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Wathne H, May C, Morken IM, Storm M, Husebø AML. Acceptability and usability of a nurse-assisted remote patient monitoring intervention for the post-hospital follow-up of patients with long-term illness: A qualitative study. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2024; 7:100229. [PMID: 39166216 PMCID: PMC11334779 DOI: 10.1016/j.ijnsa.2024.100229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 07/22/2024] [Accepted: 07/26/2024] [Indexed: 08/22/2024] Open
Abstract
Background Patients living with long-term chronic illnesses often need ongoing medical attention, lifestyle adjustments, and psychosocial support beyond the initial diagnosis and treatment phases. Many experience illness deterioration and subsequently require hospitalisation, especially in the transition period after hospital discharge. A promising strategy for managing long-term conditions is promoting self-management. eHealth interventions involving remote patient monitoring have the potential to promote self-management and offer a more seamless bridge between the hospital and the patient´s home environment. However, such interventions can only significantly impact health and health care if they are effective, accepted and adopted by users, normalised into routine practice and everyday life, and able to be widely implemented. Feasibility studies are used to determine whether an intervention is suitable for the target population and effective in achieving its intended goal. They may also provide critical information about an intervention´s acceptability and usability. Objectives We aimed to evaluate the acceptability and usability of a nurse-assisted remote patient monitoring intervention for the post-hospital follow-up of patients with long-term illnesses by use of the core constructs of normalisation process theory. Design A descriptive and explanatory qualitative approach was used, with patients observed during training and semi-structured interviews conducted with patients and nurses after study completion. Settings Participants were recruited from two university hospitals in Norway between December 2021 and February 2023. Participants Ten patients were observed during training, and 27 patients and eight nurses were interviewed after study completion. Methods Structured and overt observations were made while the patients received training to operate the remote patient monitoring service, guided by an observation guide. Semi-structured interviews were conducted with patients and nurse navigators about their experiences of remote follow-up care, guided by open ended questions. Data analysis followed a stepwise deductive inductive method. Results `Achieving acceptance and usability through digital social interaction´ emerged as a unifying theme that bridged the experiences of patients with long-term illnesses and the nurse navigators. This overarching theme was illustrated by four sub-themes, which all reflected the usability and acceptability of the nurse-assisted remote patient monitoring service in various ways. Conclusion Acceptability and usability are critical factors to consider when evaluating remote patient monitoring interventions. In this study, the most important feature for promoting acceptability and usability was the interaction between patients and nurse navigators. Therefore, the intervention´s feasibility and implementation potential rested upon the relationship between its deliverer and receiver.
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Affiliation(s)
- Hege Wathne
- Department of Public Health, University of Stavanger, Faculty of Health Science, Stavanger, Norway
| | - Carl May
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Ingvild Margreta Morken
- Department of Quality and Health Technologies, University of Stavanger, Faculty of Health Science, Stavanger, Norway
- Research Group for Health and Nursing Sciences, Stavanger University Hospital, Stavanger, Norway
| | - Marianne Storm
- Department of Public Health, University of Stavanger, Faculty of Health Science, Stavanger, Norway
- Research Group for Health and Nursing Sciences, Stavanger University Hospital, Stavanger, Norway
- Faculty of Health Sciences and Social Care, Molde University College, Molde, Norway
| | - Anne Marie Lunde Husebø
- Department of Public Health, University of Stavanger, Faculty of Health Science, Stavanger, Norway
- Research Group for Health and Nursing Sciences, Stavanger University Hospital, Stavanger, Norway
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Lee J, Boyd J, Khalil H. A scoping review of the educator role performed by Health Information Managers in health workplace-based education: The practitioner Health Information Manager-educator. HEALTH INF MANAG J 2024:18333583241263989. [PMID: 39148323 DOI: 10.1177/18333583241263989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/17/2024]
Abstract
BACKGROUND Health Information Managers (HIMs) play a crucial role in the management and governance of health information ensuring the accuracy, confidentiality and accessibility of health data for clinical care and business operational purposes. This role also extends to education and training in the workplace. OBJECTIVE The aim of this scoping review was to explore and elucidate the role played by HIMs when they undertake a health workplace-based (healthcare organisation or service) educational role and/or functions as evidenced in the existing body of literature. METHOD A scoping review of the literature to investigated the importance of the educator role for HIM health workplace-based educators. A three-step search strategy was designed to ensure a comprehensive exploration of relevant research. RESULTS Of 63 articles assess for eligibility, 14 were included in the final analysis. All included articles acknowledged the importance of the HIM-educator workplace-based role. Half of the included articles had been published within the last 7 years. Only 8 of the 14 articles provided some description of HIM-educator attributes, suggesting that these characteristics remain unexplored. DISCUSSION Findings from this scoping review have shed light on the limitations within the current available literature concerning the attributes of HIM health workplace-based educators. The findings also highlight an important gap in knowledge concerning the qualities of these HIM-educators. CONCLUSION This identified gap in the literature signals a need for further exploration and investigation into the specific attributes, skills, and characteristics that define effective HIM-educators undertaking a health workplace-based educational role.
