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Claesson M, Ljungblad C, Lindberg E. Leading care close to the patient in community home care for older persons: A lifeworld hermeneutic study from nurses' perspectives. J Clin Nurs 2024; 33:4090-4099. [PMID: 38887136 DOI: 10.1111/jocn.17333] [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: 01/07/2024] [Revised: 05/24/2024] [Accepted: 06/05/2024] [Indexed: 06/20/2024]
Abstract
AIM To explain and understand leading care close to older persons in community home care from the perspective of registered nurses (RNs). BACKGROUND Leading care close to older persons in home care is an overlooked and not well-described phenomenon. In home care, specific demands are placed on the registered nurse, as responsible for leading care guided by the older person's expectations and desires. DESIGN A reflective lifeworld hermeneutic approach grounded in the philosophy of phenomenology and hermeneutics. The study followed the COREQ checklist. METHODS Individual interviews were conducted with nine RNs working in community home care in a community in western Sweden. The data were analysed with a lifeworld hermeneutic approach. RESULTS The findings present four partially interpreted themes: leading with respect in a shared space, leadership that involves existential questions of life, balancing responsibility enables preservation of autonomy and challenges in maintaining a patient perspective. The partially interpreted themes conclude in a main interpretation: The patient perspective as an anchor when balancing responsibility for another person in an existential vulnerability of life. CONCLUSION Leading care means being both close to the patient and at a distance when caring is performed through the hands of others. Ethical demands are placed on RNs as they encounter the vulnerability of the older person. RELEVANCE TO CLINICAL PRACTICE The findings can contribute to a greater understanding of the meaning of RNs as leaders and may have an impact for decision makers and policies to create conditions for leadership that contributes to dignified care for older persons in community home care. PATIENT OF PUBLIC CONTRIBUTION Registered nurses working in community home care participated in data collection.
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Affiliation(s)
- Maria Claesson
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
| | - Cecilia Ljungblad
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
| | - Elisabeth Lindberg
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
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2
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Davenport CJ, Craven R. Supporting older adults who misuse alcohol. Nurs Older People 2024; 36:33-41. [PMID: 38773831 DOI: 10.7748/nop.2024.e1469] [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] [Accepted: 12/13/2023] [Indexed: 05/24/2024]
Abstract
Older adulthood is a unique time of transition often referred to as the 'golden years'. It is characterised by positive life experiences such as retirement but also by a loss of routine, identity and meaning. The literature identifies alcohol misuse as a growing issue in this population. However, the stigma, perceptions and patterns of drinking associated with alcohol misuse among older people can be a barrier to individuals seeking health advice. This article identifies that older adulthood is a period when nurses can offer health education and support using their unique relationships with patients to encourage healthy drinking behaviours.
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Affiliation(s)
- Caroline Jane Davenport
- Lecturer, Department of Nursing and Midwifery, Faculty of Health Sciences, University of Hull, Hull, England
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3
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Kago R, Ota K, Niimi Y. Factors affecting early career registered nurses' views of building good relationships with patients: A qualitative empirical research study. Nurs Open 2024; 11:e2155. [PMID: 38581162 PMCID: PMC10997952 DOI: 10.1002/nop2.2155] [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: 04/25/2023] [Revised: 08/22/2023] [Accepted: 03/25/2024] [Indexed: 04/08/2024] Open
Abstract
AIM To clarify the factors affecting early career registered nurses' (ECRNs') views on building good nurse-patient relationships. DESIGN An exploratory qualitative research design was implemented using detailed individual semi-structured interviews. METHODS Interview data were analysed using a thematic approach based on the systematic text condensation analysis proposed by Malterud. DATA SOURCES Eleven consenting nurses working in four hospitals. RESULTS Six characteristics were identified that influenced ECRNs' perceptions of building good nurse-patient relationships: finding clues through reflection, observing patients' reactions, clarifying their role as a nurse, doing their best for the patients, treating each patient as an irreplaceable individual and receiving support. CONCLUSIONS We discovered that the factors affecting ECRNs' views could be divided into two categories: factors that contribute to ECRNs' views on developing positive relationships with patients, and factors that influence ECRNs' relationships with patients but do not directly lead to positive relationships. It is critical for ECRNs to reflect on their experiences of poor relationship-building and observe patients' reactions. ECRNs seldom recognize that they have developed good relationships with their patients. It is critical to consider organizational environment and support as variables in developing a nurse-patient relationship so that the responsibility does not fall solely on ECRNs. IMPLICATIONS The results of this study provide clues to help ECRNs overcome difficulties in building relationships with patients. Furthermore, they can be used to develop educational programme for ECRNs. Future studies should use these findings to provide support to ECRNs and help them build relationships with patients.
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Affiliation(s)
- Reiko Kago
- School of Nursing and Health, Graduate School of Nursing and HealthAichi Prefecture UniversityNagoyaJapan
| | - Katsumasa Ota
- Faculty of Human Care at NumazuTohto UniversityNumazuJapan
| | - Yukari Niimi
- Department of Nursing, Faculty of Health and ScienceNagoya Women's UniversityNagoyaJapan
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4
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Been-Dahmen JMJ, van der Stege H, Oldenmenger WH, Braat C, van der Lans MCM, Scheper M, van Staa A, Ista E. What factors contribute to cancer survivors' self-management skills? A cross-sectional observational study. Eur J Oncol Nurs 2024; 69:102539. [PMID: 38460391 DOI: 10.1016/j.ejon.2024.102539] [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: 09/26/2023] [Revised: 02/13/2024] [Accepted: 02/17/2024] [Indexed: 03/11/2024]
Abstract
PURPOSE Many cancer survivors, facing the consequences of their disease and its treatment, have medical and supportive aftercare needs. However, limited knowledge exists regarding the relationship between support needs and survivors' self-management skills. The study aim is to explore factors contributing to cancer survivors' self-management skills. METHODS A cross-sectional study was conducted among cancer survivors (n = 277) of two outpatient oncology clinics at a university hospital in the Netherlands. Patients with head and neck cancer (n = 55) who had received radiotherapy and cisplatin or cetuximab were included, as well as patients who had undergone hematopoietic stem cell transplantation (n = 222). The primary outcome was self-management skills, assessed using the Partners in Health Scale (PIH), which comprises two subscales: knowledge and coping (PIH-KC), and recognition and management of symptoms, and adherence to treatment (PIH-MSA). Secondary outcomes were quality of life (EORTC QLQ-C30), self-efficacy (SECD6), patient-centered care (CAPHS), and social support (HEIQ). Machine learning-based Random Forest models were employed to construct associative models. Feature Importance (FI) was used to express the contribution to the model. RESULTS High emotional quality of life (FI = 33.1%), increased self-efficacy (FI = 22.2%), and greater social support (FI = 18.2%) were identified as key factors contributing to cancer survivors' self-management knowledge (PIH-KC). Furthermore, greater support from professionals (FI = 36.1%) and higher self-efficacy (FI = 18.2%) were found to benefit participants' recognition and management, and therapy adherence (PIH-MSA). CONCLUSIONS A patient-centered relationship between nurses and cancer survivors is essential for therapy adherence and the management of aftercare needs. Training to provide this holistic self-management support is required.
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Affiliation(s)
- Janet M J Been-Dahmen
- Rotterdam University of Applied Sciences, Research Center Innovations in Care, Rotterdam, P.O. Box 25035, 3001 HA, Rotterdam, the Netherlands.
| | - Heleen van der Stege
- Rotterdam University of Applied Sciences, Research Center Innovations in Care, Rotterdam, P.O. Box 25035, 3001 HA, Rotterdam, the Netherlands.
| | - Wendy H Oldenmenger
- Erasmus MC Cancer Institute, University Medical Center Rotterdam, Department of Medical Oncology, Rotterdam, the Netherlands.
| | - Cora Braat
- Erasmus MC Cancer Institute, University Medical Center Rotterdam, Department of Radiotherapy, Rotterdam, the Netherlands.
| | - Mariska C M van der Lans
- Erasmus MC Cancer Institute, University Medical Center Rotterdam, Department of Hematology, P.O. Box 2040, 3000 CA, Rotterdam, the Netherlands.
| | - Mark Scheper
- Rotterdam University of Applied Sciences, Research Center Innovations in Care, Rotterdam, P.O. Box 25035, 3001 HA, Rotterdam, the Netherlands; Macquarie University, Faculty of Medicine and Science, Allied Health Professions, Sydney, Australia.
| | - AnneLoes van Staa
- Rotterdam University of Applied Sciences, Research Center Innovations in Care, Rotterdam, P.O. Box 25035, 3001 HA, Rotterdam, the Netherlands.
| | - Erwin Ista
- Erasmus MC, University Medical Center Rotterdam, Department of Internal Medicine - Section Nursing Science, P.O. Box 2040, 3000 CA, Rotterdam, the Netherlands; Erasmus MC - Sophia Children's Hospital, University Medical Center Rotterdam, Department of Neonatal and Pediatric Intensive Care, Division of Pediatric Intensive Care, Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, the Netherlands.
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5
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El-Abidi K, Moreno-Poyato AR, Cañabate-Ros M, Garcia-Sanchez JA, Lluch-Canut MT, Muñoz-Ruoco E, Pérez-Moreno JJ, Pita-De-La-Vega J, Puig-Llobet M, Rubia-Ruiz G, Santos-Pariente C, López AMR, Golmar LJ, López CE, Roldán-Merino JF. The therapeutic relationship from the perspective of patients and nurses in the first days of admission: A cross-sectional study in acute mental health units. Int J Ment Health Nurs 2024; 33:134-142. [PMID: 37743558 DOI: 10.1111/inm.13227] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 09/05/2023] [Accepted: 09/06/2023] [Indexed: 09/26/2023]
Abstract
The therapeutic relationship (TR) is essential in mental health nursing care and plays a fundamental role in the understanding and treatment of the patient's health status. Despite being a bidirectional construct, limited evidence is available to shed light on this issue in mental health units and even less so in the first days of admission. This study aimed to examine the association and differences between nurses' and patients' perspectives on the establishment of the therapeutic relationship in acute mental health units during the first days of hospitalization. A cross-sectional study was carried out in 12 Spanish mental health units. Data were collected from patients and nurses using the Working Alliance Inventory-Short (WAI-S) questionnaire. A total of 234 cases were analysed, including 234 patients and 58 nurses. The results showed a positive association between nurses' and patients' perspectives on the therapeutic relationship, but also revealed significant differences on each WAI-S dimension. Nurses assigned higher scores compared to patients on the perception of the quality of the therapeutic relationship. The dimensions with the greatest weight from the patients' perspective regarding the quality of the therapeutic relationship were the perception of greater agreement on goals and tasks among nurses. This study demonstrates the importance of establishing shared goals and tasks with nurses from the first days of hospitalization to improve the quality of the therapeutic relationship as perceived by patients. These findings underline the need to consider the different perspectives of both parties to promote a high-quality therapeutic relationship.
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Affiliation(s)
- Khadija El-Abidi
- Institut de Neuropisquiatria i Addiccions, Centre Fòrum, Hospital del Mar, Barcelona, Spain
- Department of Public Health, Mental Health and Maternal and Child Health Nursing, Nursing School, Universitat de Barcelona, L'Hospitalet de Llobregat, Spain
| | - Antonio R Moreno-Poyato
- Department of Public Health, Mental Health and Maternal and Child Health Nursing, Nursing School, Universitat de Barcelona, L'Hospitalet de Llobregat, Spain
- Grup de Recerca en Cures Infermeres de Salut Mental, Psicocials i de Complexitat, NURSEARCH - 2021 SGR 1083, Barcelona, Spain
| | - Montserrat Cañabate-Ros
- Universidad Católica de Valencia, San Vicente Mártir, Grupo de investigación MHG, Valencia, Spain
- Hospital Clínico Universitario de Valencia, Unidad de hospitalización de psiquiatría y toxicomanía, Valencia, Spain
| | - Juan A Garcia-Sanchez
- Department of Mental Health, Biomedical Research Institute of Malaga (IBIMA), University General Hospital of Málaga, Málaga, Spain
| | - M Teresa Lluch-Canut
- Department of Public Health, Mental Health and Maternal and Child Health Nursing, Nursing School, Universitat de Barcelona, L'Hospitalet de Llobregat, Spain
- Grup de Recerca en Cures Infermeres de Salut Mental, Psicocials i de Complexitat, NURSEARCH - 2021 SGR 1083, Barcelona, Spain
| | - Estibaliz Muñoz-Ruoco
- Psychiatry Service, Galdakao-Usansolo Hospital, Osakidetza-Basque Health Service, Galdakao-Usansolo, Spain
| | - Juan J Pérez-Moreno
- Psychiatry Service, Galdakao-Usansolo Hospital, Osakidetza-Basque Health Service, Galdakao-Usansolo, Spain
| | - Javier Pita-De-La-Vega
- Children's Mental Health Centre, Department of Mental Health, Consorci Sanitari del Maresme, Mataró, Spain
| | - Montserrat Puig-Llobet
- Department of Public Health, Mental Health and Maternal and Child Health Nursing, Nursing School, Universitat de Barcelona, L'Hospitalet de Llobregat, Spain
- Grup de Recerca en Cures Infermeres de Salut Mental, Psicocials i de Complexitat, NURSEARCH - 2021 SGR 1083, Barcelona, Spain
| | | | | | | | | | - Cristina Esquinas López
- Department of Public Health, Mental Health and Maternal and Child Health Nursing, Nursing School, Universitat de Barcelona, L'Hospitalet de Llobregat, Spain
| | - Juan F Roldán-Merino
- Campus Docent Sant Joan de Déu Fundació Privada, School of Nursing, University of Barcelona, Barcelona, Spain
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Yousefzadeh NK, Dehkordi MK, Vahedi M, Astaneh AN, Bateni FS. The effectiveness of Balint group work on the quality of work life, resilience, and nurse-patient communication skills among psychiatric nurses: a randomized controlled trial. Front Psychol 2024; 15:1212200. [PMID: 38328376 PMCID: PMC10847344 DOI: 10.3389/fpsyg.2024.1212200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 01/09/2024] [Indexed: 02/09/2024] Open
Abstract
Background Balint group training has gained popularity in medical practices as an intervention designed to enhance the quality of life, well-being, and communication skills of healthcare practitioners. Psychiatric nurses, in particular, encounter distinct challenges and stressors inherent in their profession, necessitating the development and implementation of effective interventions to assist them in coping with the difficulties they experience. In this vein, the current study aimed to investigate the effectiveness of Balint group training on quality of work life, resilience, and nurse-patient communication skills among psychiatric nurses. Methods Thirty psychiatric nurses from Razi Hospital in Tehran were recruited via the purposeful sampling method in 2022 and were randomly assigned to either the Balint group, consisting of eight weekly one-hour training sessions, or a control group. Participants completed the Walton Quality of Work Life Questionnaire, Connor-Davidson Resilience Scale, and Communication Skills Scale before and after the intervention. The data were analyzed using the Analysis of Covariance (ANCOVA). Results The study found no significant differences between the Balint group and the control group in terms of quality of work life, resilience, and nurse-patient communication skills. Conclusion Findings suggest that Balint group training was not an effective intervention for improving the well-being and communication skills of psychiatric nurses. However, the study highlights the need for further investigation into the potential factors that may explain the lack of significant gains and offers insights for future research in this area.
