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Sköld P, Hälleberg-Nyman M, Joelsson-Alm E, Eldh AC. Patient participation in orthopaedic care-a survey on hip surgery patients' preferences for and experiences of engagement in their health and healthcare. Int J Orthop Trauma Nurs 2024; 54:101118. [PMID: 38901299 DOI: 10.1016/j.ijotn.2024.101118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 05/27/2024] [Accepted: 06/05/2024] [Indexed: 06/22/2024]
Abstract
INTRODUCTION Quality in health services is increasingly associated with enabling patients to participate in their own health and healthcare by recognising their resources and needs. Despite a growing recognition as to whether such participation is enabled, little is known regarding opportunities for preference-based patient participation in orthopaedic care. AIMS To investigate preference-based participation for patients in orthopaedic care due to hip surgery. METHODS Patients across 17 Swedish orthopaedic units who had had hip surgery, due to hip fracture or osteoarthritis, January-April 2021 were invited to complete the validated 4Ps questionnaire. Of 1514 patients, 458 patients returned the questionnaire with reports on their preferences for and experiences of participation. Each of the 4Ps' 12 items were analysed separately using descriptive and comparative statistics. RESULTS A complete match in preferences for, and experiences of, participation was achieved with variation between items for 41%-50% of the patients; if almost matches were included, this occurred for 57%-77% of the patients. Less participation than preferred was most common in terms of having had reciprocal communication, opportunities for partaking in planning, and in learning how to manage symptoms/issues. Hip fracture surgery was significantly associated with experiencing lower levels of participation than preferred. CONCLUSION Though standardised care promotes efficient hip surgery care, our study suggests a need for more person-centred opportunities to engage. A discrepancy was noted between patients' resources and preparation for their participation in and beyond the hip surgery process, particularly for self-care activities, calling for better use of nursing resources. ID: NCT04700969 with the U.S National Institutes of Health Clinical Registry.
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Affiliation(s)
- Patricia Sköld
- Faculty of Medicine and Health Sciences, Department of Health, Medicine, and Caring Sciences, Linköping University, SE-581 83 Linköping, Sweden.
| | - Maria Hälleberg-Nyman
- University Health Care Research Centre, Faculty of Medicine and Health, Örebro University, SE-701 82 Örebro, Sweden; Department of Orthopaedics, Faculty of Medicine and Health, Örebro University, SE-701 82 Örebro, Sweden.
| | - Eva Joelsson-Alm
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, SE-118 83 Stockholm, Sweden.
| | - Ann Catrine Eldh
- Faculty of Medicine and Health Sciences, Department of Health, Medicine, and Caring Sciences, Linköping University, SE-581 83 Linköping, Sweden; Department of Public Health and Caring Sciences, Uppsala University, Box 564, SE-751 22 Uppsala, Sweden.
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Ehk S, Petersson S, Khalaf A, Nilsson M. Nurses' experiences of integrating the salutogenic perspective with person-centered care for older people in Swedish nursing home care: an interview-based qualitative study. BMC Geriatr 2024; 24:262. [PMID: 38500060 PMCID: PMC10946094 DOI: 10.1186/s12877-024-04831-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 02/20/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND Even though there has been a cultural change within residential aged care to a more person-centered care, there remain improvements to be made for a more consistent way of working. Using a salutogenic approach along with person-centered care is a potential way to promote it. This study aimed to describe nurses' experiences of combining person-centered care with a salutogenic approach at a nursing home for older people. METHODS Nine nurses, specially trained in salutogenesis and Sense of coherence, were individually interviewed using a semi-structured interview approach. Data was analysed through qualitative content analysis. RESULTS The nurses experienced that the residential aged care was improved by using salutogenesis and Sense of coherence as a complement to person-centered care. Core aspects of person-centered care were thereby promoted, as the resources of the older persons were emphasized, and aged care became more holistic. In addition to improved residential aged care, the results indicate that this manner of working also contributed to enhanced work satisfaction of the care personnel themselves. CONCLUSIONS The results suggest that a salutogenic approach facilitates the implementation of person-centered care by focusing on the older persons' resources and maintaining health. The organization needs to prioritize training staff in salutogenesis and person-centered care, as it supports working toward a common goal and benefits both the older persons and the staff.
