Facilitating a dedicated focus on the human dimensions of care in practice settings: Development of a new humanised care assessment tool (HCAT) to sensitise care

Development and preliminary evaluation of a novel participant-led video intervention to train disability support workers

This paper describes the development and preliminary evaluation of a novel participant-led video (PLV) intervention to support people with disability (PWD) and cognitive and communication impairments to communicate their needs and preferences to their disability support workers. The PLV intervention was designed following a scoping literature review and workshop with PWD and close others. Subsequently, it was piloted with five primary participants with acquired brain injury and cognitive and communication impairments, five close other supporters and five facilitators. An independent mixed methods evaluation of the pilot was conducted with participants, close others and facilitators. All pilot evaluation participants reported high levels of satisfaction with the PLV intervention (mean ratings: primary participants 4.5/5.0; supporters 5.0/5.0; facilitators 4.8/5.0). When primary participants and their supporters were asked to rate how likely they were to recommend the PLV intervention, responses were extremely positive with the mean rating exceeding eight on a 10-point scale. Qualitative analysis of interview data revealed the PLV to be a person-centred experience for primary participants that was structured around sense of self and included having a voice and taking control in directing their lives, personal growth through participation and feeling validated through the experience. The production and use of PLV training resources has much potential to improve the delivery of support and maximise support outcomes by enabling people with cognitive and communication impairments to have choice and control, set their own goals and direct their supports. Further research is required with a larger sample size and longitudinal evaluation of participant outcomes.

Human Caring: A Concept Analysis

Introduction: Human caring combines science, art, and humanity. Humanity is the heart of care and interpersonal interactions. Despite the critical emphasis on human caring and concern for nursing care without humanity, there is no clear definition for human caring in nursing. This study aimed to analyze the concept of human caring. Methods: Walker and Avant’s strategy for concept analysis was used. Electronic databases such as PubMed, Scopus, Ovid, Google Scholar, Magiran, Iran Doc, SID, and a number of dictionaries were searched without any limitation in date. Search keywords were "care", "caring", "human caring", "humanization", "patient care", "comprehensive care" and "nursing care". We searched all documents published before September 2020. In the initial search, 1637 articles were found but finally, 39 relevant articles remained in the study. Results: The nine defining attributes of human caring were establishing therapeutic communication, presence at the patient bedside, empathy, providing scientific care, subjectivity, dynamicity, respecting the patient’s rights and ethics of care, helping the patient achieve a feeling of well-being, and art and creativity. Antecedents of human caring were categorized into three categories namely, human, personal, and organizational factors. The consequences were also categorized into consequences related to nurse, profession, patient, and organization. Conclusion: A theoretical definition and a conceptual model of human caring were developed. This concept should be included in the nursing curricula at all undergraduate and graduate levels and even in nurses’ in-service training programs.

Reflections on the Centenary of Sir William Osler: Science and Humanity are One, for Nursing and Medicine

Sir William Osler (1849-1991) was Regius Professor of Medicine at the University of Oxford in the UK and a founding professor at Johns Hopkins Hospital. The centenary of Osler’s death is a time for recognition in nursing, as well as medicine, of a pioneering and highly influential Oxford physician on both sides of the Atlantic, an influence that extended to nursing from the UK to the USA.

This letter captures reflections and discussion on contemporary nursing issues from an Osler Seminar Series, held at the University of Oxford in 2019 to mark the Centenary of Sir William Osler’s death, focusing on his thinking and influence related to nursing.

This extended letter illuminates issues on themes of science and humanity within a clinical and educational context, exploring a range of key contemporary nursing issues. These include the significance of interpersonal relations as they relate to care attitude and care technology; the therapeutic influence of the nurse; nursing education and clinical-academic development; the value of a life world perspective on nursing and wellbeing; and practice development within the context of person-centred workplace cultures. These issues are contextualised with examples from practice and include some from nursing developments and those illustrated in part by the clinical speciality of dermatological care.

The letter concludes by considering the significance of the nursing service to promoting access to quality health care in the twenty-first century and its relevance to recognising the nursing contribution to universal health care through the WHO International Year(s) of the Nurse and Midwife in 2020-21.

A lifeworld theory-led action research process for humanizing services: improving "what matters" to older people to enhance humanly sensitive care

Purpose: Using a theory-led action research process test applicability of humanizing care theory to better understand what matters to people and assess how the process can improve human dimensions of health care services. Consideration of the value of this process to guide enhancements in humanly sensitive care and investigate transferable benefits of the participatory strategy for improving human dimensions of health care services.

Methods: Action research with service users, practitioners and academics, with participatory processes led through the application of theory via a novel Humanizing Care Framework in two diverse clinical settings.

Results: Participants engaged in a theory-led participatory process, understood and valued the framework seeing how it relates to own experiences. Comparative analysis of settings identified transferable processes with potential to enhance human dimensions of care more generally. We offer transferable strategy with contextualized practical details of humanizing processes and outcomes that can contribute to portable pathways to enhance dignity in care through application of humanizing care theory in practice.

Conclusion: The theoretical framework is a feasible and effective guide to enhance human dimensions of care. Our rigorous participative process facilitates sharing of patient and staff experience, sensitizing practitioners’ understandings and helping develop new ways of providing theoretically robust person-centred care based on lifeworld approaches.

