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Hynnekleiv II, Jensen JK, Giske T, Lausund H, Maeland E, Heggdal K. Patients' and Nurses' experiences of caring in nursing: An integrative literature review across clinical practices. J Clin Nurs 2024; 33:1233-1255. [PMID: 38093547 DOI: 10.1111/jocn.16964] [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: 04/24/2023] [Revised: 10/12/2023] [Accepted: 11/01/2023] [Indexed: 03/08/2024]
Abstract
AIM To summarise, interpret and synthesize research findings on patients' and nurses' experiences of caring in nursing across clinical practices. BACKGROUND Caring is a universal element of nursing; however, economic restrictions often negatively impact health services, and time shortages and limited numbers of staff may characterize care encounters. It is unclear how these contextual conditions affect patients' and nurses' experiences of caring. DESIGN AND METHODS This integrative literature review covers papers published between 2000 and 2022. Four databases-PubMed, PsycINFO (via Ovid), MEDLINE (via Ovid) and CINAHL (via EBSCO)-were systematically searched for eligible papers in May 2022. The included studies were critically appraised. Content analysis was performed to interpret and synthesize the findings. In accordance with the EQUATOR guidelines, the PRISMA 2020 and PRISMA-S checklists were used. An Integrative review methodology guided the process. FINDINGS In total, 33 studies were included in the review. Three themes captured the experiences of caring in nursing: (1) the complexity of the nursing care context, (2) the professionalism of the nurse, and (3) the trusting patient-nurse relationship. CONCLUSION The experience of caring in nursing depended on nurses' competence and discretion in the personal encounter framed by the nursing context. The caring relationship was based on reciprocity, but it remains asymmetrical, as the nurse had the power and responsibility to empower the patient. Barriers, such as increased demands for efficiency and resource scarcity, may hinder the experience of caring in nursing. IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE By promoting an ongoing discussion of caring in nursing, nurse management can systematically support nurses in reflecting on their practice in diverse and complex clinical contexts. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution was made due to the study design.
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Affiliation(s)
| | - Jørghild K Jensen
- Faculty of Health Sciences, VID Specialized University, Oslo, Norway
| | - Tove Giske
- Faculty of Health Sciences, VID Specialized University, Bergen, Norway
| | - Hilde Lausund
- Faculty of Health Sciences, VID Specialized University, Oslo, Norway
| | - Elisabeth Maeland
- Faculty of Health Sciences, VID Specialized University, Oslo, Norway
| | - Kristin Heggdal
- Faculty of Health Sciences, VID Specialized University, Oslo, Norway
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2
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Marchetti A, Facchinetti G, Petrucci G, Piredda M, Mastroianni C, Artico M, D'angelo D, Grazia De Marinis M. Nurses experience with body care among palliative care patients: a phenomenological study. Int J Palliat Nurs 2023; 29:579-587. [PMID: 38085616 DOI: 10.12968/ijpn.2023.29.12.579] [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] [Indexed: 12/18/2023]
Abstract
BACKGROUND Palliative care is defined as active and global care that provides holistic care integrating the body, mind and spirit of the dying person. A person's health deteriorates at the end of life and nurses facilitate patients to manage their personal body care. Knowing and considering the impact of disease on individuals' lives, how they adapt to cope with it, and the meaning they give to it, can help nurses. This is because of the embodiment concept of living in and through our bodies. The aim of the study is to explore palliative care patients' experiences with nurses during body care. METHODS A descriptive phenomenological approach based on Husserl's philosophical perspective was used. A purposive sample of eight palliative care patients were enrolled in the study. Semi-structured interviews were conducted between November 2018 and January 2019, in an Italian hospice. The interviews were about patients' feelings during nursing body care. The transcripts were analysed using Giorgi's phenomenological method. Several strategies were used to ensure the study's reliability. RESULTS The qualitative analysis revealed six categories that converged in three themes: 1) body care requires a specific competence; 2) patients experience difficulties during care by nurses; 3) compassionate care relationships help patients to find wellbeing and balance. CONCLUSIONS People at the end of life find the deterioration of their body distressing and a reminder that they are about to die. These considerations give us an understanding of patient embodiment and the significance of a patient's lived experiences at the end of their life. This phenomenon in nursing should be explored further in future research, to help inform more targeted care strategies.
