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Candelaria D, Tyagi V, Gallagher R, Hendriks J, McCormack B. Person-centredness in cardiovascular care: the need for a whole-systems perspective. Eur J Cardiovasc Nurs 2024; 23:e161-e163. [PMID: 38655748 DOI: 10.1093/eurjcn/zvae052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 04/12/2024] [Accepted: 04/16/2024] [Indexed: 04/26/2024]
Affiliation(s)
- Dion Candelaria
- The University of Sydney, Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, Sydney, New South Wales, Australia
| | - Vaibhav Tyagi
- The University of Sydney, Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, Sydney, New South Wales, Australia
| | - Robyn Gallagher
- The University of Sydney, Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, Sydney, New South Wales, Australia
| | - Jeroen Hendriks
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
- Centre for Heart Rhythm Disorders, University of Adelaide and Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Brendan McCormack
- The University of Sydney, Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, Sydney, New South Wales, Australia
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Dirksen A, Hendriks JM. The impact of different approaches during invasive treatment procedures on patients and nursing staff. Eur J Cardiovasc Nurs 2024; 23:e142-e143. [PMID: 38788138 DOI: 10.1093/eurjcn/zvae075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/26/2024]
Affiliation(s)
- Andreas Dirksen
- University Heart & Vascular Center-University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Jeroen M Hendriks
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, Australia
- Centre for Heart Rhythm Disorders, University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia
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Hansen C, Guassora AD, Arreskov AB, Davidsen AS, Overbeck G. Relationally competent attitudes and actions: a systematic review of general practice literature. Scand J Prim Health Care 2024:1-13. [PMID: 39428647 DOI: 10.1080/02813432.2024.2417169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2024] [Accepted: 10/08/2024] [Indexed: 10/22/2024] Open
Abstract
OBJECTIVE To explore core elements from Teachers' Relational Competence in general practice literature regarding building relationships in consultations, specifying actions doctors take to create and maintain relationship quality with patients. This systematic literature review aims to map and propose a similar framework for the doctor-patient relationship. BACKGROUND The doctor-patient relationship, a well-researched yet complex field, often lacks clear descriptions. In recent definitions of patient-centred medicine, the responsibility of this relationship falls on the doctor, though how both relationship and responsibility is enacted needs clarification. Pedagogical literature on the student-teacher relationship provides a framework for relational competence, incorporating the needs and interactions between teacher and student and their alignment with institutional goals. METHODS A systematic review of two databases yielded 1256 hits. After screening, 15 studies were included and assessed. A qualitative synthesis was conducted through iterative and thematic deductive analysis. RESULTS Four relationally competent attitudes identified were: Attention to emotion, Devotion, Mentalization, and Time-oriented presence. Four relationally competent actions identitfied were: Being open, Attunement, Offering Support, and Using humor. Additionally, Trust and Continued connectedness were found as components of both attitudes and actions. CONCLUSION An explanatory framework for professional relational competence for GPs includes concrete actions and specific attitudes before and during consultations. These consist of four key attitudes and four categories of actions with several subgroups of actions. Two additional components to the framework was found.
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Affiliation(s)
- Cæcilie Hansen
- Centre for General Practice: The Section of General Practice Medicine and The Research Unit for General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Innovation and Research Centre for Multimorbidity, Slagelse Hospital, Slagelse, Denmark
| | - Ann Dorrit Guassora
- Centre for General Practice: The Section of General Practice Medicine and The Research Unit for General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Anne Beiter Arreskov
- Centre for General Practice: The Section of General Practice Medicine and The Research Unit for General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Annette Sofie Davidsen
- Centre for General Practice: The Section of General Practice Medicine and The Research Unit for General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Gritt Overbeck
- Centre for General Practice: The Section of General Practice Medicine and The Research Unit for General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Lindberg H, Vaktnäs J, Rasmussen M, Larsson I. Treating the disease and meeting the person with the illness-patient perspectives of needs during infective endocarditis, a qualitative study. PLoS One 2024; 19:e0309373. [PMID: 39190763 DOI: 10.1371/journal.pone.0309373] [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: 03/18/2024] [Accepted: 08/10/2024] [Indexed: 08/29/2024] Open
Abstract
BACKGROUND Infective endocarditis (IE) is a rare but severe infectious disease. Patients with IE are treated for weeks in the hospital and have profound impairments to their health. New treatment modalities increase options for outpatient care. Little is known about how patients perceive their disease and hospitalisation. We aimed to explore the needs of patients with IE during hospitalisation and the first few months after discharge. METHODS In this qualitative study, 20 patients (45-86 years of age) hospitalised due to IE in Swedish hospitals were interviewed a median of 112 (67-221) days after hospitalisation. Data were analysed with qualitative content analysis, identifying eight subcategories, two categories, and an overall theme. RESULTS The overall theme illuminated a spectrum of needs of patients suffering from IE, between treating the disease and meeting the person with the illness. The needs encompassed eight axes with dual focus on both medical excellence and person-centred care. Medical excellence was needed to optimally treat, supervise, and offer follow-up on this rare and severe disease; patients longed to come home, and there were issues of reliability in the healthcare system. Person-centred care was requested, including individualised information leading to knowledge, reorientation, the beginning of health restoration, and being met as a unique person. Symptoms of fatigue, wasting, and cognitive and mental distress were often neglected by the caregiver. CONCLUSIONS This explorative study shows the patient's needs as important areas in a spectrum between medical excellence and person-centred care. Care in specialised units secure quality. Early discharge is requested by patients. Multiprofessional individualizing outpatient care needs to develop with preserved safety and medical excellence. The disease trajectory after discharge progresses slowly, and the possibility of mitigating its progress is still unclear. Person-centred care, screening for delayed restoration and rehabilitation after endocarditis are important fields for future studies.
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Affiliation(s)
- Helena Lindberg
- Department of Infectious Diseases, Hospital of Halland, Halmstad, Sweden
- Department of Clinical Sciences Lund, Division of Infection Medicine, Lund University, Lund, Sweden
| | - Johan Vaktnäs
- Department of Oncology and Palliative Medicine, Hospital of Halland, Varberg, Sweden
| | - Magnus Rasmussen
- Department of Clinical Sciences Lund, Division of Infection Medicine, Lund University, Lund, Sweden
| | - Ingrid Larsson
- Department of Health and Nursing, School of Health and Welfare, Halmstad University, Halmstad, Sweden
- Spenshult Research and Development Centre, Halmstad, Sweden
- Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden
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Dohrn IM, von Berens Å, Olsson CB, Rydwik E, Jakobsson E, Palmlöf L. Between principles and pragmatism - primary healthcare and social services professionals' experiences and perceptions of self-care for older adults with home care: a qualitative study. Scand J Prim Health Care 2024:1-11. [PMID: 39126195 DOI: 10.1080/02813432.2024.2389116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 08/01/2024] [Indexed: 08/12/2024] Open
Abstract
OBJECTIVE To explore the experiences of healthcare and social services professionals and their perceptions of using Certificate for self-care with support (CSS) for preventive self-care for older adults with home care, including the CSS process and collaborations between primary healthcare and social services. DESIGN An inductive qualitative study including seven focus group interviews analyzed with reflexive thematic analysis. SETTING AND SUBJECTS The study was conducted in the Stockholm Region 2022/23. In total, 23 informants were recruited from four key partners involved in the CSS process: professionals from primary care rehabilitation and primary healthcare, social services officers, and home care staff. RESULT The analyses resulted in five interconnected themes: 'Guidelines with scope for interpretation,' 'Support for self-care is needed, but complicated in practice,' 'To trust the other professions' competence,' 'There is a transfer of responsibility,' and 'Communication is key.' The overarching theme 'Principles or pragmatism for safe person-centered care,' anchoring the other themes, revealed a common goal of achieving safe and individualized care within available resources, but from two conflicting perspectives: the importance of following the process according to the guidelines or taking a more pragmatic approach. CONCLUSION This study highlights the need to establish structures facilitating safe self-care among frail groups, such as older persons dependent on home care. Our findings emphasize that the demarcation between, and responsibilities of, organizations need to be discussed and clarified to offer person-centered support. Comprehensible guidelines and functioning communication channels must be established so that all important perspectives can be heard, not least the patient's.
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Affiliation(s)
- Ing-Mari Dohrn
- Stockholm Gerontology Research Center, Stockholm, Sweden
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Åsa von Berens
- Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Christina B Olsson
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Academic Primary Healthcare Centre, Region Stockholm, Stockholm, Sweden
| | - Elisabeth Rydwik
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Medical Unit Occupational Therapy and Physical Therapy, Women's Health and Allied Health Professionals Theme, Karolinska University Hospital, Solna, Sweden
| | - Elin Jakobsson
- Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Lina Palmlöf
- Stockholm Gerontology Research Center, Stockholm, Sweden
- Department of Health Promoting Science, Sophiahemmet University, Stockholm, Sweden
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Waldemar A, Bremer A, Strömberg A, Thylen I. Family presence during in-hospital cardiopulmonary resuscitation: effects of an educational online intervention on self-confidence and attitudes of healthcare professionals. Eur J Cardiovasc Nurs 2024; 23:486-496. [PMID: 38165264 DOI: 10.1093/eurjcn/zvad111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 10/06/2023] [Accepted: 11/02/2023] [Indexed: 01/03/2024]
Abstract
AIMS Guidelines support family-witnessed resuscitation (FWR) during cardiopulmonary resuscitation in hospital if deemed to be safe, yet barriers amongst healthcare professionals (HCPs) still exist. This study aimed to evaluate the effects of an educational online video intervention on nurses' and physicians' attitudes towards in-hospital FWR and their self-confidence in managing such situations. METHODS AND RESULTS A pre- and post-test quasi-experimental study was conducted October 2022 to March 2023 at six Swedish hospitals involving the departments of emergency care, medicine, and surgery. The 10 min educational video intervention was based on previous research covering the prevalence and outcome of FWR, attitudes of HCP, patient and family experiences, and practical and ethical guidelines about FWR.In total, 193 accepted participation, whereof 91 answered the post-test survey (47.2%) with complete data available for 78 and 61 participants for self-confidence and attitudes, respectively. The self-confidence total mean scores increased from 3.83 to 4.02 (P < 0.001) as did the total mean scores for attitudes towards FWR (3.38 to 3.62, P < 0.001). The majority (71.0%) had positive views of FWR at baseline and had experiences of in-hospital FWR (58.0%). Self-confidence was highest amongst participants for the delivery of chest compressions (91.2%), defibrillation (88.6%), and drug administration (83.3%) during FWR. Self-confidence was lowest (58.1%) for encouraging and attending to the family during resuscitation. CONCLUSION This study suggests that a short online educational video can be an effective way to improve HCP's self-confidence and attitudes towards the inclusion of family members during resuscitation and can support HCP in making informed decisions about FWR.
