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Zhang X, Wu Y. Roles and contributions of companions in healthcare professional-older patient interaction: A systematic review. PATIENT EDUCATION AND COUNSELING 2024; 130:108455. [PMID: 39366124 DOI: 10.1016/j.pec.2024.108455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 09/19/2024] [Accepted: 09/24/2024] [Indexed: 10/06/2024]
Abstract
OBJECTIVES Companions commonly participate in medical visits to facilitate the interactions between healthcare professionals (HCPs) and older patients. Multiple studies have investigated the contributions and roles of companions in these triadic interactions. However, no review has synthesized these studies. Therefore, a systematic review was conducted to synthesize the contributions and roles of companions in medical interactions between HCPs and older patients. METHODS The review adhered to the PRISMA guidelines. Peer-reviewed studies published prior to August 17, 2023 were included if they concentrated on the contributions and roles of companions in medical interactions between HCPs and older patients. Thirteen eligible studies were identified through database and manual searches. The findings of these studies were synthesized using thematic analysis. RESULTS Four themes emerged: (1) facilitating the delivery of patient information to HCPs; (2) advocating for older patients; (3) taking an active role in medical consultations; and (4) neglecting/excluding older patients from medical consultations. CONCLUSION The review highlighted the valuable support and potential challenges that companion participation brings to interactions between HCPs and older patients. These findings underscore the importance of enhancing HCPs' communication skills in such triadic consultations.
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Affiliation(s)
- Xin Zhang
- Center for Geriatric Healthcare Services and Health Education, Qufu Normal University, PR China
| | - Yijin Wu
- Center for Geriatric Healthcare Services and Health Education, Qufu Normal University, PR China.
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2
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Gyllander T, Näppä U, Häggström M. A journey through transitional care-family members' experiences post a life-threatening situation: A qualitative study. Scand J Caring Sci 2024. [PMID: 39317981 DOI: 10.1111/scs.13304] [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: 02/14/2024] [Accepted: 09/13/2024] [Indexed: 09/26/2024]
Abstract
BACKGROUND Being a family member to someone who suffers from a serious illness can change one's perspectives about life. A sudden and severe illness can result in a demanding journey that involves acute admission to hospital, intensive care, post-care, and finally, returning home. AIM To describe the experience of staying beside a next of kin throughout the healthcare journey, from the onset of illness at home, to the intensive care unit, post-care, and returning home. METHODS The study employed a qualitative design, with data collected via semi-structured interviews and analysed using reflexive thematic analysis. A purposive sampling was used to recruit participants (n = 14), who had experiences of staying beside a next of kin throughout the healthcare journey from the onset of illness to discharge from the hospital. FINDINGS Family members' experiences were captured under the overarching theme Journey through an emotional turmoil and the themes Entering a new world, Continuing the journey towards something unknown, and Striving for the new normal at home. They described going through a non-linear process, characterised by transitions or changes in several aspects. The transitions included shifts in the roles that the family members played, in the various environments they found themselves in, and in the progression of the patient's illness or injury. CONCLUSION The study suggested that family members with a next of kin who experienced life-threatening situations undergo challenging transitions. The informal caregiver role placed on family members of intensive care unit-survivors significantly impacts their lives and the healthcare systems should prioritise providing high-quality support to family members throughout the entire healthcare journey. Elevating the importance of nursing care within the healthcare system can contribute to delivering holistic care and facilitating transitions. Further research should focus on understanding the support that family members perceive as necessary to facilitate their transition and enhance their well-being.
