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McPherson R, Resnick B, Wallace BH. Differences in Staff-Resident Care Interactions by Nursing Home Racial Composition: a Preliminary Analysis. J Racial Ethn Health Disparities 2024; 11:2055-2063. [PMID: 37314689 DOI: 10.1007/s40615-023-01673-8] [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: 03/01/2023] [Revised: 04/28/2023] [Accepted: 06/05/2023] [Indexed: 06/15/2023]
Abstract
Limited research has examined racial differences in the quality of staff-resident care interactions in long-term care settings. The quality of care interactions can significantly affect resident quality of life and psychological well-being among nursing home residents living with dementia. Limited research has assessed racial or facility differences in the quality of care interactions. The purpose of the present study was to determine if there were differences in the quality of care interactions among nursing home residents with dementia between Maryland nursing home facilities with and without Black residents. It was hypothesized that after controlling for age, cognition, comorbidities, and function, the quality of care interactions would be better in facilities with Black residents versus those in which there were only White residents. Baseline data from the Evidence Integration Triangle for Behavioral and Psychological Symptoms of Dementia (EIT-4-BPSD) intervention study was used and included 276 residents. The results indicated that facilities in Maryland with Black residents had a 0.27 increase (b = 0.27, p < .05) in the quality of care interaction score compared to facilities without Black residents. The findings from this study will be used to inform future interventions to aid in reducing quality of care disparities in nursing home facilities with and without Black nursing home residents. Future work should continue to examine staff, resident, and facility characteristics associated with the quality of care interactions to improve quality of life among all nursing home residents regardless of race or ethnicity.
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Affiliation(s)
- Rachel McPherson
- School of Nursing, University of Maryland Baltimore, Baltimore, MD, USA.
| | - Barbara Resnick
- School of Nursing, University of Maryland Baltimore, Baltimore, MD, USA
| | - Brandy Harris Wallace
- Department of Sociology, Anthropology, and Public Health, University of Maryland Baltimore County, Baltimore, MD, USA
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2
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Zhou X, Wong H. Caregiver interactions, perceived control, and meaning in life of elderly: the moderating effect of the elderly-to-social worker ratio. BMC Geriatr 2024; 24:431. [PMID: 38750411 PMCID: PMC11097439 DOI: 10.1186/s12877-024-05029-7] [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: 09/25/2023] [Accepted: 04/30/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Meaning in life is a widely accepted aim in promoting psychosocial health in institutional care. However, how caregiver interaction and perceived control impact meaning in life among the elderly remains unclear. This study explores the effect of institutional caregiver interaction, family caregiver interaction, and perceived control on meaning in life among elderly residents in China, and the potential moderating effect of elderly-to-social worker ratio in these associations. METHODS Multistage random sampling was used to recruit a sample of 452 elderly residents from 4 elderly care homes in urban China. A structural equation model was used to test the study hypothesis. RESULTS Institutional caregiver interaction is positively related to meaning in life, and perceived control among elderly residents has a positive impact on meaning in life. Moreover, the elderly-to-social worker ratio moderated the relationship between institutional caregiver interaction and meaning in life, as well as between family caregiver interaction and meaning in life. CONCLUSIONS Increase elderly's meaning in life is an important service target for the caring professions in institutional care. Social workers affect the effectiveness of interventions on elderly's meaning in life in institutional care. A higher elderly-to-social worker ratio could improve the effectiveness of interventions on meaning in life for elderly residents.
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Affiliation(s)
- Xiaofan Zhou
- School of Sociology, Central China Normal University, Wuhan, China.
| | - Hung Wong
- Department of Social Work, The Chinese University of Hong Kong, Shatin, The New Territories, Hong Kong, China
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3
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McPherson R, Resnick B, Galik E, Gruber-Baldini AL, Holmes S, Kusmaul N. The Association Between Engagement in Activities of Daily Living and Care Interactions for Residents Living With Dementia. J Nurs Care Qual 2023; 38:E18-E24. [PMID: 36730953 PMCID: PMC9974542 DOI: 10.1097/ncq.0000000000000675] [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] [Indexed: 02/04/2023]
Abstract
BACKGROUND Care interactions are essential to residents with dementia. PURPOSE The purpose of the study was to describe the characteristics and quality of staff-resident care interactions among nursing home residents living with dementia and to test whether the quality of staff-resident care interactions varied by resident level of engagement in the interaction. Specifically, it was hypothesized that controlling for age, gender, comorbidities, cognition, and function, actively engaged residents would have more positive care interactions with staff compared with passively engaged residents. METHODS This was a secondary data analysis using baseline data from the Evidence Integration Triangle for Behavioral and Psychological Symptoms of Dementia intervention study. RESULTS A total of 532 residents were included. Actively engaged residents had significantly more positive interactions compared to passively engaged residents. CONCLUSIONS Passively engaged residents may be at risk to receive poor quality care interactions. Strategies and interventions to optimize care interactions for these individuals are needed.
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Affiliation(s)
- Rachel McPherson
- University of Maryland School of Nursing, Baltimore MD 21201, United States
| | - Barbara Resnick
- University of Maryland School of Nursing, Baltimore MD 21201, United States
| | - Elizabeth Galik
- University of Maryland School of Nursing, Baltimore MD 21201, United States
| | - Ann L. Gruber-Baldini
- University of Maryland School of Medicine, Department of Epidemiology, Baltimore, MD 21201, United States
| | - Sarah Holmes
- University of Maryland School of Nursing, Baltimore MD 21201, United States
| | - Nancy Kusmaul
- University of Maryland Baltimore County, School of Social Work, Baltimore, MD 21250, United States
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4
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Petry H, Pelzelmayer K, Ernst J, Thuerlimann E, Naef R. Nurse-patient interaction during the Covid-19 pandemic: Creating and maintaining an interactive space for care. J Adv Nurs 2023; 79:281-296. [PMID: 36344480 DOI: 10.1111/jan.15486] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 09/03/2022] [Accepted: 10/12/2022] [Indexed: 11/09/2022]
Abstract
AIMS To explore nurse-patient interactions during the Covid-19 pandemic from both nurses' and patients' perspectives. DESIGN Qualitative study using constructive grounded theory. METHODS A total of 34 patients and 49 nurses from acute and home care settings participated in individual or focus group interviews between December 2020 and May 2021. Data were analysed by a team of researchers using coding, memo-writing, theoretical sampling and constant comparison and integration. RESULTS We identified the creation and maintenance of an interactive space as the main social process. This interactive space was shaped by the care context and the course of the pandemic. For nurses, four factors were key, namely protecting oneself and others, navigating communication barriers, adapting nursing actions to the evolving situation, and providing emotional care work. Patients experienced attentive caring relationships with nurses and felt that, for the most part, their individual needs had been met despite the pandemic challenges. CONCLUSION Nurses and patients created an interactive space in which they were able to provide and receive the necessary care. Maintaining the interactive space was often challenging, and required an intentional effort by nurses, particularly in acute care settings. The findings illustrate that nurses ensured the provision of necessary care even during a public health crisis, thereby enabling patient access to good quality care. IMPACT Nurse-patient relationships are important for effective, person-centred care delivery. Despite the pandemic challenges, nurses managed to uphold their caring imperative and ensure quality care. Findings provide further insights on the importance of nurse-patient interaction in maintaining quality care. They inform models of nursing care delivery and strategies to support quality care during public health crises.