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Affiliation(s)
- Negar Kiani Yousefzadeh
- School of Behavioral Sciences and Mental Health, Razi Educational and Therapeutic Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
- Psychosis Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mansoureh Kiani Dehkordi
- Fellowship of Psychotherapy, Psychosis Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mohsen Vahedi
- Department of Biostatistics and Epidemiology, Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Ali Nazeri Astaneh
- Psychosis Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Fatemeh Sadat Bateni
- School of Behavioral Sciences and Mental Health, Razi Educational and Therapeutic Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
- Psychosis Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Kyota A, Kanda K, Senuma M, Tsukagoshi N, Futawatari T, Kondo Y. The perception of life and death in patients with end-of-life stage cancer: A systematic review of qualitative research. Eur J Oncol Nurs 2023; 66:102354. [PMID: 37586291 DOI: 10.1016/j.ejon.2023.102354] [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: 04/19/2021] [Revised: 05/08/2023] [Accepted: 05/31/2023] [Indexed: 08/18/2023]
Abstract
PURPOSE This study aims to clarify the perceptions on life and death among patients with the end-of-life stage cancer through a systematic review. METHODS The search strategy combined MeSH terminology with free text searches, and was applied to the PubMed, CINAHL, Embase, and ICHUSHI (Japan Medical Abstracts Society) databases covering from 2010 to 5/2022. To ensure the quality of the research included, the Critical Appraisal Skills Program Qualitative Studies Checklist was used. Data relating to the perceptions of life and death of patients with the end-of-life stage cancer was extracted and analyzed with reference to qualitative meta-synthesis methods. RESULTS Ultimately, 50 studies were included. Five themes were derived based on the perceptions of life and death of patients with the end-of-life stage cancer: despair, making sense of death, how to live the rest of life, special feelings for loved ones, and fluctuation. By making sense of death in their own way, and reconciling it with their current situation, patients with the end-of-life stage cancer, even in despair over their impending death, look ahead into the future and their surroundings and consider how they would live the remaining time they have. During this time, the special feelings they have for their loved ones make an impact. CONCLUSIONS An important new finding from this study lies in the fact that the patients' desire to live as ordinary people who were not patients were expressed as a face that they hid from their families. Further research is needed in low-income countries/regions.
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Affiliation(s)
- Ayumi Kyota
- Department of Nursing, Gunma University Graduate School of Health Sciences, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8514, Japan.
| | - Kiyoko Kanda
- Niigata College of Nursing, 240 Shinnan-cho, Joetsu, Niigata, 943-0147, Japan.
| | - Maiko Senuma
- Department of Nursing, Gunma University Graduate School of Health Sciences, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8514, Japan.
| | - Noriko Tsukagoshi
- Department of Nursing, Gunma University Graduate School of Health Sciences, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8514, Japan.
| | - Tamae Futawatari
- Department of Nursing, Gunma University Graduate School of Health Sciences, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8514, Japan.
| | - Yuka Kondo
- Department of Nursing, Gunma University Graduate School of Health Sciences, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8514, Japan.
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Stenner K, Shore CB, Maben J, Mold F, Winkley K, Cook A. Delegation of insulin administration to non-registered healthcare workers in community nursing teams: A qualitative study. J Adv Nurs 2023; 79:3382-3396. [PMID: 37005976 DOI: 10.1111/jan.15662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 02/09/2023] [Accepted: 03/16/2023] [Indexed: 04/04/2023]
Abstract
AIMS To explore stakeholder perspectives on the benefits and/or disadvantages of the delegation of insulin injections to healthcare support workers in community nursing services. DESIGN Qualitative case study. METHODS Interviews with stakeholders purposively sampled from three case sites in England. Data collection took place between October 2020 and July 2021. A reflexive thematic approach to analysis was adopted. RESULTS A total of 34 interviews were completed: patients and relatives (n = 7), healthcare support workers (n = 8), registered nurses (n = 10) and senior managers/clinicians (n = 9). Analysis resulted in three themes: (i) Acceptance and confidence, (ii) benefits and (iii) concerns and coping strategies. Delegation was accepted by stakeholders on condition that appropriate training, supervision and governance was in place. Continuing contact between patients and registered nurses, and regular contact between registered nurses and healthcare support workers was deemed essential for clinical safety. Services were reliant on the contribution of healthcare support workers providing insulin injections, particularly during the COVID-19 pandemic. Benefits for service and registered nurses included: flexible team working, increased service capacity and care continuity. Job satisfaction and career development was reported for healthcare support workers. Patients benefit from timely administration, and enhanced relationships with the nursing team. Concerns raised by all stakeholders included potential missed care, remuneration and task shifting. CONCLUSION Delegation of insulin injections is acceptable to stakeholders and has many benefits when managed effectively. IMPACT Demand for community nursing is increasing. Findings of this study suggest that delegation of insulin administration contributes to improving service capacity. Findings highlight the essential role played by key factors such as appropriate training, competency assessment and teamwork, in developing confidence in delegation among stakeholders. Understanding and supporting these factors can help ensure that practice develops in an acceptable, safe and beneficial way, and informs future development of delegation practice in community settings. PATIENT OR PUBLIC CONTRIBUTION A service user group was consulted during the design phase prior to grant application and provided comments on draft findings. Two people with diabetes were members of the project advisory group and contributed to the study design, development of interview questions, monitoring study progress and provided feedback on study findings.
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Affiliation(s)
- Karen Stenner
- School of Health Sciences, University of Surrey, Guildford, UK
| | - Colin B Shore
- School of Health Sciences, University of Surrey, Guildford, UK
| | - Jill Maben
- School of Health Sciences, University of Surrey, Guildford, UK
| | - Freda Mold
- School of Health Sciences, University of Surrey, Guildford, UK
| | - Kirsty Winkley
- King's College London & Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care, London, UK
| | - Angela Cook
- Head of Nursing and Quality, Shropshire Community Health NHS Trust, Shrewsbury, UK
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Kuven BM, Drageset J, Haugan G. Quality of life and nurse-patient interaction among NH residents: Loneliness is detrimental, while nurse-patient interaction is fundamental. J Clin Nurs 2023; 32:6384-6393. [PMID: 36751030 DOI: 10.1111/jocn.16645] [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: 07/18/2022] [Revised: 10/16/2022] [Accepted: 01/20/2023] [Indexed: 02/09/2023]
Abstract
AIMS AND OBJECTIVES To investigate the association between perceived nurse-patient interaction and quality-of-life among nursing home residents, adjusted for loneliness, anxiety and depression. BACKGROUND Symptoms of anxiety and depression are known to residents of nursing homes along with cognitive impairment, physical inactivity and low quality-of-life. Anxiety, depression and loneliness are found detrimental to NH residents' quality-of-life. The nurse-patient relationship is important for patient's well-being, both in terms of illness and symptom management. DESIGN Cross-sectional design. METHODS Data were collected in 2017 and 2018 from 188 residents in 27 nursing homes resided in two large urban municipalities in Middle and Western Norway. The inclusion criteria were: (1) local authority's decision of long-term NH care; (2) residential stay 3 months or longer; (3) informed consent competency recognised by responsible doctor and nurse; (4) capable of being interviewed, and (5) aged 65 years or older. This article is executed in accordance with STROBE statement. RESULTS Adjusting for age, sex, anxiety, depression and loneliness, perceived nurse-patient interaction was statistically significant to quality-of-life. While anxiety and depression showed insignificant estimates, loneliness demonstrated a significant relation with quality-of-life. Nurse-patient interaction and loneliness explained together 25% of the variation in quality-of-life. CONCLUSION This study suggests that loneliness is frequent as well as more detrimental to quality-of-life among nursing home residents compared to anxiety and depression. Furthermore, the present results show that the nurse-patient interaction represents an essential health-promoting resource for Quality-of-life in this population. RELEVANCE TO CLINICAL PRACTICE Staff nurses need to exercise their awareness of loneliness to meet residents' needs. Nursing educations should provide knowledge about nurse-patient interaction, and students as well as staff nurses in NHs should be trained, for instance by simulation, to use the nurse-patient interaction as a health-promoting resource. Finally, loneliness represents a bigger challenge than depression and anxiety; accordingly, building nurses that are capable of meeting patients' needs and facilitate care that counteracts loneliness is highly warranted.
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Affiliation(s)
| | - Jorunn Drageset
- Department of Health and Caring Sciences, Western Norway University, Bergen, Norway
| | - Gørill Haugan
- Department of Public Health and Nursing, Faculty of Nursing and Health Sciences, NTNU Norwegian University of Science and Technology, Trondheim and Nord University, Levanger, Norway
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Martínez-Angulo P, Rich-Ruiz M, Ventura-Puertos PE, López-Quero S. Integrating shared decision-making, expressing preferences and active participation of older adults in primary care nursing: a systematic review of qualitative studies and qualitative meta-synthesis. BMJ Open 2023; 13:e071549. [PMID: 37344120 DOI: 10.1136/bmjopen-2022-071549] [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] [Indexed: 06/23/2023] Open
Abstract
OBJECTIVES To systematically synthesise the results of primary qualitative studies on how community-dwelling older adults experience shared decision-making processes, express preferences and actively participate in care. DESIGN Systematic review of qualitative studies and qualitative meta-synthesis. METHODS We focused on studies about community-dwelling participants aged ≥65 undergoing a health-disease process circumscribed to a primary healthcare setting, and the central theme should focus on either shared decision-making, expressing preferences or patient participation. We searched the following databases: MEDLINE, CINAHL, Web of Science, Scopus and PsycINFO (time publication frame 2012-2022). We excluded studies in those cases where the qualitative results were not analysed or unrelated to the phenomenon addressed, phenomena were not clear enough to be included or the setting did not occur in the community. RESULTS A total of 12 studies were included in this meta-synthesis. We appraised the quality of the selected studies through Critical Appraisal Skills Programme (CASP) Checklist. The metasummary comprised the frequency and intensity of qualitative patterns across the included studies. The meta-synthesis revealed four influential elements in their interaction: recognising personal qualities, facing professional characteristics, experiences of discrimination and a double-edged context. CONCLUSIONS The phenomena studied were influenced by how older people approached their role in their binomial relationship with healthcare professionals. Those with a reinforced self-concept were better aware of health-disease-related situations regarding shared decision-making and the importance of being communicatively assertive. Professional characteristics were also crucial in how older people modulated their acting ability through their personality, communication skills and the approach healthcare professionals used towards older adults. Situations of discrimination generated through an imbalance of power inhibited the expression of preferences and hindered the active participation of older people. The context surrounding the participants influenced all these situations, key in tipping the balance between a therapeutic and a harmful side. PROSPERO REGISTRATION NUMBER CRD42022363515.