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Affiliation(s)
- Annette Waldemar
- Department of Cardiology in Norrköping, and Department of Health, Medicine and Caring Sciences, Linköping University, SE-581 83 Linköping, Sweden
| | - Anders Bremer
- Faculty of Health and Life Sciences, Linnaeus University, SE-351 95 Växjö, Sweden
| | - Anna Strömberg
- Department of Cardiology in Linköping, and Department of Health, Medicine and Caring Sciences, Linköping University, SE-581 83 Linköping, Sweden
| | - Ingela Thylen
- Department of Cardiology in Linköping, and Department of Health, Medicine and Caring Sciences, Linköping University, SE-581 83 Linköping, Sweden
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Silva C, Carlsson Lalloo E, Ventura F, Henriques MA. Person-centred care intervention to promote self-efficacy in patients following a myocardial infarction (P2MIR): a protocol of a qualitative study for cultural adaptation within a Portuguese healthcare context. BMJ Open 2024; 14:e079598. [PMID: 38925699 PMCID: PMC11202657 DOI: 10.1136/bmjopen-2023-079598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 06/13/2024] [Indexed: 06/28/2024] Open
Abstract
INTRODUCTION Cardiovascular diseases remain a leading cause of death worldwide. Recovery from myocardial infarction is challenging as the causes of symptoms span multiple aspects of health not just physical conditions. Evidence has shown a gap between the waycare is provided in the clinical setting and the person's needs and preferences. The implementation of person-centred care (PCC) interventions can promote recovery from myocardial infarction by allowing a greater understanding of the person's perception and its role on the overall recovering process. This study aims to culturally adapt an evidence-based PCC intervention to enhance self-efficacy in patients after myocardial infarction within a Portuguese healthcare context. METHODS AND ANALYSIS The Portuguese person-centred care for myocardial infarction recovery (P2MIR) intervention is set to be developed from an evidence-based intervention, rooted in the ethics of PCC. An intervention of PCC for patients with acute coronary syndrome, which has been successfully implemented and evaluated in the Swedish healthcare context will be validated, culturally adapted and harmonised to the Portuguese healthcare context by using qualitative methods. To evaluate its acceptability, appropriateness and feasibility, a sample of stakeholders, consisting of a sample of healthcare professionals and a sample of people who suffered a myocardial infarction, will be recruited from a hospital, including both inpatient and outpatient departments. The stakeholders will be invited to semistructured focus group discussions, aiming to gather their perceptions about the P2MIR intervention, which will be previously presented to them. Data analysis will be conducted using content analysis following a deductive-inductive approach to further inform the intervention adaptation process to its final intervention in a Portuguese healthcare context. ETHICS AND DISSEMINATION The study has been reviewed and approved by the Health Ethics' Committees of the Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal (registry number 20170700050). The results will be disseminated through peer-reviewed journals and conference presentations.
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Affiliation(s)
- Cláudia Silva
- Nursing School of Lisbon, Lisbon, Portugal
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Lisbon, Portugal
| | - Ewa Carlsson Lalloo
- University of Borås, Faculty of Caring Science, Work Life and Social Welfare, Borås, Sweden
- University of Gothenburg Centre for Person-centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Filipa Ventura
- Health Sciences Research Unit: Nursing (UICISA:E), Nursing School of Coimbra, Coimbra, Portugal
- Nursing School of Coimbra, Coimbra, Portugal
| | - Maria Adriana Henriques
- Nursing School of Lisbon, Lisbon, Portugal
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Lisbon, Portugal
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Koch GGV, Engel-Hills P, Friedrich-Nel H. Individual patient radiation dose tracking: Perceptions of radiographers in South Africa. Radiography (Lond) 2024; 30:1014-1020. [PMID: 38704978 DOI: 10.1016/j.radi.2024.04.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 04/15/2024] [Accepted: 04/22/2024] [Indexed: 05/07/2024]
Abstract
INTRODUCTION Medical imaging examinations that make use of ionising radiation provide valuable information towards patient management. Literature suggests that there is a significant rise in the number of patient referrals for such examinations. The concept "individual patient radiation dose tracking" (IPRDT) is introduced to optimise radiation monitoring. Many countries across the globe explored and implemented methods to enhance and promote the justification and optimisation principles essential for patient radiation safety. In South Africa (SA), however, attention to IPRDT is limited. METHODS A qualitative research design was employed. Radiographers in the Western Cape Province of SA were purposefully sampled for participation in one-on-one, semi-structured interviews. Thematic analysis was applied to the transcribed interview data. RESULTS This paper presents a theme developed from the radiographer cohort of ten (10) participants. The theme: the need for creating awareness and implementing legislative support structures, was developed from the data, with the following supporting subthemes: 1) stakeholder awareness and 'buy-in' 2) continuous professional development and 3) mandated practice. CONCLUSION This study provides findings that are of value for patient radiation safety in SA by giving a voice to local stakeholders. Other countries that are conducting similar research investigations toward the integration of an IPRDT model, method, or framework, may also benefit from these findings. IMPLICATIONS FOR PRACTICE The effective integration of IPRDT into the clinical environment requires unison amongst the relevant stakeholders and clarity on the various professionals' roles and responsibilities. The findings of this study furthermore suggest the involvement of regulatory organisations for the provision of a mandated form of practice at national and international levels.
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Affiliation(s)
- G G V Koch
- Cape Peninsula University of Technology, Faculty of Health and Wellness Sciences, Department of Medical Imaging and Therapeutic Sciences, South Africa.
| | - P Engel-Hills
- Cape Peninsula University of Technology, Faculty of Health and Wellness Sciences, Department of Medical Imaging and Therapeutic Sciences, South Africa
| | - H Friedrich-Nel
- Central University of Technology, Free State, Faculty of Health and Environmental Sciences, Department of Clinical Sciences, South Africa
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Carlsson Lalloo E, Temple F, Berg M, Berg U, Désiré AM, Mulunda A, Bogren M. Testing the feasibility of a translated and culturally adapted person-centred training programme in maternal and newborn healthcare in Democratic Republic of Congo: A process evaluation. SEXUAL & REPRODUCTIVE HEALTHCARE 2024; 40:100979. [PMID: 38754346 DOI: 10.1016/j.srhc.2024.100979] [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: 08/28/2023] [Revised: 04/08/2024] [Accepted: 04/29/2024] [Indexed: 05/18/2024]
Abstract
OBJECTIVE Ensuring quality of maternal and newborn healthcare is challenging in the Democratic Republic of Congo (DRC) as the maternal and newborn mortality and morbidity rate is high. Essential for quality care is a person-centred approach. One model of person-centred care (PCC) has been developed at Gothenburg University. To support its implementation a training programme, "Mutual Meetings", has been developed. This study aims to test the feasibility of a translated and culturally adapted version of this PCC training programme for healthcare providers in the maternal and newborn healthcare context of DRC. METHODS The PCC programme was translated into French and tested in a workshop with 31 maternal and newborn healthcare providers in eastern DRC. The feasibility of the programme was evaluated through focus group interviews and individual interviews. The interview transcripts were analysed deductively using key components in a process evaluation framework including fidelity, dose, reach, adaptation, acceptability, and application. RESULTS The French PCC programme exceeded the participants' expectations and was found being applicable in both teaching and clinical setting with some suggested contextual modifications. Its pedagogic structure including a participatory reflective approach, was perceived innovative and inspirational, mediated a sense of comfort, and enabled the participants to use a person-centred approach towards each other. CONCLUSION The results show that the French on-site version of the PCC training programme was valid in terms of feasibility and how it was received by the participants. The study demonstrates the importance of contextual adaptation of complex interventions in new settings.
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Affiliation(s)
- Ewa Carlsson Lalloo
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Allégatan 1, 501 90 Borås, Sweden; Centre for Person-centred Care (GPCC) University of Gothenburg, Arvid Wallgrens backe, House 1, 413 46 Gothenburg, Sweden.
| | - Frida Temple
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Arvid Wallgrens backe, House 1, 413 46 Gothenburg, Sweden
| | - Marie Berg
- Centre for Person-centred Care (GPCC) University of Gothenburg, Arvid Wallgrens backe, House 1, 413 46 Gothenburg, Sweden; Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Arvid Wallgrens backe, House 1, 413 46 Gothenburg, Sweden; Faculty of Medicine and Community Health, Evangelical University in Africa, Bukavu, The Democratic Republic of Congo
| | - Urban Berg
- Faculty of Medicine and Community Health, Evangelical University in Africa, Bukavu, The Democratic Republic of Congo; Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Medicinaregatan 3, 41390 Gothenburg, Sweden
| | - Alumeti Munyali Désiré
- Faculty of Medicine and Community Health, Evangelical University in Africa, Bukavu, The Democratic Republic of Congo
| | - Aline Mulunda
- United Nations Population Fund, Kinshasa, The Democratic Republic of Congo
| | - Malin Bogren
- Centre for Person-centred Care (GPCC) University of Gothenburg, Arvid Wallgrens backe, House 1, 413 46 Gothenburg, Sweden; Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Arvid Wallgrens backe, House 1, 413 46 Gothenburg, Sweden
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Oster A, Wiking E, Nilsson GH, Olsson CB. Patients' expectations of primary health care from both patients' and physicians' perspectives: a questionnaire study with a qualitative approach. BMC PRIMARY CARE 2024; 25:128. [PMID: 38658808 PMCID: PMC11040877 DOI: 10.1186/s12875-024-02389-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 04/15/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Patients' ideas, concerns, and expectations are three important concepts in consultation techniques. Limited studies on these concepts include responses from both health care providers and care recipients of the same consultation. Highlighting both perspectives provides an increased understanding of the consultation. This study aims to explore the perspectives of patients and health care professionals about patients' expectations of primary health care during consultations with primary care physicians and compare the two sets of perspectives. METHODS A cross-sectional study. Patients (n = 113) and physicians (n = 67) from five primary health care centers completed a questionnaire after planned consultations. Their responses to open-ended questions about patients' expectations, from patients' and physicians' perspectives were analyzed with qualitative content analyses. RESULTS The patients expected a personal journey, through the primary health care system where they were the subject of interest. A journey, with ready access to a health care provider followed by a consultation with the physician, medical measures administered, their outcomes discussed, and a plan developed for continued health care. The physicians observed patients' expectations to concern the responsibilities placed on primary health care where patients were the object of interest. Patients' short-term expectations were described in a similar way by both patients and physicians. Patients expressed their long-term expectations as more personal and interpersonal whereas physicians observed them from a more professional and organizational standpoint. CONCLUSIONS Patients and physicians have different views of what patients expect of primary health care. While patients' short-term expectations were perceived by physicians, their long-term expectations were not. Patients expected more of a personal journey through the primary health care system while physicians observed patients' expectations to concern the responsibilities placed on primary health care. Identifying and meeting patients' expectations is an important part of patient-centered care, and a better understanding of patients' expectations is needed to improve health professionals' consultation skills.
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Affiliation(s)
- Andreas Oster
- Barkarby Primary Health Care Center, Region Stockholm, Stockholm, Sweden
| | - Eivor Wiking
- Academic Primary Health Care Center, Region Stockholm, Stockholm, Sweden
| | - Gunnar H Nilsson
- Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden
| | - Christina B Olsson
- Academic Primary Health Care Center, Region Stockholm, Stockholm, Sweden.
- Department of Neurobiology, Care Sciences, and Society, Division of Physiotherapy, Karolinska Institutet, Alfred Nobels Alle 23, Stockholm, 141 83, Sweden.