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Affiliation(s)
- Anna Marchetti
- Registered Nurse, Fondazione Policlinico Universitario Campus Bio-Medico, Italy
| | | | - Giorgia Petrucci
- Clinical Research Nurse, Department of Orthopaedic and Trauma Surgery, 'Campus Bio-Medico di Roma' University, Italy
| | - Michela Piredda
- Associate Professor in Nursing, Department of Medicine and Surgery, Campus Bio-Medico di Roma' University, Italy
| | - Chiara Mastroianni
- Registered Nurse, Fondazione Policlinico Universitario Campus Bio-Medico, Italy
| | - Marco Artico
- Registered Nurse, Palliative Care and Pain Therapy Unit, Azienda ULSS 4 Veneto Orientale, San Donà di Piave, Italy
| | - Daniela D'angelo
- Registered Nurse, CNEC Center for Clinical Excellence and Quality of Care, Istituto Superiore di Sanità, Rome, Italy
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Gualandi R, Ivziku D, Caruso R, Di Giacinto C, Lommi M, Tartaglini D, De Benedictis A. Nurse-Patient Communication and Relationship When Wearing Personal Protective Equipment: Nurses' Experience in a COVID-19 Ward. Healthcare (Basel) 2023; 11:1960. [PMID: 37444794 DOI: 10.3390/healthcare11131960] [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: 04/30/2023] [Revised: 06/19/2023] [Accepted: 07/06/2023] [Indexed: 07/15/2023] Open
Abstract
Little is known about which communication strategies nurses carried out and whether the nurse-patient relationship has been altered due to the mandated use of personal protective equipment during the COVID-19 pandemic. This study describes how nurse-patient communication and relationships took place from the point of view of nurses engaged in caring for patients with COVID-19. A qualitative descriptive study design following COREQ guidelines was conducted. Semi-structured telephone interviews with nurses working in the COVID ward of an Italian university hospital were performed between September 2020 and June 2021. Ten nurses were recruited using convenience sampling. One overarching theme, three main themes, and nine sub-themes were identified. The overarching theme 'The in-out relationship: 'in here and out there' and 'inside me and out of me' included the main themes 'A closed system different from normal', 'Uncovering meaningful human gestures', and 'A deep experience to live''. The relational nature of nursing-where 'me and you' and the context are the main elements-leads nurses to find new ways of interacting and communicating with patients, even in a new situation that has never been experienced. Enhancing human gestures, thinking about new contexts of care, and educating new generations to maintain human-to-human interaction, regardless of the context of care, are the directives to be explored for creating the future of nursing care.