The Impact of Relational and Organizational-Environmental Aspects in Hospital Blood Collection: Clinical and Health Indications and New Training Needs

This study deals with people who underwent a blood test and consequently suffered a fainting episode in the past. This phenomenon affects many people and if not adequately dealt with, it can lead to a perception of the blood test as a serious and traumatic event, which could limit its use as a preventive diagnostic tool. These experiences have been explored by research mainly on the basis of the physiological mechanisms involved in fainting, with a few studies considering the actual lived experience related to the blood test. This study explored how this experience is lived and managed, capturing aspects that could facilitate blood tests and the procedures associated with them, thus it focused on people with vasovagal syncope and was articulated through the semi-structured interview methodology. Among the significant results is the importance of the relational aspects implemented by health staff, the differing organisation of the blood test procedure, the need to make the hospital environment less aseptic and more humanistic, effective actions to counter the anxieties relating to the administration of the blood test and the importance of including the blood test with an inter-disciplinarity perspective.

'Everyone's so kind and jolly it boosts my spirits, if you know what I mean': A humanising perspective on exercise programme participation

BACKGROUND

Maintaining a physically active lifestyle across the life course can add to an individual's health and well-being. Many people are insufficiently active to achieve these gains with a trend towards further decreases in activity as people age. Community-based group exercise programmes have been shown to be one means of increasing sustained activity levels for older people.

AIM

To understand how and why older people sustain participation to community-based group exercise programmes from a humanising perspective.

METHODS

A multiple-case study approach was employed to study three exercise programmes in the South-West of England. Data were collected through participant observation, focus groups and documentation. Data were analysed with deductive thematic analysis and mapped against the humanisation framework.

RESULTS

Findings suggest that the humanising nature of these particular exercise programmes supported sustained participation. In these programmes, agency was evidenced in the way participants self-selected their level of exertion with exercises. There was freedom to be their unique selves and exercise within the limits of their insider challenges of an ageing body. Through this non-judgemental exercise environment, there was an embodied understanding of who they were as people. The exercise programme became part of their personal journey. This journey helped inform their future by enabling them to keep active and maintain independence, allowing them to continue engaging in the world. There was a sense of togetherness and belonging which led to feelings of homeliness as they found a sense of place within the group. The friendships they formed helped them make sense and add meaning to their experiences and personal health challenges.

CONCLUSIONS

When planning exercise environments to support the long-term adoption of a sustained behaviour change, in the form of physical activity for older people, it is helpful to consider dimensions that make an individual feel human.

Why We Have to Develop Instruments of Our Caring Measurement Based on an Indonesian Perspective

Introduction: Caring is the core or focus in nursing as a form of professional nursing practice. The current caring instrument is an original instrument that measures the attitudes or behavior of nurses, has not paid attention to the administrative and environmental aspects of the hospital. The use of an instrument that does not yet contain certain characteristics gives rise to improper measurement results. The purpose of this study was to explain the importance of developing caring measurement instruments with an Indonesian perspective.Methods: Systematic reviews were carried out from database articles on ScienceDirect, Scopus, Google Scholar, SpringerLink, Wiley online, Proquest, and EBSCOhost. Criteria for articles were articles published in the last 10 years, national and international research locations, and in Indonesian and English. 15 references were obtained from 2100 references that met the predetermined criteria. The development of a caring behavior instrument based on an Indonesian perspective does not yet exist.Results: The results found that development on the basis of linguistics, cultural adjustment, and according to the prevalence of disease in a country because the epidemiology of the disease differs on the climate region.Conclusion: Specific caring instruments in an Indonesian perspective is expected that the research results will be more accurate. 

Preliminary development of proxy-rated quality-of-life scales for children and adults with Niemann-Pick type C

OBJECTIVES

Niemann-Pick disease type C (NPC) is a rare life-limiting disease for which there is no cure. No scales currently exist to measure the impact of medication, physical therapy or clinical trials. The aim of this study was to develop age-appropriate Quality-of-Life (QoL) scales to measure the impact of NPC on children and adults.

DESIGN

Scale development study using a phenomenological approach to data generation and analysis.

METHODS

Fourteen interviews were conducted with people living with NPC and/or their parents/carers. Themes were generated and examined against an existential-phenomenological theory of wellbeing. A matrix was constructed to represent the phenomenological insight gained on participants' subjective experiences and a bank of items that were related to their QoL was developed.

RESULTS

NPC quality-of-life questionnaires for children (NPCQLQ-C) and adults (NPCQLQ-A) proxy prototype scales were produced and completed by 23 parents/carers of children (child age mean = 8.61 years) and 20 parents/carers of adults (adult age = 33.4 years). Reliability analysis resulted in a 15-item NPCQLQ-C and a 30-item NPCQLQ-A, which showed excellent internal consistency, Cronbach's α = 0.925 and 0.947, respectively.

CONCLUSION

The NPCQLQ-C and NPCQLQ-A are the first disease-specific QoL scales to be developed for people living with NPC. This novel approach to scale development values the experiential, real life impact of living with NPC and focused on the lived-experiences and impact on QoL. The scales will enable healthcare professionals and researchers to have a better understanding and quantifiable measurement of the impact of living with NPC on a patient's daily life.