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Affiliation(s)
- Sofia Ehk
- Faculty of Health Sciences, Kristianstad University, SE-291 88, Kristianstad, Sweden
| | - Sara Petersson
- Faculty of Health Sciences, Kristianstad University, SE-291 88, Kristianstad, Sweden
| | - Atika Khalaf
- Faculty of Health Sciences, Kristianstad University, SE-291 88, Kristianstad, Sweden
- Department of Nursing, Fatima College of Health Sciences, Ajman, United Arab Emirates
| | - Marie Nilsson
- Faculty of Health Sciences, Kristianstad University, SE-291 88, Kristianstad, Sweden.
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Östlund AS, Högnelid J, Olsson A. Being an older hospitalized patient during the COVID-19 pandemic - A qualitative interview study. BMC Geriatr 2023; 23:810. [PMID: 38053062 PMCID: PMC10698926 DOI: 10.1186/s12877-023-04562-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 12/04/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND Older people hospitalized for COVID-19 are a vulnerable group due to the disease itself, aging and often loss of hearing and vision. Person-centered care, where patients have opportunities to communicate and participate in their own care, is important. However, because healthcare staff needed to wear personal protective equipment during the pandemic, to protect the patients and themselves, providing person-centered care was often difficult. This study aims to describe older hospitalized patients' experiences both of being cared for, while having COVID-19, and of the care provided by healthcare staff wearing PPE. METHODS Fourteen older patients, over 65 years of age, were interviewed, and the data were analyzed using qualitative content analysis. The study adhered to Consolidated criteria for reporting qualitative research guidelines. RESULTS Three subthemes and one overall theme, "The desire for survival overshadows difficulties", emerged in the analysis. The main findings revealed that the older hospitalized patients experienced the care they received from the healthcare staff as satisfactory. The older patients reported understanding and accepting that the pandemic situation meant that their ability to participate in their own care and communicate with healthcare staff were given lower priority. CONCLUSIONS Older hospitalized patients need to be provided person-centered care, and situations such as a pandemic are no exception. Care tasks that are not acute in nature, e.g., planning for patients' return home, could be conducted by healthcare staff not required to wear PPE.
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Affiliation(s)
- Ann-Sofi Östlund
- Faculty of Health and Occupational Studies, Department of Caring Sciences, University of Gävle, Gävle, S-801 76, Sweden
| | - Julia Högnelid
- Faculty of Health and Occupational Studies, Department of Caring Sciences, University of Gävle, Gävle, S-801 76, Sweden
| | - Annakarin Olsson
- Faculty of Health and Occupational Studies, Department of Caring Sciences, University of Gävle, Gävle, S-801 76, Sweden.
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Unbeck M, Lidgren F, Tabbakh E, Nymark C. The patient's experience of participation when admitted for elective surgical procedures: an interview study. Int J Qual Stud Health Well-being 2023; 18:2163958. [PMID: 36617889 PMCID: PMC9833403 DOI: 10.1080/17482631.2022.2163958] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
PURPOSE To describe the patient's experience of participation in their care when admitted for elective surgical procedures. MATERIALS AND METHODS A purposive sample of 14 patients who had undergone elective surgery was included in semi-structured individual interviews at a university hospital. The data was analysed using qualitative content analysis. RESULTS One theme was identified: Creating a meaningful relationship to enable participation in the care, based on three categories; Abilities, willingness, and a lack of experience affect participation, A professional approach with an open communication and individualized information, and The importance of structural factors. CONCLUSIONS To meet the patient's individual needs and wishes regarding participation, meaningful relationships need to be created between patient and healthcare personnel. The results also indicate that the patients have insufficient knowledge about their role regarding participation. To improve patient participation, its meaning needs to be clarified individually to the patient, emphasizing the importance to be active involved in his or her own care.