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Affiliation(s)
- Jenn Lee
- La Trobe University, Public Health, Melbourne, VIC, Australia
| | - James Boyd
- La Trobe University, Public Health, Melbourne, VIC, Australia
| | - Hanan Khalil
- La Trobe University, Public Health, Melbourne, VIC, Australia
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Shakya NR, Emén A, Webb G, Myezwa H, Karmacharya BM, Stensdotter AK. Barriers and facilitators for strengthening physiotherapy services in Nepal: perspectives from physiotherapists and health providers. BMC Health Serv Res 2024; 24:876. [PMID: 39090613 PMCID: PMC11295310 DOI: 10.1186/s12913-024-11272-w] [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: 04/15/2024] [Accepted: 07/02/2024] [Indexed: 08/04/2024] Open
Abstract
BACKGROUND Physiotherapy provides non-invasive and non-pharmaceutical intervention for curative, rehabilitation and preventative purposes. Physiotherapy is also a central provider of health promotion. As the global burden of non-communicable diseases and chronic health conditions is rising, the importance of physiotherapy services increases. Unfortunately, physiotherapy services in low- and middle-income countries (LMICs) are generally unsatisfactory. In Nepal, the earthquake in 2015 and the COVID pandemic have clearly illuminated the importance of physiotherapy. OBJECTIVE This qualitative study aimed to identify barriers and facilitators at different system levels for strengthening physiotherapy services in Nepal. METHODS Forty semi-structured individual interviews were performed with different health providers. Transcribed interviews were assessed with thematic analysis. A five-level socioecological framework conceptualised multilevel determinants of barriers and facilitators. RESULTS The study revealed various factors that were potential barriers and facilitators across five different levels, namely individual (taking the lead, need for advocacy), interpersonal (lack of recognition and autonomy, networking for referrals and coordination), community (lack of knowledge and awareness, social and family support), organisational (accessibility, workplace and clinical practice, educational opportunities, role of organisations and rehabilitation centres), and public policy level (planning and implementation of policies and programs, medical hegemony, priorities). Government officials, local leaders, and clinicians, half of whom were physiotherapists, agreed on many of the same issues, where a lack of awareness of what physiotherapy is and knowledge about what physiotherapists do was central. CONCLUSIONS The results provide information for the development of physiotherapy by pointing out key elements that need attention. Our broad and structured investigation strategy is applicable to others for a comprehensive analysis of barriers and facilitators for physiotherapy services.
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Affiliation(s)
- Nishchal Ratna Shakya
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, 7491, Norway.