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Affiliation(s)
- Raffaella Gualandi
- Department of Health Professions, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
| | - Dhurata Ivziku
- Department of Health Professions, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
| | - Rosario Caruso
- Clinical Research Service, IRCCS Policlinico San Donato, San Donato Milanese, 20097 Milano, Italy
- Department of Biomedical Sciences for Health, University of Milan, 20133 Milano, Italy
| | - Chiara Di Giacinto
- Department of Health Professions, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
| | - Marzia Lommi
- Department of Biomedicine and Prevention, University Tor Vergata, 00133 Rome, Italy
| | - Daniela Tartaglini
- Department of Health Professions, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
| | - Anna De Benedictis
- Clinical Directory, Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Rome, Italy
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Rosendal KA, Lehn S, Overgaard D. Body care of older people in different institutionalized settings: A systematic mapping review of international nursing research from a Scandinavian perspective. Nurs Inq 2023; 30:e12503. [PMID: 35666581 PMCID: PMC10078501 DOI: 10.1111/nin.12503] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 05/12/2022] [Accepted: 05/19/2022] [Indexed: 01/25/2023]
Abstract
Body care is considered a key aspect of nursing and imperative for the health, wellbeing, and dignity of older people. In Scandinavian countries, body care as a professional practice has undergone considerable changes, bringing new understandings, values, and dilemmas into nursing. A systematic mapping review was conducted with the aims of identifying and mapping international nursing research on body care of older people in different institutionalized settings in the healthcare system and to critically discuss the dominant assumptions within the research by adapting a problematization approach. Most identified papers reported on empirical research with a biomedical approach focusing on outcome and effectiveness. Conceptual papers, papers with a focus on the perspectives of the older people, or contextual and material aspects were lacking. The research field is dominated by four dominant assumptions: Body care as an evidence-based practice, body care as a relational ethical practice, the body as a body-object and a body-subject, the objects in the body care practices as nonrelational materialities. Given the complexities of professional body care practices, there is a need for other research designs and theoretical perspectives within nursing that expand our understanding of body care taking into consideration the multiple social and material realities.
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Affiliation(s)
- Kirstine A Rosendal
- Department of People and Technology, Research Centre in Health Promotion, University of Roskilde, Roskilde, Denmark
| | - Sine Lehn
- Department of People and Technology, Research Centre in Health Promotion, University of Roskilde, Roskilde, Denmark
| | - Dorthe Overgaard
- Department of Nursing and Nutrition, Faculty of Health, University College Copenhagen, Copenhagen N, Denmark
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Garrigues L, Soulé I, Vermeesch AL. Nursing Students and the Human Body: Application of an Ethics Pilot Project. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11603. [PMID: 36141876 PMCID: PMC9517040 DOI: 10.3390/ijerph191811603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Revised: 09/12/2022] [Accepted: 09/13/2022] [Indexed: 06/16/2023]
Abstract
This manuscript offers findings from a pilot project which prepares nursing students for embodied professional practice through the lens of ethics. Four undergraduate nursing students were mentored by two nursing faculty in the Dundon-Berchtold Institute Faculty Fellowship Program in the Application of Ethics through an exploration on the ethics of embodiment using an arts pedagogy across one academic year. Inspired by the intersection of nature and health, this project explores the impact of an arts-integrated pedagogy on the human body. The findings from this project provide a natural first step for nursing students to consider multiple interpretations of the human body and to facilitate the students' development of an embodied ethical practice that is perceptive, empathic, and attuned to themselves as natural beings as well as diverse individuals and populations. The findings from this pilot project presents a pivotal opportunity to guide future nursing curricular development toward holistic, nature-inspired, and mindful-based interventions in order to increase resilience, decrease risk factors of compassion fatigue and burnout, and support nursing students to develop strength-based skills to use in their professional nursing practice.