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Affiliation(s)
- Pablo Martínez-Angulo
- Department of Nursing, Pharmacology and Physiotherapy, Faculty of Medicine and Nursing, University of Córdoba (UCO), Córdoba, Andalucía, Spain
- Interdisciplinary Research Group in Discourse Analysis (HUM380), University of Córdoba (UCO), Córdoba, Andalucía, Spain
| | - Manuel Rich-Ruiz
- Department of Nursing, Pharmacology and Physiotherapy, Faculty of Medicine and Nursing, University of Córdoba (UCO), Córdoba, Andalucía, Spain
- Nursing and Healthcare Research Unit (Investén-isciii), Instituto de Salud Carlos III, Madrid, Spain
- Ciber Fragility and Healthy Aging (CIBERFES), Madrid, Spain
| | - Pedro E Ventura-Puertos
- Department of Nursing, Pharmacology and Physiotherapy, Faculty of Medicine and Nursing, University of Córdoba (UCO), Córdoba, Andalucía, Spain
- Interdisciplinary Research Group in Discourse Analysis (HUM380), University of Córdoba (UCO), Córdoba, Andalucía, Spain
| | - Salvador López-Quero
- Interdisciplinary Research Group in Discourse Analysis (HUM380), University of Córdoba (UCO), Córdoba, Andalucía, Spain
- Department of Language Sciences, Faculty of Philosophy and Letters, University of Córdoba (UCO), Córdoba, Andalucía, Spain
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Tong LK, Zhu MX, Wang SC, Cheong PL, Van IK. Gender similarities and differences in the perception of caring among nurses during the COVID-19 pandemic: a mixed-methods study. BMC Nurs 2023; 22:115. [PMID: 37046318 PMCID: PMC10091316 DOI: 10.1186/s12912-023-01267-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 03/24/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND Caring is the essence and core of nursing. Current studies on the effect of gender on nurses' perception of caring have been inconsistent. Most of these studies were quantitative and conducted before the COVID-19 pandemic. The study aimed to explore the gender similarities and differences in nurses' perception of caring during the COVID-19 pandemic. METHODS In 2020, a cross-sectional mixed-method study was conducted in 11 cities in China using structured online questionnaire (n = 8030) and face-to-face individual interview (n = 42). Data collection tools included the Caring Dimensions Inventory and semi-structured interview. RESULTS In stepwise multivariable linear regression analysis, female nurses scored 1.93 points higher on caring than male nurses, after completely controlling for the other factors. The interview results showed that both male and female nurses agreed that caring was to deal with three kinds of relationships, namely nurses and people, nurses and themselves, nurses and society. There were gender differences in the connotation of caring between nurses and themselves, but not in the connotations of caring between other relationships. The ranking of the importance of caring connotations among these relationships showed no gender difference except between nurses and themselves. CONCLUSION The quantitative findings suggest that gender influences nurses' perception of caring. The qualitative findings demonstrate that nurses regard themselves as both recipients and implementers of caring. The qualitative results indicate nurses of different genders have similarities and differences in their perception of caring, and the biggest difference lies in the relationship between nurses and themselves.
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Affiliation(s)
| | | | | | | | - Iat Kio Van
- Kiang Wu Nursing College of Macau, Macao, China.
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12
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Mehralian G, Yusefi AR, Dastyar N, Bordbar S. Communication competence, self-efficacy, and spiritual intelligence: evidence from nurses. BMC Nurs 2023; 22:99. [PMID: 37024881 PMCID: PMC10077309 DOI: 10.1186/s12912-023-01262-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 03/22/2023] [Indexed: 04/08/2023] Open
Abstract
INTRODUCTION Communication skills and acceptable levels of spiritual intelligence (SI) are the prerequisites of the nursing profession, which can significantly impact the individual and organizational performance of nurses. This study aimed to investigate the competency and self-efficacy of communication and its relationship with the SI of nurses. METHODS This cross-sectional study was conducted in 2021 and included 312 nurses working in a COVID-19 hospital in the south of Iran. The data collection instruments were the Standard Communication Competence Scale, Communication Self-Efficacy, and SI Questionnaires. Data were analyzed with SPSS software version 23 using descriptive and inferential statistics, and t-test, ANOVA, Pearson's correlation coefficient, and multiple linear regression were performed at 5% significance level. RESULTS The mean scores of nurses' communication competence, communication self-efficacy, and SI were 89.11 ± 7.32 out of 180, 64.45 ± 5.61 out of 120, and 147.13 ± 11.26 out of 210, respectively. A direct and significant correlation was observed between competence (r = 0.527, p<0.001) and communication self-efficacy (r = 0.556, p<0.001) with spiritual intelligence. The dimensions of spiritual intelligence, including the ability to deal with and interact with problems, self-awareness, love and affection, general thinking and doctrinal dimension, and dealing with moral issues, were identified as predictors of nurses' communicative competence and self-efficacy (p<0.05). There was a positive and significant correlation between nurses' competence and self-efficacy with their age (p<0.05). The nurses' mean communication competence and self-efficacy score were different regarding their level of education and the number of shifts (p<0.05). The mean scores of self-efficacy revealed a statistically significant difference between the participants' gender and the number of patients under observation (p<0.05). Moreover, the nurses' SI significantly correlated with age, and the mean scores of this intelligence had statistically significant differences regarding gender (p<0.05). CONCLUSION The nurses' communication competence and self-efficacy were at a moderate level. Considering the correlation and predictive role of SI and its dimensions, it is recommended to promote problem-solving skills, improve self-awareness, and pay attention to moral standards to nurture communication competence and self-efficacy among nurses.
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Affiliation(s)
| | - Ali Reza Yusefi
- Department of Public Health, School of Health, Jiroft University of Medical Sciences, Jiroft, Iran.
| | - Neda Dastyar
- Department of midwifery, Nursing and Midwifery School, Jiroft University of Medical Sciences, Jiroft, Iran
| | - Shima Bordbar
- Health Human Resources Research Center, School of Health Managemet and Information Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
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13
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Hauan M, Kvigne K, Alteren J. Politically Engaged Mindset of Everyday Coping in Relation to Nursing Values: A Phenomenological-Hermeneutic Study of District Nurses' Experiences. SAGE Open Nurs 2023; 9:23779608231157969. [PMID: 36824317 PMCID: PMC9941590 DOI: 10.1177/23779608231157969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 11/29/2022] [Accepted: 01/31/2023] [Indexed: 02/22/2023] Open
Abstract
Introduction To accommodate challenges threatening the healthcare sector's sustainability, district nursing in Norway implemented the rehabilitative and health promoting mindset of everyday coping. When implementing new ideas and practices in nursing care, understanding the significance of this mindset on patient care and whether it corresponds to nursing values are important to ensure healthcare quality. Objective This study aimed to understand how nurses practice care where everyday coping is implemented in district nursing and their experience of everyday coping as a mindset in relation to nursing values. Methods A qualitative study was conducted including 19 observations and 19 narrative interviews with 10 district nurses, during two data collection periods. Data were analyzed using a phenomenological-hermeneutic method. The analysis process consisted of three steps: naïve reading, structural analysis, and comprehensive understanding. Results The following two main themes and four sub-themes emerged from the data analyses: (i) Understanding individual patient situations; "Creating a nurse-patient relationship to understand the patient landscape" and "providing care based on individual patient needs," (ii) knowing when and how to motivate or help patients; "distinction between motivating patients and causing stress" and "realistic and desirable demands to motivate patients to perform tasks." Conclusion Participants determined how to provide care to patients based on their values, professional knowledge, and individual patient situations. The patient landscape is diverse and everyday coping is unable to capture the diversity of patient groups. Thus, everyday coping is not expressed as an overall mindset in nursing practice.
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Affiliation(s)
- Marianne Hauan
- Faculty of Nursing and Health Science, Nord University, Mo i Rana, Norway,Marianne Hauan, Faculty of Nursing and Health Science, Nord University, Campus Helgeland, Nytorget 5, 8622 Mo i Rana, Norway.
| | - Kari Kvigne
- Faculty of Health and Social Science, Inland University of Applied Science, Elverum, Norway
| | - Johanne Alteren
- Faculty of Health Science and Social Care, Molde University College, Molde, Norway
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14
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Chung C, McKenna L, Cooper SJ. Contextual factors influencing patients' experiences of acute deterioration and medical emergency team (MET) encounter: A grounded theory study. J Adv Nurs 2022; 78:4062-4070. [PMID: 35822295 PMCID: PMC9796959 DOI: 10.1111/jan.15336] [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: 03/16/2022] [Revised: 05/28/2022] [Accepted: 06/14/2022] [Indexed: 01/07/2023]
Abstract
AIM This paper explores the personal, social and structural factors that influence patients' experiences of acute deterioration and medical emergency team (MET) encounter. BACKGROUND Patient experience is recognized as a means of assessing healthcare delivery with a positive experience being linked to high-quality healthcare, improved patient safety and reduced length of stay. The experience of acute deterioration is unique, extensive and complex. However, little is known about this experience from the patient's perspective. DESIGN Constructivist grounded theory, informed by Kathy Charmaz, was used to explore the personal, social and structural factors that influence patients' experiences of acute deterioration and MET encounter. METHODS Using a semi-structured interview guide, in-depth individual interviews were conducted with 27 patients from three healthcare services in Victoria, Australia. Data were collected over a 12-month period from 2018 to 2019. Interview data were analysed using grounded theory processes. FINDINGS Contextual factors exert a powerful influence on patients' experiences of acute deterioration and MET encounter. The most significant factors identified include patients' expectations and illness perception, relationship with healthcare professionals during MET call and past experiences of acute illness. The expectations and perceptions patients had about their disease can condition their overall experience. Healthcare professional-patient interactions can significantly impact quality of care, patient experience and recovery. Patients' experiences of illness and healthcare can impact a person's future health-seeking behaviour and health status. CONCLUSION Patients' actions and processes about their experiences of acute deterioration and MET encounter are the result of the complex interface of contextual factors. IMPACT The findings from this study have highlighted the need for revised protocols for screening and management of patients who experience acute deterioration.
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Affiliation(s)
- Catherine Chung
- Institute of Health and WellbeingFederation University AustraliaChurchillVictoriaAustralia
| | - Lisa McKenna
- Institute of Health and WellbeingFederation University AustraliaChurchillVictoriaAustralia,School of Nursing and MidwiferyLa Trobe UniversityBundooraAustralia
| | - Simon J. Cooper
- Institute of Health and WellbeingFederation University AustraliaChurchillVictoriaAustralia
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15
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Tang X, Lu J, Chen Z, Liu C, Jiang X, Ning M. Influencing Factors of Patients' Trust in Nurses During the COVID-19 Pandemic: A Mixed-Methods Study. Disaster Med Public Health Prep 2022; 17:e302. [PMID: 36325834 PMCID: PMC9947035 DOI: 10.1017/dmp.2022.262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE This study aimed to investigate the nurse-patient trust among in-patients in the context of the coronavirus disease (COVID-19) epidemic; it further analyzed the related influencing factors, which will provide a theoretical basis for developing corresponding measures. METHODS This study employed a mixed-method design and analyzed 149 patients at the Hongqi Hospital, affiliated with Mudanjiang Medical University, from December 2020 to February 2021. Quantitative analysis was carried out using the "Nurse Patient Trust Scale," and qualitative analysis was performed using a semi-structured interview with in-patients. RESULTS The average score on the scale was 46.65 ± 2.83, and the scores of the 2 dimensions were: 23.24 ± 1.51 for ability and peace of mind, and 23.32 ± 1.53 for attitude and care. According to the interview data, the factors included 3 aspects: a comfortable hospital environment and humane management measures; the nurse's own competence; and effective communication with patients. CONCLUSION During the COVID-19 epidemic, there are still many factors affecting patients' trust in nurses that can be addressed by taking different measures. All these factors must be considered by the relevant managers and clinical nursing staff to maintain a better nurse-patient trust relationship.
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Affiliation(s)
- Xiaolan Tang
- College of Nursing, Mudanjiang Medical University, Mudanjiang, Heilongjiang Province, China
| | - Junhua Lu
- College of Nursing, Mudanjiang Medical University, Mudanjiang, Heilongjiang Province, China
| | - Zhihui Chen
- Department of Emergency, Hongqi Hospital Affiliated to Mudanjiang Medical University, Mudanjiang, Heilongjiang Province, China
| | - Chao Liu
- Department of General Surgery, Hongqi Hospital Affiliated to Mudanjiang Medical University, Mudanjiang, Heilongjiang Province, China
| | - Xue Jiang
- Department of General Surgery, Hongqi Hospital Affiliated to Mudanjiang Medical University, Mudanjiang, Heilongjiang Province, China
| | - Mei Ning
- Department of General Surgery, Hongqi Hospital Affiliated to Mudanjiang Medical University, Mudanjiang, Heilongjiang Province, China
- Corresponding author: Mei Ning,
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16
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Al Mahrouqi AS, Mallinson RK, Oh KM, Weinstein AA. Patients’ and Nurses’ Perceptions of Diabetes Self-Management in Oman: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116929. [PMID: 35682513 PMCID: PMC9180150 DOI: 10.3390/ijerph19116929] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 05/28/2022] [Accepted: 06/02/2022] [Indexed: 02/04/2023]
Abstract
Patient-centered care enhances diabetes self-management; however, the primary care nurse’s role in promoting diabetes self-management within a patient-centered care model is unexplored. This study investigated the perceptions of Omani patients with type-2 diabetes and their clinic nurses on the nurses’ role in promoting diabetes self-management within a patient-centered care approach. The thematic analysis of the data from individual interviews with patients (n = 24) revealed two themes: patients experienced “missteps on an unclear path” and “nurses doing their best.” Patients struggled to identify treatment goals and faltered in their attempts to adopt diabetes self-management behaviors. The nurses’ role was perceived as task-oriented. Nurse narratives (n = 21) revealed that very few nurses were aware of the patient-centered care philosophy. A theme emerged of nurses “needing a new perspective” to transition their care delivery to align with the patient-centered care model. Nurses expected patients to comply with their instructions and missed opportunities for assessment, engagement, and collaborative problem-solving during patient encounters. The shift from a physician-based medical model to a patient-centered primary care delivery system may necessitate that nurses engage more effectively with patients, collaborate on an individual treatment plan, and motivate them to adopt self-management behaviors.