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Tikkanen V, Sundberg K. Care relationship and interaction between patients and ambulance clinicians: A qualitative meta-synthesis from a person-centred perspective. Scand J Caring Sci 2024; 38:24-34. [PMID: 37997183 DOI: 10.1111/scs.13225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 10/30/2023] [Accepted: 11/05/2023] [Indexed: 11/25/2023]
Abstract
BACKGROUND Ambulance care is characterised by disaster medicine, traumatology and care for acute illnesses and accidents. The focus of ambulance care is clearly on medical care, whereas interpersonal interaction between patients and ambulance clinicians appears less prioritised. A patient within ambulance care needs to be listened to, be taken seriously, be treated with empathy and be seen as a unique person. These are fundamental to delivering Person-centred care. AIM The purpose is to describe how the care relationship and interaction between patients and ambulance clinicians in prehospital emergency care are described in the literature and how they can be interpreted from a person-centred perspective. DATA SOURCES AND REVIEW METHODS A qualitative meta-synthesis was used. Data collection was carried out with PubMed, CINAHL Plus and Web of Science in September-October 2022 and in August-September 2023. The first article searching applied a timeline 1990-2022 and the second applied a timeline 2022-2023. A total of 13 studies employing a qualitative approach were evaluated and included in the interpretive analysis. RESULTS Three themes were identified: A good care relationship, Decision-making and Hindrances to practising person-centred care in ambulance care. Trust, good communication and respect for patients' dignity were the most important parts of the good care relationship between patients and ambulance clinicians. Decision-making regarding the examination of patients, medical treatment and transport to the receiving care unit was one of the tasks that ambulance clinicians do independently but in cooperation with patients and family members. Person-centred care within ambulance care may be hindered due to environmental factors, attitudes and behaviour of ambulance clinicians and patient-related factors. CONCLUSION Many ambulance clinicians have already adopted Person-centred care, but several factors can hinder Person-centred care in interactions with patients. Although the results build on a limited number of studies, they indicate that person-centred care needs to be further developed and studied for high-quality ambulance care.
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Affiliation(s)
- Viivi Tikkanen
- School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna, Sweden
- FALCK Ambulance Stockholm, Hägersten, Sweden
| | - Kay Sundberg
- Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
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Kelmendi N, Nilsson M, Taloyan M, Sundberg K, Langius-Eklöf A, Craftman ÅG. Preferences for Tailored Support - Patients' and Health Care Professionals' Experiences Regarding Symptoms and Self-Management Strategies During the First Year After Curatively Intended Prostate Cancer Treatment. Patient Prefer Adherence 2024; 18:275-288. [PMID: 38333642 PMCID: PMC10850763 DOI: 10.2147/ppa.s440689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Accepted: 01/06/2024] [Indexed: 02/10/2024] Open
Abstract
Purpose There is an increase in the number of men undergoing screening for prostate cancer, and advancements in treatments, which implies current knowledge about symptoms and self-management. This study aims to explore experiences of symptom distress, and self-management strategies during the first year after curatively intended treatment for prostate cancer, as identified by patients and health care professionals. Methods A qualitative design was used, including data triangulation from individual interviews with patients (n =17) and one focus group interview with healthcare professionals (n =5). Thematic analysis was used. Results The two main themes were identified: living with the consequences of treatment and navigating a new situation. Living with the consequences of treatment illustrated how losing control of bodily functions such as bladder, bowel, and sexual functions interfered with daily life. A stigma around the disease was described, and a life living in an unfamiliar body challenged ideas of masculinity. The first months after treatment ended was a distressing period related to the abruption in frequent contact with healthcare providers, and concerns about the future. The second theme, navigating a new situation, illustrates that self-management strategies varied, due to individual factors as did the need for tailored information and support provided from healthcare professionals and family, which was highly valued. Information and support were described as complex topics and healthcare professionals emphasized the need for appropriate education for staff to provide proper support to men after ended treatment. Conclusion Lingering symptoms and concerns were evident during the first year after treatment. Self-management strategies varied, and timely and tailored information and support during the first year were considered highly valued, important, and preferred by patients. Our results indicate that support should be offered immediately after curatively intended treatment.
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Affiliation(s)
- Nazmije Kelmendi
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden
- Academic Primary Health Care Center, Region Stockholm, Stockholm, Sweden
| | - Marie Nilsson
- Academic Primary Health Care Center, Region Stockholm, Stockholm, Sweden
- Department of Neurobiology, Care Sciences and Society, Division of Family Medicine and Primary Care, Karolinska Institutet, Stockholm, Sweden
| | - Marina Taloyan
- Academic Primary Health Care Center, Region Stockholm, Stockholm, Sweden
- Department of Neurobiology, Care Sciences and Society, Division of Family Medicine and Primary Care, Karolinska Institutet, Stockholm, Sweden
| | - Kay Sundberg
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden
| | - Ann Langius-Eklöf
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden
| | - Åsa G Craftman
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden
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Al-Adili L, Nordgren L, Orrevall Y, McGreevy J, Lövestam E. Nutrition intervention goals from the perspectives of patients at risk of malnutrition: A qualitative study. J Hum Nutr Diet 2024; 37:217-226. [PMID: 37794834 DOI: 10.1111/jhn.13246] [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: 04/27/2023] [Accepted: 09/18/2023] [Indexed: 10/06/2023]
Abstract
BACKGROUND Nutrition counselling is characterised by a collaborative approach where the patient and the dietitian establish goals that promote health and self-management. Little is known about goal-setting in nutrition interventions of patients at risk of malnutrition. The present study aims to describe the perspectives and needs of patients at risk of malnutrition regarding goals of nutrition interventions. METHODS Semi-structured interviews were conducted with 15 patients from three primary care centres and one hospital in mid-Sweden selected through purposive sampling. Interview transcripts were analysed using reflexive thematic analysis following the six-phase guidelines of Braun and Clarke to identify patterns of shared meaning and themes in the data. RESULTS The findings highlight that the participants rarely reflected on their personal goals of the nutrition intervention. Instead, they strived to maintain strength and energy, with the nutrition counselling being seen as supportive in managing nutrition impact symptoms. They described discrepancies between their perspectives and the dietitian's regarding weight goals and the diet prescribed to gain weight. CONCLUSIONS The study findings suggest that elucidating patients' goals is key to counteracting the discrepancies between the dietitians' clinically oriented goals and patients' perspectives. Goal-setting is part of the dietitian's structured working process, whereas the patient's lifeworld is complex and unstructured. To provide person-centred nutrition care, new strategies and tools are needed to facilitate collaborative goal-setting. These approaches will bridge the gap between clinical goals and patients' individual needs, promoting better alignment and improved outcomes.
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Affiliation(s)
- Lina Al-Adili
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
| | - Lena Nordgren
- Centre for Clinical Research Sörmland, Uppsala University, Uppsala, Sweden
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Ylva Orrevall
- Department of Biosciences and Nutrition, Karolinska Institute, Stockholm, Sweden
- Medical Unit Clinical Nutrition, Women's Health and Allied Health Professionals Theme, Karolinska University Hospital, Stockholm, Sweden
| | - Jenny McGreevy
- Department of Food Studies, Nutrition and Dietetics, Centre for Clinical Research Sörmland/Uppsala University, Uppsala University, Uppsala, Sweden
- Department of Dietetics, Nykoping Hospital, Nykoping, Sweden
| | - Elin Lövestam
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, Uppsala, Sweden
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Hellstrand M, Kornevs M, Raghothama J, Meijer S. Tensions between real-world practices and the digitalization paradigm for data-driven services in eldercare: observations from an ethnographic study in Sweden. BMC Geriatr 2024; 24:98. [PMID: 38273237 PMCID: PMC10809594 DOI: 10.1186/s12877-024-04693-z] [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: 06/30/2023] [Accepted: 01/10/2024] [Indexed: 01/27/2024] Open
Abstract
BACKGROUND The implementation of a data-driven approach within the health care system happens in a rapid pace; including in the eldercare sector. Within Swedish eldercare, data-driven health approach is not yet widely implemented. In the specific context of long-term care for older adults, quality of care is as much determined by how social care is being performed as it is by what kind medical care that is provided. In particular, relational aspects have been proven to have a crucial influence on the experience of quality of care for the actors involved. Drawing on ethnographic material collected at a Swedish nursing home, this paper explores in what way the relational aspects of care could potentially become affected by the increased use of a data-driven health approach. METHODS An ethnographic approach was adopted in order to investigate the daily care work at a long-term care facility as it unfolded. Fieldwork was conducted at a somatic ward in a Swedish long-term care facility over 4 months (86 h in total), utilizing the methods of participant observation, informal interviews and document analysis. The material was analyzed iteratively throughout the entire research process adopting thematic analysis. RESULTS Viewing our ethnographic material through an observational lense problematising the policy discourse around data-driven health approach, two propositions were developed. First, we propose that relational knowledge risk becoming less influential in shaping everyday care, when moving to a data-driven health approach. Second, we propose that quality of care risk becoming more directed on quality of medical care at the expense of quality of life. CONCLUSION While the implementation of data-driven health approach within long-term care for older adults is not yet widespread, the general development within health care points towards a situation in which this will become reality. Our study highlights the importance of taking the relational aspects of care into consideration, both during the planning and implementation phase of this process. By doing this, the introduction of a data-driven health approach could serve to heighten the quality of care in a way which supports both quality of medical care and quality of life.
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Affiliation(s)
- Mikaela Hellstrand
- Division of Health Informatics and Logistics, KTH Royal Institute of Technology, Hälsovägen 11C, Huddinge, Sweden.
| | - Maksims Kornevs
- Division of Health Informatics and Logistics, KTH Royal Institute of Technology, Hälsovägen 11C, Huddinge, Sweden
| | - Jayanth Raghothama
- Division of Health Informatics and Logistics, KTH Royal Institute of Technology, Hälsovägen 11C, Huddinge, Sweden
| | - Sebastiaan Meijer
- Division of Health Informatics and Logistics, KTH Royal Institute of Technology, Hälsovägen 11C, Huddinge, Sweden
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Drake Af Hagelsrum K, Mogard E, Bremander A, Lindqvist E, Larsson I. Healthcare professionals' perceptions of working on lifestyle management for patients with early rheumatoid arthritis - a qualitative study. Int J Qual Stud Health Well-being 2023; 18:2241225. [PMID: 37499140 PMCID: PMC10375922 DOI: 10.1080/17482631.2023.2241225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 07/22/2023] [Indexed: 07/29/2023] Open
Abstract
AIM To explore HPs' perceptions of working on lifestyle management for patients with early rheumatoid arthritis (RA). METHODS In this qualitative study, individual interviews were conducted with 20 HPs. Qualitative content analysis was used, and three categories and six subcategories were identified. RESULTS HPs' perceptions of working on lifestyle management for patients with early RA revealed a need for commitment from different levels. This included commitment from healthcare managers and organizations prioritizing work on lifestyle management and providing competence development for HPs. Commitment within the team regarding coordination of interdisciplinary teamwork and development of a structured lifestyle management approach, and commitment to involving patients in lifestyle management, by facilitating patient engagement and a person-centred approach. CONCLUSIONS HPs' perceptions of working on lifestyle management for patients with early RA revealed that commitment from healthcare managers, organizations, and the interdisciplinary team was essential to facilitate collaboration, patient involvement, and a person-centred approach.