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Affiliation(s)
- Layla Garrigues
- School of Nursing and Health Innovations, The University of Portland, 5000 N, Willamette Blvd., Portland, OR 97203, USA
| | - Isabelle Soulé
- School of Nursing and Health Innovations, The University of Portland, 5000 N, Willamette Blvd., Portland, OR 97203, USA
| | - Amber L. Vermeesch
- Department of Family and Community Nursing, School of Nursing, University of North Carolina Greensboro, 1007 Walker Avenue, Greensboro, NC 27402, USA
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De Benedictis A, Gualandi R, Saccoccia S, Pensieri C, Piredda M, De Micco F, Marchetti A, Facchinetti G, Pasquarelli AA, De Carolis C, Di Blasio I, Tartaglini D, Alloni R. Back to the Roots of Nursing: Qualitative Study on the Experience of Nurses in the Front Line During the COVID-19 Pandemic. Front Med (Lausanne) 2022; 9:903517. [PMID: 35755029 PMCID: PMC9231184 DOI: 10.3389/fmed.2022.903517] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 05/09/2022] [Indexed: 12/23/2022] Open
Abstract
The COVID-19 emergency has led many health facilities to reorganize themselves in a very short time to meet the urgent needs for intensive, semi-intensive or ordinary care of SARS-CoV-2 patients. In this pandemic, characterized by speed of transmission and severity of respiratory symptoms, care has been affected by the increase in volume and clinical complexity of patients, the sudden and unpredictable staff decrease and the lack of support from family members / caregivers. At the same time, experience in the field has shown how “informal” resources have been activated, which enabled to treat the highest possible number of patients above the real availability of resources. The purpose of this study was to explore the experiences of nurses involved in frontline care (COVID Centers) during the pandemic with a particular focus on professional motivation and on the development of technical-professional and personal skills. A study with a qualitative research design using focus group technique was conducted. Two focus groups were held with nine nurses. Data were analyzed with inductive content analysis. The findings can be summarized in five main categories: professional identity; motivation and sense of mission; development of professional and personal skills; spirituality; person-centered care; uniqueness of the lived experience. These findings shed new light on the correlation between motivation, professional identity and value, sense of duty and sense of belonging to the professional group. Moreover, the experience in the COVID Centers represented a valuable opportunity for participants to rediscover some specific issues related to nursing professional identity and to develop new personal and technical-professional skills in a very short time. Finally, nurses experienced once again how the nurse-patient relationship and basic care are essential to provide effective and excellent care, even and especially for patients in critical conditions. Nurses re-discovered, in a careful body care and basic care, irreplaceable elements to give back to patients, often dying, their own dignity, and all the needed closeness and attention necessary also to compensate the absence of the loved ones. These elements represent a way to concretely and deeply express the ethics of a job well done in nursing.
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Affiliation(s)
- Anna De Benedictis
- Campus Bio-Medico University Hospital Foundation, Rome, Italy.,Campus Bio-Medico University of Rome, Rome, Italy
| | | | | | | | | | - Francesco De Micco
- Campus Bio-Medico University Hospital Foundation, Rome, Italy.,Campus Bio-Medico University of Rome, Rome, Italy
| | - Anna Marchetti
- Campus Bio-Medico University Hospital Foundation, Rome, Italy
| | | | | | | | - Irene Di Blasio
- Agostino Gemelli University Hospital Foundation, Rome, Italy
| | - Daniela Tartaglini
- Campus Bio-Medico University Hospital Foundation, Rome, Italy.,Campus Bio-Medico University of Rome, Rome, Italy
| | - Rossana Alloni
- Campus Bio-Medico University Hospital Foundation, Rome, Italy.,Campus Bio-Medico University of Rome, Rome, Italy
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Jørgensen L, Pedersen B, Lerbæk B, Haslund-Thomsen H, Thorup CB, Albrechtsen MT, Jacobsen S, Nielsen MG, Kusk KH, Laugesen B, Voldbjerg SL, Grønkjær M, Bundgaard K. Nursing care during COVID-19 at non-COVID-19 hospital units: A qualitative study. NORDIC JOURNAL OF NURSING RESEARCH 2022; 42:101-108. [PMID: 35729941 PMCID: PMC9204132 DOI: 10.1177/20571585211047429] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/02/2021] [Indexed: 11/15/2022]
Abstract
The maintenance of physical distance, the absence of relatives and the relocation of registered nurses to COVID-19 units presumably affects nursing care at non-COVID-19 units. Using a qualitative design, this study explored registered nurses’ experiences of how COVID-19 influenced nursing care in non-COVID-19 units at a Danish university hospital during the first wave of the virus. The study is reported using the COREQ checklist. The analysis offered two findings: (1) the challenge of an increased workload for registered nurses remaining in non-COVID-19 units and (2) the difficulty of navigating the contradictory needs for both closeness to and distance from patients. The study concluded that several factors challenged nursing care in non-COVID-19 units during the COVID-19 pandemic. These may have decreased the amount of contact between patients and registered nurses, which may have contributed to a task-oriented approach to nursing care, leading to missed nursing care.