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Affiliation(s)
- Abdullah Salim Al Mahrouqi
- Oman Government Ministry of Health, Oman College of Health Sciences, Ibri 516, Oman
- Correspondence: ; Tel.: +968-993-132-02
| | - Robert Kevin Mallinson
- School of Nursing, George Mason University, 4400 University Dr, Fairfax, VA 22030, USA; (R.K.M.); (K.M.O.)
| | - Kyeung Mi Oh
- School of Nursing, George Mason University, 4400 University Dr, Fairfax, VA 22030, USA; (R.K.M.); (K.M.O.)
| | - Ali A. Weinstein
- Department of Global and Community Health, George Mason University, 4400 University Dr, Fairfax, VA 22030, USA;
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17
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Schreiber C, Verrall C, Whitehead D. Spiritual care in Australian general practice nursing: An interpretive descriptive study. Nurs Health Sci 2022; 24:670-678. [PMID: 35647683 DOI: 10.1111/nhs.12961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 05/23/2022] [Accepted: 05/24/2022] [Indexed: 11/26/2022]
Abstract
Spiritual care as an aspect of holistic or person-centered care has been well documented. Studies on spirituality and spiritual care in nursing have taken place in various countries and contexts. Studies about spiritual care from the nurse perspective in the primary healthcare setting of Australian General Practice are not evident. Using an interpretive description study design, data about views on spirituality, spiritual care experiences, and descriptions about any spiritual care provided were collected from eight practice nurses. Four themes were drawn from the findings: the personal importance of spirituality and spiritual care to nurses and patients, spiritual care as an aspect of person-centered care, spiritual care practices, and barriers and enablers to addressing spiritual needs. Participants identified that practice nurses require improved education about spirituality to adequately address spiritual needs as expressed by patients, as well as the tools to be able to provide spiritual care. They also identified that documentation templates used in general practice should include prompts to address spiritual and/or religious needs.
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Affiliation(s)
- Christine Schreiber
- College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, Australia
| | - Claire Verrall
- College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, Australia
| | - Dean Whitehead
- College of Nursing and Health Sciences, Flinders University, Bedford Park, South Australia, Australia
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18
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Jujuan L, Zhihui Z, Li G, Yufeng H, Qingqing Y, Yubei C, Xiaohong L, Shuqin P, Xia L. Title of the manuscript: Reliability and Validity of the Mandarin Version of the Trust in Nurses Scale. J Nurs Manag 2022; 30:1366-1375. [PMID: 35403295 DOI: 10.1111/jonm.13623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 03/23/2022] [Accepted: 04/04/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Liu Jujuan
- Fujian University of Traditional Chinese Medicine
| | - Zheng Zhihui
- Fujian University of Traditional Chinese Medicine
| | - Ge Li
- Fujian University of Traditional Chinese Medicine
| | - Huang Yufeng
- Fujian University of Traditional Chinese Medicine
| | | | - Chen Yubei
- Sanming First Hospital and First Hospital of Sanming Affiliated to Fujian Medical University
| | - Li Xiaohong
- Ningde City Hospital Affiliated to Ningde Normal University
| | - Pang Shuqin
- Fujian University of Traditional Chinese Medicine
| | - Li Xia
- Fujian University of Traditional Chinese Medicine
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19
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Watz S, Ingstad K. Keeping calm on a busy day-an interpersonal skill home care patients desire in health workers: hermeneutical phenomenological method. BMC Nurs 2022; 21:49. [PMID: 35209894 PMCID: PMC8876402 DOI: 10.1186/s12912-022-00825-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 02/11/2022] [Indexed: 11/16/2022] Open
Abstract
Background In Western countries, many health and social care provisions have been transferred to primary care, and most older patients wish to remain in their own homes for as long as possible. For older patients who live alone, health workers could be their only personal contacts. Hence, health workers’ personal skills affect their relationships with these patients. Accordingly, this study aimed to shed light on the interpersonal skills needed by health workers to establish good relationships with older home care patients and highlight the importance of interpersonal skills training in nursing education. Methods This study adopted a hermeneutical phenomenological approach. The qualitative method was used to elicit data on patients’ perspectives. Ten home care patients were interviewed individually in their own homes between December 2019 and January 2020. Results Despite individual variations, health workers’ interpersonal skills are of significance with regard to the social well-being of patients living at home. The findings revealed that patients want health workers to be mentally present, congruent in their communications, calm and relaxed during the available time spent with them, and capable of facilitating autonomy. Conclusions It is important to present patients’ perspectives to ensure that nursing education is geared towards patients’ best interests. Trial registration number The Norwegian Centre for Research Data (NSD): 953937.
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Affiliation(s)
- Siw Watz
- Oslo Metropolitan University, Karethe Johnsens hus, Kunnskapsveien 55, 2007, Kjeller, Norway.
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20
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Heerings M, van de Bovenkamp H, Cardol M, Bal R. Ask us! Adjusting experience-based codesign to be responsive to people with intellectual disabilities, serious mental illness or older persons receiving support with independent living. Health Expect 2022; 25:2246-2254. [PMID: 35178839 PMCID: PMC9615044 DOI: 10.1111/hex.13436] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 12/16/2021] [Accepted: 12/24/2021] [Indexed: 11/29/2022] Open
Abstract
Introduction Experience‐based codesign (EBCD) is a valuable tool for participatory quality improvement. However, the EBCD process needs to be adjusted to make it suitable for long‐term care. The focus of the improvement process needs to shift to the care relationship, as this is an important part of the quality of care in these settings. Furthermore, the EBCD process needs to be made more accessible to vulnerable populations. Methods Through a participatory research approach, EBCD was adjusted to long‐term care. The research was conducted in two care organisations: one supporting people with serious mental illness and intellectual disabilities in independent living and one providing homecare services for older persons. Results The participatory research resulted in the development of ‘Ask us!’—a method for critical reflective codesign. The research furthermore provided valuable lessons for participatory projects with vulnerable clients. A common problem with participatory research in long‐term care is ensuring the involvement of clients and informal carers. We report on various strategies developed to include experiences of a diverse set of services users, such as combining interviews with participant observation, photo‐voice and involving experts‐by‐experiences as co‐ethnographers. In close collaboration with an inclusive theatre company, these experiences were translated into 42 short videos on complex situations in the care relationship from the perspective of clients, professionals or informal carers. These videos instigate critical reflection and accelerate the participatory quality improvement process. Moreover, practical tools were developed to overcome barriers regarding the involvement of people with disabilities. These include the use of photo‐elicitation to enable participation of clients with disabilities in heterogeneous group discussions and involving experts‐by‐experience as proxies to share experiences of clients for whom participation in the ‘Ask us’ method remains inaccessible. Conclusion The result of a robust participatory process, ‘Ask us!’ is a promising method for participatory quality improvement in long‐term care. The research furthermore generated lessons for involving vulnerable populations in participatory research and codesign. Patient or Public Contribution Clients were involved as informants, sharing their experiences with the care relationship in interviews, photovoice and observations. They were also involved as consultants, helping to analyse input for the film scripts during data validation sessions.
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Affiliation(s)
- Marjolijn Heerings
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Hester van de Bovenkamp
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Mieke Cardol
- Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rotterdam, The Netherlands
| | - Roland Bal
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
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21
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Babb C, Jones CRG, Fox JRE. Investigating Service Users' Perspectives of Eating Disorder Services: A Meta-Synthesis. Clin Psychol Psychother 2022; 29:1276-1296. [PMID: 35141970 PMCID: PMC9546143 DOI: 10.1002/cpp.2723] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 02/03/2022] [Accepted: 02/04/2022] [Indexed: 12/05/2022]
Abstract
Objective Despite a number of qualitative studies published from the perspective of eating disorder (ED) service users, there has been no attempt to exclusively synthesize their views to gain a fuller understanding of their ED service experiences. It is important to understand this perspective, since previous research highlights the difficulties ED healthcare professionals report when working with this client group. Method A systematic search of the literature was conducted to identify qualitative studies focusing on experiences of ED services from the perspective of service users. Twenty‐two studies met the inclusion criteria and underwent a quality appraisal check using the Critical Appraisal Skills Programme (CASP) tool for qualitative research. These were then synthesized using a meta‐synthesis approach. Results Four overarching themes were generated: “Treatment: Focus on physical vs. psychological symptoms”; “Service Environment: The role of control within services”; “Staff: Experiences with staff and the value of rapport”; and “Peer Influence: Camaraderie vs. comparison.” Service users expressed a desire for more psychological input to tackle underlying difficulties relating to their ED. A complex relationship with feelings of control was described, with some feeling over‐controlled by service providers, while others retrospectively recognized the need for control to be taken away. Staff values, knowledge and trust played a significant role in treatment and recovery. Peers with an ED were described to be a valuable source of understanding and empathy, but some found peer influence to perpetuate comparison and competitiveness. Discussion The results portray some of the conflicts and complexities that service users encounter in ED services. A running thread throughout is the perceived importance of adopting an individualized approach within these services.
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Affiliation(s)
- Charli Babb
- School of Psychology, Cardiff University, UK
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22
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Dostálová V, Bártová A, Bláhová H, Holmerová I. The experiences and needs of frail older people receiving home health care: A qualitative study. Int J Older People Nurs 2022; 17:e12418. [PMID: 34418315 PMCID: PMC9285561 DOI: 10.1111/opn.12418] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Revised: 08/04/2021] [Accepted: 08/09/2021] [Indexed: 01/26/2023]
Abstract
BACKGROUND Due to the rapid ageing of the population, there is increasing demand for long-term care in the people's home environment. Such care aims to allow the people to stay at home and avoid hospitalisation or other institutional care. In home health care, care must be provided at the highest possible quality, with the focus on the people's needs and experiences. OBJECTIVES This study explores the experiences and needs of frail older people receiving home health care. DESIGN AND METHODS An exploratory descriptive qualitative approach was chosen. Audio-taped semi-structured interviews were conducted with fifteen older people receiving home health care. A content analysis was used to analyse the data collected. RESULTS The content analysis identified one main theme, three categories and seven subcategories related to frail older people's needs and experiences of home health care. The main theme was quality of care. The first category, Safe and Secure Care, consisted of three subcategories: Education and Experience of Nurses, Information, and Continuity of Care in terms of personnel continuity and regular care. The second category, Autonomy, contained two subcategories: Decision-making and Self-sufficiency. The last category, Relationship with Professionals, consisted of two subcategories: Personality of Nurse and Partnerships. CONCLUSION Older people are able to express their satisfaction or dissatisfaction with home health care. The results of this study revealed that the quality of care is crucial for frail older people. IMPLICATION FOR PRACTICE The provision of home health care is inherently highly specific; home care nurses should work to provide the highest possible quality of care. In particular, nurses should focus on ensuring that the care they provide is safe, effective, timely, efficient and person-centred.
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Affiliation(s)
- Vladimíra Dostálová
- Department of Longevity StudiesFaculty of HumanitiesCharles UniversityPragueCzech Republic
| | - Alžběta Bártová
- Department of Longevity StudiesFaculty of HumanitiesCharles UniversityPragueCzech Republic
| | - Hana Bláhová
- Department of Longevity StudiesFaculty of HumanitiesCharles UniversityPragueCzech Republic
| | - Iva Holmerová
- Department of Longevity StudiesFaculty of HumanitiesCharles UniversityPragueCzech Republic
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Allande-Cussó R, Fernández-García E, Porcel-Gálvez AM. Defining and characterising the nurse-patient relationship: A concept analysis. Nurs Ethics 2021; 29:462-484. [PMID: 34879785 DOI: 10.1177/09697330211046651] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
The nurse-patient relationship involves complex attitudes and behaviours with ethical and deontological implications. It has been linked to improvements in patient health outcomes, although there is still no consensus in the scientific literature as to the definition and characterisation of the concept. This article aim to define the concept of the nurse-patient relationship. A concept analysis was conducted using the Walker and Avant method to identify the attributes defining the nurse-patient relationship. An integrative review of the literature was conducted using the PubMed, Web of Science, Scopus, and Cumulative Index to Nursing & Allied Health Literature databases. A review of the grey literature and other minor non-indexed publications on the topic was also conducted. A total of 36 articles were included in the review. A model case, a contrary case, a related case, and empirical references were produced to clarify the concept and identify its essential attributes. The concept is defined as a helping relationship involving interaction between different players. It is the basis of nursing care and is intended to meet the healthcare needs of the individual receiving this care. It is also viewed as an intervention in itself, requiring a specific training process just like any other nursing skill. The essential attributes of the relationship are empathy, presence, contact, authenticity, trust, and reciprocity. In conclusion, the nurse-patient relationship is a helping relationship established with the patient and/or their family based on interaction, communication, respect for ethical values, acceptance, and empathy in order to encourage introspection and behavioural change. Key components include communication, active listening, and respect. Bioethical values and confidentiality must also be present to ensure that the relationship is built on equality and intimacy.