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Affiliation(s)
- Heidi Petry
- Center of Clinical Nursing Science, University Hospital Zurich, Zurich, Switzerland
| | | | - Jutta Ernst
- Center of Clinical Nursing Science, University Hospital Zurich, Zurich, Switzerland
| | - Eva Thuerlimann
- Institute for Implementation Science in Health Care, Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Rahel Naef
- Center of Clinical Nursing Science, University Hospital Zurich, Zurich, Switzerland.,Institute for Implementation Science in Health Care, Faculty of Medicine, University of Zurich, Zurich, Switzerland
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5
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Fadayevatan R, Rahimi M, Abedi H. Care Process in Iranian Nursing Homes: A Grounded Theory Study. J Caring Sci 2021; 10:160-168. [PMID: 34849360 PMCID: PMC8609117 DOI: 10.34172/jcs.2021.024] [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: 12/13/2019] [Accepted: 04/02/2020] [Indexed: 12/02/2022] Open
Abstract
Introduction: The need and use of long-term care services for older people has increased with their rising population and there is little information about the state of serving in nursing homes. This study aimed to identify the caring process in Iranian nursing homes.
Methods: This qualitative study was conducted in three Iranian nursing homes using grounded theory approach. The participants included 28 individuals (14 older people and 14 caregivers). The data were collected using unstructured interviews up to data saturation, and analyzed by constant comparative method.
Results: Fragmented care emerged as the core variable. The main factor for developing the core variable was ‘experience-based caring’. Other factors included ‘inappropriate structure for care’ as contextual factors in the nursing homes environment and ‘keeping instead of caring’, ‘dismal life’, and ‘up and down of the path’ as strategies and consequences.
Conclusions: The most common type of care was the routine and unplanned one with focusing on physical aspects. To improve a delivery care system for older people in nursing homes, proposing a care plan with focus on an integrated model of care in nursing homes, provision of instructions for treatment, as well as supervision and training caregivers to provide better care are necessary
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Affiliation(s)
- Reza Fadayevatan
- Department of Gerontology, Iranian Research Center of Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Majid Rahimi
- Department of Health Education and Promotion, Health Faculty, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Heidarali Abedi
- Department of Nursing, Isfahan Branch, Islamic Azad University, Khorasghan, Iran
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6
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Soriano GP, Calong Calong KA. Spiritual well-being, self-transcendence, and spiritual practices among Filipino women with breast cancer. Palliat Support Care 2021; 19:723-726. [PMID: 33678214 DOI: 10.1017/s1478951521000079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The study was conducted in order to determine the relationship between spiritual well-being and self-transcendence and to identify the spiritual practices utilized by Filipino patients who are recovering from breast cancer. METHODS A descriptive correlational study was used, and a purposive sampling technique was utilized to select the participants in the study. Data were collected using self-administered questionnaires and were analyzed using frequency, percentage, mean, standard deviation, and Pearson's r correlation. RESULTS The study revealed that the overall mean score of the spiritual index of well-being among the participants was 4.41 (±0.54), while the mean score of self-transcendence was 3.64 (±0.50). The results showed that there was a significant relationship between spirituality and self-transcendence among Filipino women with breast cancer. SIGNIFICANCE OF RESULTS Filipino women with breast cancer rely on their spirituality, which enables them to find meaning in their illness. Hence, assessing spirituality among this population group will enable nurses to provide holistic nursing care, as this can help them cope with the challenges associated with their illness.
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Affiliation(s)
- Gil P Soriano
- College of Nursing, San Beda University, Manila, Philippines
- Graduate School, Wesleyan University Philippines, Cabanatuan City, Nueva Ecija, Philippines
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7
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Isene TA, Kjørven Haug SH, Stifoss-Hanssen H, Danbolt LJ, Ødbehr LS, Thygesen H. Meaning in Life for Patients With Severe Dementia: A Qualitative Study of Healthcare Professionals' Interpretations. Front Psychol 2021; 12:701353. [PMID: 34539501 PMCID: PMC8440833 DOI: 10.3389/fpsyg.2021.701353] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Accepted: 08/05/2021] [Indexed: 11/13/2022] Open
Abstract
The need for meaning in life is a key aspect of being human, and a central issue in the psychology of religion. Understanding experience of meaning for persons with severe dementia is challenging due to the impairments associated with the illness. Despite these challenges, this article argues that meaning in life is as important for a person with severe dementia as it is for everyone else. This study was conducted in a Norwegian hospital and nursing home context and was part of a research project on meaning in life for persons with severe dementia. The study builds on two other studies which focused on how meaning-making and experience of meaningfulness appeared in patients with severe dementia. By presenting the findings from these two studies for a group of healthcare professionals and introducing them to research on meaning in life, the aim of this study was to explore how healthcare professionals interpret the patients' experience of meaning in life in practise for patients with severe dementia in a hospital and nursing home context, and to highlight its clinical implications. The study was conducted using a qualitative method with exploratory design. The data were collected at a round table conference, a method inspired by a mode of action research called "co-operative inquiry." Altogether 27 professional healthcarers, from a variety of professions, with high competence in dementia care participated together with six researchers authoring this article. This study revealed that healthcare professionals were constantly dealing with different forms of meaning in their everyday care for people with dementia. The findings also showed clear connexions between understanding of meaning and fundamental aspects of good dementia care. Meaning corresponded well with the principles of person-centred care, and this compatibility allowed the healthcare professionals to associate meaning in life as a perspective into their work without having much prior knowledge or being familiar with the use of this perspective. The study points out that awareness of meaning in life as an integrated perspective in clinical practise will contribute to a broader and enhanced repertoire, and hence to improved dementia care. Facilitating experience of meaning calls for increased resources in personnel and competence in future dementia care.