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Affiliation(s)
- Theresa Gyllander
- Department of Health Sciences, Mid Sweden University, Ostersund, Sweden
| | - Ulla Näppä
- Department of Health Sciences, Mid Sweden University, Ostersund, Sweden
| | - Marie Häggström
- Department of Health Sciences, Mid Sweden University, Ostersund, Sweden
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Belser T, Exl MT, Nydahl P, Zumstein-Shaha M, Jeitziner MM. Experiences of parents visiting an adult family member in the intensive care unit accompanied by their underaged children: A qualitative study. Aust Crit Care 2024; 37:783-789. [PMID: 38631938 DOI: 10.1016/j.aucc.2024.02.004] [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: 11/06/2023] [Revised: 02/12/2024] [Accepted: 02/16/2024] [Indexed: 04/19/2024] Open
Abstract
OBJECTIVES The objective of this study was to explore experiences and needs of parents visiting critically ill family members in intensive care units (ICUs) accompanied by their underaged children (<18 years). METHODS Six semistructured interviews with parents were conducted in a qualitative design. Data analysis and synthesis were performed using Braun and Clarke's thematic analysis. This study was conducted in five adult ICUs in Switzerland. FINDINGS Parents opted for early and truthful involvement of their children, and the majority initiated the visits themselves. Five themes were identified: feeling of shock by the entire family; crying in front of the children; feeling welcome with the children; knowing that the children can cope with it; and holding the family together. Parents felt only partially welcomed in the ICU when accompanied by their children. In one case, the parents withdrew the child from the visit. CONCLUSIONS Parents experienced the visit to a critically ill family member in the ICU with their underaged children as challenging. They were emotionally vulnerable and yet took the initiative to keep the family together. Parents had to mediate between their children, the critically ill family member, and the treatment team. Awareness of the needs of the parents visiting with underaged children is important in clinical practice. There is a need for family-centred structures and processes, including adequate visiting times and rooms suitable for children with books, pictures, and toys.
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Affiliation(s)
- Tanja Belser
- Department of Neurosurgery, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, 3010 Bern, Switzerland.
| | - Matthias Thomas Exl
- Department of Intensive Care Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, 3010 Bern, Switzerland.
| | - Peter Nydahl
- Nursing Research, University Hospital of Schleswig-Holstein, Arnold-Heller-Str. 3, 24105 Kiel, Germany; Institute of Nursing Science and Development, Paracelsus Medical University, Salzburg, Austria.
| | - Maya Zumstein-Shaha
- Bern University of Applied Sciences Health, Murtenstrasse 10, 3008 Bern, Switzerland; University of Witten/Herdecke, Department of Nursing, Alfred-Herrhausen-Strasse 50, 58448 Witten, Germany.
| | - Marie-Madlen Jeitziner
- Department of Intensive Care Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 18, 3010 Bern, Switzerland; Institute of Nursing Science (INS), Department of Public Health (DPH), Faculty of Medicine, University of Basel, Bernoullistrasse 28, 4056 Basel, Switzerland.
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Woldring JM, Paans W, Gans R, Dorland L, Luttik ML. Families' importance in nursing care-families' opinions: a cross-sectional survey study in the homecare setting. Arch Public Health 2024; 82:87. [PMID: 38886839 PMCID: PMC11181553 DOI: 10.1186/s13690-024-01314-4] [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: 01/30/2024] [Accepted: 06/05/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Informal care is an essential part of support provided in the homecare setting. To ensure effective healthcare provision, good communication and collaboration between informal and formal care providers are crucial. To achieve this aim, it is necessary to have a clear understanding of the perspectives of all stakeholders. In the scientific literature, limited knowledge is available regarding family members' opinions about their involvement in care. To date, no instruments have been developed that accurately measure these opinions. This study aims to elucidate the opinions of family members about their involvement in nursing care. METHODS A cross-sectional survey approach was employed. The methodological steps in this study were (1) convert the Families' Importance in Nursing Care-Nurses' Attitudes (FINC-NA) from a nurses' perspective to a family perspective and thus develop the Families' Importance in Nursing Care-Families' Opinions (FINC-FO) and (2) measure families' opinions regarding their involvement in home nursing care. The questionnaire was sent to 3,800 patients with activated patient portals, which accounts for about 17% of the total patient base. Responses were received from 1,339 family members, a response rate of 35%. RESULTS The developed FINC-FO questionnaire showed homogeneity and internal consistency. The results of the questionnaire indicate that family members consider it important to be involved in care and that they wish to be acknowledged as participants in discussions about care (planning) but are less inclined to actively participate in the provision of care by nurses. Family members expressed less explicit opinions about their own support needs. Factors such as level of education, type of partnership, and amount of care provided are seemingly associated with these opinions. CONCLUSIONS Family members in the homecare setting wish to be involved in discussions about care (planning). The transition in care from primarily formal to more informal care necessitates an awareness and clear definition-on part of both healthcare professionals and families-of their respective roles in the provision of care. Communication about wishes, expectations, and the need for support in care is essential to ensure quality of care and that the family can sustain caregiving.