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24
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Gill Meeley N. Undergraduate student nurses' experiences of their community placements. NURSE EDUCATION TODAY 2021; 106:105054. [PMID: 34329964 DOI: 10.1016/j.nedt.2021.105054] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 06/14/2021] [Accepted: 07/05/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Community nursing placements play an increasingly important part in the undergraduate nursing students learning experience as a greater proportion of health care delivery is set to migrate to community care settings. Therefore, nursing education programmes and health services must ensure that student nurses are exposed to high quality community placements that provide suitable learning experiences for students to acquire the skills and knowledge required for the health service of the future. OBJECTIVES This qualitative evidence synthesis examines undergraduate nursing students' experiences of community nursing placements from 1996 to date. DESIGN Qualitative Evidence Synthesis, Thematic synthesis. DATA SOURCES CINHAL, EMBASE, ProQuest, Medline, Embase, Scopus, Psycinfo. REVIEW METHODS A systematic search across electronic databases was carried out to identify all available existing evidence relevant to the search question. Data was extracted and synthesised through thematic synthesis to identify and interpret emerging themes. RESULTS Six qualitative studies were included in the data, from these three themes were identified. The first of these highlighted the important influence of the community nursing teams and mentor on the students' placement experience. The second theme highlights the students' professional development as a result of their community placements and finally the third theme explores the students' perceptions of the essence of caring in the community. CONCLUSION The community provides valuable learning experiences of nursing from an alternative perspective, enhancing professional development and understanding of the nurse patient relationship. Mentorship and inclusion in teams are key factors that influence students' experiences and this working environment is useful for teaching about holistic care that is person and family centered. Role modeling is enhanced by the pace and proximity of the mentoring relationship.
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Rafii F, Nasrabadi AN, Tehrani FJ. The omission of some patterns of knowing in clinical care: A qualitative study. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2021; 26:508-514. [PMID: 34900649 PMCID: PMC8607894 DOI: 10.4103/ijnmr.ijnmr_75_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 10/14/2020] [Accepted: 07/17/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Providing holistic and humanistic care to patients requires a variety of factors. A care solely based on objective knowledge might be unsafe and of low quality. Using the patterns of knowing in an integrated manner and relative to the context of caring is one of the necessities for proving a holistic and efficient nursing care. This study aimed to explore the role of patterns of knowing in the formation of uncaring behaviors. MATERIALS AND METHODS The researchers used a qualitative research design for this study. Participants included 19 clinical nurses who attended semi-structured and in-depth interviews. In addition, theoretical and purposeful sampling methods were used in this research. Observation of caring processes in different hospital wards was another method used for collecting data. The data analysis was carried out according to conventional content analysis technique. RESULTS The study findings revealed five categories for the theme of "omission of some patterns of knowing" including omission of scientific principles, omission of therapeutic relationship, omission of ethics, omission of social justice, and omission of flexibility. CONCLUSIONS The omission of some patterns of knowing creates an ugly image of nursing and a negative outcome of caring as well.
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Affiliation(s)
- Forough Rafii
- Nursing Care Research Centre (NCRC), School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
| | - Alireza Nasrabadi Nasrabadi
- Department of Medical and Surgical, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Fereshteh Javaheri Tehrani
- Nursing Care Research Centre (NCRC), School of Nursing and Midwifery, Iran University of Medical Sciences, Tehran, Iran
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Heyn LG, Brembo EA, Eide H, Hafskjold L, Sundling V. Older persons' expressed worries during nursing care at home: Do health complexity and nature of nursing care in the visit matter? PATIENT EDUCATION AND COUNSELING 2021; 104:2418-2424. [PMID: 34294490 DOI: 10.1016/j.pec.2021.07.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 07/08/2021] [Accepted: 07/12/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Older persons receiving home care express more cues and concerns compared to other clinical contexts. Increased health condition complexity requires a corresponding increase in nursing competence. The aim of this study was to explore how complexity of older persons' health and nature of the visit influenced their expressed worries. METHODS In this cross-sectional explorative study, we analysed older persons' expressed worries (n = 508) identified by the Verona Coding Definitions of Emotional Sequences (VR-CoDES) in 129 audio-recorded home care visits with older persons (≥65 years), collected in 3 city districts and 1 rural area in Norway. RESULTS Expressed worries of 45 older persons were included in the analysis: 18 had low health complexity, 5 moderate and 22 high health complexity. The nature of the visit affected the number of expressed worries, health complexity did not. Most of the worries were expressed during basic nursing care visits and/or medication administration. CONCLUSION Findings suggest that home visit type may influence the older persons' expressed worries. The complexity of the older persons' health condition seems to have little impact on the expressed worries. PRACTICE IMPLICATIONS Knowledge about communication in different complexity of visits is important when planning care for older persons.
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Affiliation(s)
- Lena Günterberg Heyn
- Centre for Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway.
| | - Espen Andreas Brembo
- Centre for Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway.
| | - Hilde Eide
- Centre for Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway.
| | - Linda Hafskjold
- Faculty of Health and Social Sciences, Department of Optometry, Radiography and Lighting Design, University of South-Eastern Norway, Drammen, Norway.
| | - Vibeke Sundling
- Centre for Health and Technology, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway; National Centre for Optics, Vision and Eye Care, Faculty of Health and Social Sciences, Department of Optometry, Radiography and Lighting Design, University of South-Eastern Norway, Kongsberg, Norway.
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Mohd Mydin FH, Othman S, Choo WY, Mohd Hairi NN, Mohd Hairi F, Ali Z, Abdul Aziz S. Primary care nurses' challenges, opportunities, and facilitators of elder abuse intervention in Malaysia. Public Health Nurs 2021; 39:3-14. [PMID: 34386986 DOI: 10.1111/phn.12961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 08/02/2021] [Accepted: 08/03/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To explore the views of nurses on challenges, perceived roles and improvement strategies concerning elder abuse intervention in Malaysia. DESIGN AND SAMPLE Eleven focus group discussions were conducted using a semi-structured interview based on the socio-ecological framework. The data were analyzed using a multistep process of thematic analysis. RESULTS Three themes emerged from the data analysis: (1) The predicament: being unwilling or not able to intervene (2) Bridging the older people and health system gap (3) Getting to grips with the barriers. There are multifactorial contributors identified at the individual, interpersonal, organizational, community and policy levels in each theme. These factors interact across the levels to influence nurses' capability to intervene in elder abuse. CONCLUSION A framework is needed to articulate Malaysian nurses' role in elder abuse intervention in terms of personal and professional development through culturally sensitive education and the establishment of clinical guidelines in the primary care setting. Strengthening organizational support and the institution of national policy and permissive reporting laws of elder abuse will empower the primary care nurses to address elder abuse in primary care settings and communities.
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Affiliation(s)
- Fadzilah Hanum Mohd Mydin
- Department of Primary Care Medicine, University Malaya Primary Care Research Group, University of Malaya, Kuala Lumpur, Malaysia
| | - Sajaratulnisah Othman
- Department of Primary Care Medicine, University Malaya Primary Care Research Group, University of Malaya, Kuala Lumpur, Malaysia
| | - Wan Yuen Choo
- Department of Social Preventive Medicine, Centre for Evidence-Based Practice, University of Malaya, Kuala Lumpur, Malaysia
| | - Noran Naqiah Mohd Hairi
- Department of Social Preventive Medicine, Centre for Evidence-Based Practice, University of Malaya, Kuala Lumpur, Malaysia
| | - Farizah Mohd Hairi
- Department of Social Preventive Medicine, Centre for Evidence-Based Practice, University of Malaya, Kuala Lumpur, Malaysia
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Shen L, Fei X, Zhou Y, Wang J, Zhu Y, Zhuang Y. The effect of felt trust from patients among nurses on attitudes towards nursing service delivery. J Adv Nurs 2021; 78:404-413. [PMID: 34363632 DOI: 10.1111/jan.14973] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 05/13/2021] [Accepted: 06/27/2021] [Indexed: 11/29/2022]
Abstract
AIMS To examine how felt trust motivates nurses to desire to deliver better nursing services and how perspective taking makes nurses feel trusted by their patients. By introducing the concept of prosocial motivation into nursing research, this study further explored a boundary condition that influences the positive relationship between felt trust from patients and attitudes towards nursing service delivery. DESIGN This study used a cross-sectional and survey design. METHOD This study was conducted among 339 nurses on medical teams sent to support Hubei, China, during the COVID-19 pandemic in April 2020. RESULTS The results indicate that felt trust from patients mediated the positive relationship between perspective taking and attitudes towards nursing service delivery. In addition, prosocial motivation moderated the relationship between felt trust from patients and attitudes towards nursing service delivery, such that the relationship was stronger when prosocial motivation was high (vs. low). Prosocial motivation also moderated the indirect effects of perspective taking on attitudes towards nursing service delivery via felt trust from patients. CONCLUSION This study shows that despite the challenges posed by COVID-19, nurses who experience a high level of trust from patients are still eager to deliver high-quality nursing services, and this finding is especially salient among those with high prosocial motivation. IMPACT This study introduces felt trust from patients as a new motivational mechanism that can induce nurses' willingness to deliver better nursing services. We suggest that nurses and nurse leaders should be aware of the significance of the trust relationship between nurses and patients. Nurses need to be trained to take patients' perspectives in the interaction process, which can make them feel trusted by patients and can consequently be motivated to deliver better nursing services.
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Affiliation(s)
- Lihua Shen
- Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xuan Fei
- Huaiyin Normal University, Huaian, China.,Nottingham University Business School China, University of Nottingham Ningbo China, Ningbo, China
| | - Yan Zhou
- Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jie Wang
- Nottingham University Business School China, University of Nottingham Ningbo China, Ningbo, China
| | - Yue Zhu
- School of Business Administration, Zhejiang Gongshang University, Hangzhou, China
| | - Yiyu Zhuang
- Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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Heumann M, Röhnsch G, Hämel K. Primary healthcare nurses' involvement in patient and community participation in the context of chronic diseases: An integrative review. J Adv Nurs 2021; 78:26-47. [PMID: 34288041 DOI: 10.1111/jan.14955] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 05/23/2021] [Accepted: 06/15/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Primary healthcare nurses' potential to enable patient and community participation has been increasingly acknowledged. A conceptual understanding of their contributions within a broad range of participation processes is still lacking. AIMS The aims of this study were to develop a conceptual framework that provides information on the role of primary healthcare nurses in shaping participation processes with patients and communities in the context of chronic diseases and to identify conditions that enable or hinder the promotion of patient and community participation by nurses. DESIGN An integrative review was conducted. DATA SOURCES Twenty-three articles published from 2000 to 2019 were included in the analysis: 19 retrieved from PubMed and CHINAL and 4 added through other sources. REVIEW METHODS An inductive data analysis and quality appraisal of studies were conducted. RESULTS The analysis reveals four areas where nurses are involved in facilitating patient and community participation: (1) sharing understanding of health problems and needs, (2) developing resources and facilitating patient education for self-management, (3) raising patients' voices as an advocate in service development and (4) supporting individual and community networks. The conditions affecting nurses' engagement in fostering participation processes are as follows: (1) care priorities and overall workload, (2) nurses' attitudes towards participation and (3) users' acceptance of nurses as partners. CONCLUSIONS Future research can use the framework as a basis for empirical studies investigating nurses' involvement in pursuing patient and community participation. Interventions should focus less on indirect forms of participation, like patient education or advocacy, but should also focus on active forms of participation. Research is needed on nurses' involvement in community participation processes. IMPACT This framework can be used and adapted in future research on patient and community participation in primary healthcare. It describes areas of participation and the facilitators and barriers within the broad range of activities of primary healthcare nurses.
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Affiliation(s)
- Marcus Heumann
- Department of Health Services Research and Nursing Science, School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Gundula Röhnsch
- Department of Health Services Research and Nursing Science, School of Public Health, Bielefeld University, Bielefeld, Germany
| | - Kerstin Hämel
- Department of Health Services Research and Nursing Science, School of Public Health, Bielefeld University, Bielefeld, Germany
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Cockroft M, Laboy J, Mullen L, Hubbell SL. Nurse-Led Mobile Health Clinics: An Opportunity for Student Scholarship and Faculty Practice. J Nurs Educ 2021; 59:594-596. [PMID: 33002168 DOI: 10.3928/01484834-20200921-11] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 04/03/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND The benefits of nurse-led mobile clinics to the communities they serve have been adequately documented in the nursing and health literature. Nurse-led clinics are credited with a variety of positive outcomes from improving access to care to helping build healthier communities. However, the impact of nurse-led clinics on nursing education has not been as widely discussed. METHOD A nurse-led, mobile health clinic was established to serve individuals and families facing financial crisis and provide a practice site for students and faculty. RESULTS Students developed nursing skills, including leadership, cultural awareness, active listening, critical thinking, effective communication, and collaboration. In the first 4 years of operation, 30 students have been assigned to the mobile clinic and approximately 2,250 visitors received free health care. CONCLUSION These findings can inform the implementation of nursing curriculum or activities specifically designed for student involvement in nurse-led mobile health clinics and the development and advancement of nursing skills. [J Nurs Educ. 2020;59(10):594-596.].