- Department of Physiotherapy, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal.
| | - Amanda Emén
- Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Gillian Webb
- Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Australia
| | - Hellen Myezwa
- School of Therapeutic Sciences, University of the Witwatersrand, Johannesburg-Braamfontein, Gauteng, South Africa
| | - Biraj Man Karmacharya
- Department of Public Health, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - Ann-Katrin Stensdotter
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, 7491, Norway
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Santamaría-García JM, González-Aguña A, Fernández-Batalla M, Herrero-Jaén S, Jiménez-Rodríguez ML, González-Sotos LA. Deductive Care Methodology: Describing and testing modes of care research. ENFERMERIA CLINICA (ENGLISH EDITION) 2024; 34:194-206. [PMID: 38614457 DOI: 10.1016/j.enfcle.2024.04.001] [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: 08/30/2023] [Accepted: 10/19/2023] [Indexed: 04/15/2024]
Abstract
OBJECTIVE Define the modes of procedure of the Deductive Care Methodology (DCM) in the generation of knowledge about person's health care. METHODOLOGY Design and test of the DCM modes based on three phases: mapping of the DCM, generation of models from this methodology and testing of the models through studies in a clinical context. RESULTS The DCM presents five levels of abstraction with three modes broken down to 16 types. The modes are: Philosophical Mode to conceptualize and obtain generalities about reality, Mathematical Mode to operate with generalities, and Physical Mode to operationally verify, validating the results and the predictive capacity of the model. This MDC allows the creation of three models: Knowledge Model about Person Care, an ontology of care, Vulnerability Model about the person and Taxonomic Triangulation Model for knowledge management. All models generate products for computational knowledge management. In addition, the models are applied in teaching and generate research with more than a hundred participations in conferences and journals, of which five impact publications (from 2008 to 2022) classified in the categories of Nursing and Informatics are analysed. CONCLUSIONS The DCM collects prior knowledge to work with certainties, evidence and applying inferences that do not depend on the number of cases or inductive designs. This research presents a formal structure of the DCM with an interdisciplinary orientation between Health Sciences and Computer Sciences.
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Affiliation(s)
- José María Santamaría-García
- MISKC Research Group, Computational Science Department, University of Alcala, Polytechnic Building, University Campus, Carretera de Barcelona km. 33.6, 28805 Madrid, Spain; Meco Healthcare Centre, Madrid Healthcare Service (SERMAS), 28880 Madrid, Spain
| | - Alexandra González-Aguña
- MISKC Research Group, Computational Science Department, University of Alcala, Polytechnic Building, University Campus, Carretera de Barcelona km. 33.6, 28805 Madrid, Spain; Intensive Care Unit, Henares University Hospital, Foundation for Biomedical Research and Innovation (FIIB HUIS HHEN), Madrid Healthcare Service (SERMAS), 28822 Madrid, Spain.
| | - Marta Fernández-Batalla
- MISKC Research Group, Computational Science Department, University of Alcala, Polytechnic Building, University Campus, Carretera de Barcelona km. 33.6, 28805 Madrid, Spain
| | - Sara Herrero-Jaén
- MISKC Research Group, Computational Science Department, University of Alcala, Polytechnic Building, University Campus, Carretera de Barcelona km. 33.6, 28805 Madrid, Spain; Mejorada del Campo Healthcare Centre, Madrid Healthcare Service (SERMAS), 28840 Madrid, Spain
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Lin CC, Han CY, Chen LC, Huang YL, Hwang SL. Undergraduate nurses' reflections on visual thinking learning to construct inductive reasoning through situated patient pictures: A mixed-method study. NURSE EDUCATION TODAY 2023; 131:105991. [PMID: 37865014 DOI: 10.1016/j.nedt.2023.105991] [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: 05/16/2023] [Revised: 08/21/2023] [Accepted: 10/15/2023] [Indexed: 10/23/2023]
Abstract
BACKGROUND/OBJECTIVE Deductive logic has often been used to develop critical thinking. However, inductive logical thinking, essential to care decision-making, has yet to be emphasized. This study aimed to explore visual thinking learning among undergraduate nursing students by asking them to draw situated patient pictures in order to integrate theoretical knowledge and promote inductive logical thinking. METHODS A mixed-methods research design was used to obtain quantitative and qualitative data from a convenience sample of 100 students. The study was conducted in a Taiwanese university from September 2022 to January 2023. In the quantitative component, learners' views of situated patient pictures were captured based on 15 paired identifiers and two questions: (a) What word should be used in describing the situated patient's picture? (b) How strongly do you feel about the selection? Written feedback was analyzed using qualitative content analysis. RESULTS Quantitative analysis identified specific, unpretentious, humorous, harmonious, conservative, realistic, rational, entire, image performance, professional performance, understandable, expressive, static performance, rigorous, and profuse with a reasonable degree of choice. Qualitative analysis identified four stages in participants' development of inductive reasoning through situated patient pictures and visual thinking learning. These were: exploration, intuition, theme, and logic and creation. CONCLUSIONS The results suggest that visual thinking learning is a practical pedagogical approach to increasing learners' communication abilities, group cooperation, theoretical knowledge integration, and logical thinking. Neither educators nor learners required any artistic skills. Nonetheless, participants demonstrated creativity and innovation through continuous visual thinking learning.