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Affiliation(s)
- Tor-Arne Isene
- Centre for Psychology of Religion, Innlandet Hospital Trust, Hamar, Norway.,Centre of Diakonia and Professional Practise, VID Specialised University, Oslo, Norway
| | - Sigrid Helene Kjørven Haug
- Centre for Psychology of Religion, Innlandet Hospital Trust, Hamar, Norway.,Faculty of Social and Health Sciences, Department of Health and Nursing Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
| | - Hans Stifoss-Hanssen
- Centre of Diakonia and Professional Practise, VID Specialised University, Oslo, Norway
| | - Lars J Danbolt
- Centre for Psychology of Religion, Innlandet Hospital Trust, Hamar, Norway.,MF Norwegian School of Theology, Oslo, Norway
| | - Liv S Ødbehr
- Faculty of Social and Health Sciences, Department of Health and Nursing Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
| | - Hilde Thygesen
- Faculty of Health Sciences, Department of Occupational Therapy, Prosthetics and Orthotics, Oslo Metropolitan University, Oslo, Norway.,Faculty of Health Studies, VID Specialised University, Oslo, Norway
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Emiliussen J, Engelsen S, Christiansen R, Klausen SH. The Good Life in Care Homes–a Qualitative Investigation with Residents, Relatives, Care Workers and Managers. AGEING INTERNATIONAL 2021. [DOI: 10.1007/s12126-021-09438-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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9
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André B, Grønning K, Jacobsen FF, Haugan G. "Joy of life" in nursing homes. Healthcare personnel experiences of the implementation of the national strategy. A qualitative study with content analysis of interviews. BMC Health Serv Res 2021; 21:771. [PMID: 34348715 PMCID: PMC8335868 DOI: 10.1186/s12913-021-06801-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 07/20/2021] [Indexed: 11/10/2022] Open
Abstract
Background Nursing homes are under strong pressure to provide good care to the residents. In Norway, municipalities have applied the ‘Joy-of-Life-Nursing-Home’ strategy to increase a health-promoting perception that focuses on the older persons` resources. Implementations represent introducing changes to the healthcare personnel; however, changing one’s working approaches, routines and working culture may be demanding. On this background, we explored how the ‘Joy-of-Life-Nursing-Home’ strategy is perceived by the employees in retrospective, over a period after the implementation and which challenges the employees experience with this implementation. Method We used a qualitative approach and interviewed 14 healthcare personnel working in nursing homes in one Norwegian municipality, which had implemented the ‘Joy-of-Life-Nursing-Home’ strategy. The analysis was conducted following Kvale’s approach to qualitative content analysis. Results The main categories were: (a) the characteristics of care activities before implementations of ‘Joy-of-Life-Nursing-Home’, (b) how ‘Joy-of-Life-Nursing-Home’ influenced the care activities, and (c) challenges with the implementation of ‘Joy-of-Life-Nursing-Home’. Some of the informants spoke well about the implementation concerning the care quality stating “to see the joy in the eyes of the resident then I feel we have succeeded”. For informants who experienced resistance toward the implementation, they felt it was too much to document, it was too complicated, and the requirements were too many. Conclusions Quality of care seems to have increased after the implementation, as perceived by the informants. Nevertheless, the fact that the informants seemed to be divided into two different groups related to their main perspective of the implementation is concerning. One group has positive experiences with the implementations process and the benefits of it, while the other group focuses on lack of benefits and problems with the implementation process. To understand what facilitates and hinders the implementation, research on contextual factors like work environment and leadership is recommended.
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Affiliation(s)
- Beate André
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), 7491, Trondheim, Norway. .,NTNU Center for Health Promotion Research, 7491, Trondheim, Norway.
| | - Kjersti Grønning
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), 7491, Trondheim, Norway.,NTNU Center for Health Promotion Research, 7491, Trondheim, Norway
| | - Frode F Jacobsen
- Centre for Care Research, Western Norway University of Applied Sciences, Bergen, Norway.,Institute for Health and Care Sciences, Western Norway University of Applied Sciences, Bergen, Norway.,VID Specialized University, Bergen, Norway
| | - Gørill Haugan
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), 7491, Trondheim, Norway.,NTNU Center for Health Promotion Research, 7491, Trondheim, Norway
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10
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Rinnan E, André B, Espnes GA, Drageset J, Garåsen H, Haugan G. Despite Symptom Severity, do Nursing Home Residents Experience Joy-of-Life? The Associations Between Joy-of-Life and Symptom Severity in Norwegian Nursing Home Residents. J Holist Nurs 2021; 40:84-96. [PMID: 34213960 PMCID: PMC9121523 DOI: 10.1177/08980101211021219] [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] [Indexed: 11/15/2022]
Abstract
Background: Finding new approaches to increase health and well-being among nursing home (NH) residents is highly warranted. From a holistic perspective, several Norwegian municipalities have implemented the certification scheme framed "Joy-of-Life Nursing Home" Aims: In a holistic perspective on NH care, this study investigated if NH residents despite potential symptom severity experience joy-of-life (JoL). Therefore, we examined the frequency of common symptoms and the association between common symptoms and JoL in cognitively intact NH residents. Methods: A cross-sectional design was employed. Using the QLQ-C15-PAL quality-of-life questionnaire, hospital anxiety and depression scale, and JoL scale, a total of 188 cognitively intact NH residents participated. Results: Symptom severity was high; 54% reported fatigue, 52% reported constipation, 45% reported pain, 43% reported dyspnea, 32% reported insomnia, 22% reported appetite loss, and 20% reported nausea, while 20% reported anxiety and 23% reported depressive symptoms. Nevertheless, 59% of the NH residents reported high JoL, which was significantly positively related to the quality of life and negatively associated with anxiety and depression.
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Affiliation(s)
- Eva Rinnan
- 8018NTNU Norwegian University of Science and Technology.,25574Trondheim Municipality
| | - Beate André
- NTNU Norwegian University of Science and Technology
| | | | - Jorun Drageset
- 1657Western Norway University of Applied Sciences.,1658University of Bergen
| | | | - Gørill Haugan
- 8018NTNU Norwegian University of Science and Technology.,1786Nord University
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11
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Usta E, Bayram S. Determination of Factors Affecting Self-Transcendence and Meaning in Life Among the Elderly Receiving Institutional Care. JOURNAL OF RELIGION AND HEALTH 2021; 60:2024-2036. [PMID: 33590328 DOI: 10.1007/s10943-020-01165-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/16/2020] [Indexed: 06/12/2023]
Abstract
This study was conducted in order to determine factors that influence self-transcendence and meaning in life in the elderly receiving institutional care. This descriptive and analytic study was conducted on 72 elderly individuals living in a nursing home in Turkey. Data were collected with the Barthel Index of Activities of Daily Living (ADL), the Lawton&Brody Instrumental Activities of Daily Living (IADL), the Meaning in Life Questionnaire (MLQ) and the Self-Transcendence Scale (STS). The mean score of STS is 48.17 ± 6.67 at the intermediate level, and the mean scores of presence and search subscales of the MLQ are 28.07 ± 6.55 and 24.06 ± 7.73 above the intermediate level. The STS mean score is poorly correlated with the ADL (r = 0.277) and the IADL scale (r = 0.343). Increased perception of general health status of the elderly improved self-transcendence (ST) level (p = 0.04) and search for meaning in life (ML) level (p = 0.02). These findings show that the health perceptions of the elderly must be improved in the first place.
