential homes for older people. Geriatr Nurs 2016; 37:260-5. [PMID: 26995489 DOI: 10.1016/j.gerinurse.2016.02.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2015] [Revised: 02/08/2016] [Accepted: 02/15/2016] [Indexed: 10/22/2022]
Abstract
Having a sick family member living at a residential home for older people can be difficult for families, who as a result often suffer from feelings of forsakenness and powerlessness. In response, the purpose of this study was to illuminate family members' experiences with participating in Family Health Conversations at residential homes for older persons 6 months after concluding the conversation series. Twenty-two family members who participated in the conversations later took part in group interviews, the texts of which were analyzed according to qualitative content analysis. Findings showed that participating in Family Health Conversations mediated consolation, since within such a liberating communicative interaction, family members for the first time felt visible as persons with individual significance. Family members reported a positive experience involving both being open to each other and speaking and listening to each other in a new, structured way. As a result, families were able to discover their family members' problems and suffering, as well as to identify their family's resources and strengths.
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Affiliation(s)
- Åsa Dorell
- Umeå University, Department of Nursing, S-891 18 Örnsköldsvik, Sweden.
| | - Karin Sundin
- Umeå University, Department of Nursing, S-891 18 Örnsköldsvik, Sweden
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Klinke ME, Thorsteinsson B, Jónsdóttir H. Advancing Phenomenological Research: Applications of "Body Schema," "Body Image," and "Affordances" in Neglect. QUALITATIVE HEALTH RESEARCH 2014; 24:824-836. [PMID: 24819692 DOI: 10.1177/1049732314533425] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
In this article, we review the latest trends of data collection methods in phenomenological nursing studies. Subsequently, by using a philosophical analysis, mainly inspired by Merleau-Ponty's embodied phenomenology and a case construction of an individual with hemi-spatial neglect-a common disorder following stroke-we explore the concepts "body schema," "body image," and "affordances." Applying these concepts helps to illuminate the temporal, spatial, and perceptual world of people encountering discrepancy between perception and reality because of disease-a discrepancy seen in hemi-spatial neglect. Concepts to capture the multifaceted challenges that occur under these circumstances are lacking. Systematically incorporating the aforementioned concepts might help to advance phenomenological research and articulate these difficulties. We propose suggestions on data generation to reveal situated, meaning-infused, embodied experiences in patients with hemi-spatial neglect. The need to step beyond the privileged emphasis on interviews, toward experimenting with other approaches of data collection, is underscored.
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Pusa S, Hägglund K, Nilsson M, Sundin K. District nurses' lived experiences of meeting significant others in advanced home care. Scand J Caring Sci 2014; 29:93-100. [DOI: 10.1111/scs.12134] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Accepted: 03/04/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Susanna Pusa
- Department of Nursing; Umeå University; Örnsköldsvik Sweden
| | | | | | - Karin Sundin
- Department of Nursing; Umeå University; Örnsköldsvik Sweden
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Roxberg Å, Brunt D, Rask M, da Silva AB. Where can I find consolation? A theoretical analysis of the meaning of consolation as experienced by job in the Book of Job in the Hebrew Bible. JOURNAL OF RELIGION AND HEALTH 2013; 52:114-127. [PMID: 21246278 DOI: 10.1007/s10943-011-9459-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
The aim of the study was to explore the meaning of consolation as experienced by Job in the Book of Job and as presented in literature and how consolation relates to suffering and care. The study's theoretical design applied Ricoeur's view on phenomenology and hermeneutics. The resulting themes were as follows: consolation that is present, that originates in confrontation, that keeps suffering at a distance, that does not alleviate suffering, that originates in experience from giving comfort, and that facilitates a change of perspective. The authentic and caring consolation accepts the sufferer's incomprehensible "otherness" but however provides no answers about how to console.
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Affiliation(s)
- Åsa Roxberg
- School of Health and Caring Sciences, Linnaeus University, 351 95, Växjö, Sweden.