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Affiliation(s)
- Josien M Woldring
- Research Group Nursing Diagnostics, Family Care & Family Nursing, School of Nursing, Hanze University of Applied Sciences, Petrus Driessenstraat 3, Groningen, 9714 CA, The Netherlands.
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Hanzeplein 1, Groningen, 9713 GZ, The Netherlands.
| | - Wolter Paans
- Research Group Nursing Diagnostics, Family Care & Family Nursing, School of Nursing, Hanze University of Applied Sciences, Petrus Driessenstraat 3, Groningen, 9714 CA, The Netherlands
- Department of Critical Care, University Medical Centre Groningen, PO Box 30.001, Groningen, 9700 RB, The Netherlands
| | - Reinold Gans
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Hanzeplein 1, Groningen, 9713 GZ, The Netherlands
| | - Laura Dorland
- Merkbaar Beter, PO Box 102, Espria, Beilen, 9410 AC, the Netherlands
| | - Marie Louise Luttik
- Research Group Nursing Diagnostics, Family Care & Family Nursing, School of Nursing, Hanze University of Applied Sciences, Petrus Driessenstraat 3, Groningen, 9714 CA, The Netherlands
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Feo R, Young JA, Urry K, Lawless M, Hunter SC, Kitson A, Conroy T. 'I wasn't made to feel like a nut case after all': A qualitative story completion study exploring healthcare recipient and carer perceptions of good professional caregiving relationships. Health Expect 2024; 27:e13871. [PMID: 37858980 PMCID: PMC10726062 DOI: 10.1111/hex.13871] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 09/04/2023] [Accepted: 09/05/2023] [Indexed: 10/21/2023] Open
Abstract
BACKGROUND Professional caregiving relationships are central to quality healthcare but are not always developed to a consistently high standard in clinical practice. Existing literature on what constitutes high-quality relationships and how they should be developed is plagued by dyadic conceptualisations; discipline, context and condition-specific research; and the absence of healthcare recipient and informal carer voices. This study aimed to address these issues by exploring how healthcare recipients and carers conceptualise good professional caregiving relationships regardless of discipline, care setting and clinical condition. DESIGN A qualitative story completion approach was used. Participants completed a story in response to a hypothetical stem that described a healthcare recipient (and, in some instances, carer) developing a good relationship with a new healthcare provider. Stories were analysed using reflexive thematic analysis. PARTICIPANTS Participants were 35 healthcare recipients and 37 carers (n = 72 total). RESULTS Participants' stories were shaped by an overarching discourse that seeking help from new providers can elicit a range of unwanted emotions for both recipients and carers (e.g., anxiety, fear, dread). These unwanted emotions were experienced in relation to recipients' presenting health problems as well as their anticipated interactions with providers. Specifically, recipient and carer characters were fearful that providers would dismiss their concerns and judge them for deciding to seek help. Good relationships were seen to develop when healthcare providers worked to relieve or minimise these unwanted emotions, ensuring healthcare recipients and carers felt comfortable and at ease with the provider and the encounter. Participants positioned healthcare providers as primarily responsible for relieving recipients' and carers' unwanted emotions, which was achieved via four approaches: (1) easing into the encounter, (2) demonstrating interest in and understanding of recipients' presenting problems, (3) validating recipients' presenting problems and (4) enabling and respecting recipient choice. Participants' stories also routinely oriented to temporality, positioning relationships within recipients' and carers' wider care networks and biographical and temporal contexts. CONCLUSION The findings expand our understanding of professional caregiving relationships beyond dyadic, static conceptualisations. Specifically, the findings suggest that high-quality relationships might be achieved via a set of core healthcare provider behaviours that can be employed across disciplinary, context and condition-specific boundaries. In turn, this provides a basis to support interprofessional education and multidisciplinary healthcare delivery, enabling different healthcare disciplines, specialties, and teams to work from the same understanding of what is required to develop high-quality relationships. PATIENT OR PUBLIC CONTRIBUTION The findings are based on stories from 72 healthcare recipient and carer participants, providing rich insight into their conceptualisations of high-quality professional caregiving relationships.