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Affiliation(s)
- Maria Unbeck
- School of Health and Welfare, Dalarna University, Falun, Sweden,Department of Neurobiology, Care sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden
| | - Filippa Lidgren
- Emergency and Reparative Medicine Theme, Department of Plastic and Craniofacial Surgery, Karolinska University Hospital, Stockholm, Sweden
| | - Ella Tabbakh
- Heart, Vascular and Neuro Theme, Department of Thoracic Surgery, Karolinska University Hospital, Stockholm, Sweden
| | - Carolin Nymark
- Department of Neurobiology, Care sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden,Heart, Vascular and Neuro Theme, Department of Cardiology, Karolinska University Hospital, Stockholm, Sweden,CONTACT Carolin Nymark Heart, Vascular and Neuro Theme, Department of Cardiology, Karolinska University Hospita, StockholmSE-171 76, Sweden
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Gustafsson SR, Wahlberg AC. The telephone nursing dialogue process: an integrative review. BMC Nurs 2023; 22:345. [PMID: 37770869 PMCID: PMC10537534 DOI: 10.1186/s12912-023-01509-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 09/13/2023] [Indexed: 09/30/2023] Open
Abstract
BACKGROUND Telephone nursing involves triage, advice, and care management provided by a nurse over the telephone. The telephone nursing dialogue process has been used clinically in telephone nursing in Sweden for several years to structure the communication and ensure a safe assessment and advice. Studies are needed to determine whether there is sufficient scientific evidence to support the method. AIM To describe the scientific basis of the phases of the telephone nursing dialogue process. DESIGN This was an integrative review. METHODS The literature searches were performed in August 2023, in the PubMed, CINAHL, Cochrane Database of Systematic Reviews and SwePUB databases. Sixty-two articles were included. Data was sorted deductively according to the five phases of the telephone nursing dialogue process and categorized inductively to form subcategories describing the content of each phase. RESULT All five phases in the telephone nursing dialogue process were supported by a range of articles (n = 32-50): Opening (n = 32), Listening (n = 45), Analysing (n = 50), Motivating (n = 48), and Ending (n = 35). During the opening of the call, the nurse presents herself, welcomes the caller and establishes a caring relationship. In the listening phase, the nurse invites the caller to tell their story, listens actively and confirms understanding. During the analyzing phase, the nurse gathers, assesses, and verifies information. In the motivating phase, the nurse reaches a final assessment, informs the caller, gives advice and creates a mutual agreement and understanding while supporting the caller. Ultimately, the nurse ends the call after checking for mutual agreement and understanding, giving safety-net advice, deciding on whether to keep monitoring the caller and rounding off the call. CONCLUSION The phases of the telephone nursing dialogue process as described in the scientific literature are well aligned with the theoretical descriptions of the telephone nursing dialogue process.
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Affiliation(s)
- Silje Rysst Gustafsson
- Division of nursing and medical technology, Department of Health, Learning and Technology, Luleå University of Technology, Luleå, SE-971 87, Sweden.