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Affiliation(s)
- Chun-Chih Lin
- Department of Nursing, Chang Gung University of Science and Technology, 2, West Sec. Jiapu Rd., Pu-tz City 613, Chiayi County, Taiwan; Research Fellow (joint appointment), New Taipei Municipal TuCheng Hospital, Built and Operated by Chang Gung Medical Foundation, 6, Sec., 2, Jincheng Rd., Tucheng Dist., New Taipei City 263, Taiwan.
| | - Chin-Yen Han
- Department of Nursing, Chang Gung University of Science and Technology, Linkou Campus, 261, Wenhua 1st Rd., Guishan Dist., Taoyuan City 33303, Taiwan; Research Fellow (joint appointment), New Taipei Municipal TuCheng Hospital, Built and Operated by Chang Gung Medical Foundation, 6, Sec., 2, Jincheng Rd., Tucheng Dist., New Taipei City 263, Taiwan.
| | - Li-Chin Chen
- Department of Nursing, New Taipei Municipal TuCheng Hospital, Built and Operated by Chang Gung Medical Foundation, No. 6, Sec. 2, Jincheng Rd., Tucheng Dist., New Taipei City 236, Taiwan.
| | - Ya-Ling Huang
- Faculty of Health (Nursing), Southern Cross University, Gold Coast Campus B7.47, Locked Mail Bag 4, Coolangatta (Southern Cross University), QLD 4225, Australia; Department of Emergency Medicine, Gold Coast Hospital and Health Service, Gold Coast University Hospital, Gold Coast Campus B7.47, Locked Mail Bag 4, Coolangatta (Southern Cross University), QLD 4225, Australia.
| | - Su-Lun Hwang
- Department of Nursing, Chang Gung University of Science and Technology, 2, West Sec. Jiapu Rd., Pu-tz City 613, Chiayi County, Taiwan; Associate Research Fellow (joint appointment), Chronic Diseases and Health Promotion Research Center, Chang Gung University of Science and Technology, 2, West Sec. Jiapu Rd., Pu-tz City 613, Chiayi County, Taiwan; Associate Research Fellow (joint appointment), Division of Thoracic Oncology, ChiaYi Chang Gung Memorial Hospital, Chang Gung Medical Foundation, 2, West Sec. Jiapu Rd., Pu-tz City 613, Chiayi County, Taiwan.