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Affiliation(s)
- Rebecca Feo
- College of Nursing and Health SciencesFlinders UniversityAdelaideSouth AustraliaAustralia
- Caring Futures InstituteFlinders UniversityAdelaideSouth AustraliaAustralia
| | - Jessica A. Young
- College of Nursing and Health SciencesFlinders UniversityAdelaideSouth AustraliaAustralia
| | - Kristi Urry
- College of Nursing and Health SciencesFlinders UniversityAdelaideSouth AustraliaAustralia
- School of PsychologyUniversity of AdelaideAdelaideSouth AustraliaAustralia
| | - Michael Lawless
- College of Nursing and Health SciencesFlinders UniversityAdelaideSouth AustraliaAustralia
- Caring Futures InstituteFlinders UniversityAdelaideSouth AustraliaAustralia
| | - Sarah C. Hunter
- College of Nursing and Health SciencesFlinders UniversityAdelaideSouth AustraliaAustralia
- Caring Futures InstituteFlinders UniversityAdelaideSouth AustraliaAustralia
| | - Alison Kitson
- College of Nursing and Health SciencesFlinders UniversityAdelaideSouth AustraliaAustralia
- Caring Futures InstituteFlinders UniversityAdelaideSouth AustraliaAustralia
| | - Tiffany Conroy
- College of Nursing and Health SciencesFlinders UniversityAdelaideSouth AustraliaAustralia
- Caring Futures InstituteFlinders UniversityAdelaideSouth AustraliaAustralia
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Woldring JM, Gans ROB, Paans W, Luttik ML. Physicians and nurses view on their roles in communication and collaboration with families: A qualitative study. Scand J Caring Sci 2023; 37:1109-1122. [PMID: 37248644 DOI: 10.1111/scs.13185] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 04/18/2023] [Accepted: 05/16/2023] [Indexed: 05/31/2023]
Abstract
BACKGROUND Families are introduced as new partners in interprofessional communication and collaboration during hospitalisation of an adult patient. Their introduction into the healthcare team has consequences for the roles and responsibilities of all healthcare professionals. Role clarification is thus needed to create optimal communication and collaboration with families. AIM To gain insight into how physicians and nurses view their own roles and each other's roles in communication and collaboration with families in the care of adult patients. METHODS A qualitative interpretive interview design was used. Fourteen semi-structured interviews, with seven physicians and seven nurses, were conducted. Data were analysed according to the steps of thematic analysis. For the study design and analysis of the results, the guidelines of the consolidated criteria for reporting qualitative studies (COREQ) were followed. The ethical committee of the University Medical Center Groningen approved the study protocol (research number 202100640). FINDINGS Thematic analysis resulted in three themes, each consisting of two or three code groups. Two themes "building a relationship" and "sharing information" were described as roles that both nurses and physicians share regarding communication and collaboration with families. The role expectations differed between physicians and nurses, but these differences were not discussed with each other. The theme "providing support to family" was regarded a nurse-specific role by both professions. CONCLUSION Physicians and nurses see a role for themselves and each other in communication and collaboration with families. However, the division of roles and expectations thereof are different, overlapping, and unclear. To optimise the role and position of family during hospital care, clarification and division of the roles between physicians and nurses in this partnership is necessary.
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Affiliation(s)
- Josien M Woldring
- Research Group Nursing Diagnostics, School of Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Rijk O B Gans
- Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Wolter Paans
- Research Group Nursing Diagnostics, School of Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands
- Department of Critical Care, University Medical Centre Groningen, Groningen, The Netherlands
| | - Marie Louise Luttik
- Research Group Nursing Diagnostics, School of Nursing, Hanze University of Applied Sciences, Groningen, The Netherlands
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Nyende A, Ellis-Hill C, Mantzoukas S. A Sense of Control and Wellbeing in Older People Living with Frailty: A Scoping Review. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2023; 66:1043-1072. [PMID: 37139581 DOI: 10.1080/01634372.2023.2206438] [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: 07/18/2022] [Revised: 04/19/2023] [Accepted: 04/20/2023] [Indexed: 05/05/2023]
Abstract
A sense of control is important for supporting older people living with frailty to develop adaptive functioning to optimize wellbeing. This scoping review examined the literature on the sense of control and wellbeing in older people living with frailty within their everyday life and care service use. Nine databases were searched using the timeframe 2000 to 2021 to identify key ideas regarding control and wellbeing in older people with frailty. The review highlighted three major themes: a) Control as conveyed in bodily expressions and daily activities, b) Sense of control and influence of place of residence, and c) Control within health and social care relationships. Maintaining a sense of control is not only an internal feeling but is impacted by physical and social environments. Greater focus is needed on the nature of relationships between older people living with frailty and those who work alongside them, which support control and wellbeing.