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Affiliation(s)
- Esra Usta
- Sağlık Hizmetleri Meslek Yüksekokulu Konuralp Yerleşkesi, Düzce University, 81620, Düzce, Turkey.
| | - Serap Bayram
- Sağlık Hizmetleri Meslek Yüksekokulu Konuralp Yerleşkesi, Düzce University, 81620, Düzce, Turkey
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12
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Chua JYX, Shorey S. Effectiveness of end-of-life educational interventions at improving nurses and nursing students' attitude toward death and care of dying patients: A systematic review and meta-analysis. NURSE EDUCATION TODAY 2021; 101:104892. [PMID: 33866077 DOI: 10.1016/j.nedt.2021.104892] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 03/13/2021] [Accepted: 03/28/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVES To examine the effectiveness of end-of-life educational interventions in improving nurses and nursing students' attitude toward death and care of dying patients. DESIGN A systematic review and meta-analysis of randomized controlled trials and controlled clinical trials. DATA SOURCES English language studies were sourced from five electronic databases (PubMed, Embase, CINAHL, PsycINFO and ProQuest Dissertations & Theses Global) to November 2020. REVIEW METHODS A meta-analysis was conducted using the random-effect model. Standardized mean differences with 95% confidence intervals were used as the effect measure under the inverse-variance method. Heterogeneity was assessed using the I2 statistics and Cochran's Q chi-squared test. The Cochrane risk of bias tool conducted quality appraisal at the study level while the Grades of Recommendation, Assessment, Development, and Evaluation approach conducted quality appraisal at the outcome level. RESULTS Nine studies were included. Meta-analyses showed that end-of-life educational interventions were effective in improving attitude toward death and care of dying patients among nurses and nursing students at post-intervention. The sustainability of improvement of both attitudes could not be determined due to the lack of follow-up assessments by the included studies. Subgroup analyses revealed that both nurses and nursing students showed similar attitude improvement, online educational courses were feasible and attitude toward death may require longer interventions (more than 2 months) to show improvement. CONCLUSIONS Future trials could be improved by organizing both group-based segments and combined sessions for nurses and nursing students. Online components could be incorporated for convenience. Topics related to spirituality and grief management should be included. Future research is needed to examine the sustainability of nurses and nursing students' improvement in attitude toward death and care of dying patients, as well as how the change in their attitude affects their clinical practices.
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Affiliation(s)
- Joelle Yan Xin Chua
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD11,10 Medical Drive, Singapore 117597, Singapore
| | - Shefaly Shorey
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD11,10 Medical Drive, Singapore 117597, Singapore.
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13
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Hwang HL, Tu CT, Kuo TY. Correlates of perceived caring behaviour of formal caregivers in long-term care facilities: A cross-sectional survey. Scand J Caring Sci 2021; 36:225-234. [PMID: 33778974 DOI: 10.1111/scs.12981] [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: 06/29/2020] [Revised: 02/05/2021] [Accepted: 02/21/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Researchers have identified several factors that correlate with the caring behaviours of formal caregivers in long-term care facilities (LTCFs). However, a limited range of socio-demographic factors has been discussed, and no studies have discussed the combined effects of the institutional characteristics of the LTCF and the personal characteristics (i.e. bio-psycho-socio-spiritual attributes) of the formal caregiver on the caring behaviour. AIM The aim of this study was to examine caring behaviours of formal caregivers for older residents of LTCFs and to explore factors that explain and predict the caring behaviours of them. METHODS A valid sample of 224 formal caregivers (nurses and nurse aids) employed at 56 LTCFs (21 nursing homes and 35 assisted living facilities) was analysed. Hierarchical regression analysis with two-tailed significance test was used to investigate whether the caring behaviours of the caregivers were independently associated with the characteristics of the caregivers or the institutions. FINDINGS Caring behaviours of the formal caregivers had significant positive associations with their job satisfaction (β = 0.152, p < 0.05) and with their perceived satisfaction of LTCF residents (β = 0.214, p < 0.001).The organisational-level analysis revealed that caring behaviours had positive associations with accreditation level (β = 0.163, p < 0.01) and with nurse-aid staffing level (β = 0.126, p < 0.05). Additionally, the caring behaviour had positive associations with their attitude towards older adults (β = 0.193, p < 0.01) and with their self-transcendence (β = 0.184, p < 0.01). These two factors explained 42.2% of the variance in the caring behaviours of caregivers. CONCLUSION AND IMPLICATIONS Caring behaviours were related to both personal characteristics (attributes, mindset) and organisational characteristics. By clarifying factors in the caring behaviours of caregivers, this study provides information that LTCFs can use to develop strategies for managing their caregivers and that policymakers can use to establish and implement healthcare policies for older populations.
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Affiliation(s)
- Huei-Lih Hwang
- Nursing Department, National Tainan Junior College of Nursing, Tainan, Taiwan
| | - Chin-Tang Tu
- Office of Teacher Education and Careers Service, National Kaohsiung Normal University, Kaohsiung City, Taiwan
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14
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Lee SK, Shin JH, Ahn J, Lee JY, Jang DE. Identifying the Risk Factors Associated with Nursing Home Residents' Pressure Ulcers Using Machine Learning Methods. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18062954. [PMID: 33805798 PMCID: PMC8001016 DOI: 10.3390/ijerph18062954] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 03/08/2021] [Accepted: 03/09/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND Machine learning (ML) can keep improving predictions and generating automated knowledge via data-driven predictors or decisions. OBJECTIVE The purpose of this study was to compare different ML methods including random forest, logistics regression, linear support vector machine (SVM), polynomial SVM, radial SVM, and sigmoid SVM in terms of their accuracy, sensitivity, specificity, negative predictor values, and positive predictive values by validating real datasets to predict factors for pressure ulcers (PUs). METHODS We applied representative ML algorithms (random forest, logistic regression, linear SVM, polynomial SVM, radial SVM, and sigmoid SVM) to develop a prediction model (N = 60). RESULTS The random forest model showed the greatest accuracy (0.814), followed by logistic regression (0.782), polynomial SVM (0.779), radial SVM (0.770), linear SVM (0.767), and sigmoid SVM (0.674). CONCLUSIONS The random forest model showed the greatest accuracy for predicting PUs in nursing homes (NHs). Diverse factors that predict PUs in NHs including NH characteristics and residents' characteristics were identified according to diverse ML methods. These factors should be considered to decrease PUs in NH residents.
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Affiliation(s)
- Soo-Kyoung Lee
- College of Nursing, Keimyung University, 1095 Dalgubeol-daero, Dalseo-gu, Daegu 42601, Korea;
| | - Juh Hyun Shin
- College of Nursing, Ewha Womans University, Science & Ewha Research Institute of Nursing Science, Seoul 120750, Korea
- Correspondence:
| | - Jinhyun Ahn
- Department of Management Information Systems, Jeju National University, Jeju 63243, Korea;
| | - Ji Yeon Lee
- College of Nursing, Catholic University of Pusan, Busan 46252, Korea;
| | - Dong Eun Jang
- School of Nursing, University of Texas at Austin, Austin, TX 78712, USA;
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15
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Mejia C, Severt D. Linking Service Quality Attributes to Meaning-in-Life Outcomes for Residents Who Have Transitioned to an Assisted Living Community. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2021; 64:151-174. [PMID: 33081601 DOI: 10.1080/01634372.2020.1830329] [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: 06/11/2020] [Revised: 09/22/2020] [Accepted: 09/26/2020] [Indexed: 06/11/2023]
Abstract
The growing number of persons aged 65 and older, combined with their greater reliance on care outside the family unit, has contributed to the rapid growth of older people residing in assisted living (AL) communities. Given the increased attention paid to service standards in older adults' housing models, this qualitative study was conducted in AL to generate residents' perspectives on service and meaning-in-life outcomes. Utilizing the attributes of service quality through a transition theory lens, the data revealed empathy and responsiveness as most essential to the perceptions of service and meaning-in-life among residents. Theoretical results from this study suggest that linking current service theory to meaning-in-life outcomes would be of benefit to AL service standards research. Practical application of the research outcomes revealed how appropriate personalized attention provided in a timely manner to residents is critical to their well-being, and to their successful transition to AL.