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Affiliation(s)
- Klara Drake Af Hagelsrum
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
- Department of Rheumatology, Skåne University Hospital, Lund, Sweden
| | - Elisabeth Mogard
- Department of Rheumatology, Skåne University Hospital, Lund, Sweden
- Section of Rheumatology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Ann Bremander
- Section of Rheumatology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
- Spenshult Research and Development Centre, Halmstad, Sweden
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark
- Danish Hospital for Rheumatic Diseases, University Hospital of Southern Denmark, Sonderborg, Denmark
| | - Elisabet Lindqvist
- Department of Rheumatology, Skåne University Hospital, Lund, Sweden
- Section of Rheumatology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Ingrid Larsson
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
- Section of Rheumatology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
- Spenshult Research and Development Centre, Halmstad, Sweden
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Johnsson N, Strandberg S, Tuvesson H, Fagerström C, Ekstedt M, Lindberg C. Delineating and clarifying the concept of self-care monitoring: a concept analysis. Int J Qual Stud Health Well-being 2023; 18:2241231. [PMID: 37506372 PMCID: PMC10392281 DOI: 10.1080/17482631.2023.2241231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Accepted: 07/22/2023] [Indexed: 07/30/2023] Open
Abstract
AIM To delineate and clarify the meaning of the concept of self-care monitoring from a patient perspective. METHODS A systematic search was performed in the databases ASSIA, CINAHL, PsycInfo, and PubMed (January 2016-September 2021). A selection of 46 peer-reviewed articles was included in the study and analysed using Rodgers' Evolutionary Method for Concept Analysis. RESULTS The following four attributes were identified: Tracking symptoms, signs, and actions, Paying attention, Being confident, and Needing routines, creating a descriptive definition: "Self-care monitoring is an activity that means a person has to pay attention and be confident and needs routines for tracking symptoms, signs, and action." The antecedents of the concept were shown to be Increased knowledge, Wish for independence, and Commitment. The concepts' consequences were identified as Increased interaction, Perceived burden, and Enhanced well-being. CONCLUSIONS This concept analysis provides extensive understanding of self-care monitoring from a patient perspective. It was shown that the concept occurs when a person practices self-care monitoring at home either with or without devices. A descriptive definition was constructed and presented with exemplars to encourage practice of the concept in various healthcare settings and could be of relevance to people with chronic illnesses or other long-term conditions.
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Affiliation(s)
- Natali Johnsson
- Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden
| | | | - Hanna Tuvesson
- Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden
| | - Cecilia Fagerström
- Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden
| | - Mirjam Ekstedt
- Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden
- Department of Learning, Informatics, Management, and Ethics, Karolinska Institutet, Stockholm, Sweden
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Markström U, Näslund H, Schön UK, Rosenberg D, Bejerholm U, Gustavsson A, Jansson M, Argentzell E, Grim K, Engdahl P, Nouf F, Lilliehorn S, Svedberg P. Developing sustainable service user involvement practices in mental health services in Sweden: the "Userinvolve" research program protocol. Front Psychiatry 2023; 14:1282700. [PMID: 37900294 PMCID: PMC10601639 DOI: 10.3389/fpsyt.2023.1282700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 09/22/2023] [Indexed: 10/31/2023] Open
Abstract
Background The purpose of this paper is to outline the protocol for the research program "UserInvolve," with the aim of developing sustainable, service user involvement practices in mental health services in Sweden. Methods This protocol outlines the knowledge gap and aim of the UserInvolve-program. It further provides an overview of the research infrastructure, with specific focus on the organization and management of the program as well as the design of the six underlying research projects. These six research projects form the core of the UserInvolve-program and will be carried out during a six-year period (2022-2027). The projects are focused on examining articulations of experiential knowledge in user collectives, on four specific user involvement interventions (shared decision-making, peer support, user-focused monitoring, and systemic involvement methods) and on developing theory and method on co-production in mental health research and practice. Results or conclusion The knowledge gained through the co-production approach will be disseminated throughout the program years, targeting service users, welfare actors and the research community. Based on these research activities, our impact goals relate to strengthening the legitimacy of and methods for co-production in the mental health research and practice field.
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Affiliation(s)
| | - Hilda Näslund
- Department of Social Work, Umeå University, Umeå, Sweden
| | - Ulla-Karin Schön
- Department of Social Work, Stockholm University, Stockholm, Sweden
| | | | | | | | - Mårten Jansson
- The Swedish Partnership for Mental Health, NSPH, Stockholm, Sweden
| | | | - Katarina Grim
- Department of Social and Psychological Studies, Karlstad University, Karlstad, Sweden
| | - Patrik Engdahl
- Department of Health Sciences, Lund University, Lund, Sweden
| | - Faten Nouf
- Department of Social Work, Umeå University, Umeå, Sweden
| | | | - Petra Svedberg
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
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Waldemar A, Strömberg A, Thylén I, Bremer A. Experiences of family-witnessed cardiopulmonary resuscitation in hospital and its impact on life: An interview study with cardiac arrest survivors and their family members. J Clin Nurs 2023; 32:7412-7424. [PMID: 37300340 DOI: 10.1111/jocn.16788] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 05/17/2023] [Accepted: 05/29/2023] [Indexed: 06/12/2023]
Abstract
AIM To explore experiences of cardiac arrest in-hospital and the impact on life for the patient who suffered the arrest and the family member who witnessed the resuscitation. BACKGROUND Guidelines advocate that the family should be offered the option to be present during resuscitation, but little is known about family-witnessed cardiopulmonary resuscitation in hospital and the impact on the patient and their family. DESIGN A qualitative design consisting of joint in-depth interviews with patients and family members. METHODS Family interviews were conducted with seven patients and their eight corresponding family members (aged 19-85 years) 4-10 months after a family-witnessed in-hospital cardiac arrest. Data were analysed using interpretative phenomenological analysis. The study followed the guidelines outlined in the consolidated criteria for reporting qualitative research (COREQ) checklist. RESULTS The participants felt insignificant and abandoned following the in-hospital cardiac arrest. Surviving patients and their close family members felt excluded, alone and abandoned throughout the care process; relationships, emotions and daily life were affected and gave rise to existential distress. Three themes and eight subordinate themes were identified: (1) the intrusion of death-powerless in the face of the fragility of life, highlights what it is like to suffer a cardiac arrest and to cope with an immediate threat to life; (2) being totally exposed-feeling vulnerable in the care relationship, describes how a lack of care from healthcare staff damaged trust; (3) learning to live again-making sense of an existential threat, pertaining to the family's reactions to a difficult event that impacts relationships but also leads to a greater appreciation of life and a positive view of the future. CONCLUSION Surviving and witnessing a cardiac arrest in-hospital is a critical event for everyone involved. Patients and family members are vulnerable in this situation and need to be seen and heard, both in the hospital and after hospital discharge. Consequently, healthcare staff need to show compassion and attend to the needs of the family, which involves continually assessing how family members are coping during the process, and providing support and information during and after resuscitation. RELEVANCE TO CLINICAL PRACTICE It is important to provide support to family members who witness the resuscitation of a loved one in-hospital. Structured follow-up care is crucial for cardiac arrest survivors and their families. To promote person-centred care, nurses need interprofessional training on how to support family members during resuscitation, and follow-up care focusing on providing resources for multiple challenges faced by survivors (emotional, cognitive, physical) and families (emotional) is needed. PATIENT OR PUBLIC CONTRIBUTION In-hospital cardiac arrest patients and family members were involved when designing the study.
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Affiliation(s)
- Annette Waldemar
- Department of Cardiology in Norrköping, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Anna Strömberg
- Department of Cardiology in Linköping, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Ingela Thylén
- Department of Cardiology in Linköping, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Anders Bremer
- Department of Health and Caring Sciences, Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden
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Muntlin Å, Jangland E, Laugesen B, Voldbjerg SL, Gunningberg L, Greenway K, Merriman C, Grønkjær M, Heinen M, Huisman-de Waal G. Bedside nurses' perspective on the Fundamentals of Care framework and its application in clinical practice: A multi-site focus group interview study. Int J Nurs Stud 2023; 145:104526. [PMID: 37390582 DOI: 10.1016/j.ijnurstu.2023.104526] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 05/04/2023] [Accepted: 05/12/2023] [Indexed: 07/02/2023]
Abstract
BACKGROUND A changing nursing workforce and an increase in demands for care together with more complex care, raise arguments that leading and guiding nursing practice is more challenging than ever. Therefore, nurses need to have a shared agenda and a common language to show the importance of nursing care and the consequences of not addressing this in an appropriate way. In response to this the Fundamentals of Care framework was developed to also contribute to the delivery of person-centred care in an integrated way. However, to gain acceptance and applicability we need to ensure the framework's relevance to clinical practice from bedside nurses' perspectives. OBJECTIVE To describe bedside nurses' perspectives on the Fundamentals of Care framework and how it can be applied in clinical practice. DESIGN A descriptive qualitative design informed by the Fundamentals of Care framework. SETTING(S) The study was undertaken at seven hospitals in Sweden, Denmark and the Netherlands during 2019. PARTICIPANTS A total sample of 53 registered nurses working at the bedside participated. Participants had a wide variety of clinical experience and represented a range of different nursing practice areas. METHODS Twelve focus group interviews were used to collect data and analysed with a deductive content analysis approach. RESULTS Bedside nurses perceived that the Fundamentals of Care framework was adequate, easy to understand and recognised as representative for the core of nursing care. The definition for fundamental care covered many aspects of nursing care, but was also perceived as too general and too idealistic in relation to the registered nurses' work. The participants recognised the elements within the framework, but appeared not to be using this to articulate their practice. Three main categories emerged for implications for clinical practice; guiding reflection on one's work; ensuring person-centred fundamental care and reinforcing nursing leadership. CONCLUSIONS The Fundamentals of Care framework is perceived by bedside nurses as a modern framework describing the core of nursing. The framework was recognised as having clinical relevance and provides bedside nurses with a common language to articulate the complexity of nursing practice. This knowledge is crucial for bedside nurses both in clinical practice and in leadership roles to be able to speak up for the need to integrate all dimensions of care to achieve person-centred fundamental care. Various activities for reflection, person-centred care and leadership to apply the framework in clinical practice were presented, together with minor suggestions for development of the framework. TWEETABLE ABSTRACT Bedside nurses recognise their clinical practice within the Fundamentals of Care framework, showing the core of modern nursing.