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Olsson M, Larsson LG, Flensner G, Bäck-Pettersson S. The impact of concordant communication in outpatient care planning - nurses' perspective. J Nurs Manag 2013; 20:748-57. [PMID: 22967293 DOI: 10.1111/j.1365-2834.2012.01479.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM To elucidate registered nurses' experiences of coordinated care planning in outpatient care. BACKGROUND Coordinated care planning has been studied from the perspectives of both patients and nurses in inpatient care, but it is deficient in outpatient care. METHOD Qualitative content analysis of interviews with 10 registered nurses participating in two focus groups. RESULTS An overall theme was identified: creating concordant communication in relation to patient and health-care providers. The result is based on four categories and nine subcategories. CONCLUSIONS Nurses need extraordinary communication skills to reach concordance in outpatient care planning. In addition to involving and supporting the patients and next of kin in the decision-making process, the outcome of the nursing process must be understood by colleagues and members of other professions and health-care providers (non-nursing). IMPLICATIONS FOR NURSING MANAGEMENT An effective outpatient care-planning process requires that care managers understand the impact of communicating, transferring information and reaching consensus with other health-care providers, actively supporting employees in the outpatient care-planning process and contributing to the development of common goals and policy documents across organisational boundaries.
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Affiliation(s)
- Maivor Olsson
- Department of Psychiatry, NU-Hospital Organisation, Trollhättan, Sweden.
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Thompson J, Mckeever M. The impact of stroke aphasia on health and well-being and appropriate nursing interventions: an exploration using the Theory of Human Scale Development. J Clin Nurs 2012; 23:410-20. [DOI: 10.1111/j.1365-2702.2012.04237.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Lamb M, Buchanan D, Godfrey CM, Harrison MB, Oakley P. The psychosocial spiritual experience of elderly individuals recovering from stroke: a systematic review. INT J EVID-BASED HEA 2012; 6:173-205. [PMID: 21631820 DOI: 10.1111/j.1744-1609.2008.00079.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Objectives The objective of this review was to appraise and synthesise best available evidence on the psychosocial spiritual experience of elderly individuals recovering from stroke. Inclusion criteria This review considered qualitative studies whose participants were adults, mean age of 65 years and older, and who had experienced a minimum of one stroke. Studies were included that described the participant's own experience of recovering from stroke. Search strategy The search strategy sought to find both published and unpublished studies and papers, not limited to the English language. An initial limited search of MEDLINE and CINAHL was undertaken followed by an analysis of text words contained in the title and abstract, and of index terms used to describe the article. A second extensive search was then undertaken using all identified key words and index terms. Methodological quality Each paper was assessed by two independent reviewers for methodological quality prior to inclusion in the review using the Qualitative Assessment and Review Instrument (QARI) developed by the Joanna Briggs Institute. Disagreements were resolved through consultation with a third reviewer. Data collection Information was extracted from each paper independently by two reviewers using the data extraction tool from QARI developed by the Joanna Briggs Institute. Disagreements were resolved through consultation with a third reviewer. Data synthesis Data synthesis aimed to portray an accurate interpretation and synthesis of concepts arising from the selected population's experience during their recovery from stroke. Results A total of 35 studies were identified and of those 27 studies were included in the review. These qualitative studies examined the perceptions of elderly individuals who had experienced a stroke. Findings were analysed using JBI-QARI. The process of meta-synthesis using this program involved categorising findings and developing synthesised topics from the categories. Four syntheses were developed related to the perceptions and experiences of stroke survivors: sudden unexpected event, connectedness, reconstruction of life and life-altering event. Conclusion The onset and early period following a stroke is a confusing and terrifying experience. The period of recovery involves considerable psychological and physical work for elderly individuals to reconstruct their lives. For those with a spiritual tradition, connectedness to others and spiritual connection is important during recovery. The experience of stroke is a life-altering one for most elderly individuals, involving profound changes in functioning and sense of self.