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Affiliation(s)
- Adam Nyende
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, UK
| | - Caroline Ellis-Hill
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, UK
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8
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Golomski C. Visiting Hours: Spacetimes of Human-Animal Interaction in South African Elder Care. Med Anthropol Q 2022; 36:217-236. [PMID: 35338789 DOI: 10.1111/maq.12702] [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: 11/26/2022]
Abstract
This article examines human-animal interaction in elder care by focusing on an old age home in postapartheid South Africa. Residents admire and desire to be near animals, but staff mostly prohibit pets and service animals due to regulations about hygiene and frailty. Instead, people make meaningful relationships with media representations of animals and wilder animals in the home's yard. This article uses the clinical timescale of visiting hours to interpret these alternative human-animal interactions and their temporal incongruities-to show how people make sense of differences they perceive between their own and animals' mortality and longevity, and how animals enable remembering and articulations of aging selfhood and social relations across the life course. A reinterpretation of visiting hours reveals the making of self-other distinctions in late life and temporal aspects of medical institutionalism that shape multispecies relations.
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Mwamba C, Mukamba N, Sharma A, Lumbo K, Foloko M, Nyirenda H, Simbeza S, Sikombe K, Holmes CB, Sikazwe I, Moore CB, Mody A, Geng E, Beres LK. "Provider discretionary power practices to support implementation of patient-centered HIV care in Lusaka, Zambia". FRONTIERS IN HEALTH SERVICES 2022; 2:918874. [PMID: 36925865 PMCID: PMC10012689 DOI: 10.3389/frhs.2022.918874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 08/16/2022] [Indexed: 11/13/2022]
Abstract
Introduction Traditional patient-provider relationships privilege the providers, as they possess the formal authority and clinical knowledge applied to address illness, but providers also have discretion over how they exercise their power to influence patients' services, benefits, and sanctions. In this study, we assessed providers' exercise of discretionary power in implementing patient-centered care (PCC) practices in Lusaka, Zambia. Methods HIV clinical encounters between patients on antiretroviral therapy (ART) and providers across 24 public health facilities in Lusaka Province were audio recorded and transcribed verbatim. Using qualitative content analysis, we identified practices of discretionary power (DP) employed in the implementation of PCC and instances of withholding DP. A codebook of DP practices was inductively and iteratively developed. We compared outcomes across provider cadres and within sites over time. Results We captured 194 patient-provider interactions at 24 study sites involving 11 Medical Officers, 58 Clinical Officers and 10 Nurses between August 2019 to May 2021. Median interaction length was 7.5 min. In a hierarchy where providers dominate patients and interactions are rapid, some providers invited patients to ask questions and responded at length with information that could increase patient understanding and agency. Others used inclusive language, welcomed patients, conducted introductions, and apologized for delayed services, narrowing the hierarchical distance between patient and provider, and facilitating recognition of the patient as a partner in care. Although less common, providers shared their decision-making powers, allowing patients to choose appointment dates and influence regimens. They also facilitated resource access, including access to services and providers outside of scheduled appointment times. Application of DP was not universal and missed opportunities were identified. Conclusion Supporting providers to recognize their power and intentionally share it is both inherent to the practice of PCC (e.g., making a patient a partner), and a way to implement improved patient support. More research is needed to understand the application of DP practices in improving the patient-centeredness of care in non-ART settings.