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Affiliation(s)
- Lone Jørgensen
- Clinic for Surgery and Cancer Treatment, Aalborg University Hospital, Aalborg, Denmark.,Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Birgith Pedersen
- Clinic for Surgery and Cancer Treatment, Aalborg University Hospital, Aalborg, Denmark.,Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark.,Clinical Cancer Research Centre, Aalborg University Hospital, Aalborg, Denmark
| | - Birgitte Lerbæk
- Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark.,Clinic for Internal and Emergency Medicine, Aalborg University Hospital, Aalborg, Denmark
| | - Helle Haslund-Thomsen
- Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.,Clinic for Anesthesiology, Children, Circulation and Women, Aalborg University Hospital, Aalborg, Denmark
| | - Charlotte Brun Thorup
- Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.,Clinical Cancer Research Centre, Aalborg University Hospital, Aalborg, Denmark
| | | | - Sara Jacobsen
- Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark
| | - Marie Germund Nielsen
- Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark.,Department of Health Science and Technology, Aalborg University, Aalborg, Denmark
| | | | - Britt Laugesen
- Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark.,Center for Clinical Guidelines, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Siri Lygum Voldbjerg
- Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.,Department of Nursing Education, University College North Denmark, Aalborg, Denmark
| | - Mette Grønkjær
- Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Karin Bundgaard
- Clinical Nursing Research Unit, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark.,Clinic for Neuro-, Head and Orthopaedic Diseases, Aalborg University Hospital, Aalborg, Denmark
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Sill J, Kottner J, Balzer K. [Justification of nurses' interventions for skin cleansing and skincare: Qualitative results of the SKINCARE-Pilot study]. Pflege 2022; 36:286-295. [PMID: 35506292 DOI: 10.1024/1012-5302/a000882] [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] [Indexed: 11/19/2022]
Abstract
Justification of nurses' interventions for skin cleansing and skincare: Qualitative results of the SKINCARE-Pilot study Abstract. Background: Skin care interventions are core tasks of nursing. Various factors influence the implementation of evidence-based care. Aims: To explore the perspectives of nursing staff on the relevance of skin care interventions in long-term care settings and the justification of clinical decisions about the application of such interventions. Methods: Qualitative part of a mixed methods study in three long-term-care facilities, consisting of short interviews with nursing staff members directly after nursing assistance with personal hygiene, focus group discussions with nursing staff members, and semi-structured interviews with nursing managers. The data were analyzed by means of content analysis. Results: The sample (N = 30) comprises 10 short interviews, 3 focus groups (n = 17), and 3 individual interviews. Nurses predominantly assigned a high relevance to nursing support in personal hygiene. As a basis for their decision-making, residents' needs and preferences, nurses' personal knowledge as well as own experiences and preferences were reported. Evidence-based sources of knowledge were hardly mentioned. The availability of skin cleansing and skin care products, staff and time resources, and nurse-physician cooperation were identified as influencing factors. Conclusions: Decisions about nursing support in personal hygiene seem poorly informed by evidence-based sources for clinical decision-making. Evidence-based decision support could facilitate the use of appropriate nursing interventions.
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Affiliation(s)
- Janna Sill
- Sektion Forschung und Lehre in der Pflege, Institut für Sozialmedizin und Epidemiologie, Universität zu Lübeck, Deutschland
| | - Jan Kottner
- Institut für Klinische Pflegewissenschaft, Charité - Universitätsmedizin Berlin, Deutschland
| | - Katrin Balzer
- Sektion Forschung und Lehre in der Pflege, Institut für Sozialmedizin und Epidemiologie, Universität zu Lübeck, Deutschland
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Allande-Cussó R, Fernández-García E, Gómez-Salgado J, Porcel-Gálvez AM. Understanding the nurse-patient relationship: A predictive approach to caring interaction. Collegian 2022. [DOI: 10.1016/j.colegn.2022.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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