| | - Anna Carin Wahlberg
- Division of Nursing, Department of Neurobiology, Care sciences and Society, Karolinska Institutet, Stockholm, SE- 171 77, Sweden
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Winberg M, Hälleberg Nyman M, Fjordkvist E, Joelsson-Alm E, Eldh AC. Patients' experiences of urinary retention and bladder care - A qualitative study in orthopaedic care. Int J Orthop Trauma Nurs 2023; 50:101034. [PMID: 37437464 DOI: 10.1016/j.ijotn.2023.101034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 05/25/2023] [Accepted: 06/07/2023] [Indexed: 07/14/2023]
Abstract
BACKGROUND Urinary retention is a common complication associated with hip surgery. There are easily available, evidence-based clinical practice guidelines prescribing how to prevent both urinary retention and other voiding issues, by means of bladder monitoring and risk assessments. A detected lack of adherence to such guidelines increases risks for unnecessary suffering among patients but a greater understanding of patients' experiences can benefit tailored interventions to address quality and safety gaps in orthopaedic nursing and rehabilitation. PURPOSE The aim was to describe patients' experiences of urinary retention, bladder issues, and bladder care in orthopaedic care due to hip surgery. METHOD This was a qualitative study with a descriptive design: content analysis with an inductive approach was applied to interviews (n = 32) and survey free-text responses (n = 122) across 17 orthopaedic units in Sweden. RESULTS The patients had received no or limited details for the recurrent bladder care interventions (such as bladder scans and prompted voiding) while at the hospital. They relied on the staff for safe procedures but were left to themselves to manage and comprehend prevailing bladder issues. Despite the patients' experiences of bladder issues or the risk of urinary retention postoperatively, the link to hip surgery remained unknown to the patients, leaving them searching for self-management strategies and further care. CONCLUSIONS Patients' perspectives on bladder care, urinary retention and bladder issues can serve as a means for increased understanding of procedures and issues, reinforcing improved implementation of guidelines, including person-centred information. Safer bladder procedures imply further patient engagement, highlighted in guidelines.
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Affiliation(s)
- Madeleine Winberg
- Faculty of Medicine and Health Sciences, Department of Health, Medicine and Caring Sciences, Linköping University, SE-581 83, Linköping, Sweden.
| | - Maria Hälleberg Nyman
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, SE-701 82, Örebro, Sweden; Department of Orthopaedics, Faculty of Medicine and Health, Örebro University, SE-701 82, Örebro, Sweden.
| | - Erika Fjordkvist
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, SE-701 82, Örebro, Sweden; Department of Orthopaedics, Faculty of Medicine and Health, Örebro University, SE-701 82, Örebro, Sweden.
| | - Eva Joelsson-Alm
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, SE-118 83, Stockholm, Sweden.
| | - Ann Catrine Eldh
- Faculty of Medicine and Health Sciences, Department of Health, Medicine and Caring Sciences, Linköping University, SE-581 83, Linköping, Sweden; Department of Public Health and Caring Sciences, Uppsala University, Box 564, SE-751 22, Uppsala, Sweden.
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Jerofke-Owen TA, Tobiano G, Eldh AC. Patient engagement, involvement, or participation - entrapping concepts in nurse-patient interactions: A critical discussion. Nurs Inq 2023; 30:e12513. [PMID: 35871476 DOI: 10.1111/nin.12513] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 07/05/2022] [Accepted: 07/10/2022] [Indexed: 01/25/2023]
Abstract
The importance of patients taking an active role in their healthcare is recognized internationally, to improve safety and effectiveness in practice. There is still, however, some ambiguity about the conceptualization of that patient role; it is referred to interchangeably in the literature as engagement, involvement, and participation. The aim of this discussion paper is to examine and conceptualize the concepts of patient engagement, involvement, and participation within healthcare, particularly nursing. The concepts were found to have semantic differences and similarities, although, from a nursing perspective, they can be summoned to illustrate the establishment of a mutual partnership between a patient and a nurse. The individualization of such processes requires the joint effort of engagement, involvement, or participation, represented by interactive actions of both the patient (asking questions, telling/speaking up, knowledge acquisition, learning, and decision-making) and the nurse (recognizing, responding, information sharing, teaching, and collaborating). Suggesting that the concepts can be used interchangeably comes with some caution, requiring that nurses embrace patients playing a role in their health and healthcare. Further research and practice development should focus on how patients and nurses receive and respond to each other to establish patient engagement, involvement, and participation.