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Affiliation(s)
- Cynthia Mejia
- Department of Foodservice & Lodging Management, Rosen College of Hospitality Management, University of Central Florida , Orlando, FL
| | - Denver Severt
- Department of Hospitality Services, Rosen College of Hospitality Management, University of Central Florida , Orlando, FL, USA
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16
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Suprayitno E, Setiawan I. Nurses' roles in palliative care: An Islamic perspective. BELITUNG NURSING JOURNAL 2021; 7:50-54. [PMID: 37469792 PMCID: PMC10353631 DOI: 10.33546/bnj.1254] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Revised: 01/04/2021] [Accepted: 02/08/2021] [Indexed: 07/21/2023] Open
Abstract
Palliative care is an important approach for nurses to improve the quality of life of patients holistically and mitigate suffering among the patients in critical condition and near to death. This article provides an Islamic perspective about nurses' roles in palliative care, which can be applied worldwide, especially in Muslim-majority countries. Understanding Islamic beliefs will help nurses provide professional and culturally sensitive nursing care. In its principle, Islam always respects the process of life until death comes. So, the application of Islamic values in palliative care will make the patients accept their ill condition completely, keep being close to Allah SWT (God), and die peacefully. The concepts of illness, death, early action on the dead, and palliative care application in nursing are explained in this article to open up new ideas rather than provide definitive answers. We hope that this perspective will highlight healthcare policymakers the need to integrate Islamic values in nursing practice.
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Affiliation(s)
- Edy Suprayitno
- Department of Nursing, Faculty of Health Sciences, Universitas ‘Aisyiyah Yogyakarta, Indonesia
| | - Iwan Setiawan
- Department of Nursing, Faculty of Health Sciences, Universitas ‘Aisyiyah Yogyakarta, Indonesia
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17
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Alexandersen I, Haugdahl HS, Paulsby TE, Lund SB, Stjern B, Eide R, Haugan G. A qualitative study of long-term ICU patients' inner strength and willpower: Family and health professionals as a health-promoting resource. J Clin Nurs 2020; 30:161-173. [PMID: 33058361 DOI: 10.1111/jocn.15532] [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: 04/24/2020] [Revised: 09/14/2020] [Accepted: 10/04/2020] [Indexed: 11/26/2022]
Abstract
AIMS AND OBJECTIVES To explore how the presence of family and health professionals influences long-term critically ill patients' inner strength and willpower as an incitement to keep fighting for recovery. BACKGROUND This study reports long-term critically ill patients' experiences of family and health professionals as health-promoting resources in terms of significance for their inner strength and willpower. Earlier research on this topic is scarce. DESIGN A qualitative, hermeneutic-phenomenological approach, within the context of Antonovsky's salutogenic theory. METHODS Seventeen long-term critically ill patients were interviewed once, at 6-18 months after ICU discharge. The consolidated criteria for reporting qualitative research (COREQ) were used (Supplementary File 1). RESULTS Four main themes identified how family and staff promoted and challenged the patient's inner strength and willpower: (a) the importance of family and friends; my family was surrounding me, (b) staff contributions, (c) challenges to inner strength and willpower in relation to family and (d) loneliness and indifferent care. CONCLUSION This study brings new knowledge from the long-term critically ill patient's view about the impact of family, friends and nurses on the patient's inner strength and willpower. All impact is experienced positively and negatively. RELEVANCE TO CLINICAL PRACTICE Knowledge from the long-term critically ill patient's view is vital in nurse-patient interactions to facilitate liberation of inner strength and willpower.
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Affiliation(s)
- Ingeborg Alexandersen
- Department of Public Health and Nursing, NTNU Norwegian University of Science and Technology, Trondheim, Norway
| | - Hege S Haugdahl
- Department of Public Health and Nursing, NTNU Norwegian University of Science and Technology, Trondheim, Norway.,Nord-Trøndelag Hospital Trust, Levanger, Norway
| | - Tove Engan Paulsby
- Department of Public Health and Nursing, NTNU Norwegian University of Science and Technology, Trondheim, Norway
| | - Stine Borgen Lund
- Department of Public Health and Nursing, NTNU Norwegian University of Science and Technology, Trondheim, Norway
| | - Berit Stjern
- Department of Public Health and Nursing, NTNU Norwegian University of Science and Technology, Trondheim, Norway
| | - Regina Eide
- St. Olav University Hospital, Trondheim, Norway
| | - Gørill Haugan
- Department of Public Health and Nursing, NTNU Norwegian University of Science and Technology, Trondheim, Norway.,Nord University, Faculty of nursing and health sience, Levanger, Norway
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18
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Relational aspects of meaning in life among older people – a group-interview gerontechnology study. AGEING & SOCIETY 2020. [DOI: 10.1017/s0144686x20001300] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
Earlier studies show that experiencing life as meaningful in old age promotes holistic wellbeing and health among older people. As more and more people are living with reduced capacities in their own homes, there is an urgent need to find new ways of promoting holistic wellbeing of the ageing population. Analysing data gathered from existential discussion groups on Service TV (STV), we show how strongly relationality and meaning in life are intertwined for older people. Our findings indicate that respect and support for the autonomy of older people is very important: in order to continue living at home, and prepare for a future with reduced capacities, they need family members for support. Autonomy of ageing becomes relational as choices and wishes are negotiated with family members. Relationships also contribute to loss of meaning. When older people felt that they were not close enough to their family, longed for friends of the same age, were bereaved or widowed, the relational gap caused a violation of meaning. In contrast, participation and activities with peers brought deep joy and connectedness to the lives of the participants. STV provided a new channel for participants to find and form meaningful relationships. Therefore, it is concluded that relationality can be supported by technological means of care.
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19
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Albougami ASB, Almazan JU, Stitt N, P Cruz J, C Colet P, Adolfo CS. Challenges of nurses and care management of depressed older adults: a narrative literature review. Scand J Caring Sci 2020; 35:710-721. [PMID: 32901929 DOI: 10.1111/scs.12908] [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: 03/20/2020] [Revised: 07/28/2020] [Accepted: 08/11/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND The number of older adults with depression has increased in recent years. In relation to this, conducting a narrative review helps provide a better understanding of the adaptive functioning of depressed older adults and the significance of interventions in reducing depression. This narrative review investigates the nurses' management of depressed older adult patients. It also presents a detailed investigation of the barriers preventing nurses from successfully implementing nursing care for older adults. METHODS A narrative literature review was performed on four electronic databases, namely, (i) Cumulative Index of Nursing and Allied Health Literature, (ii) Pubmed, (iii) PsycINFO and (iv) Taylor and Francis. English language and peer-reviewed journal articles were included. RESULTS A total of 19 articles were selected for the review, and four main themes were generated: (i) the challenges in implementing depression care management, (ii) the role of social support in depression treatment, (iii) the pharmacological management approach and (iv) the health care management process. CONCLUSION Nurses experience several challenges in implementing depression care management. The role of social support in the treatment of depression, pharmacological management and different types of health care management strategies all provide solutions for depressed older adults. The review findings provide insights for improving health care nursing services for depressed older adults and reducing the negative health outcomes in this population.