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Affiliation(s)
- Marianne Lamb
- School of Nursing, Queen's University, Kingston, Ontario, Canada, K7L 3N6, Queen's Joanna Briggs Collaboration, Queen's University, Kingston, Ontario, Canada, K7L 3N6, National Research Council Information Centre Institute for Information Technology, Fredericton, New Brunswick, Canada, E3B 9W4
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Bronken BA, Kirkevold M, Martinsen R, Kvigne K. The aphasic storyteller: coconstructing stories to promote psychosocial well-being after stroke. QUALITATIVE HEALTH RESEARCH 2012; 22:1303-16. [PMID: 22785627 DOI: 10.1177/1049732312450366] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Telling stories is essential to the continuous process of creating meaning and to self-understanding. Persons with aphasia are vulnerable to psychosocial problems by their limited ability to talk and interact with others. This single-case study illustrates how a young woman with aphasia and a trained nurse interacted to coconstruct stories within the context of a longitudinal clinical intervention aimed at promoting psychosocial well-being in the first year after a stroke. Data were collected through qualitative interviews and participant observation; they were then analyzed from a hermeneutic-phenomenological perspective. The experience of coconstructing stories made an important contribution to improving the participant's psychological well-being. The shared construction of the participant's story evolved as a cumulative process, and it was facilitated by the establishment of trust in the participant-nurse relationship, the systematic use of worksheets and supported conversations, and a specific focus on psychosocial topics and structural organization.
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Affiliation(s)
- Berit Arnesveen Bronken
- Department of Nursing Science, Faculty of Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway.
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Bruce E, Sundin K. Experience of support for parents of adolescents with heart defects--supported to be supportive. J Pediatr Nurs 2012; 27:366-74. [PMID: 22703684 DOI: 10.1016/j.pedn.2011.04.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2010] [Revised: 04/13/2011] [Accepted: 04/20/2011] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to illuminate the meanings of the lived experience of support for parents of adolescents with heart defects. Narrative interviews were conducted with four mothers and two fathers of adolescents with heart defects. Interviews were interpreted using a phenomenological-hermeneutic method. The interpretation revealed that parents, themselves, attempt to be very supportive. They support their adolescent children, the rest of their families, the staffs of their children's schools, and others around their children. The sense of gratification and contentment that parents receive from fulfilling supportive functions is, in turn, influenced by the support that they, themselves, receive from care providers.
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Psychosocial well-being in persons with aphasia participating in a nursing intervention after stroke. Nurs Res Pract 2012; 2012:568242. [PMID: 22888417 PMCID: PMC3409547 DOI: 10.1155/2012/568242] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2012] [Accepted: 05/10/2012] [Indexed: 11/17/2022] Open
Abstract
The psychosocial adjustment process after stroke is complicated and protracted. The language is the most important tool for making sense of experiences and for human interplay, making persons with aphasia especially prone to psychosocial problems. Persons with aphasia are systematically excluded from research projects due to methodological challenges. This study explored how seven persons with aphasia experienced participating in a complex nursing intervention aimed at supporting the psychosocial adjustment process and promoting psychosocial well-being. The intervention was organized as an individual, dialogue-based collaboration process based upon ideas from “Guided self-determination.” The content addressed psychosocial issues as mood, social relationships, meaningful activities, identity, and body changes. Principles from “Supported conversation for adults with aphasia” were used to facilitate the conversations. The data were obtained by participant observation during the intervention, qualitative interviews 2 weeks, 6 months, and 12 months after the intervention and by standardized clinical instruments prior to the intervention and at 2 weeks and 12 months after the intervention. Assistance in narrating about themselves and their experiences with illness, psychological support and motivation to move on during the difficult adjustment process, and exchange of knowledge and information were experienced as beneficial and important by the participants in this study.