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Affiliation(s)
| | - Georgia Tobiano
- National Health and Medical Research Council Centre of Research Excellence in Wiser Wound Care, Menzies Health Institute Queensland, Griffith University, Parklands, Queensland, Australia.,Gold Coast Health, Gold Coast University Hospital, Southport, Queensland, Australia
| | - Ann C Eldh
- Department of Health, Medicine and Caring Sciences, Faculty of Medicine, Linköping University, Linköping, Sweden.,Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
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Participating in the Illness Journey: Meanings of Being a Close Relative to an Older Person Recovering from Hip Fracture-A Phenomenological Hermeneutical Study. NURSING REPORTS 2022; 12:733-746. [PMID: 36278766 PMCID: PMC9624350 DOI: 10.3390/nursrep12040073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/03/2022] [Accepted: 10/09/2022] [Indexed: 01/24/2023] Open
Abstract
When an older person suffers an acute event, such as a hip fracture, it influences the whole family. Research shows that while close relatives want to be a part of the older person's life during recovery it is associated with a high perceived level of stress and burden. To provide in-depth knowledge of close relatives' experiences in this situation, the aim of this study was to elucidate meanings of being a close relative to an older person recovering from hip fracture surgery.This study has a qualitative descriptive phenomenological hermeneutical design. Narrative interviews were conducted with ten close relatives. Analysis was conducted using phenomenological hermeneutical interpretation which provided a deeper understanding of the close relatives' lived experiences of their older person's recovery from hip fracture surgery. The structural analysis revealed two themes; "Participating in the illness journey", which was constructed of the subthemes of facing the unimaginable yet expected, encountering healthcare personnel, and noticing recovery and "Putting oneself aside", which was constructed of the subthemes of placing daily life on hold, giving support, and feeling concern and fear.
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Association between General Anesthesia and the Occurrence of Cerebrovascular Accidents in Hip Fracture Patients. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:7271136. [PMID: 34961827 PMCID: PMC8710151 DOI: 10.1155/2021/7271136] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Accepted: 11/18/2021] [Indexed: 12/22/2022]
Abstract
Background General anesthesia is an important factor leading to postoperative complications, and cerebrovascular accidents take the first place in the causes of postoperative death. Therefore, it is extremely important to explore the correlation between general anesthesia and the occurrence of cerebrovascular accidents in hip fracture patients. Objective To explore the association between general anesthesia and the occurrence of cerebrovascular accidents in hip fracture patients. Methods The data of 240 hip fracture patients treated in our hospital from February 2017 to February 2021 were retrospectively analyzed, and the patients were divided into the general anesthesia group (n = 120) and nongeneral anesthesia group (n = 120) according to whether or not they received general anesthesia, so as to compare their incidence rate of cerebrovascular accidents between the two groups, record their hemodynamic changes, and analyze the association between various risk factors under general anesthesia and the occurrence of cerebrovascular accidents. Results No statistical differences in patients' general information such as age and gender between the two groups were observed (P > 0.05); compared with the nongeneral anesthesia group, the incidence rate of cerebrovascular accidents was significantly higher in the general anesthesia group (P < 0.001); between the two groups, the heart rates and mean arterial pressure (MAP) at 15 min after anesthesia, at the time of skin incision, and 15 min before the end of surgery were significantly different (P < 0.05); according to the multiple logistic regression analysis, general anesthesia was a risk factor affecting the occurrence of cerebrovascular accidents in hip fracture patients, and under general anesthesia, age ≥80 years, BMI ≥23 kg/m2, types of anesthetic drugs ≥4, intraoperative blood pressure ≥140 mmHg, and intraoperative heart rate ≥80 bpm were also regarded as the risk factors. Conclusion General anesthesia is a risk factor affecting the occurrence of cerebrovascular accidents in hip fracture patients, and under general anesthesia, age ≥80 years, BMI ≥23 kg/m2, types of anesthetic drugs ≥4, intraoperative blood pressure ≥140 mmHg, and intraoperative heart rate ≥80 bpm will further increase the possibility of cerebrovascular accidents.
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