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Affiliation(s)
- Chanda Mwamba
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Njekwa Mukamba
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Anjali Sharma
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Kasapo Lumbo
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Marksman Foloko
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Herbert Nyirenda
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Sandra Simbeza
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Kombatende Sikombe
- Department of Public Health Environments and Society, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Charles B Holmes
- Department of Medicine, Georgetown University Medical Centre, Georgetown University, Washington, DC, United States
| | - Izukanji Sikazwe
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia
| | | | - Aaloke Mody
- Washington University School of Medicine, St. Louis, MO, United States
| | - Elvin Geng
- Washington University School of Medicine, St. Louis, MO, United States
| | - Laura K Beres
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
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10
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Sion KYJ, Rutten JER, Hamers JPH, de Vries E, Zwakhalen SMG, Odekerken-Schröder G, Schols JMGA, Verbeek H. Listen, look, link and learn: a stepwise approach to use narrative quality data within resident-family-nursing staff triads in nursing homes for quality improvements. BMJ Open Qual 2021; 10:bmjoq-2021-001434. [PMID: 34548376 PMCID: PMC8458352 DOI: 10.1136/bmjoq-2021-001434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 08/29/2021] [Indexed: 11/06/2022] Open
Abstract
Purpose The use of qualitative data to assess quality of care in nursing homes from the resident’s perspective has shown to be valuable, yet more research is needed to determine how this data can be used to gain insight into the quality of care within nursing homes. Whereas it is crucial to stay close to the stories that are the strength of qualitative data, an intermittent step to classify this data can support the interpretation and use. Therefore, this study introduces an approach that enables the use of narrative quality of care data to learn from and improve with. Design A cross-sectional mixed-methods study in which qualitative data were collected with the narrative quality assessment method Connecting Conversations and interpreted for analysis. Methods Connecting Conversations was used to collect narrative data about experienced quality of care in nursing homes according to residents, their families and nursing staff (triads). Data analysis consisted of coding positive/negative valences in each transcript. Findings A stepwise approach can support the use of narrative quality data consisting of four steps: (1) perform and transcribe the conversations (listen); (2) calculate a valence sore, defined as the mean %-positive within a triad (look); (3) calculate an agreement score, defined as the level of agreement between resident-family-nursing staff (link); and (4) plot scores into a graph for interpretation and learning purposes with agreement score (x-axis) and valence score (y-axis) (learn). Conclusions Narrative quality data can be interpreted as a valence and agreement score. These scores need to be related to the raw qualitative data to gain a rich understanding of what is going well and what needs to be improved.
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Affiliation(s)
- Katya Y J Sion
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands .,Living Lab in Ageing and Long-Term Care, Maastricht University, Maastricht, The Netherlands
| | - Johanna E R Rutten
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands.,Living Lab in Ageing and Long-Term Care, Maastricht University, Maastricht, The Netherlands
| | - Jan P H Hamers
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands.,Living Lab in Ageing and Long-Term Care, Maastricht University, Maastricht, The Netherlands
| | - Erica de Vries
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands.,Living Lab in Ageing and Long-Term Care, Maastricht University, Maastricht, The Netherlands
| | - Sandra M G Zwakhalen
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands.,Living Lab in Ageing and Long-Term Care, Maastricht University, Maastricht, The Netherlands
| | - Gaby Odekerken-Schröder
- Department of Marketing and Supply Chain Management, School of Business and Economics, Maastricht University, Maastricht, The Netherlands
| | - Jos M G A Schols
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands.,Living Lab in Ageing and Long-Term Care, Maastricht University, Maastricht, The Netherlands
| | - Hilde Verbeek
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands.,Living Lab in Ageing and Long-Term Care, Maastricht University, Maastricht, The Netherlands
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11
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Koster L, Nies H. It takes three to tango: An ethnography of triadic involvement of residents, families and nurses in long-term dementia care. Health Expect 2021; 25:80-90. [PMID: 34288293 PMCID: PMC8849257 DOI: 10.1111/hex.13224] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 02/10/2021] [Accepted: 02/13/2021] [Indexed: 11/28/2022] Open
Abstract
Background Researchers often stress the necessity and challenge of integrating the positionings of residents, family members and nurses in order to realize each actor's involvement in long‐term dementia care. Yet most studies approach user and family involvement separately. Aim To explain how productive involvement in care provision is accomplished in triadic relationships between residents, family members and nurses. Methods An ethnographic study of identity work, conducted between 2014 and 2016 in a Dutch nursing home. Findings We identify four ideal‐typical identity positionings performed by nurses through daily activities. The findings reveal how their identity positionings were inseparable from those of the residents and family members as they formed triads. Congruent, or ‘matching’, identity positionings set the stage for productive involvement. Our systematic analysis of participants' identity work shows how—through embedded rights and responsibilities—their positionings inherently shaped and formed the triadic types and degrees of involvement observed within these relationships. Discussion and conclusion This study both unravels and juxtaposes the interrelatedness of, and differences between, the concepts of user and family involvement. Accordingly, our findings display how residents, family members and nurses—while continuously entangled in triadic relationships—can use their identity positionings to accomplish a variety of involvement activities. To mirror and optimize the implementation of user and family involvement, we propose a rights‐based and relational framework based on our findings. Patient or public contribution Conversations with and observations of residents; feedback session with the Clients' Council.