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Brännström H, Bäckman M, Santamäki Fischer R. Walking on the edge: meanings of living in an ageing body and using a walker in everyday life - a phenomenological hermeneutic study. Int J Older People Nurs 2012; 8:116-22. [DOI: 10.1111/j.1748-3743.2012.00334.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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The Joanna Briggs Institute Best Practice Information Sheet: The psychosocial and spiritual experiences of elderly individuals recovering from a stroke. Nurs Health Sci 2010; 12:515-8. [DOI: 10.1111/j.1442-2018.2010.00555.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Larsson I, Thorén-Jönsson AL. The Swedish speech interpretation service: An exploratory study of a new communication support provided to people with aphasia. Augment Altern Commun 2009; 23:312-22. [DOI: 10.1080/07434610601180026] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Abstract
This article discusses the application and integration of intentional comfort touch as a holistic nursing practice. A review of the literature on touch and its related concepts is included. Although nurses use touch frequently in patient encounters, it is not always used intentionally or deliberately to enhance care. The article compares and contrasts intentional comfort touch with nonintentional or procedural touch. The use of intentional comfort touch in innovative clinical settings with diverse and at-risk populations is described. Based on clinical experiences and the current literature, a conceptual model of intentional comfort touch is proposed. The application of touch is discussed as is the meaning and importance of intentional touch for students, faculty, and patients.
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Gordon C, Ellis-Hill C, Ashburn A. The use of conversational analysis: nurse-patient interaction in communication disability after stroke. J Adv Nurs 2009; 65:544-53. [DOI: 10.1111/j.1365-2648.2008.04917.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Fischer RS, Norberg A, Lundman B. Embracing Opposites: Meanings of Growing Old as Narrated by People Aged 85. Int J Aging Hum Dev 2008; 67:259-71. [PMID: 19049246 DOI: 10.2190/ag.67.3.d] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Many old people suffer from prolonged and multiple bodily ailments, new diseases, and increased risk for disadvantages and losses in life. Aging also means becoming mature and wise. This study illuminates the meaning of the lived experience with respect to changes in late life. Using a phenomenological hermeneutic method, this study analyzes transcribed interviews of 15 85-year-old people. Four themes were formulated: embracing weakness and strength, embracing slowness and swiftness of time, embracing reconciliation and regret, and embracing connectedness and loneliness. From these analyses, growing old was described as —maintaining one's identity in spite of the changes that come with aging and, embracing opposites—being changed and feeling being the same.
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Hedberg B, Johanson M, Cederborg AC. Communicating stroke survivors’ health and further needs for support in care-planning meetings. J Clin Nurs 2008; 17:1481-91. [DOI: 10.1111/j.1365-2702.2007.02053.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Roxberg Å, Eriksson K, Rehnsfeldt A, Fridlund B. The meaning of consolation as experienced by nurses in a home-care setting. J Clin Nurs 2008; 17:1079-87. [DOI: 10.1111/j.1365-2702.2007.02127.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Lamb M, Buchanan D, Godfrey CM, Harrison MB, Oakley P. The psychosocial spiritual experience of elderly individuals recovering from stroke: a systematic review. ACTA ACUST UNITED AC 2008; 6:432-483. [PMID: 27820476 DOI: 10.11124/01938924-200806120-00001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVES The objective of this review was to appraise and synthesise best available evidence on the psychosocial spiritual experience of elderly individuals recovering from stroke. INCLUSION CRITERIA This review considered qualitative studies whose participants were adults, mean age of 65 years and older, and who had experienced a minimum of one stroke. Studies were included that described the participant's own experience of recovering from stroke. SEARCH STRATEGY The search strategy sought to find both published and unpublished studies and papers, not limited to the English language. An initial limited search of MEDLINE and CINAHL was undertaken followed by an analysis of text words contained in the title and abstract, and of index terms used to describe the article. A second extensive search was then undertaken using all identified key words and index terms. METHODOLOGICAL QUALITY Each paper was assessed by two independent reviewers for methodological quality prior to inclusion in the review using the Qualitative Assessment and Review Instrument (QARI) developed by the Joanna Briggs Institute. Disagreements were resolved through consultation with a third reviewer. DATA COLLECTION Information was extracted from each paper independently by two reviewers using the data extraction tool from QARI developed by the Joanna Briggs Institute. Disagreements were resolved through consultation with a third reviewer. DATA SYNTHESIS Data synthesis aimed to portray an accurate interpretation and synthesis of concepts arising from the selected population's experience during their recovery from stroke. RESULTS A total of 35 studies were identified and of those 27 studies were included in the review. These qualitative studies examined the perceptions of elderly individuals who had experienced a stroke. Findings were analysed using JBI-QARI. The process of meta-synthesis using this program involved categorising findings and developing synthesised topics from the categories. Four syntheses were developed related to the perceptions and experiences of stroke survivors: sudden unexpected event, connectedness, reconstruction of life and life-altering event. CONCLUSION The onset and early period following a stroke is a confusing and terrifying experience. The period of recovery involves considerable psychological and physical work for elderly individuals to reconstruct their lives. For those with a spiritual tradition, connectedness to others and spiritual connection is important during recovery. The experience of stroke is a life-altering one for most elderly individuals, involving profound changes in functioning and sense of self.