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Affiliation(s)
- Åsa Muntlin
- Department of Emergency Care and Internal Medicine, Uppsala University Hospital, Uppsala, Sweden; Department of Medical Sciences/Clinical Epidemiology, Uppsala University, Uppsala, Sweden; College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia.
| | - Eva Jangland
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
| | - Brit Laugesen
- Clinical Nursing Research Unit, Aalborg University Hospital, Denmark; Centre for Clinical Guidelines, Aalborg University, Denmark
| | - Siri Lygum Voldbjerg
- Clinical Nursing Research Unit, Aalborg University Hospital, Department of Clinical Medicine, Aalborg University, Denmark; School of Nursing, University College Nordjylland, Denmark
| | - Lena Gunningberg
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Kathleen Greenway
- Oxford Institute of Nursing, Midwifery and Allied Health Research, Oxford Brookes University, Oxford, England, United Kingdom of Great Britain and Northern Ireland.
| | - Clair Merriman
- Oxford Institute of Nursing, Midwifery and Allied Health Research, Oxford Brookes University, Oxford, England, United Kingdom of Great Britain and Northern Ireland.
| | - Mette Grønkjær
- Clinical Nursing Research Unit, Aalborg University Hospital, Department of Clinical Medicine, Aalborg University, Denmark
| | - Maud Heinen
- Radboud University Medical Center, Radboud Institute for Healthcare Sciences, IQ Health, Nijmegen, the Netherlands.
| | - Getty Huisman-de Waal
- Radboud University Medical Center, Radboud Institute for Healthcare Sciences, IQ Health, Nijmegen, the Netherlands.
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Gasser F, Bala SV, Westergren A, Ekstrand J, Hagell P. Further development and evaluation of a questionnaire targeting person-centred outpatient care for persons with long-term conditions. J Patient Rep Outcomes 2023; 7:85. [PMID: 37610497 PMCID: PMC10447667 DOI: 10.1186/s41687-023-00623-6] [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: 03/13/2023] [Accepted: 07/28/2023] [Indexed: 08/24/2023] Open
Abstract
AIM To further develop the Person-Centred Care instrument for outpatient care (PCCoc), evaluate its user-friendliness and content validity, and to explore its basic psychometric properties in various outpatient settings for adults with long-term conditions. BACKGROUND Person-centred care (PCC) has been identified as a key factor to provide high-quality care. However, there is still a lack of instruments that are based on a clearly defined framework for PCC for persons with long-term conditions in an outpatient context. The PCCoc is a patient-reported experience measure under development aiming to fill this gap. METHODS First, the 35-item PCCoc was reviewed and further developed in collaboration with a user-council. Second, the revised 36-item PCCoc was tested among persons receiving outpatient care for various long-term conditions. A total of 179 persons with long-term conditions from four different specialties participated in the study. User-friendliness and content validity were assessed through structured interviews and relevance ratings of each item. Content validity index (CVI) for individual items (I-CVI) and for the overall scale (S-CVI) were calculated, and basic psychometric properties of the PCCoc using classical test theory were explored. RESULTS It took a median of 8 min for participants to complete the PCCoc. The majority found items easy to understand, response categories distinct and that no important areas were missing. Results from the CVI analyses suggested that participants found the content of the PCCoc relevant (I-CVI range 0.82-1, S-CVI = 0.95). All psychometric properties examined were satisfactory (e.g., item-total correlations, 0.45-0.75; Cronbach's alpha, 0.96; test-retest stability, 0.83). CONCLUSION The PCCoc was considered user-friendly and relevant by the intended users, and its psychometric properties were satisfactory. This implies that the PCCoc can be a valuable instrument for evaluating and developing PCC in outpatient care for persons with long-term conditions. However, further studies of the PCCoc are needed to establish its measurement properties in various outpatient settings.
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Affiliation(s)
- Fredrik Gasser
- The Pro-CARE Group, Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden.
- The Research Platform for Collaboration for Health, Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden.
| | - Sidona-Valentina Bala
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
- Department of Medicine, Section of Rheumatology, Helsingborg Central Hospital, Helsingborg, Sweden
| | - Albert Westergren
- The Pro-CARE Group, Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
- The Research Platform for Collaboration for Health, Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
| | - Joakim Ekstrand
- The Pro-CARE Group, Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
| | - Peter Hagell
- The Pro-CARE Group, Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden
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Grynne A, Wångdahl J, Fristedt S, Smith F, Browall M. Women's experience of the health information process involving a digital information tool before commencing radiation therapy for breast cancer: a deductive interview study. BMC Health Serv Res 2023; 23:842. [PMID: 37559113 PMCID: PMC10410896 DOI: 10.1186/s12913-023-09837-2] [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: 02/06/2023] [Accepted: 07/21/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Individuals undergoing radiation therapy for breast cancer frequently request information before, throughout and after the treatment as a means to reduce distress. Nevertheless, the provision of information to meet individuals needs from their level of health literacy is often overlooked. Thus, individuals information needs are often unmet, leading to reports of discontent. Internet and digital information technology has significantly augmented the available information and changed the way in which persons accesses and comprehends information. As health information is no longer explicitly obtained from healthcare professionals, it is essential to examine the sequences of the health information process in general, and in relation to health literacy. This paper reports on qualitative interviews, targeting women diagnosed with breast cancer who were given access to a health information technology tool, Digi-Do, before commencing radiation therapy, during, and after treatment. METHODS A qualitative research design, inspired by the integrated health literacy model, was chosen to enable critical reflection by the participating women. Semi-structured interviews were conducted with 15 women with access to a digital information tool, named Digi-Do, in addition to receiving standard information (oral and written) before commencing radiation therapy, during, and after treatment. A deductive thematic analysis process was conducted. RESULTS The results demonstrate how knowledge, competence, and motivation influence women's experience of the health information process. Three main themes were found: Meeting interactive and personal needs by engaging with health information; Critical recognition of sources of information; and Capability to communicate comprehended health information. The findings reflect the women's experience of the four competencies: to access, understand, appraise, and apply, essential elements of the health information process. CONCLUSIONS We can conclude that there is a need for tailored digital information tools, such as the Digi-Do, to enable iterative access and use of reliable health information before, during and after the radiation therapy process. The Digi-Do can be seen as a valuable complement to the interpersonal communication with health care professionals, facilitating a better understanding, and enabling iterative access and use of reliable health information before, during and after the radiotherapy treatment. This enhances a sense of preparedness before treatment starts.
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Affiliation(s)
- Annika Grynne
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden.
- School of Research, School of Health and Welfare, Jönköping university, Jönköping, Sweden.
- The Jönköping Academy for Improvement of Health and Welfare, School of Health and Welfare, Jönköping University, Jönköping, Sweden.
| | - Josefin Wångdahl
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Sofi Fristedt
- The Jönköping Academy for Improvement of Health and Welfare, School of Health and Welfare, Jönköping University, Jönköping, Sweden
- Department of Rehabilitation, School of Health and Welfare, Jönköping University, Jönköping, Sweden
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden
| | - Frida Smith
- Regional Cancer Centre West, Gothenburg, Sweden
- Department of Technology Management and Economics, Chalmers University of Technology, Gothenburg, Sweden
| | - Maria Browall
- Department of Nursing, School of Health and Welfare, Jönköping University, Jönköping, Sweden
- The Jönköping Academy for Improvement of Health and Welfare, School of Health and Welfare, Jönköping University, Jönköping, Sweden
- Dep of Oncology, Inst of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Vrinzen CEJ, Bloemendal HJ, Jeurissen PPT. How to create value with constrained budgets in oncological care? A narrative review. Expert Rev Pharmacoecon Outcomes Res 2023; 23:989-999. [PMID: 37650221 DOI: 10.1080/14737167.2023.2253375] [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: 06/15/2023] [Accepted: 08/25/2023] [Indexed: 09/01/2023]
Abstract
INTRODUCTION As a result of an increasing focus on patient-centered care within oncology and more pressure on the sustainability of health-care systems, the discussion on what exactly constitutes value re-appears. Policymakers seek to improve patient values; however, funding all values is not sustainable. AREAS COVERED We collect available evidence from scientific literature and reflect on the concept of value, the possible incorporation of a wide spectrum of values in reimbursement decisions, and alternative strategies to increase value in oncological care. EXPERT OPINION We state that value holds many different aspects. For reimbursement decisions, we argue that it is simply not feasible to incorporate all patient values because of the need for efficient resource allocation. We argue that we should shift the value debate from the individual perspective of patients to creating value for the cancer population at large. The different strategies we address are as follows: (1) shared decision-making; (2) biomarkers and molecular diagnostics; (3) appropriate evaluation, payment and use of drugs; (4) supportive care; (5) cancer prevention and screening; (6) monitoring late effect; (7) concentration of care and oncological networking; and (8) management of comorbidities. Important preconditions to support these strategies are strategic planning, consistent cancer policies and data availability.
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Affiliation(s)
- Cilla E J Vrinzen
- Scientific Institute for Quality of Healthcare, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Haiko J Bloemendal
- Department of Oncology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Patrick P T Jeurissen
- Scientific Institute for Quality of Healthcare, Radboud University Medical Centre, Nijmegen, The Netherlands
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23
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Blomqvist M, Ivarsson A, Carlsson IM, Sandgren A, Jormfeldt H. Relationship between Physical Activity and Health Outcomes in Persons with Psychotic Disorders after Participation in a 2-Year Individualized Lifestyle Intervention. Issues Ment Health Nurs 2023:1-10. [PMID: 37364236 DOI: 10.1080/01612840.2023.2212771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Abstract
People with psychotic disorders have a significantly increased risk of physical diseases and excessive mortality rates. The aim of the study was to investigate relationships between changes in physical activity, levels of salutogenic health, and glycated hemoglobin among people with psychotic disorders after participation in an individualized lifestyle intervention. The results from analyses showed that self-reported increased physical activity was positively associated with the level of salutogenic health and negatively associated with the level of HbA1c on an individual level. The results indicate that coordinated, individualized, holistic and health-promoting nursing care is crucial to enabling enhanced lifestyle within this vulnerable target group.
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Affiliation(s)
- Marjut Blomqvist
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | - Andreas Ivarsson
- School of Health and Welfare, Halmstad University, Halmstad, Sweden
| | | | - Anna Sandgren
- Center for Collaborative Palliative Care, Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden
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24
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Lindahl J, Thulesius H, Wijk H, Edvardsson D, Elmqvist C. The Perceived Support From Light and Color Before and After an Evidence-Based Design Intervention in an Emergency Department Environment: A Quasi-Experimental Study. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2023; 16:109-124. [PMID: 36866406 PMCID: PMC10133835 DOI: 10.1177/19375867221150215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
AIM To evaluate patients' and family members' perceived support from light and color before, compared with after an evidence-based design (EBD) intervention at an emergency department (ED) using a validated instrument-the Light and Color Questionnaire (LCQ). BACKGROUND EDs offer acute care day and night. Thus, a supportive physical environment where light and color is crucial for how the milieu is experienced is vital. Research is limited on how care settings are perceived as supportive by users. METHODS Quasi-experimental evaluation of the refurbishing and remodeling of an ED by an expert group of nurse managers, nursing staff, nursing researchers and architects in south Sweden. LCQ includes dimensions "maximizing awareness and orientation," "maximizing safety and security," "supporting functional abilities," "providing privacy," "opportunities for personal control" (not for LCQ-Color), and "regulation and quality of stimulation." LCQ was analyzed and compared in 400 surveys from 100 patients and 100 family members before the intervention and 100 patients and 100 family members after the intervention. RESULTS The LCQ total score significantly improved after the intervention for both patients and family members. Four of the six dimensions of LCQ Light subscale scores were significantly higher for family members, and three of the six dimensions were significantly higher for patients after the intervention. The LCQ Color subscale score showed significant improvements for all five dimensions for both patients and family members after the intervention. CONCLUSION This study showed improved perceived support from light and color in the physical environment for patients and family members after an EBD intervention at an emergency department using a validated instrument-the Light and Color Questionnaire.