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Barrett D, Younas A. Induction, deduction and abduction. Evid Based Nurs 2023:ebnurs-2023-103873. [PMID: 37949635 DOI: 10.1136/ebnurs-2023-103873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Affiliation(s)
- David Barrett
- Department of Health Sciences, University of York, York, UK
| | - Ahtisham Younas
- Memorial University of Newfoundland, St. John's, Newfoundland, Canada
- Swat College of Nursing, Pakistan
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Bergdahl E, Berterö CM. Creating theory: Encouragement for using creativity and deduction in qualitative nursing research. Nurs Philos 2023; 24:e12421. [PMID: 36846926 DOI: 10.1111/nup.12421] [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: 10/18/2020] [Revised: 09/28/2022] [Accepted: 02/06/2023] [Indexed: 03/01/2023]
Abstract
Texts about theory in nursing often refer to theory construction by using inductive methods in a rigid way. In this paper, it is instead argued that theories are created, which is in line with most philosophers of science. Theory creation is regarded as a creative process that does not follow a specific method or logic. As in any creative endeavour, the inspiration for theory creation can come from many sources, including previous research and existing theory. The main idea put forward is that deductive qualitative research approaches should play a key role in theory creation. Furthermore, there is a need to differentiate between theory creation and theory justification. A model that emphasizes the creative aspects of theory creation and theory justification using qualitative approaches is presented. The model suggests that knowledge development is a deductive trial-and-error process where theory creation is followed by testing. Scientific theory creation and justification are presented as an iterative process that is deductive in that a testable hypothesis is derived from the theory. If the hypothesis is falsified, then the theory needs modification or might be altogether wrong. Several factors can block the creative process, both in theory development and in finding ways to test a theory in the justification phase. Some of these blockers are the idea of 'building blocks' and the inductive view of science often brought forward in nursing. Other blockers include striving for consensus and adherence to existing nursing philosophies and existing theories. Research and knowledge development are creative processes, and following predefined methods is not enough to ensure scientific rigour in qualitative nursing research.
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Affiliation(s)
| | - Carina M Berterö
- Division of Nursing Science, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
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Palese A, Chiappinotto S, Bayram A, Sermeus W, Suhonen R, Papastavrou E. Exploring unfinished nursing care among nursing students: a discussion paper. BMC Nurs 2023; 22:272. [PMID: 37596561 PMCID: PMC10436392 DOI: 10.1186/s12912-023-01445-z] [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: 05/10/2023] [Accepted: 08/10/2023] [Indexed: 08/20/2023] Open
Abstract
BACKGROUND In line with the impetus traceable among the nursing staff, studies regarding the perception of Unfinished Care among students have increased in recent years as also recommended by some policy documents in the consideration that, as future members of the staff, they are expected to raise concerns about failures in the standards of care. However, no discussion of their methodological requirements has been provided to date. The aim of this study is to debate Unfinished Care explorations among nursing students and developing recommendations. METHODS A Rapid Review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, followed by a scientific discussion based on empirical evidence that emerged from the review combined with expert knowledge. Medline, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Scopus databases were searched up to May 2022. RESULTS In the last five years, seven studies have been conducted by researchers affiliated at the university level, involving from 18 to 737 undergraduate students across Europe. By critically analysing their key aspects, there are derived some recommendations in conducting investigations in this field as, (a) the hidden meaning of Unfinished Care investigations among students by also deciding which concept is mostly appropriate to investigate; (b) the need of establishing alliances with the clinical settings in order to involve them in such explorations; (c) more complex research methods capable of exploring this issue among students by promoting learning outcomes and not only a simple data collection; and (e) the influences of these explorations on students' wellbeing, as well as on ethical implications and that regarding the relationship between the healthcare services and the universities. CONCLUSION Policymakers consider students to be key informants of the quality of nursing care issues witnessed during their clinical placements. The related emerging line of research is intriguing because of the underlying methodological, ethical and system complexities that need to be addressed according to some considerations.
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Affiliation(s)
- Alvisa Palese
- Department of Medical Science, University of Udine, Udine, Italy.