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Feo R, Kumaran S, Conroy T, Heuzenroeder L, Kitson A. An evaluation of instruments measuring behavioural aspects of the nurse-patient relationship. Nurs Inq 2021; 29:e12425. [PMID: 34076309 DOI: 10.1111/nin.12425] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 04/27/2021] [Accepted: 04/28/2021] [Indexed: 12/24/2022]
Abstract
The Fundamentals of Care Framework is an evidence-based, theory-informed framework that conceptualises high-quality fundamental care. The Framework places the nurse-patient relationship at the centre of care provision and outlines the nurse behaviours required for relationship development. Numerous instruments exist to measure behavioural aspects of the nurse-patient relationship; however, the literature offers little guidance on which instruments are psychometrically sound and best measure the core relationship elements of the Fundamentals of Care Framework. This study evaluated the quality of nurse-patient relationship instruments by (1) assessing their content development and measurement properties (e.g. dimensionality, targeting, reliability, validity) and (2) mapping instrument content to the Framework's core relationship elements: trust, focus, anticipate, know, and evaluate. Twenty-seven instruments were evaluated. Findings demonstrated that patients and nurses were rarely involved in item development. Most instruments exhibited poor measurement properties, with only one instrument having complete information on all quality indicators. Instrument content focused primarily on nurses getting to know patients and earning their trust, with only 54, 18, and 1 item(s), respectively, measuring 'focus', 'anticipate' and 'evaluate'. Hence, there does not appear to be a robust instrument measuring behavioural aspects of nurse-patient relationships, nor one capturing the relationship elements of the Fundamentals of Care Framework.
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Affiliation(s)
- Rebecca Feo
- College of Nursing and Health Sciences, Flinders University, Bedford Park, SA, Australia.,Caring Futures Institute, Flinders University, Bedford Park, SA, Australia
| | - Sheela Kumaran
- College of Nursing and Health Sciences, Flinders University, Bedford Park, SA, Australia
| | - Tiffany Conroy
- College of Nursing and Health Sciences, Flinders University, Bedford Park, SA, Australia.,Caring Futures Institute, Flinders University, Bedford Park, SA, Australia
| | - Louise Heuzenroeder
- College of Nursing and Health Sciences, Flinders University, Bedford Park, SA, Australia
| | - Alison Kitson
- College of Nursing and Health Sciences, Flinders University, Bedford Park, SA, Australia.,Caring Futures Institute, Flinders University, Bedford Park, SA, Australia
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Solbakken R, Bondas T, Kasén A. Relationships influencing caring in first-line nursing leadership: A visual hermeneutic study. Scand J Caring Sci 2021; 36:957-968. [PMID: 33955011 DOI: 10.1111/scs.12992] [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: 09/30/2020] [Revised: 02/26/2021] [Accepted: 03/26/2021] [Indexed: 11/26/2022]
Abstract
AIM To explore and interpret relationships that influence caring in nursing leadership, in the context of Nordic municipal health care, from first-line nurse managers' perspectives. DESIGN AND METHOD We chose a visual hermeneutic design. A three-stage interpretation process outlined by Drew and Guillemin, based on Rose, was used to analyse drawings and the following reflective dialogue from three focus groups, with a purposive sample of 11 first-line nurse managers. The study was conducted from February to May 2018. RESULTS The findings demonstrated that first-line nurse managers struggled to balance their vision with administrative demands. Caring for patients implied caring for staff; however, they often felt as if they were drowning in contradictory demands. First-line nurse management could be a lonely position, where the first-line nurse managers longed for belonging based on increased self-awareness of their position within an organisation. Superiors' support enabled first-line nurse managers' in their primary aim of caring for patients. CONCLUSION First-line nurse managers showed deep roots to their identities as nurses. Caring for patients included caring for staff and was their main concern, despite demanding reforms and demographic changes affecting leadership. Superiors' support was important for FLNMs' self-confidence and independence in leadership, so the first-line nurse managers can enact their vision of the best possible patient care. This study adds knowledge of the significance of caring in nursing leadership and the caritative leadership theory. IMPACT In order to recognise FLNMs as vulnerable human beings and provide individual confirmation and support, a caring organisational culture is needed. FLNMs need knowledge based on caring and nursing sciences, administration and participation in formal leadership networks. These findings can serve as a foundation for developing educational programmes for nurse leaders at several organisational levels.
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Affiliation(s)
- Rita Solbakken
- Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway
| | - Terese Bondas
- Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Anne Kasén
- Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway
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Atashzadeh‐Shoorideh F, Monjazabi F, Fathollahzadeh E, Parastoo O. The obstacles to nurses being present with patients. Nurs Open 2021; 8:1115-1124. [PMID: 34482655 PMCID: PMC8046123 DOI: 10.1002/nop2.723] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 10/04/2020] [Accepted: 11/05/2020] [Indexed: 11/24/2022] Open
Abstract
AIM The aim of the present research was to investigate the obstacles, which prevent nurses being present with patients. BACKGROUND It is vital for nurses to be able to spend time with patients for an accurate assessment of patients' needs to take place and to allow patients to express their concerns. The factors, which prevent nurses spending time with patients, are still unclear. METHOD Data were collected using semi-structured interviews with thirty-five participants, including the nurses and physicians from educational hospitals of Tehran. The analysis was performed through the conventional content analysis. To achieve accuracy and trustworthiness of the data, the Lincoln and Guba criteria were used. RESULT The results of the study can be summarized as: "conflict between human considerations and bureaucratic structure," "failure to meet basic needs," "the personal and interpersonal aspects of caring" and "safety in caring context." CONCLUSION To ensure high-quality care, it is important to understand more fully the factors that prevent nurses spending time with patients. Interventions are needed to allow nurses to spend more time with the patients. IMPLICATION FOR NURSING MANAGEMENT Health service managers should consider that the intrinsic motivation of nurses is to care for patients. They can increase the presence of nurses at patients' bedside and improve care quality by creating an attractive working environment, appreciating nurses' values, paying attention to their opinions and establishing professional communication based on mutual respect.
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Affiliation(s)
- Foroozan Atashzadeh‐Shoorideh
- Department of Psychiatric Nursing and ManagementSchool of Nursing & MidwiferyShahid Beheshti University of Medical SciencesTehranIran
| | - Fatemeh Monjazabi
- Department of Medical‐Surgical NursingSchool of Nursing & MidwiferyShahid Beheshti University of Medical SciencesTehranIran
| | | | - Oujian Parastoo
- Department of Pediatric NursingSchool of Nursing & MidwiferyShahid Beheshti University of Medical SciencesTehranIran
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Weilenmann M, Händler-Schuster D, Petry H, Zanolari D, Schmid-Mohler G, Beckmann S. Patient Satisfaction With the Quality of Counseling Provided by Advanced Practice Nurses Specialized in Multiple Sclerosis: A Quantitative Analysis. J Neurosci Nurs 2021; 53:99-103. [PMID: 33605649 DOI: 10.1097/jnn.0000000000000578] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT BACKGROUND: The challenges in dealing with multiple sclerosis (MS) have increased considerably in recent years. In addition to neurologists, MS nurse specialists are key to the management of MS patients, but there is a lack of evidence regarding their quality of counseling. METHODS: The data collection took place between October 2018 and March 2019 in the outpatient clinic of a university hospital. The quality of counseling was assessed using the APN-BQ, an instrument that contains 19 items that can be assigned to 4 dimensions. Participants were asked to rate their satisfaction on a scale from 0 to 3. General satisfaction was assessed on a scale from 0 to 100. RESULTS: The participants (n = 110) rated the quality of counseling and their general satisfaction high. The mean (SD) of the structure quality dimension was 2.64 (0.44), and satisfaction with length and frequency of consultations (2.53 [0.63]) scored better than outcome quality (1.99 [0.62]) and process quality (2.13 [0.60]). CONCLUSION: Overall, there was a high rate of satisfaction with the quality of counseling. In addition to the length and frequency of consultations, MS patients particularly appreciated the availability and expertise of MS nurse specialists.
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Suikkala A, Koskinen S, Katajisto J, Leino-Kilpi H. Congruence between nursing students' and patients' views of student-patient relationships. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2021; 26:79-115. [PMID: 32436071 PMCID: PMC7900057 DOI: 10.1007/s10459-020-09972-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Accepted: 04/27/2020] [Indexed: 06/11/2023]
Abstract
The growing emphasis on learning with and from patients has shifted the focus from education and healthcare professionals to the student-patient relationship. The relationship between student and patient, with a supportive preceptor as a resource, can influence the progression and development of an authentic person-centred approach to care among students. The purpose of this study was to analyse the congruence between nursing students' and patients' views of their relationship during students' clinical placement. The study compared data from cross-sectional matched cohort pairs of nursing students (n = 187) and patients (n = 187) in Finland. The data were collected between March 2015 and May 2016 using corresponding questionnaires and procedures in both cases. Both students' and patients' views were moderately or weakly congruent in terms of facilitative relationship, characterised as a mutually enriching relationship for both students and patients through dialogue. Patients, however, tended to see the relationship significantly more often as mechanistic, focusing on students learning practical skills, compared to students who saw the relationship more often as facilitative. Patients' age and the reasons for care were the only background variables that predicted the congruence between students' and patients' views of their relationships. These findings suggest ways in which student-patient relationships can be made more meaningful in supporting learning in clinical education.
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Affiliation(s)
- Arja Suikkala
- Department of Nursing Science, University of Turku, Turku, Finland.
- Department of Nursing Science, University of Turku, FI-20014, Turku, Finland.
| | - Sanna Koskinen
- Department of Nursing Science, University of Turku, Turku, Finland
| | - Jouko Katajisto
- Department of Mathematics and Statistics, University of Turku, Turku, Finland
| | - Helena Leino-Kilpi
- Department of Nursing Science, University of Turku and Turku University Hospital, Turku, Finland
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Lemmers AL, van der Voort PHJ. Trust in Intensive Care Patients, Family, and Healthcare Professionals: The Development of a Conceptual Framework Followed by a Case Study. Healthcare (Basel) 2021; 9:208. [PMID: 33671940 PMCID: PMC7919028 DOI: 10.3390/healthcare9020208] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 02/04/2021] [Accepted: 02/10/2021] [Indexed: 11/17/2022] Open
Abstract
Intensive care patients experience anxiety, pain, uncertainty, and total dependency. In general, it is important to develop trust between the healthcare professionals (HCPs), patients, and their family. Trust building in the ICU setting is challenging because of the time sensitivity of decision making and the dependency of patients on health care professionals. The objectives of this study are the development of a trust framework and then to use this framework in a case study in the intensive care. In three steps we developed a comprehensive trust framework from the literature concerning trust. First, we identified the elements of trust. Second, we adapted and integrated the dimensions to six concepts to construct the trust framework. Third, these concepts are incorporated into a comprehensive trust framework. In a case study we explored the facilitators and barriers within this framework in eight semi-open interviews with healthcare professionals and eight patients or partners. Trust was first explored inductively and then deductively. We showed that HCPs, patients, and family have largely the same perspective regarding the facilitators of trust, in which communication emerged as the most important one. Other facilitators are maintaining an open feedback culture for HCPs and being aware of patients' physical and informational privacy. Patients want to be approached as an individual with individual needs. Dishonesty and differences in values and norms were the most important barriers. To contribute to a positive perception of health delivery and to avoid conflicts between HCP and patients or their family we formulated five practical recommendations.
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Affiliation(s)
- Anne Lotte Lemmers
- Department of Intensive Care, OLVG Hospital, P.O. Box 95500, 1090HM Amsterdam, The Netherlands;
| | - Peter H. J. van der Voort
- Department of Critical Care, University Medical Center Groningen, University of Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands
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Abstract
Delusional disorder is a difficult-to-treat clinical condition with health needs that are often undertreated. Although individuals with delusional disorder may be high functioning in daily life, they suffer from serious health complaints that may be sex-specific. The main aim of this narrative review is to address these sex-specific health needs and to find ways of integrating their management into service programs. Age is an important issue. Delusional disorder most often first occurs in middle to late adult life, a time that corresponds to menopause in women, and menopausal age correlates with increased development of both somatic and psychological health problems in women. It is associated with a rise in the prevalence of depression and a worsening of prior psychotic symptoms. Importantly, women with delusional disorder show low compliance rates with both psychiatric treatment and with medical/surgical referrals. Intervention at the patient, provider, and systems levels are needed to address these ongoing problems.
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Lindberg J, Bhatt R, Ferm A. Older people and rural eHealth: perceptions of caring relations and their effects on engagement in digital primary health care. Scand J Caring Sci 2021; 35:1322-1331. [PMID: 33448031 PMCID: PMC9290949 DOI: 10.1111/scs.12953] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 12/13/2020] [Indexed: 12/01/2022]
Abstract
Background The aim of this article is to describe older people’s perceptions of caring relations in the context of rural eHealth, as well as to explore how such relations can facilitate engagement in digital primary health care. There is an ongoing implementation of eHealth in Western health care, and rural areas and older people are specifically targeted. eHealth is said to be a solution to emergent problems and a technology that will facilitate people’s opportunities to achieve good and equal health. From this perspective, it is crucial that older people engage in eHealth services, but there are barriers for use, and care providers need to adapt to the preferences of older people. Methods Semi‐structured interviews with 19 individuals aged 61‐85 were conducted. The participants were using digital services at two primary healthcare centres located in northern Sweden. Qualitative content analysis was used. An important theoretical tenet was that older people’s perceptions of and engagements in eHealth are affected by the specific rural conditions. Ethical approval for the study has been obtained. Results The analysis rendered a total of three themes: in‐person interaction was central to people’s perceptions of good caring relations; patient–nurse relations were particularly emphasised; and caring relations in rural eHealth appeared to be multi‐directional and fuelled by a shared sense of rural community. Altogether, this facilitated participants’ engagement in local eHealth initiatives. Conclusions eHealth is an opportunity for primary health care and for rural communities. However, the results provide insight into matters that can affect the quality, access, and equality of rural primary health care. Participants’ engagement in eHealth was almost always facilitated by close caring relations with local Registered Nurses. Digital care needs to be approached as a combination of digital and in‐person presence. Separating digital and physical task assignments among different personnel could make older people refrain from seeking health care.