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Affiliation(s)
- Jeanette Lindahl
- Centre of Interprofessional Collaboration within Emergency care (CICE), Department of Health Caring Sciences, Linnaeus University, Växjö, Sweden.,Department of Research and Development, Region Kronoberg, Växjö, Sweden
| | - Hans Thulesius
- Department of Research and Development, Region Kronoberg, Växjö, Sweden.,Department of Clinical Sciences, Lund University, Malmö, Sweden.,Department of Medicine and Optometry, Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden
| | - Helle Wijk
- Institute of Health and Care Sciences, Sahlgrenska Academy at Gothenburg University, Sweden.,Department of Quality Assurance and Patient Safety, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Architecture and Civil Engineering, Chalmers University of Technolog, Gothenburg, Sweden
| | - David Edvardsson
- School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia.,Department of Nursing, Umeå University, Sweden
| | - Carina Elmqvist
- Centre of Interprofessional Collaboration within Emergency care (CICE), Department of Health Caring Sciences, Linnaeus University, Växjö, Sweden.,Department of Research and Development, Region Kronoberg, Växjö, Sweden
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25
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Vrinzen CEJ, Bloemendal HJ, Stuart E, Makady A, van Agthoven M, Koster M, Merkx MAW, Hermens RPMG, Jeurissen PPT. Cancer treatments touch a wide range of values that count for patients and other stakeholders: What are the implications for decision-making? Cancer Med 2023; 12:6105-6116. [PMID: 36373590 PMCID: PMC10028089 DOI: 10.1002/cam4.5336] [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: 06/03/2022] [Revised: 09/02/2022] [Accepted: 09/25/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Cancer rates and expenditures are increasing, resulting in debates on the exact value of this care. Perspectives on what exactly constitutes worthwhile values differ. This study aims to explore all values-elements regarding new oncological treatments for patients with cancer and all stakeholders involved and to assess their implications in different decision-making procedures. METHOD Thirty-one individual in-depth interviews were conducted with different stakeholders to identify values within oncology. A focus group with seven experts was performed to explore its possible implications in decision-making procedures. RESULTS The overarching themes of values identified were impact on daily life and future, costs for patients and loved ones, quality of life, impact on loved ones, societal impact and quality of treatments. The expert panel revealed that the extended exploration of values that matter to patients is deemed useful in patient-level decision-making, information provision, patient empowerment and support during and after treatment. For national reimbursement decisions, implications for the broad range of values seems less clear. CONCLUSION Clinical values are not the only ones that matter to oncological patients and the stakeholders in the field. We found a much broader range of values. Proper recognition of values that count might add to patient-level decision-making, but implications for reimbursement decisions are less clear. The results could be useful to guide clinicians and policymakers when it comes to decision-making in oncology. Making more explicit which values counts for whom guarantees a more systematic approach to decision-making on all levels.
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Affiliation(s)
- Cilla E J Vrinzen
- Scientific Institute for Quality of Healthcare (IQ Healthcare), Radboud Institute of Health Sciences (RIHS), Radboudumc, Nijmegen, The Netherlands
- Netherlands Comprehensive Cancer Center (IKNL), Utrecht, The Netherlands
| | - Haiko J Bloemendal
- Department of Oncology, Radboud Institute of Health Sciences (RIHS), Radboudumc, Nijmegen, The Netherlands
| | - Esra Stuart
- Scientific Institute for Quality of Healthcare (IQ Healthcare), Radboud Institute of Health Sciences (RIHS), Radboudumc, Nijmegen, The Netherlands
| | - Amr Makady
- Janssen-Cilag B.V., Pharmaceutical Companies of Johnson & Johnson, Breda, The Netherlands
| | - Michel van Agthoven
- Janssen-Cilag B.V., Pharmaceutical Companies of Johnson & Johnson, Breda, The Netherlands
| | - Mariska Koster
- Janssen-Cilag B.V., Pharmaceutical Companies of Johnson & Johnson, Breda, The Netherlands
| | - Matthias A W Merkx
- Scientific Institute for Quality of Healthcare (IQ Healthcare), Radboud Institute of Health Sciences (RIHS), Radboudumc, Nijmegen, The Netherlands
- Netherlands Comprehensive Cancer Center (IKNL), Utrecht, The Netherlands
| | - Rosella P M G Hermens
- Scientific Institute for Quality of Healthcare (IQ Healthcare), Radboud Institute of Health Sciences (RIHS), Radboudumc, Nijmegen, The Netherlands
| | - Patrick P T Jeurissen
- Scientific Institute for Quality of Healthcare (IQ Healthcare), Radboud Institute of Health Sciences (RIHS), Radboudumc, Nijmegen, The Netherlands
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26
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Shmarina E, Ericson D, Götrick B, Franzén C. Dental professionals' perception of their role in the practice of oral health promotion: a qualitative interview study. BMC Oral Health 2023; 23:43. [PMID: 36698102 PMCID: PMC9875771 DOI: 10.1186/s12903-023-02756-y] [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: 12/05/2022] [Accepted: 01/19/2023] [Indexed: 01/26/2023] Open
Abstract
OBJECTIVE To explore dental professionals' perceptions of their role in the practice of oral health promotion. MATERIAL AND METHOD In-depth interviews were conducted with three dentists, one specialist dentist and seven dental hygienists. All were employed in the public dental service in Kalmar County, Sweden and had at least 2 years' work experience. The interview questions addressed the experience and views of dental professionals with reference to their role in the practice of health promotion. The interview data were subjected to qualitative content analysis. RESULTS Analysis revealed two themes which capture the essence of the dental professionals' perception of their role in the practice of oral health promotion. One theme, having person-focused approach, comprised four categories: 'considering the patient's life situation', 'establishing a trusting relationship with patients', 'strengthening patients' commitment to oral health' and 'health education'. The other theme, perceiving social responsibility for oral health, comprised three categories: 'dissemination of oral health knowledge', 'interprofessional collaboration' and 'equality in oral health care'. CONCLUSION Dental professionals perceived promotion of oral health to be an important aspect of their professional role. They aspired to patient participation in the decision-making process and educational activities, as well as practising and evaluating skills development. Although the dental professionals perceived that they undertook health promotion activities, they did not clearly distinguish between oral health promotion and disease prevention. There was intra- and inter-professional agreement among the dentists and dental hygienists with respect to expected outcomes for health promotion activities.
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Affiliation(s)
- Elena Shmarina
- grid.32995.340000 0000 9961 9487Department of Oral Diagnostics, Faculty of Odontology, Malmö University, Malmö, Sweden ,grid.466900.d0000 0001 0597 1373Kalmar County Council, Public Dental Service, Oskarshamn, Sweden
| | - Dan Ericson
- grid.32995.340000 0000 9961 9487Department of Cariology, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Bengt Götrick
- grid.32995.340000 0000 9961 9487Department of Oral Diagnostics, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Cecilia Franzén
- grid.32995.340000 0000 9961 9487Department of Oral Diagnostics, Faculty of Odontology, Malmö University, Malmö, Sweden
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27
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Martín-Sanz MB, Salazar-de-la-Guerra RM, Cuenca-Zaldivar JN, Salcedo-Perez-Juana M, Garcia-Bravo C, Palacios-Ceña D. Person-centred care in individuals with stroke: a qualitative study using in-depth interviews. Ann Med 2022; 54:2167-2180. [PMID: 35930376 PMCID: PMC9359161 DOI: 10.1080/07853890.2022.2105393] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 07/02/2022] [Accepted: 07/18/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Person-centred care (PCC) has considerable effects on the clinical practice of health professionals. The purpose of this study was to describe the perspectives and perceived barriers and enablers of individuals with stroke regarding the PCC model in stroke rehabilitation. METHODS A qualitative exploratory study was conducted based on an interpretive framework. Participants were recruited using non-probabilistic purposeful sampling and a snowball-technique strategy. The inclusion criteria consisted of: (a) individuals > 18 years, (b) diagnosed with moderate or severe stroke according to the National Institutes of Health Stroke Scale and (c) in the post-acute or chronic stage of the disease. In total, 31 individuals with stroke were included. In-depth interviews and researchers' field notes were used to collect the data. A thematic analysis was performed. Also, credibility, transferability, dependability and confirmability techniques were followed to establish trustworthiness of the data. RESULTS Thirty-one individuals with stroke (11 women) were included. Three main themes were identified: (a) The person behind the "patient" label, recognizing the person beyond their illness and valuing their identity and individual characteristics, (b) The person at the centre of care, considering themselves as an active agent in their own care and respecting their preferences and expectations for their care process and (c) Training for PCC, providing health professionals with tools to achieve professional skills for the implementation and development of the PCC model. CONCLUSIONS AND SIGNIFICANCE This paper describes relevant aspects that health professionals should consider when providing PCC in the context of the rehabilitation of individuals with stroke. Key messagesThe individuals' perspective regarding person-centred care (PCC) has considerable effects on the clinical practice of health professionals.Individuals with stroke describe how there is a person behind the "patient" label, with identity, needs and desire to participate in decision making.Training in the PCC model helps healthcare professionals identify the needs of individuals with stroke during rehabilitation.
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Affiliation(s)
- María Belén Martín-Sanz
- Research Group of Humanities and Qualitative Research in Health Science of Universidad Rey Juan Carlos (Hum&QRinHS), Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, Alcorcón, Spain
| | | | - Juan Nicolas Cuenca-Zaldivar
- Research Group in Nursing and Health Care, Puerta de Hierro Health Research Institute-Segovia de Arana (IDIPHISA), Madrid, Spain
| | - María Salcedo-Perez-Juana
- Research Group of Humanities and Qualitative Research in Health Science of Universidad Rey Juan Carlos (Hum&QRinHS), Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, Alcorcón, Spain
| | - Cristina Garcia-Bravo
- Research Group in Evaluation and Assessment of Capacity, Functionality and Disability of Universidad Rey Juan Carlos (TO + IDI), Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, Alcorcón, Spain
| | - Domingo Palacios-Ceña
- Research Group of Humanities and Qualitative Research in Health Science of Universidad Rey Juan Carlos (Hum&QRinHS), Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, Alcorcón, Spain
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Johansson G, Juuso P, Engström Å. Nature-based interventions to promote health for people with stress-related illness: An integrative review. Scand J Caring Sci 2022; 36:910-925. [PMID: 35604072 PMCID: PMC9790340 DOI: 10.1111/scs.13089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 04/05/2022] [Accepted: 05/07/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Stress-related illness is increasing and is a common cause of sick leave. Spending time in nature have a positive effect on health and well-being for instance by reducing stress. Specific programmes with nature-based interventions (NBI) with the intention to involve people in activities in a supportive natural environment have been developed for people with stress-related illness. AIM To identify and summarise scientific studies of NBIs to promote health for people with stress-related illness. METHOD The design used in this study is integrative literature review. Scientific studies focusing on any type of NBI for people with stress-related illness were sought in Cinahl, PubMed, PsycInfo, AMED and Scopus. In total, 25 studies using both qualitative and quantitative designs were included in the review. RESULT The reviewed studies focused on garden or forest interventions. In the majority of the studies, NBIs were performed in groups, including individual activities, and the length of programmes varied. Interventions in natural environments have unique qualities for individualised, meaningful activities and interactions with others in a non-demanding atmosphere. NBIs offer restoration that reduces stress, improves health and well-being and strengthen self-efficacy and work ability. Connectedness with nature support existential reflections and people with stress-related illness can achieve balance in everyday life. CONCLUSION In conclusion, NBIs may have advantages to promote health for people with stress-related illness and should therefore be considered as an alternative to those affected. Further research from different perspectives, including nursing, is needed to understand the possibilities of NBIs and how they can be integrated into practice.