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Affiliation(s)
- Luzan Koster
- Department of Organization Sciences, Faculty of Social Sciences, VU University, Amsterdam, The Netherlands.,City of Amsterdam, Dep. Mobility & Public Space, Amsterdam, The Netherlands
| | - Henk Nies
- Department of Organization Sciences, Faculty of Social Sciences, VU University, Amsterdam, The Netherlands.,Vilans, National Centre of Expertise for Long-term Care, Utrecht, The Netherlands
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Thakur K, Sharma SK. Nurse with smile: Does it make difference in patients' healing? Ind Psychiatry J 2021; 30:6-10. [PMID: 34483517 PMCID: PMC8395552 DOI: 10.4103/ipj.ipj_165_20] [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: 12/23/2020] [Revised: 02/10/2021] [Accepted: 04/07/2021] [Indexed: 11/04/2022] Open
Abstract
Smiling is a highly significant component of nurses' caring behavior. Nurses have to deal with too many people at workplace and interpersonal relation building is the key secret for quality work and also enhances job satisfaction. A genuine smile given by a nurse can do wonders as it conveys acceptance, builds trust and establishes inter-personal relationship. It also helps nurses to feel better and avoid anxiety or stress burnout in clinical situation. This paper of ours highlights the importance of nurses' smile in patients' recovery and important research literature to support smiling culture among health-care professionals.
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Affiliation(s)
- Kalpana Thakur
- College of Nursing, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Suresh K Sharma
- College of Nursing, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
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Poole EL. Artful Communication: Are You Listening? J Perianesth Nurs 2020; 35:231-232. [DOI: 10.1016/j.jopan.2020.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 01/11/2020] [Indexed: 10/24/2022]
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Johnsson A, Wagman P, Boman Å, Pennbrant S. Striving to establish a care relationship-Mission possible or impossible?-Triad encounters between patients, relatives and nurses. Health Expect 2019; 22:1304-1313. [PMID: 31588667 PMCID: PMC6882259 DOI: 10.1111/hex.12971] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 08/28/2019] [Accepted: 09/03/2019] [Indexed: 11/27/2022] Open
Abstract
Background When patients, relatives and nurses meet, they form a triad that can ensure a good care relationship. However, hospital environments are often stressful and limited time can negatively affect the care relationship, thus decreasing patient satisfaction. Objective To explain the care relationship in triad encounters between patients, relatives and nurses at a department of medicine for older people. Design A qualitative explorative study with an ethnographic approach guided by a sociocultural perspective. Method Participatory observations and informal field conversations with patients, relatives and nurses were carried out from October 2015‐September 2016 and analysed together with field notes using ethnographic analysis. Result The result identifies a process where patients, relatives and nurses use different strategies for navigating before, during and after a triad encounter. The process is based on the following categories: orienting in time and space, contributing to a care relationship and forming a new point of view. Conclusion The result indicates that nurses, who are aware of the process and understand how to navigate between the different perspectives in triad encounters, can acknowledge both the patient's and relatives’ stories, thus facilitating their ability to understand the information provided, ensure a quality care relationship and strengthen the patient's position in the health‐care setting, therefore making the mission to establish a care relationship possible.
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Affiliation(s)
- Anette Johnsson
- Department of Health Sciences, University West, Trollhättan, Sweden.,School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Petra Wagman
- School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Åse Boman
- Department of Health Sciences, University West, Trollhättan, Sweden
| | - Sandra Pennbrant
- Department of Health Sciences, University West, Trollhättan, Sweden
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