What the curtains do not shield: A phenomenological exploration of patient-witnessed resuscitation in hospital. Part 1: patients' experiences

How Do Nurses Experience Relational Work in the Emergency Department-Qualitative Study

INTRODUCTION

This study aimed to explore how nurses experience relational work in the emergency department.

METHODS

A qualitative design with 34 focus group interviews using an abductive thematic analysis were completed for this study. Participants were recruited from an annual mandatory continuous learning program in 2020-2022 at 2 university hospitals in the Capital Region of Denmark. We applied semistructured interviews in an instructor-supported reflection session on the topic "relational nursing care." Group discussion was supported by an interview guide addressing key elements of the nurse-patient relationship as described in the fundamentals of care framework.

RESULTS

Acute care nurses' attention was primarily directed toward the initial patient assessment, rather than toward the later stages of the patient trajectory. Forming a relationship with the patient was highly individual and done at the discretion of each nurse. The key elements of relational nursing were not mutually exclusive, but the findings could be separated into biomedical and relational care, where biomedical tasks took precedence.

DISCUSSION

Relational care in the emergency department is optional and individually performed. Moreover, emergency nurses lack a vocabulary to express this type of work. Consequently, there is a risk that patients' psychosocial needs are not sufficiently met. According to the emergency nurses participating in this study, nurses fall short when performing and describing relational care. Nurses need more knowledge to address the psychosocial patient needs during short-term hospital admissions. Relational care and patient centeredness also need to be acknowledged by nursing leaders and further developed.

Exploring depression, comorbidities and quality of life in geriatric patients: a study utilizing the geriatric depression scale and WHOQOL-OLD questionnaire

BACKGROUND

The increasing prevalence of depression among older adults is a growing concern. Chronic health conditions, cognitive impairments, and hospitalizations amplify emotional distress and depression levels in this population. Assessing the quality of life is crucial for the well-being of older adults.

AIMS

Our study aimed to examine how comorbidities affect depression and quality of life in geriatric patients in both outpatient and hospital settings.

METHODS

100 patients (50 from internal medicine outpatient clinic and 50 from internal medicine ward) were included in the study according to inclusion and exclusion criteria. Patients were classified into different age groups (65-74 years, 75-84 years and ≥ 85 years). Data on patients' location of application, age, sex, living alone or with family status, number of comorbid diseases, types of accompanying diseases were recorded and WHOQOL-OLD and Geriatric Depression Scale (GDS) questionnaires were administered. Results were evaluated using SPSS.

RESULTS

The WHOQOL-OLD questionnaire score was higher in the 65-74 age group compared to other groups, but there was no significant difference between outpatient group and hospitalized group. Patients with comorbid diseases had lower WHOQOL-OLD questionnaire scores compared to those without comorbid diseases. In the 75-84 and ≥ 85 age groups, the GDS scores were higher compared to the 65-74 age group. In hospitalized group, GDS scores were higher than outpatient clinic group. In patients with comorbid diseases, GDS scores were higher than the ones without comorbid diseases.

DISCUSSION

Our findings indicate that quality of life is higher among those aged 65-74, with lower incidence of depression compared to other age groups. Hospitalization correlates with higher depression rates but not quality of life. As number of comorbid diseases increases in older adults, the frequency of depression rises and the quality of life declines.

CONCLUSIONS

Early detection and intervention for depression are crucial for enhancing older adults' well-being.

What the curtains do not shield: A phenomenological exploration of patient-witnessed resuscitation in hospital. Part 2: Healthcare professionals' experiences

AIMS

To explore healthcare professionals' experiences of patient-witnessed resuscitation in hospital.

DESIGN

Descriptive phenomenology.

METHODS

Healthcare professionals involved in hospital resuscitation activities were recruited from medical, intensive care, resuscitation and education departments in a university hospital in England. Data were collected through face-to-face and focus group interviews, between August 2018 and January 2019. Data were analysed using Giorgi's phenomenological approach.

RESULTS

Nine registered nurses, four healthcare assistants and seven doctors participated in four individual interviews and three focus groups. Findings were related to three themes: (1) Protecting patients from witnessing resuscitation: healthcare professionals used curtains to shield patients during resuscitation, but this was ineffective. Thus, they experienced challenges in explaining resuscitation events to the other patients and communicating sensitively. (2) Emotional impact of resuscitation: healthcare professionals recognized that witnessing resuscitation impacted patients, but they also felt emotionally affected from performing resuscitation and needed coping strategies and support. (3) Supporting patients who witnessed resuscitation: healthcare professionals recognized the importance of patients' well-being, but they felt unable to provide effective and timely support while providing life-saving care.

CONCLUSION

Healthcare professionals involved in hospital resuscitation require specific support, guidance and education to care effectively for patients witnessing resuscitation. Improving communication, implementing regular debriefing for staff, and allocating a dedicated professional to support patients witnessing resuscitation must be addressed to improve clinical practice.

IMPACT

The WATCH study uncovers patients' and healthcare professionals' experiences of patient-witnessed resuscitation, a phenomenon still overlooked in nursing research and practice. The main findings highlight that, in common with patients, healthcare professionals are subject to the emotional impact of resuscitation events and encounter challenges in supporting patients who witness resuscitation. Embedding the recommendations from this research into clinical guidelines will impact the clinical practice of healthcare professionals involved in hospital resuscitation and the quality and timeliness of care delivered to patients.