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Affiliation(s)
- Gunilla Johansson
- Division of Nursing and Medical Technology, Department of Health, Education and TechnologyLuleå University of TechnologyLuleåSweden
| | - Päivi Juuso
- Division of Nursing and Medical Technology, Department of Health, Education and TechnologyLuleå University of TechnologyLuleåSweden
| | - Åsa Engström
- Division of Nursing and Medical Technology, Department of Health, Education and TechnologyLuleå University of TechnologyLuleåSweden
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Al‐Adili L, Boström A, Orrevall Y, Lang NR, Peersen C, Persson I, Thoresen L, Lövestam E. Self‐reported documentation of goals and outcomes of nutrition care – A cross‐sectional survey study of Scandinavian dietitians. Scand J Caring Sci 2022; 37:472-485. [PMID: 36329640 DOI: 10.1111/scs.13131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 10/05/2022] [Accepted: 10/15/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND The documentation of goals and outcomes of nutrition care in Electronic Health Records is insufficient making further exploration of this of particular interest. Identifying common features in documentation practice among Scandinavian dietitians might provide information that can support improvement in this area. AIMS To explore the associations between clinical dietitians' self-reported documentation of patients' goals and outcomes and demographic factors, self-reported implementation of the systematic framework the Nutrition Care Process 4th step (NCP) and its associated terminology, and factors associated with the workplace. METHODS Data from a cross-sectional study based on a previously tested web-based survey (INIS) disseminated in 2017 to dietitians in Scandinavia (n = 494) was used. Respondents were recruited through e-mail lists, e-newsletters and social media groups for dietitians. Associations between countries regarding the reported documentation of goals and outcomes, implementation levels of the NCP 4th step, demographic information and factors associated with the workplace were measured through Chi-square test. Associations between dependent- and independent variables were measured through logistic regression analysis. RESULTS Clinically practicing dietitians (n = 347) working in Scandinavia, Sweden (n = 249), Norway (n = 60), Denmark (n = 38), who had completed dietetic education participated. The reported documentation of goals and outcomes from nutrition intervention was highly associated with the reported implementation of NCP 4th step terminology (OR = 5.26; p = 0.009, OR = 3.56; p = 0.003), support from the workplace (OR = 4.0, p < 0.001, OR = 8.89, p < 0.001) and area of practice (OR = 2.02, p = 0.017). Years since completed dietetic training and educational level did not have any significant associations with documentation practice regarding goals and outcomes. CONCLUSION Findings highlight strong associations between the implementation of the NCP 4th step terminology and the documentation of goals and outcomes. Strategies to support dietitians in using standardized terminology and the development of tools for comprehensive documentation of evaluation of goals and outcome are required.
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Affiliation(s)
- Lina Al‐Adili
- Department of Food Studies, Nutrition and Dietetics Uppsala University Uppsala Sweden
| | - Anne‐Marie Boström
- Department of Neurobiology, Care Science and Society Division of Nursing, Karolinska Institutet Huddinge Sweden
- Theme Inflammation and Aging Karolinska University Hospital Huddinge Sweden
- Research and Development Unit Stockholms Sjukhem Stockholm Sweden
- Karolinska Institutet Huddinge Sweden
| | - Ylva Orrevall
- Department of Biosciences and Nutrition Karolinska Institute Stockholm Sweden
- Medical Unit Clinical Nutrition Women's Health and Allied Health Professionals Theme, Karolinska University Hospital Stockholm Sweden
| | - Nanna R. Lang
- Department of Nutrition and Health VIA University College Denmark
| | - Charlotte Peersen
- Department of Unit for Service and Intern Control Department of Service and Quality, Trondheim Municipality Trondheim Norway
| | - Inger Persson
- Department of Statistics Uppsala University Uppsala Sweden
| | - Lene Thoresen
- Cancer Clinic, St. Olavs Hospital Trondheim University Hospital Trondheim Norway
| | - Elin Lövestam
- Department of Food Studies, Nutrition and Dietetics Uppsala University Uppsala Sweden
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30
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van Harlingen AOW, van de Ven LG, Hasselaar J, Thalen J, Jukema J, Vissers K, Uitdehaag M. Developing a toolkit for patients with COPD or chronic heart failure and their informal caregivers to improve person-centredness in conversations with healthcare professionals: A Design Thinking approach. PATIENT EDUCATION AND COUNSELING 2022; 105:3324-3330. [PMID: 35843846 DOI: 10.1016/j.pec.2022.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 03/22/2022] [Accepted: 07/01/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The perspective of patients and informal caregivers is often not expressed in conversations with healthcare professionals which can have a negative impact on quality of care and quality of life. OBJECTIVE Describe the development of a toolkit for patients with COPD or chronic heart failure and their informal caregivers enabling them to explore and express their perspective in conversations with healthcare professionals. Patient involvement: Patients, informal caregivers and healthcare professionals were involved in the design process from problem definition to solution development. METHOD Design Thinking Approach using eight co-creation sessions and qualitative data-collection methods. Nineteen patients, ten informal caregivers and thirteen healthcare professionals participated in one or more co-creation sessions. Homogenous subgroups of participants were used in session 1, 2 and 4 and mixed groups were used in session 3, 5 and 6. Session 7 and 8 were used to test prototype toolkits. RESULTS Three challenges to expressing the personal perspective to healthcare professionals, four statements defining the desired situation for conversations, eleven design criteria for the toolkit and ten selection criteria for tools were identified. This information was used to develop a prototype toolkit. DISCUSSION Most patients and informal caregivers had moderate to high levels of education and all participating healthcare professionals were female with a majority of nurses and only three physicians. It is possible that this has influenced the design of the toolkit. PRACTICAL VALUE The toolkit can support patients and informal caregivers in exploring and expressing their perspective in conversations with healthcare professionals. Feasibility of the toolkit and implications for healthcare professionals will be examined in a pilot implementation study.
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Affiliation(s)
- Annet Olde Wolsink- van Harlingen
- Saxion University of Applied Sciences, Research Group Smart Health, Enschede, Netherlands; Radboudumc Medical Centre, Department of Anaesthesiology, Pain and Palliative Medicine Nijmegen, Netherlands.
| | - Leontine Groen- van de Ven
- Windesheim University of Applied Sciences, Research Group Living Well With Dementia, Zwolle, Netherlands
| | - Jeroen Hasselaar
- Radboudumc Medical Centre, Department of Anaesthesiology, Pain and Palliative Medicine Nijmegen, Netherlands; Nivel Netherlands Institute for Health Services Research, Utrecht, Netherlands
| | - Jos Thalen
- Saxion University of Applied Sciences, Research Group Industrial Design, Enschede, Netherlands
| | - Jan Jukema
- Saxion University of Applied Sciences, Research Group Smart Health, Enschede, Netherlands
| | - Kris Vissers
- Radboudumc Medical Centre, Department of Anaesthesiology, Pain and Palliative Medicine Nijmegen, Netherlands
| | - Madeleen Uitdehaag
- Radboudumc Medical Centre, Department of Anaesthesiology, Pain and Palliative Medicine Nijmegen, Netherlands
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31
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Al-Adili L, McGreevy J, Orrevall Y, Nydahl M, Boström AM, Lövestam E. Setting goals with patients at risk of malnutrition: A focus group study with clinical dietitians. PATIENT EDUCATION AND COUNSELING 2022; 105:2103-2109. [PMID: 35241324 DOI: 10.1016/j.pec.2022.02.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 01/28/2022] [Accepted: 02/21/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVE Setting goals collaboratively with patients is a key aspect in shared decision-making (SDM) in malnutrition interventions. The aim, therefore, was to gain an understanding of clinical dietitians' reflections regarding the process of goal-setting with patients at risk of malnutrition. METHODS Six semi-structured audio-recorded focus group discussions were held with registered dietitians (n = 29) from primary healthcare and hospitals in Sweden. Focus group transcripts were analysed thematically to find patterns in the data and identify themes. RESULTS Dietitians expressed striving to explore patients' narratives, capabilities, and resources before deciding on goals. They described different strategies in counseling patients and a lack of patient participation in the goal-setting. They emphasized the difficulties of setting feasible goals due to discrepancies between their clinically-oriented goals and patients' personal goals. CONCLUSION Findings highlight a gap in the process of setting goals for patients at risk of malnutrition, where patients' participation was lacking. Education in SDM, and strategies and tools to support dietitians in involving patients in goal-setting, are required to bridge the gap and promote person-centeredness. PRACTICE IMPLICATIONS Findings may be further used to develop tools and strategies, and design studies on the implementation of and education in SDM and goal-setting for malnutrition interventions.
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Affiliation(s)
- Lina Al-Adili
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, P.O. Box 560, SE-751 22 Uppsala, Sweden.
| | - Jenny McGreevy
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, P.O. Box 560, SE-751 22 Uppsala, Sweden; Centre for Clinical Research Sörmland/Uppsala University, Eskilstuna, Sweden; Department of Dietetics, Nykoping Hospital, 611 85 Nykoping, Sweden.
| | - Ylva Orrevall
- Department of Biosciences and Nutrition, Karolinska Institute, Stockholm, Sweden; Medical Unit Clinical Nutrition, Women's Health and Allied Health Professionals Theme, Karolinska University Hospital, SE-171 76 Stockholm, Sweden.
| | - Margaretha Nydahl
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, P.O. Box 560, SE-751 22 Uppsala, Sweden.
| | - Anne-Marie Boström
- Department of Neurobiology, Care Science and Society, Division of Nursing, Karolinska Institutet, Huddinge, Sweden; Theme Inflammation and Aging, Karolinska University Hospital, Huddinge, Sweden; Research and Development Unit, Stockholms Sjukhem, Stockholm, Sweden.
| | - Elin Lövestam
- Department of Food Studies, Nutrition and Dietetics, Uppsala University, P.O. Box 560, SE-751 22 Uppsala, Sweden.