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Affiliation(s)
| | - Joseph U Almazan
- Nursing Program, Nazarbayev University School of Medicine, Nazarbayev University, Nur-Sultan, Kazakhstan
| | - Nancy Stitt
- Nursing Program, Nazarbayev University School of Medicine, Nazarbayev University, Nur-Sultan, Kazakhstan
| | - Jonas P Cruz
- Nursing Department, College of Applied Medical Sciences, Shaqra University, Dawadmi, Saudi Arabia
| | - Paolo C Colet
- Nursing Program, Nazarbayev University School of Medicine, Nazarbayev University, Nur-Sultan, Kazakhstan
| | - Cris S Adolfo
- Nursing Department, College of Applied Medical Sciences, Majmaah University, Al Majma'ah, Saudi Arabia
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20
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Drageset J, Taasen SE, Espehaug B, Kuven BM, Eide WM, André B, Rinnan E, Haugan G. Associations Between Nurse-Patient Interaction and Sense of Coherence Among Cognitively Intact Nursing Home Residents. J Holist Nurs 2020; 39:16-28. [PMID: 32700622 PMCID: PMC8041445 DOI: 10.1177/0898010120942965] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Aim: To investigate the association between nurse-patient interaction and sense of coherence among cognitively intact nursing home residents. Method: In a cross-sectional design, data were collected in 2017 and 2018 using the Nurse-Patient Interaction Scale (NPIS) and the 13-item Sense of Coherence Scale (SOC-13). Of the 204 cognitively intact nursing home residents who met the inclusion criteria, 188 (92%) participated, representing 27 nursing homes. Multiple regression in a general linear model estimated the possible effects of the 14 NPIS items on SOC-13 sum score, the possible effects of the NPIS (sum score) on SOC-13 (sum score) as well as on the subdimensions of SOC-13, comprehensibility, meaningfulness, and manageability (both without and with adjusting for sex and age). Results: Four of the 14 NPIS items revealed highly significant correlations with SOC-13 (sum score; unadjusted and adjusted for age and gender). Furthermore, the analysis adjusted for age and gender showed significant associations for NPIS (sum score) with SOC-13 (sum score), manageability, and comprehensibility. The correlation between NPIS and meaningfulness was not statistically significant. Conclusion: Nurse-patient interaction is significantly associated with SOC-13 and its subdimensions of comprehensibility and manageability but not meaningfulness. Nurse-patient interaction might be an important resource in relation to residents' sense of coherence and its subdimensions.
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Affiliation(s)
- Jorunn Drageset
- Western Norway University of Applied Sciences.,University of Bergen
| | | | | | | | | | | | - Eva Rinnan
- Norwegian University of Science and Technology
| | - Gørill Haugan
- Norwegian University of Science and Technology.,Nord University
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21
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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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22
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Haugan G, Kuven BM, Eide WM, Taasen SE, Rinnan E, Xi Wu V, Drageset J, André B. Nurse-patient interaction and self-transcendence: assets for a meaningful life in nursing home residents? BMC Geriatr 2020; 20:168. [PMID: 32381032 PMCID: PMC7203905 DOI: 10.1186/s12877-020-01555-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 04/13/2020] [Indexed: 12/12/2022] Open
Abstract
Background Due to the shift to an older population worldwide and an increased need for 24-h care, finding new and alternative approaches to increase wellbeing among nursing home (NH) residents is highly warranted. To guide clinical practice in boosting wellbeing among NH residents, knowledge about nurse-patient interaction (NPI), inter- (ST1) and intra-personal (ST2) self-transcendence and meaning-in-life (PIL) seems vital. This study tests six hypotheses of the relationships between NPI, ST1, ST2 and PIL among cognitively intact NH residents. Methods In a cross-sectional design, 188 (92% response rate) out of 204 long-term NH residents representing 27 NHs responded to NPI, ST, and the PIL scales. Inclusion criteria were: (1) municipality authority’s decision of long-term NH care; (2) residential time 3 months or longer; (3) informed consent competency recognized by responsible doctor and nurse; and (4) capable of being interviewed. The hypothesized relations between the latent constructs were tested through structural equation modeling (SEM) using Stata 15.1. Results The SEM-model yielded a good fit (χ2 = 146.824, p = 0.021, df = 114, χ2/df = 1.29 RMSEA = 0.040, p-close 0.811, CFI = 0.97, TLI = 0.96, and SRMR = 0.063), supporting five of the six hypothesized relationships between the constructs of NPI, ST1, ST2 and PIL. Conclusion NPI significantly relates to both ST1, ST2 and PIL in NH residents. ST revealed a fundamental influence on perceived PIL, while NPI demonstrated a significant indirect influence on PIL, mediated by ST.
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Affiliation(s)
- Gørill Haugan
- Department of Public Health and Nursing, Faculty of Medicine and Health Science, NTNU Norwegian University of Science and Technology, Trondheim, Norway. .,NORD University, Faculty of Nursing and Health Science, Levanger, Norway.
| | - Britt Moene Kuven
- Faculty of Health and Social Science, Western University of Applied Science, Bergen, Norway
| | - Wenche Mjanger Eide
- Faculty of Health and Social Science, Western University of Applied Science, Bergen, Norway
| | - Siv Eriksen Taasen
- Faculty of Health and Social Science, Western University of Applied Science, Bergen, Norway
| | - Eva Rinnan
- Department of Public Health and Nursing, Faculty of Medicine and Health Science, NTNU Norwegian University of Science and Technology, Trondheim, Norway.,Trondheim Municiaplity, Trondheim, Norway
| | - Vivien Xi Wu
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, The National University of Singapore, Singapore, Singapore
| | - Jorunn Drageset
- Faculty of Health and Social Science, Western University of Applied Science, Bergen, Norway.,Department of Global Health and Primary Care, University of Bergen, Bergen, Norway
| | - Beate André
- Department of Public Health and Nursing, Faculty of Medicine and Health Science, NTNU Norwegian University of Science and Technology, Trondheim, Norway
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23
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Haugan G, Eide WM, André B, Wu VX, Rinnan E, Taasen SE, Kuven BM, Drageset J. Joy-of-life in cognitively intact nursing home residents: the impact of the nurse-patient interaction. Scand J Caring Sci 2020; 35:208-219. [PMID: 32200564 DOI: 10.1111/scs.12836] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Revised: 01/12/2020] [Accepted: 02/11/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND The nursing-home population is at a high risk of declined well-being and quality of life. Finding approaches to increase well-being among older adults in nursing-homes is highly warranted. Responding to this need, the approach framed 'Joy-of-Life-Nursing-Homes' (JoLNH) was developed in Norway. AIM To investigate the association between nurse-patient interaction and joy-of-life in the nursing-home population. METHODS Cross-sectional data were collected in 2017 and 2018 using the Nurse-Patient Interaction Scale and the Joy-of-Life Scale. A total of 204 cognitively intact nursing-home residents met the inclusion criteria and 188 (92%) participated. A structural equation model (SEM) of the relationship between nurse-patient interaction and joy-of-life was tested by means of STATA/MP 15.1. Ethical approval was given and each participant provided voluntarily written informed consent. RESULTS The SEM-model yielded a good fit with the data (χ2 = 162.418, p = 0.004, df = 118, χ2 /df = 1.38, RMSEA = 0.046, p-close 0.652, CFI = 0.97, TLI = 0.96, and SRMR = 0.054). As hypothesised, nurse-patient interaction related significantly with joy-of-life (γ1,1 = 0.61, t = 7.07**). LIMITATIONS The cross-sectional design does not allow for conclusions on causality. The fact that the researchers visited the participants to help fill in the questionnaire might have introduced some bias into the respondents' reporting. CONCLUSION Relational qualities of the nurse-patient interaction should be essential integral aspects of nursing-home care. Consequently, such qualities should be emphasised in clinical practice, and research and education should pay more attention to nurse-patient interaction as an important, integral part of the caring process promoting joy-of-life and thereby well-being.