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Affiliation(s)
- Jens Lindberg
- Department of Social Work, Umeå University, Umeå, Sweden.,Centre for Demography and Ageing Research (CEDAR), Umeå University, Umeå, Sweden.,Vitalities Lab, Centre for Social Research in Health, University of New South Wales, Sydney, NSW, Australia
| | - Robert Bhatt
- Department of Nursing, Umeå University, Umeå, Sweden
| | - Anton Ferm
- Department of Nursing, Umeå University, Umeå, Sweden
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Luca CE, Cavicchioli A, Bianchi M. Nurses Who Assume the Role of Advocate for Older Hospitalized Patients: A Qualitative Study. SAGE Open Nurs 2021; 7:23779608211030651. [PMID: 34377782 PMCID: PMC8323413 DOI: 10.1177/23779608211030651] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 06/12/2021] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Patient advocacy, acting on behalf of patients' unmet needs, is fundamental to nursing, and the perception of the need for advocacy motivated this study. Nurses experience moral discomfort, which results from a divergent view regarding medical or caregivers' decisions about patients' clinical proceedings, in which patients' involvement in making those decisions is either doubtful or absent. OBJECTIVES The aim of this study is to assess the need for advocacy and explore the perspectives of nurses engaged in the care of older patients. METHODS The methodological orientation is that of a qualitative design, by using a purposive and criterion sampling. The sample was of 14 nurses of a ward of general medicine. Focus group as collecting data tool was used, followed by a thematic analysis. RESULTS Nurses demonstrated a high level of moral sensitivity to ethical problems in clinical practice and on occasions, the courage to bring the problem to the physicians or patients' family's attention, or help patients develop self-determination. However, it is difficult to advocate because of insufficient communication between professionals, insufficient knowledge of ethics, and the emotional burden it places on nurses which results in emotional resignation in the face of interprofessional teams' lack of consideration of nurses' opinions. CONCLUSION This research highlighted nurses' need for advocacy to promote patients' rights, wishes, and values. It is essential for nurses to be aware of their level of moral sensitivity and develop a strategy to regain courage to engage in advocacy. Therefore, ethics education and interprofessional ethical leadership is desired, which inspires healthcare professionals' work and allows the foundations of an ethical decisionmaking process to be laid through patients and their families' active involvement.
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Affiliation(s)
- Corina Elena Luca
- Ente Ospedaliero Cantonale, Ospedale Regionale di Lugano,
Lugano, Switzerland
| | - Andrea Cavicchioli
- Department of Business Economics, Health and Social Care, University of Applied Sciences and
Arts of Southern Switzerland, University of Applied Sciences and Arts of Southern
Switzerland, Manno, Switzerland
| | - Monica Bianchi
- Department of Business Economics, Health and Social Care, University of Applied Sciences and
Arts of Southern Switzerland, University of Applied Sciences and Arts of Southern
Switzerland, Manno, Switzerland
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Akgün M, Kavradim ST, Boz İ, Özer Z. Development and psychometric properties of the Caring Behaviors Assessment Tool Nursing Version-Short Form. Int J Qual Health Care 2020; 32:701-707. [PMID: 33057712 DOI: 10.1093/intqhc/mzaa134] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 08/06/2020] [Accepted: 10/09/2020] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES To develop and examine the psychometric properties of the Caring Behaviors Assessment Tool Nursing Version-Short Form (CBAN-SF) based on the Theory of Human Caring to assess the nurses' perceptions about caring behaviors. DESIGN This study is based on the Consensus-based Standards for the Selection of Health Measurement Instruments checklist. SETTING The study was conducted at the medical-surgical services of Akdeniz University Hospital between October 2019 and January 2020. PARTICIPANTS This study was conducted with 216 nurses working in the surgery and internal clinics. MAIN OUTCOME MEASURES Psychometric properties of the Turkish version of the CBAN-SF with 27 items. RESULTS It was found that the Content Validity Index (CVI) for the items of the draft scale was between 0.972 and 1.00 and the instrument's CVI had an average score of 0.994. The CBAN-SF had good fit indexes (chi-square goodness of fit / degrees of freedom = 2.914, root mean square error of approximation = 0.075, comparative fit index = 0.984, non-normed fit index = 0.983, normed fit index = 0.972 and standardized root mean square residuals = 0.054) in structural validity. For internal consistency, the Cronbach's alpha, Spearman-Brown and the Guttman split-half coefficients were all 0.974. The Cronbach's alpha coefficient for the seven subfactors of the scale ranged between 0.793 and 0.904 and had acceptable internal consistency. The item-total score correlation of the scale was 0.648-0.829, and the factor loadings were 0.455-0.769. CONCLUSION The structural validity, internal consistency and content validity of the CBAN-SF supported to be a reliable and valid tool for assessment of caring behaviors by nurses.
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Affiliation(s)
- Mehtap Akgün
- Akdeniz University, Nursing Faculty, Antalya, Turkey
| | | | - İlkay Boz
- Akdeniz University, Nursing Faculty, Antalya, Turkey
| | - Zeynep Özer
- Akdeniz University, Nursing Faculty, Antalya, Turkey
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Lundberg K, Jong M, Jong MC, Porskrog Kristiansen L. Patients' experiences of the caring encounter in health promotion practice: a qualitative study in Swedish primary health care. BMC FAMILY PRACTICE 2020; 21:232. [PMID: 33176696 PMCID: PMC7661190 DOI: 10.1186/s12875-020-01296-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 10/25/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND Previous studies have reported that organizational structures and cultures in primary health care are obstacles to district nurses doing successful work in health promotion practice (HPP). Because organizational structures are not easily changed, Jean Watson's Attending Nurse Caring Model (ANCM) was introduced and piloted at a primary health care center in Sweden, aiming to transform HPP so as to empower district nurses and increase their work satisfaction. AIM To investigate patients' experiences of the caring encounter in HPP after introduction of the ANCM in Swedish primary health care, the aim being to explore the essential components of the caring encounter between patients and district nurses. METHODS A descriptive and qualitative research design was used. Data collection was performed using individual face-to-face interviews with twelve patients at risk for developing CVD. Data analysis consisted of both deductive content analysis, using a categorization matrix based on the ANCM and, subsequently, inductive latent content analysis. RESULTS The findings were abstracted into three themes: 1.'Feeling the deepest essence of being cared for': to be respected and being put at the center of the encounter; 2. 'Feeling acceptance and worth': being treated with openness and permissive attitudes, 3. 'Being in a supportive atmosphere that promotes hope': to feel trust and being trusted in the encounter, and being empowered by hope. The unifying main theme of the caring encounter was abstracted as 'Experiencing human dignity'. CONCLUSION The present study revealed that the essence of the caring encounter between patients and district nurses in HPP is to be unconditionally accepted in an environment that inspires hope and encouragement. The ANCM seems to be a promising model to use for strengthening the caring encounter and supporting CVD patients in making healthy lifestyle choices. However, further studies of qualitative and quantitative designs are needed to investigate what the ANCM can contribute to HPP in Swedish primary health care.
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Affiliation(s)
- Kristina Lundberg
- Department of Caring Sciences, University of Gävle, Faculty of Health and Occupational Studies, Kungsbäcksvägen 47, SE-801 76, Gävle, Sweden.
| | - Mats Jong
- Department of Health Sciences, Mid Sweden University, Holmgatan 10, SE-851 70, Sundsvall, Sweden
| | - Miek C Jong
- Department of Health Sciences, Mid Sweden University, Holmgatan 10, SE-851 70, Sundsvall, Sweden
- National Research Center in Complementary and Alternative Medicine (NAFKAM), Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Hansine Hansens veg 19, 9019, Tromsø, Norway
| | - Lisbeth Porskrog Kristiansen
- Department of Caring Sciences, University of Gävle, Faculty of Health and Occupational Studies, Kungsbäcksvägen 47, SE-801 76, Gävle, Sweden
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Allande Cussó R, Siles González J, Ayuso Murillo D, Gómez Salgado J. A new conceptualization of the nurse-patient relationship construct as caring interaction. Nurs Philos 2020; 22:e12335. [PMID: 33090718 DOI: 10.1111/nup.12335] [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: 05/14/2020] [Revised: 10/01/2020] [Accepted: 10/01/2020] [Indexed: 11/30/2022]
Abstract
The journey through the history of nursing, and its philosophical and political influences of the moment, contextualizes the interest that arose about the nurse-patient relationship after World War II. The concept has always been defined as a relationship but, from a phenomenological approach based on a historical, philosophical, psychological and sociological cosmology, it is possible to re-conceptualize it as 'caring interaction'. Under the vision of aesthetics and sociopoetics, the object of nursing care is the most delicate, vulnerable and unrepeatable raw material: the person, whose feelings and reciprocity, which must be considered. In addition, it involves the adoption of the socio-critical paradigm, as it considers the importance of actively involving the person, not just patient anymore, or their family in the nursing cares, optimizing the reciprocity inherent to this interactivity. In short, our philosophical and epistemological approach to the concept of nurse-patient relationship proposes a new conceptualization of it as a caring interaction.
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Affiliation(s)
- Regina Allande Cussó
- Department of Nursing, Faculty of Nursing, Physiotherapy, and Podiatry of the University of Seville, Sevilla, Spain
| | - José Siles González
- Department of Nursing, Faculty of Health Sciences, University of Alicante, Alicante, Spain
| | | | - Juan Gómez Salgado
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, Huelva, Spain.,Safety and Health Postgraduate Program, Universidad de Especialidades Espíritu Santo, Guayaquil, Ecuador
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Fernández-Basanta S, Coronado C, Bondas T, Movilla-Fernández MJ. Primary healthcare midwives' experiences of caring for parents who have suffered an involuntary pregnancy loss: a phenomenological hermeneutic study. Midwifery 2020; 92:102863. [PMID: 33130341 DOI: 10.1016/j.midw.2020.102863] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 08/20/2020] [Accepted: 10/13/2020] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To illuminate the experiences of primary healthcare midwives who care for parents who have suffered an involuntary pregnancy loss. DESIGN The phenomenological hermeneutic approach developed by Lindseth and Norberg was used to carry out narrative interviews. SETTING AND PARTICIPANTS A purposive sample of 11 public primary healthcare midwives from a municipality in northern Spain, was selected. The participants' ages ranged between 26 and 62 years, and they were all women. FINDINGS Four main themes were identified: (1) handling adversity, (2) finding a motive to get involved, (3) providing care from the rear, and (4) avoiding emotional connections with the parents. For the midwives, caring for parents who had suffered an involuntary pregnancy loss meant leaving their own comfort zone and handling adversity. They described acting in different ways such as going beyond task-focused care, following their intuition or avoiding encounters with the parents. CONCLUSIONS More knowledge and preparation in terms of communication skills and bereavement is crucial for midwives in order to meet the needs of parents who have suffered an involuntary pregnancy loss. A caring organizational culture and supportive leadership will facilitate care continuity between specialized and primary healthcare and promote the welfare of midwives.
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Affiliation(s)
- Sara Fernández-Basanta
- Research group GRINCAR, Department of Health Sciences, Faculty of Nursing and Podiatry, University of A Coruña, Naturalista López Seoane s/n, 15471 Ferrol, Spain.
| | - Carmen Coronado
- Associate professor. Research group GRINCAR, Department of Health Sciences, Faculty of Nursing and Podiatry, University of A Coruña, Naturalista López Seoane s/n, 15471 Ferrol, Spain..
| | - Terese Bondas
- Professor (Full) and Leader of 'Childbearing - the Qualitative Research Network'. Faculty of Health Sciences, University of Stavanger, PO Box 8600, Forus, Stavanger, Norway..
| | - María-Jesús Movilla-Fernández
- Associate professor. Research group GRINCAR, Department of Health Sciences, Faculty of Nursing and Podiatry, University of A Coruña, Naturalista López Seoane s/n, 15471 Ferrol, Spain..
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Topping M, Douglas JM, Winkler D. Factors that influence the quality of paid support for adults with acquired neurological disability: scoping review and thematic synthesis. Disabil Rehabil 2020; 44:2482-2499. [PMID: 33049158 DOI: 10.1080/09638288.2020.1830190] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE Theoretically, individualised funding schemes empower people with disability (PWD) to choose high quality support services in line with their needs and preferences. Given the importance of support, the aim of this scoping review was to understand the factors that influence the quality of paid disability support for adults with acquired neurological disability. METHODS A comprehensive scoping review of the published literature from 2009-2019 was conducted on five databases: Medline, CINAHL, Embase, PsycINFO and Scopus. RESULTS Of the 3391 records retrieved, 16 qualitative articles were eligible for review. Thematic synthesis of the findings revealed six key interrelated themes: (1) choice and control, (2) individualised support, (3) disability support worker (DSW) qualities, (4) DSW competence, (5) PWD - DSW relationship, and (6) accessing consistent support. The themes depict factors influencing the quality of paid disability support from the perspective of PWD, close others and DSWs. CONCLUSIONS Although the evidence base is sparse, the factors identified were in line with international rights legislation and policy ideals. The findings can provide insights to PWD hiring and managing support, and facilitate the delivery of quality disability support. Further research is required to understand the interactions between the factors and how to optimise support in practice.Implications for rehabilitationThe quality of paid disability support is determined by a multitude of interrelated factors influenced by the disability support worker's qualities and competencies, the interaction between the person with disability and the disability support worker, as well as external contextual factors.Optimising choice and control for adults with acquired neurological disability and providing individualised support should be a significant focus for disability support workers.Training modules for disability support workers can be informed by five of the identified themes: (1) choice and control, (2) individualised support, (3) DSW qualities, (4) DSW competence and (5) the relationship between PWD and DSWs.