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Wallengren C, Billig H, Björkman I, Ekman I, Feldthusen C, Lindström Kjellberg I, Lundberg M. Person-centered care content in medicine, occupational therapy, nursing, and physiotherapy education programs. BMC MEDICAL EDUCATION 2022; 22:492. [PMID: 35739515 PMCID: PMC9229130 DOI: 10.1186/s12909-022-03502-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 05/20/2022] [Indexed: 05/11/2023]
Abstract
BACKGROUND Although person-centered care (PCC) ensures high-quality care for patients, studies have shown that it is unevenly applied in clinical practice. The extent to which future health care providers are currently offered education in PCC at their universities is unclear. We aimed to clarify the PCC content offered to students as a basis for their understanding by exploring the PCC content of Swedish national study programs in medicine, nursing, occupational therapy, and physiotherapy. METHODS Using a qualitative document analysis design, we sampled the steering documents from all higher education institutions (n = 48) with accreditation in medicine (n = 7), nursing (n = 25), occupational therapy (n = 8), or physiotherapy (n = 8) at a single time point. All national study programs (n = 4), local program syllabuses (n = 48), and local course syllabuses (n = 799) were reviewed using a 10-item protocol. RESULTS We found no content related to PCC in the steering documents at the national level. At the local level, however, signs of PCC were identified in local program syllabuses and local course syllabuses. Seven of the 48 local program syllabuses (15%) included PCC in their intended learning outcomes. Eight of the 799 local course syllabuses (1%) contained course titles that included the phrase 'person-centered care,' and another 101 listed 142 intended learning outcomes referring to PCC. A total of 21 terms connected to PCC were found, and the term 'person-centered care' was most commonly used in the nursing programs and least commonly in the medical programs. CONCLUSIONS There is a broad range in how the national study programs in Sweden have incorporated PCC. The implementation has been driven by a bottom-up strategy. A deliberate and standardized strategy is needed to ensure full implementation of PCC into clinical curricula in higher education.
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Affiliation(s)
- Catarina Wallengren
- University of Gothenburg Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, P.O. Box 457, 40530, Gothenburg, Sweden.
- Department of Learning and Leadership for Health Care Professionals, Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, P.O. Box 457, 40530, Gothenburg, Sweden.
| | - Håkan Billig
- Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Ida Björkman
- University of Gothenburg Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, P.O. Box 457, 40530, Gothenburg, Sweden
- Department of Life Context and Health Promotion, Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Inger Ekman
- University of Gothenburg Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, P.O. Box 457, 40530, Gothenburg, Sweden
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Medicine/Geriatrics, Sahlgrenska University Hospital/Östra, Gothenburg, Sweden
| | - Caroline Feldthusen
- University of Gothenburg Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, P.O. Box 457, 40530, Gothenburg, Sweden
- Division of Physiotherapy, Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Irma Lindström Kjellberg
- University of Gothenburg Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, P.O. Box 457, 40530, Gothenburg, Sweden
- Department of Learning and Leadership for Health Care Professionals, Institute of Health and Care Sciences, The Sahlgrenska Academy, University of Gothenburg, P.O. Box 457, 40530, Gothenburg, Sweden
| | - Mari Lundberg
- University of Gothenburg Centre for Person-Centred Care (GPCC), Sahlgrenska Academy, University of Gothenburg, P.O. Box 457, 40530, Gothenburg, Sweden
- Department of Health Promoting Science, Sophiahemmet University, Stockholm, Sweden
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Lydahl D, Britten N, Wolf A, Naldemirci Ö, Lloyd H, Heckemann B. Exploring documentation in Person-centred care: A content analysis of care plans. Int J Older People Nurs 2022; 17:e12461. [PMID: 35393772 PMCID: PMC9540033 DOI: 10.1111/opn.12461] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 02/28/2022] [Accepted: 03/08/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Person-centred care is a growing imperative in healthcare, but the documentation of person-centred care is challenging. According to the Gothenburg Framework of Person-centred Care, care should be documented in continuously revised care plans and based on patients' personally formulated goals and resources to secure a continuous partnership. OBJECTIVES This study aimed to examine care plans produced within a randomised controlled trial that tested a person-centred care intervention in older people with acute coronary syndrome. Nurses with training in the theory and practice of person-centred care had written the care plans. METHODS We conducted a secondary analysis of care plans developed in a randomised controlled trial for assessing person-centred care in patients with acute coronary syndrome (Myocardial Infarct [MI] or unstable angina pectoris). The study sample included 84 patients, with three care plans for each patient from inpatient (T1), outpatient (T2) and primary care (T3), that is, a total of 252 care plans. We conducted a descriptive quantitative content analysis of the care plans to examine the reported patients' life-world and medical/health resources and goals. RESULTS The analysis illustrates the differences and overlaps between life-world and medical/health goals and resources. The documented goals and resources change over time: life-world goals and resources decreased with time as medical/health goals and resources documentation increased. CONCLUSIONS This paper illustrates that in the setting of a randomised controlled trial, nurses with training in person-centred care recorded fewer life-world and more medical/health goals over time. Placing life-world goals at the top of the goal hierarchy enables alignment with medical/health goals. Further research should explore whether the goals and resources documented in care plans accurately reflect patients' wishes as they transition along the care chain. TRIAL REGISTRATION Swedish registry, Researchweb.org, ID NR 65 791.
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Affiliation(s)
- Doris Lydahl
- Department of Sociology and Work Science, University of Gothenburg, Gothenburg, Sweden
| | - Nicky Britten
- University of Exeter Medical School, Exeter, UK.,Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Axel Wolf
- Centre for Person-Centred Care, Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Anaesthetics, Surgery and Intensive Care, Sahlgrenska University Hospital, Östra, Gothenburg, Sweden.,Institute of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | | | - Helen Lloyd
- School of Psychology, University of Plymouth, Plymouth, UK
| | - Birgit Heckemann
- Centre for Person-Centred Care, Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Anaesthetics, Surgery and Intensive Care, Sahlgrenska University Hospital, Östra, Gothenburg, Sweden
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Andersson A, Graneheim UH, Nilsson MS. Newly-graduated nurses' work-integrated learning: A qualitative study from an educational and occupational perspective. Nurse Educ Pract 2022; 59:103290. [PMID: 35038660 DOI: 10.1016/j.nepr.2022.103290] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 07/27/2021] [Accepted: 01/07/2022] [Indexed: 11/25/2022]
Abstract
AIM The aim of this study was to describe newly graduated nurses' (NGNs') experience of work-integrated learning (WIL), from an educational and occupational perspective. BACKGROUND NGNs often find themselves unprepared to meet occupational demands on their competence on entering working life, and express difficulties integrating educational theory into a practical context. Qualitative and effective WIL becomes particularly important for NGNs to develop the competence required to handle the transition from education to working life. DESIGN This is a qualitative, descriptive study with an inductive approach. METHODS Seven focus-group discussions were performed and subjected to qualitative content analysis. RESULTS The results revealed that WIL for NGNs includes personal mastering of several professional roles: a self-directed and collaborative learning role, a relational nursing role, and a transition from a student role to a collegial role. Furthermore, WIL entails adapting to organisational requirements, including development of contextual workplace knowledge and understanding; striving for confidence in medical-technical performance; and developing an experience-based understanding of clinical situations. CONCLUSION The results reveal that WIL is complex, encompassing adaptation to roles and personal capabilities that increase new graduates' competence and preparation for work. In addition, WIL requires personal commitment to one's own learning as well as organisational and social support.
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Affiliation(s)
- Anna Andersson
- Department of Health Sciences, University West, SE-46132 Trollhättan, Sweden.
| | - Ulla Hällgren Graneheim
- Department of Health Sciences, University West, SE-46132 Trollhättan, Sweden; Department of Nursing, Umeå University, SE-90187 Umeå, Sweden
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Bogaert B. Moving Toward Person-Centered Care: Valuing Emotions in Hospital Design and Architecture. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2021; 15:355-364. [PMID: 34879737 DOI: 10.1177/19375867211062101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The intangible value of emotions is often neglected in healthcare evaluations; however, it forms an important part of the hospital experience that needs to be taken into consideration to move toward person-centered care. This article conceptualizes how space and architecture may influence patient, family, and healthcare provider emotions. Building upon Gaston Bachelard's Poetics of Space, theories on emotional design and architecture, as well as research in environmental design, we suggest several ways to value emotions in hospital design and architecture. The first theme explores several hospital spaces (the waiting room, the hospital room, the treatment room) using Bachelard's phenomenology in order to show how to facilitate emotional security by catering to the individual needs of the user. The second discusses the overall hospital room environment, notably the influence of light, color, and sound on the patient's emotional experience. The third explores architectural theorist Giuliana Bruno's theory of e(motion) to explore the hospital space as vissuto, a space of lived experiences, that invites us to rethink the design and architecture of hospital spaces to allow for patient participation. The article also gives suggestions of qualitative, person-centered methodologies that can be used to move forward this debate.
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Affiliation(s)
- Brenda Bogaert
- Healthcare Values Chair, Institut de Recherches Philosophiques de Lyon. Université Jean Moulin 3, Lyon, France
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Sundberg K, Nilsson M, Petersson LM, Kenne Sarenmalm E, Langius-Eklöf A. The sense of coherence scale in a clinical nursing perspective: A scoping review. J Clin Nurs 2021; 31:1428-1439. [PMID: 34570928 DOI: 10.1111/jocn.16066] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 08/27/2021] [Accepted: 09/12/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND The concept of sense of coherence explains a person's resources to maintain health during times of considerable strain and is suggested to be applicable in nursing. A summary of how it has been applied and adapted in clinical nursing is warranted for further conceptual development and research. OBJECTIVE The scoping review aimed to explore how the sense of coherence scale has been used from a clinical nursing research perspective. METHOD Published articles (N = 2812) through December 2018 were identified in the PubMed, Cinahl and PsychInfo databases. A total of 298 articles were included in the review. A five-stage process was used to extract data based on pre-determined selection criteria. Summative content analysis was used for the categorisation of the data. The PRISMA-ScR checklist was chosen. RESULTS A majority of the articles were published within the Nordic countries and the short version SOC-13 was the most frequently used scale. Most studies stated the significant relationship of a higher sense of coherence and higher emotional and psychosocial well-being, quality of life, and well-being irrespective of condition. Other articles proposed identifying patients' degree of sense of coherence either to individualise care or to plan an intervention to strengthen sense of coherence. CONCLUSIONS The sense of coherence scale has been widely used within nursing and identified as an important factor to individualise care. Future research should focus on rigorous intervention studies to determine if recognising patients' degree of sense of coherence in clinical nursing enables tailored care for patients when dealing with a disease-related condition. More evidence is needed when seeking to improve sense of coherence. RELEVANCE TO CLINICAL PRACTICE These results show an expansion of the concept of sense of coherence and endorses its use in nursing care for identifying patients' needs in the process of presenting individualised care.
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Affiliation(s)
- Kay Sundberg
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden
| | - Marie Nilsson
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden.,Karolinska University Hospital, Function Area Social Work in Health Care, Stockholm, Sweden
| | - Lena-Marie Petersson
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden.,Department of Medicin, Capio St Görans Hospital, Stockholm, Sweden
| | - Elisabeth Kenne Sarenmalm
- Research, Development, Education and Innovation, Skaraborg Hospital, Skövde, Sweden.,Institute of Health and Care Science and University of Gothenburg, Centre for Person-Centred Care Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Ann Langius-Eklöf
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Stockholm, Sweden
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