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Affiliation(s)
- Marianne Lamb
- 1. School of Nursing, Queen's University, Kingston, Ontario, Canada, K7L 3N6 2. Queen's Joanna Briggs Collaboration, Queen's University, Kingston, Ontario, Canada, K7L 3N6 3. National Research Council Information Centre Institute for Information Technology, Fredericton, New Brunswick, Canada, E3B 9W4 4. Originally published in the International Journal of Evidence-based Healthcare in 2008
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Bäckström B, Sundin K. The meaning of being a middle-aged close relative of a person who has suffered a stroke, 1 month after discharge from a rehabilitation clinic. Nurs Inq 2007; 14:243-54. [PMID: 17718750 DOI: 10.1111/j.1440-1800.2007.00373.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The sudden and unexpected impact of stroke may have a stressful affect on close relatives. To illuminate the essential meaning in the lived experience of a middle-aged close relative of a person who has suffered a stroke, narrative interviews were conducted with 10 close relatives of people who had suffered their first stroke where both parties were aged over 18 and under 65. A phenomenological-hermeneutic interpretation of the narratives was then conducted. Three intimately intertwined themes emerged during the analysis: 'being called to mission', 'feeling lost and set adrift' and 'struggling to keep going'. The middle-aged close relatives felt unreflectively duty bound. There was a struggle with suffering and enduring the process of coping with life and overcoming a feeling of helplessness. Life turned out to be a struggle with overwhelming feelings. They felt alienated in a restricted life situation, disconnected from themselves and others, and from a world that supports feelings of being lost and set adrift (i.e. feeling homeless). Strength was found in moments when the situation improved, in being related to oneself and others, and when feelings of normality were regained.
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Affiliation(s)
- Britt Bäckström
- Mid-Sweden University, Department of Health Science, Campus Sundsvall, Sundsvall, Sweden.
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Hedberg B, Cederborg AC, Johanson M. Care-planning meetings with stroke survivors: nurses as moderators of the communication. J Nurs Manag 2007; 15:214-21. [PMID: 17352705 DOI: 10.1111/j.1365-2834.2007.00619.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Stroke survivors often have communicative disabilities. They should, however, be involved when decisions are made about their care treatment. AIM To explore and describe how nurses act as moderators of the communication in cooperative care-planning meetings and what kind of participant status the patients achieve in this type of multi-party talk. METHOD Thirteen care-planning meetings were audio-recorded and transcribed. Nurses, social workers and stroke survivors were the main participants for the meetings. A coding scheme was created and three main categories were used for the analysis: pure utterance types, expert comments (EC) and asymmetries. RESULTS The nurses never invited the patients to tell their own versions without possible influence from them. Mostly the nurses gave ECs. The nurses acted as the patients' advocates by talking for or about them. They rarely supported the patients' utterances. CONCLUSION There is an urgent need for nurses to learn how to involve the patients in the communicative process about their treatment. Assessment of the patients' communicative abilities before the care-planning meetings as well as knowledge about how to invite them can improve the patients' participant status.