| | | | - Aysun Bayram
- Faculty of Health Sciences, Karadeniz Technical University, Trabzon, Turkey
| | - Walter Sermeus
- Leuven Institute for Healthcare Policy, University of Leuven, Leuven, Belgium
| | - Riitta Suhonen
- Department of Nursing Science, University of Turku and Turku University Hospital, Turku, Finland
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Persson HÅ, Ahlström G, Ekwall A. Professionals´ readiness for change to knowledge-based palliative care at nursing homes: a qualitative follow-up study after an educational intervention. BMC Palliat Care 2022; 21:132. [PMID: 35854375 PMCID: PMC9412037 DOI: 10.1186/s12904-022-01018-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 07/08/2022] [Indexed: 11/10/2022] Open
Abstract
Background There has been a global increase in the number of people who are dying of old age. This development implies a need for good palliative care among older persons at the end of life. Here nursing homes have an important role to play. However, the principles of palliative care have not been sufficiently applied in nursing homes, and there is a need to increase the implementation of palliative care in these settings. Therefore the project named Implementation of Knowledge-Based Palliative Care in Nursing Homes (the KUPA project, to use its Swedish acronym) was started as a contribution to filling this knowledge gap. The aim of the present study was to investigate the professionals’ experiences of readiness for change to knowledge-based palliative care at nursing homes after the educational intervention within the KUPA project. Methods The focus group method was used to interview 39 health-care professionals with the aid of semistructured questions based on the Organizational Readiness for Change theoretical framework. Six focus groups were formed at six nursing homes in two counties in southern Sweden. The groups included different types of professionals: assistant nurses, nurses, occupational therapists, physiotherapists and social workers. The analysis was conducted with an abductive approach and included deductive and inductive content analysis. Results The analysis revealed one overarching theme: hopeful readiness for change in palliative care despite remaining barriers. The main categories were increased knowledge facilitating development, enhanced team spirit, uncertainty about future plans connected with hopeful readiness and remaining organizational barriers. Conclusions This study adds knowledge and understanding concerning professionals’ readiness for change palliative care in nursing homes and shows how ready nursing home settings undertake these changes in practice. The Organizational Readiness for Change theory proved suitable for application in nursing homes to assess the professionals’ experiences and to evaluate educational interventions regardless of the organization’s readiness for change. Trial registration ClinicalTrials NCT02708498, first registration 15/03/2016.
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Affiliation(s)
- Helene Åvik Persson
- Department of Health Sciences, Faculty of Medicine, Lund University, Box 157, 221 00, Lund, SE, Sweden.
| | - Gerd Ahlström
- Department of Health Sciences, Faculty of Medicine, Lund University, Box 157, 221 00, Lund, SE, Sweden
| | - Anna Ekwall
- Department of Health Sciences, Faculty of Medicine, Lund University, Box 157, 221 00, Lund, SE, Sweden
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Shimizu T, Graber M. How insight contributes to diagnostic excellence. Diagnosis (Berl) 2022; 9:311-315. [PMID: 35670643 DOI: 10.1515/dx-2022-0007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Accepted: 05/10/2022] [Indexed: 11/15/2022]
Abstract
In the quest to improve diagnosis, a great deal of attention has already been focused on how to optimize clinical reasoning, and the importance of System 1 and System 2 processing. In this essay we consider the role of 'insight', a relatively overlooked pathway for arriving at the correct diagnosis. Insight refers to spontaneous emergence of the correct answer at some later point in time. We discuss factors that might facilitate insight, and how these could be incorporated into the diagnostic process.
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Affiliation(s)
- Taro Shimizu
- Dokkyo Medical University, Shimotsuga-gun, Tochigi, Japan
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Ahlström G, Rosén H, Persson EI. Quality of Life among Next of Kin of Frail Older People in Nursing Homes: An Interview Study after an Educational Intervention concerning Palliative Care. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052648. [PMID: 35270339 PMCID: PMC8909579 DOI: 10.3390/ijerph19052648] [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: 12/17/2021] [Revised: 02/14/2022] [Accepted: 02/22/2022] [Indexed: 11/30/2022]
Abstract
One cornerstone of palliative care is improving the family’s quality of life (QoL). The principles of palliative care have not been sufficiently applied in nursing homes. The aim of this study was to investigate the experiences of QoL of next of kin of frail older persons in nursing homes after an educational intervention concerning palliative care. This qualitative interview study with 37 next of kin used an abductive design with deductive and inductive content analysis. The deductive analysis confirmed the three themes of QoL from the study before the implementation: (1) orientation to the new life-situation, (2) challenges in the relationship, and (3) the significance of the quality of care in the nursing home. The inductive analysis resulted in the sub-theme “Unspoken palliative care”. Being the next of kin of an older person living in a nursing home can be distressing despite round-the-clock care, so staff need to apply a more explicitly palliative care perspective. Future research needs to evaluate the influence of meaning-focused coping on next of kin’s QoL and integrate this knowledge in psychosocial interventions. Clinical Trial Database for Clinical Research: KUPA project NCT02708498.
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