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Affiliation(s)
- Gørill Haugan
- NTNU Center for Health Promotion Research, NTNU Norwegian University of Science and Technology, Trondheim, Norway.,Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway
| | - Wenche Mjanger Eide
- Faculty of Health and Social Sciences, Western University of Applied Sciences, Bergen, Norway
| | - Beate André
- NTNU Center for Health Promotion Research, NTNU Norwegian University of Science and Technology, Trondheim, Norway
| | - Vivien Xi Wu
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Eva Rinnan
- Department of Public Health and Nursing, NTNU Norwegian University of Science and Technology, Trondheim, Norway
| | - Siv Eriksen Taasen
- Faculty of Health and Social Sciences, Western University of Applied Sciences, Bergen, Norway
| | - Britt Moene Kuven
- Faculty of Health and Social Sciences, Western University of Applied Sciences, Bergen, Norway
| | - Jorunn Drageset
- Faculty of Health and Social Sciences, Western University of Applied Sciences, Bergen, Norway.,University of Bergen, Department of Global Public Health and Primary Care, Bergen, Norway
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24
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Haugan G, Drageset J, André B, Kukulu K, Mugisha J, Utvær BKS. Assessing quality of life in older adults: psychometric properties of the OPQoL-brief questionnaire in a nursing home population. Health Qual Life Outcomes 2020; 18:1. [PMID: 31898546 PMCID: PMC6941243 DOI: 10.1186/s12955-019-1245-3] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 11/14/2019] [Indexed: 12/02/2022] Open
Abstract
Background Well-adapted and validated quality-of-life measurement models for the nursing home population are scarce. Therefore, the aim of this study was to test the psychometrical properties of the OPQoL-brief questionnaire among cognitively intact nursing home residents. The research question addressed evidence related to the dimensionality, reliability and construct validity, all of which considered interrelated measurement properties. Methods Cross-sectional data were collected during 2017–2018, in 27 nursing homes representing four different Norwegian municipalities, located in Western and Mid-Norway. The total sample comprised 188 of 204 (92% response rate) long-term nursing home residents who met the inclusion criteria: (1) municipality authority’s decision of long-term nursing home care; (2) residential time 3 months or longer; (3) informed consent competency recognized by responsible doctor and nurse; and (4) capable of being interviewed. Results Principal component analysis and confirmative factor analyses indicated a unidimensional solution. Five of the original 13 items showed low reliability and validity; excluding these items revealed a good model fit for the one-dimensional 8-items measurement model, showing good internal consistency and validity for these 8 items. Conclusion Five out of the 13 original items were not high-quality indicators of quality-of-life showing low reliability and validity in this nursing home population. Significant factor loadings, goodness-of-fit indices and significant correlations in the expected directions with the selected constructs (anxiety, depression, self-transcendence, meaning-in-life, nurse-patient interaction, and joy-of-life) supported the psychometric properties of the OPQoL-brief questionnaire. Exploring the essence of quality-of-life when residing in a nursing home is highly warranted, followed by development and validation of new tools assessing quality-of-life in this population. Such knowledge and well-adapted scales for the nursing home population are beneficial and important for the further development of care quality in nursing homes, and consequently for quality-of-life and wellbeing in this population.
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Affiliation(s)
- Gørill Haugan
- NTNU Center for health promotion research, Norwegian University of Science and Technology, Trondheim, Norway. .,Faculty of Nursing and Health Sciences, Nord University, Bodø, Norway.
| | - Jorunn Drageset
- Faculty of Health and Social Science, Western University of Applied Science, Bergen, Norway.,University of Bergen, Bergen, Norway
| | - Beate André
- NTNU Center for health promotion research, Norwegian University of Science and Technology, Trondheim, Norway
| | - Kamile Kukulu
- Faculty of Nursing, Akdeniz University, Antalya, Turkey
| | - James Mugisha
- Social Worker, Kyambogo University and Butabika National Referral and Teaching Hospital, Kampala, Uganda
| | - Britt Karin S Utvær
- Department of Teacher Education, Norwegian University of Science and Technology, Trondheim, Norway
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25
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Qualitative analyses of nursing home residents' quality of life from multiple stakeholders' perspectives. Qual Life Res 2020; 29:1229-1238. [PMID: 31898111 DOI: 10.1007/s11136-019-02395-3] [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] [Accepted: 12/11/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE Quality of life has been defined in various ways by nursing home stakeholders over the years. As such, analyzing the levels of agreement or disagreement among these stakeholders to ascertain if staff and leadership align with resident-identified factors for "good" quality of life has become important to include in the literature. This study sought to identify contributory factors to resident quality of life, as well as analyze areas of commonality in qualitative responses. METHODS Semi-structured interviews were conducted at 46 Midwestern nursing homes, with residents (n = 138), nursing assistants (n = 138), social workers (n = 46), activities directors (n = 46), and administrators (n = 46), on whether each stakeholder felt residents had a good quality of life and the factors contributing to resident quality of life. RESULTS Overall, the majority of residents perceived their quality of life as "good," though differences were noted in their main contributing factors when compared to staff members' and management's perspectives. Findings also demonstrated that nursing assistants most closely aligned with resident perspectives. CONCLUSIONS Given the implications of resident satisfaction with quality of life on multiple facets of a nursing home (e.g., survey process, financial reimbursement), it remains ever critical for management to engage residents and to truly listen to resident perspectives to enhance and ensure an optimal quality of life.