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Affiliation(s)
- Berith Hedberg
- Institute of Health Care Pedagogics, The Sahlgrenska Academy at Göteborg University, Sweden.
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Bute JJ, Donovan-Kicken E, Martins N. Effects of communication-debilitating illnesses and injuries on close relationships: a relational maintenance perspective. HEALTH COMMUNICATION 2007; 21:235-46. [PMID: 17567255 DOI: 10.1080/10410230701307675] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
A communication-debilitating illness or injury (CDI) presents significant challenges for patients as well as for friends and family. In a qualitative study of the effects of a CDI on close relationships, 28 individuals with loved ones who had experienced a CDI were interviewed. Participants described adjustments in communication with the patient and explained what it is like to experience a relationship with a CDI patient. Themes that emerged transcended the type of illness and relationship. Recommendations are made for further research that focuses on patients' relationships with a variety of social network members, beyond primary caregivers.
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Affiliation(s)
- Jennifer J Bute
- School of Communication Studies, Ohio University, Athens, OH 45701, USA.
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Abstract
The literature on 'nursing phenomenology' is driven by a range of ontological and epistemological considerations, intended to distance it from conventionally scientific approaches. However, this paper examines a series of discrepancies between phenomenological rhetoric and phenomenological practice. The rhetoric celebrates perceptions and experience; but the concluding moment of a research report almost always makes implicit claims about reality. The rhetoric insists on uniquely personal meanings; but the practice offers blank, anonymous abstractions. The rhetoric invites us to believe that knowing is subjective and involved, but at the same time it recommends a technique (bracketing) which can only represent a crude, and entirely misconceived, gesture towards objectivity. Finally, the rhetoric claims that generalisation is beside the point; but the majority of researchers generalise anyway. In quietly ignoring their own rhetoric, 'phenomenologists' appropriate scientific prerogatives illegitimately. For their methods do not entitle them to lay claim to anything resembling 'objectivity', or generalisability, or 'reality', or theoretical abstraction. Like other researchers, they want to talk in generalisable terms about reality; they want to be objective, they want to do theory. But they are saddled with a philosophy that is disabling, because it says they can only talk about perceptions, and meanings, and uniqueness.
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Affiliation(s)
- John Paley
- Department of Nursing and Midwifery, University of Stirling, Stirling, UK.
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Abstract
BACKGROUND AND PURPOSE Qualitative studies are increasingly used to investigate social processes and phenomena influencing health behaviors and service provision. We aimed to identify the scope of published qualitative studies of stroke, consider their relevance to development and delivery of services for people with stroke, and make recommendations for future work. METHODS Literature review of published articles was identified by systematically searching online literature databases using keywords from the start of each database until 2002. Articles were reviewed by 2 authors, using a standardized matrix for data extraction. The 2003 European Stroke Initiative recommendations for stroke management were used to categorize the literature for consideration of its contribution to stroke research. RESULTS We included 95 articles. Their empirical contribution includes an emphasis on recording the "human" experience of stroke; identification of needs as perceived by patients and their families, differences in priorities between patients and professionals, and barriers to best-quality care. We identified 12 papers that were specifically undertaken to develop or evaluate interventions. CONCLUSIONS Qualitative studies have addressed a wide range of issues related to the impact of stroke on individuals and caregivers, and to the organization and delivery of services. Significant problems remain in ensuring the delivery of best-quality stroke care, which such studies have the potential to address. Maximizing this potential requires greater collaboration between nonclinical and clinical scientists, service providers, and users to formulate research questions of interest as well as new research strategies, such as meta-analysis, to pool qualitative research findings and multisited investigations.
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Affiliation(s)
- Christopher McKevitt
- Department of Public Health Sciences, King's College London, Capital House, 42 Weston Street, London SE1 3QD, UK.
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