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Affiliation(s)
- Megan Topping
- Living with Disability Research Centre, La Trobe University, Bundoora, Australia.,Summer Foundation Ltd, Blackburn, Australia
| | - Jacinta M Douglas
- Living with Disability Research Centre, La Trobe University, Bundoora, Australia.,Summer Foundation Ltd, Blackburn, Australia
| | - Dianne Winkler
- Living with Disability Research Centre, La Trobe University, Bundoora, Australia.,Summer Foundation Ltd, Blackburn, Australia
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45
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Sim IO. Capabilities that experienced nurses expect of new nurses in pediatric wards: A research study using Q methodology. NURSE EDUCATION TODAY 2020; 92:104511. [PMID: 32599473 DOI: 10.1016/j.nedt.2020.104511] [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: 10/18/2019] [Revised: 04/09/2020] [Accepted: 06/17/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND To meet the expected levels of nursing care in pediatric wards, it is necessary to identify and strengthen the skills, job satisfaction levels, and personality characteristics required of nurses. OBJECTIVES This study aimed to identify the types of capabilities experienced nurses expect of new nurses in order to perform professional nursing in pediatric wards. DESIGN Q methodology was used to explore the subjective perceptions of experienced nurses regarding new nurses. SETTING The research was conducted in the pediatric wards of university hospitals. PARTICIPANTS A convenience sample of 31 experienced nurses was recruited for the P-set from the pediatric wards of university hospitals. METHODS Data were collected from the 31 participants from August to December 2019. RESULTS Based on the study results, the abilities experienced nurses expect new nurses to possess were grouped into three categories: 1) "honesty and effort type," 2) "problem-solving type," and 3) "relationship-oriented type." CONCLUSIONS This study provides basic data for constructing a program that is advantageous for clinical practice and for the education of pediatric nurses. The results also suggest that increasing the effectiveness of collaboration, understanding, and communication between newly graduated and experienced nurses may improve the level of professional care provided in pediatric wards.
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Affiliation(s)
- In Ok Sim
- Red Cross College of Nursing, Chung-Ang University, Seoul, South Korea.
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46
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Suikkala A, Leino-Kilpi H, Katajisto J, Koskinen S. Nursing student-patient relationship and related factors-A self-assessment by nursing students. J Clin Nurs 2020; 29:4030-4044. [PMID: 32696592 DOI: 10.1111/jocn.15426] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 06/13/2020] [Accepted: 07/10/2020] [Indexed: 12/01/2022]
Abstract
AIMS AND OBJECTIVES To describe the nursing student-patient relationship in terms of three types of relationships-mechanistic, authoritative and facilitative-and analyse the factors related to the type of relationship. BACKGROUND As future professionals, nursing students have a central role in facilitating patient autonomy while working in partnership with patients. Supporting student-patient relationship throughout the nursing education may result in positive outcomes for both students and patients. DESIGN A cross-sectional study. METHODS The data were collected from a convenience sample of Finnish nursing students using a structured web survey. Statistical data analysis was performed using chi-square test, two-sample t test, one-way analysis of variance and multinomial logistic regression. The STROBE Statement - Checklist for cross-sectional studies was used (Appendix S1). RESULTS Students most often assessed their relationship with the patients as facilitative, followed by authoritative and mechanistic relationships. The results revealed three predictors for facilitative relationship: students' older age, long enough contact time with the patient and higher competence in ensuring quality. In authoritative and facilitative relationships, students had significantly more positive perceptions of the contextual factors and consequences of the relationship and higher ratings of self-assessed competence levels than students in a mechanistic relationship. CONCLUSIONS It seems that the facilitative student-patient relationship is connected to the professional competence of nursing students, especially in the area of ensuring the quality of patient care. Therefore, sustaining clinical learning environments and pedagogical approaches that value and support facilitative relationships in students' clinical learning should be enhanced. RELEVANCE TO CLINICAL PRACTICE Efforts aimed at contributing to facilitative student-patient relationships have a crucial role in shaping students' competency and in promoting high-quality patient care. Thus, supervision of students organised around establishing mutual student-patient relationships with the preceptors acting as facilitators will benefit both students and patients.
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Affiliation(s)
- Arja Suikkala
- Department of Nursing Science, University of Turku, Turku, Finland.,Diaconia University of Applied Sciences, Helsinki, Finland
| | - Helena Leino-Kilpi
- Department of Nursing Science, University of Turku, Turku, Finland.,Turku University Hospital, Turku, Finland
| | - Jouko Katajisto
- Department of Mathematics and Statistics, University of Turku, Turku, Finland
| | - Sanna Koskinen
- Department of Nursing Science, University of Turku, Turku, Finland
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Guven Ozdemir N, Sendir M. The relationship between nurses' empathic tendencies, empathic skills, and individualized care perceptions. Perspect Psychiatr Care 2020; 56:732-737. [PMID: 32072651 DOI: 10.1111/ppc.12489] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 02/04/2020] [Accepted: 02/08/2020] [Indexed: 11/28/2022] Open
Abstract
PURPOSE The study aims to determine the relationship between nurses' empathic tendencies, empathic skills, and individualized care perceptions. DESIGN AND METHODS This study employed a descriptive and correlational design. Data were collected from nurses in eight training and research hospitals in Turkey. The study sample consisted of 472 nurses who were both volunteered to participate and randomly selected. FINDINGS A definite high-level relation was determined between nurses' empathic tendencies and individualized care perceptions, but no relation was determined between nurses' empathic skills and individualized care perceptions. PRACTICE IMPLICATIONS This study can underline practices accounting for empathy and individualized care in nursing research and training programs.
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Affiliation(s)
- Nur Guven Ozdemir
- Department of Fundamentals of Nursing, Zonguldak Bülent Ecevit University, Zonguldak, Turkey
| | - Merdiye Sendir
- Department of Fundamentals of Nursing, University of Health Sciences, Istanbul, Turkey
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Yue P, Xu T, Greene B, Wang Y, Wang R, Dai G, Xu L. Caring in community nursing practice: Inductive content analysis reveals an inter-dynamic system between patients and nurses. J Clin Nurs 2020; 29:3025-3041. [PMID: 32353918 DOI: 10.1111/jocn.15312] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 03/15/2020] [Accepted: 04/12/2020] [Indexed: 12/16/2022]
Abstract
AIMS AND OBJECTIVES To examine the understanding of caring in the practice of community nursing from the perspectives of patients and nurses. BACKGROUND An increasing population of patients with chronic disease has produced a need for humanistic caring in communities. As a result, caring has become a core value of community nursing professionals. However, community nurses meet many difficulties in trying to practice person-centred care with their clients. Furthermore, most community nurses-especially in China-lack systematic education and training about caring because the practical meaning of caring in community practice is unknown. DESIGN The qualitative study described herein employed inductive content analysis. METHODS Eleven community patients with chronic disease and fifteen community nurses who were nominated as a caring nurse from different community clinics in Beijing, China, participated in thirty-one interviews during January to August in 2018. Nine documents from the interviewed nurses were collected. Both interview data and documents were analysed using strategies of inductive content analysis. The COREQ checklist was used. RESULTS Patients and their corresponding nurses described a wide range of caring experiences that were generalised into 28 concepts. Caring emerged as an inter-dynamic system that comprised the foundation and quality of a caring relationship, the caring philosophy and behaviours of interactions, and positive feedback from caring interactions. A relationship-based framework of caring in community nursing practice was constructed. CONCLUSIONS Identifying this systematic concept of caring provides insights that are applicable to the creation of targeted management, education and practice interventions to ultimately enhance the quality of community health care-in China or elsewhere. RELEVANCE TO CLINICAL PRACTICE The systematic understanding of caring in community nursing practice will inform nurses in community health clinics, their educators and their managers on how to provide care to community patients and how to develop caring competence for community nurses.
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Affiliation(s)
- Peng Yue
- School of Nursing, Capital Medical University, Beijing, China
| | - Tianmeng Xu
- School of Nursing, Capital Medical University, Beijing, China
| | - Brian Greene
- School of Nursing, University of Pittsburgh, Pittsburgh, PA, USA
| | - Yongli Wang
- Yuetan Community Health Service Center, Fuxing Hospital, Capital Medical University, Beijing, China
| | - Rongjin Wang
- School of Nursing, Capital Medical University, Beijing, China
| | - Guizhi Dai
- Yongdingmenwai Community Health Service Center, Dongcheng District, Beijing, China
| | - Lijie Xu
- School of Nursing, Capital Medical University, Beijing, China
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Hupkens S, Goumans M, Derkx P, Machielse A. Nurse's attunement to patient's meaning in life - a qualitative study of experiences of Dutch adults ageing in place. BMC Nurs 2020; 19:41. [PMID: 32477004 PMCID: PMC7236336 DOI: 10.1186/s12912-020-00431-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 05/03/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Meaning in life (MiL) is considered to be an important part of health and is associated with many positive outcomes in older adults, such as quality of life and longevity. As health promotors, nurses may take patients' MiL into account in the care process. There is a knowledge gap in terms of what constitutes good care in relation to older patients' MiL, and what the benefits may be for patients when nursing is attuned to this aspect. The purpose of this study was to explore the experiences of home nursing older adults in relation to nurses' attunement to MiL. METHODS Gadamerian hermeneutic phenomenological design with semi-structured interviews. Participants were 24 aged home nursing patients. A framework of care ethical evaluation was used in the analysis. Multiple dialogues enhanced understanding. RESULTS Patients did not expect nurses' regard for their MiL. They rather expected 'normal contact' and adequate physical care. Nurses showed that they were open to patients' MiL by being interested in the patient as a person and by being attentive to specific and hidden needs. Participants explained that the nurse's behaviour upon arrival set the tone: they knew immediately if there was room for MiL or not. All participants had positive and negative experiences with nurses' behaviour in relation to MiL. Valued nursing care included maintaining a long, kind and reciprocal relationship; doing what was needed; and skilled personalised care. Participants mentioned 'special ones': nurses who attuned to them in a special way and did more than expected. Benefits of care that was attuned to patients' MiL were: experiencing a cheerful moment, feeling secure, feeling like a valuable person and having a good day. Older adults also stressed that consideration for MiL helps identify what is important in healthcare. CONCLUSION Aged homecare patients value nurses' attunement to their MiL positively. Although patients regard MiL mostly as their own quest, nurses play a modest yet important role. Managers and educators should support nurses' investment in reciprocal nurse-patient relationships.
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Affiliation(s)
- Susan Hupkens
- Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rochussenstraat 198, 3015 EK Rotterdam, The Netherlands
| | - Marleen Goumans
- Research Centre Innovations in Care, Rotterdam University of Applied Sciences, Rochussenstraat 198, 3015 EK Rotterdam, The Netherlands
| | - Peter Derkx
- University of Humanistic Studies, Utrecht, the Netherlands
| | - Anja Machielse
- University of Humanistic Studies, Utrecht, the Netherlands
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50
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Strudwick RM. Ethnographic research in healthcare - patients and service users as participants. Disabil Rehabil 2020; 43:3271-3275. [PMID: 32202439 DOI: 10.1080/09638288.2020.1741695] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Purpose: This discussion paper provides an introduction and overview of Ethnography as a qualitative research methodology and outlines its usefulness in understanding the experiences of patients and service users during their healthcare journey. Ethnographic research provides an insight into the group being studied. In this paper that author suggests that ethnography can provide an insight into the behaviours, thoughts and feelings of a patient group.Methods: Research methods used in ethnographic research have been outlined and discussed along with some of the possible methodological and ethical issues that might occur when carrying out an ethnographic study with a group of patients.Results: This paper discusses some of the potential results of an ethnographic study with patients and how ethnographic research can be used to study the experiences of patients.Conclusion: the author draws together some lessons that can be learnt and some possible applications of ethnographic research in healthcare settings with patients. Implications for rehabilitation are also proposed.IMPLICATIONS FOR REHABILITATIONEthnography is a simple and effective qualitative research methodology for studying groups of people with a common enterprise or experience, ethnography studies the culture, behaviours and norms of the group.Ethnography is a useful research methodology to understand the experiences of patients and service users during their healthcare journey. It can provide information about what it is like to have a particular medical condition or diagnosis and the norms and behaviours of patients with this condition. Ethnographic data allows the patient's voice to be heard. Data from ethnographic studies of patient groups can be used for service improvement within health and social care.
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Affiliation(s)
- Ruth M Strudwick
- School of Health and Sports Sciences, University of Suffolk, Ipswich, UK
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