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26
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Hwang HL, Tu CT. Factors related to perceived caring among older people residing in long-term care facilities: a cross-sectional study. Scand J Caring Sci 2019; 34:964-970. [PMID: 31830320 DOI: 10.1111/scs.12804] [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: 07/04/2019] [Accepted: 11/13/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND Healthcare providers who exhibit caring behaviours promote quality of care. Theoretical and empirical models have promoted a three-dimensional paradigm of care perception. However, the perception of elderly residents in long-term care facilities related to caring has not been investigated. OBJECTIVES This study explored factors related to the elderly's perception of healthcare providers' caring in long-term care facilities. METHODS A cross-sectional survey was conducted among 461 elderly residents living in 57 long-term care facilities in southern Taiwan. A structured questionnaire included demographic information, facility characteristics and the 12-item Caring Scale for Institutionalized Elders. Hierarchical regression analysis was used to determine significant factors related to the elderly residents' caring perceptions. FINDINGS A hierarchical regression model showed 49.9% of the variance in elderly's perception of caring. Significant related factors included resident's age, number of comorbidities, need for caring, time spent being cared for, bed-to-nurse staffing ratios and accreditation status. CONCLUSIONS Improved Registered Nurse staffing ratios with a higher level of accreditation status yield better perceptions of caring among residential elderly. Those with comorbid diseases and fewer caring needs have a higher perception of healthcare provider caring. IMPLICATIONS The related factors of elderly's perceived caring provide long-term care managers and nursing staff with beneficial information to develop strategies that can manage residents with high expected-care needs. Policies to improve the accreditation standards of long-term care facilities are needed.
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Affiliation(s)
- Huei-Lih Hwang
- National Tainan Junior College of Nursing, Tainan City, Taiwan
| | - Chin-Tang Tu
- Department of Education, National Kaohsiung Normal University, Kaohsiung City, Taiwan
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Predictors of therapeutic communication between nurses and hospitalized patients. Heliyon 2019; 5:e02665. [PMID: 31720457 PMCID: PMC6838810 DOI: 10.1016/j.heliyon.2019.e02665] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2019] [Revised: 05/01/2019] [Accepted: 10/11/2019] [Indexed: 11/20/2022] Open
Abstract
Background Therapeutic communication is a purposeful interaction between health professionals and patients that helps to achieve positive health outcomes. There is a pressing need for research examining factors influencing effective implementation of therapeutic communication in relation to patient-centered care and satisfaction. Objective This study was aimed at determining the effective implementation of therapeutic communication and its predictors. Methods Institution based cross-sectional study was conducted at the Jimma University Specialized Hospital from March 21 to April 9, 2016. One hundred ninety two patients were recruited using stratified sampling. A questionnaire was used to collect data. One-way ANOVA for mean difference by socio-demographic characteristics, simple and multivariable linear regressions were conducted. Results The study revealed that 67(34.9%) of the patients rated high level of therapeutic communication. Significant predictors of therapeutic communication implementation were educational status (β = 5.87, P = 0.011), language difference (β = -6, P = 0.014), education difference (β = 5.21, P = 0.010) and perceived patient view score (β = 3.57, P˂0.001). Conclusion Therapeutic communication was poorly implemented. Education, language difference, education difference and perceived patient view scores were significant predictors of therapeutic communication.
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Coutinho E, Amaral S, Parreira MVBDC, Chaves CB, Amaral O, Nelas P. Nurses- puerperal mothers interaction: searching for cultural care. Rev Bras Enferm 2019; 72:910-917. [PMID: 31432946 DOI: 10.1590/0034-7167-2018-0216] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 08/18/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To identify the importance of the cultural care dimension in the nurse-puerperal mother interaction. METHOD Qualitative study based on content analysis. To collect data, 36 semi structured interviews were applied (21 nurses and 15 women who had recently given birth). The participants' free and informed consent was ensured and all ethical requirements were respected. Data analysis was supported by NVivo 10 software. RESULTS The following categories were considered the most relevant: (i) nurses' attitudes that puerperal mothers consider crucial in health care provision; (ii) nurses' cultural competence; (iii) language resources used by nurses in their interaction with people from other cultures; (iv) the limitations that were observed during nurses-new mothers interactions. CONCLUSION Evidence shows that, generally speaking, nurses claim to provide personalized health care assistance. However data revealed that the kind of interaction observed between nurses and women who had just given birth has not always been the most effective and that the former often show they lacked the appropriate cultural competence to deal with the latter's expectations and needs.
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Affiliation(s)
- Emília Coutinho
- Instituto Politécnico de Viseu, Escola Superior de Saúde de Viseu. Viseu, Portugal
| | - Sónia Amaral
- Instituto Politécnico de Viseu, Escola Superior de Saúde de Viseu. Viseu, Portugal
| | | | | | - Odete Amaral
- Instituto Politécnico de Viseu, Escola Superior de Saúde de Viseu. Viseu, Portugal
| | - Paula Nelas
- Instituto Politécnico de Viseu, Escola Superior de Saúde de Viseu. Viseu, Portugal
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Calha AGM, Monteiro FJL, Hilário MIT. Photography in the planning of health interventions for the elderly. Rev Bras Enferm 2019; 72:940-947. [DOI: 10.1590/0034-7167-2018-0329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 09/09/2018] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: To analyze potentialities of the use of photo-elicitation technique as a tool of access to the real needs of the beneficiaries of the intervention of health professionals. For this purpose, the aspects of their quality of life that they considered more relevant were identified with an elderly group. Method: It is a qualitative investigation in which the discourse of the elderly on the changes to their quality of life is encouraged through the use of photographic images. Results: Based on the data obtained, it was possible to identify the aspects of quality of life considered more relevant by the elderly, allowing, therefore, to sustain a later intervention adjusted to the needs and expectations of the elderly. Final considerations: The use of photo-elicitation allowed verifying its potentialities as a strategy to collect significant and relevant information for the planning of interventions in the Health area.
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Haugan G, Rinnan E, Espnes GA, Drageset J, Rannestad T, André B. Development and psychometric properties of the Joy-of-Life Scale in cognitively intact nursing home patients. Scand J Caring Sci 2019; 33:801-814. [PMID: 30866075 DOI: 10.1111/scs.12676] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Accepted: 02/10/2019] [Indexed: 11/26/2022]
Abstract
AIM To develop and psychometrically test the Joy-of-Life Scale. The research question addressed evidence related to the dimensionality, reliability and construct validity, all of which considered inter-related measurement properties. METHODS Cross-sectional data were collected during 2017-2018, in 27 nursing homes representing four different Norwegian municipalities, located in Western and Mid-Norway. The total sample comprised 188 of 204 (92% response rate) long-term nursing home patients who met the inclusion criteria: (i) local authority's decision of long-term nursing home care; (ii) residential time 3 months or longer; (iii) informed consent competency recognised by responsible doctor and nurse; and (iv) capable of being interviewed. RESULTS Exploratory and confirmative factor analyses clearly suggested a unidimensional solution. Five of the original 18 items showed low reliability and validity; excluding these items revealed an acceptable model fit for the one-dimensional 13-item measurement model. Reliability and construct validity were acceptable, indicating good internal consistency. CONCLUSION Significant factor loadings, several goodness-of-fit indices and significant correlations in the expected directions with the selected constructs (anxiety, depression, self-transcendence, meaning-in-life, sense of coherence, nurse-patient interaction and quality of life) supported the psychometric properties of the Joy-of-Life Scale. IMPACT The 'Joy-of-Life-Nursing-Home' is a national strategy for promoting quality of life, meaning and quality of life among nursing home patients in Norway. Therefore, exploring the essence of the Joy-of-Life phenomenon and developing a measurement scale assessing joy-of-life in this population is important for the further development of care quality in nursing homes.
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Affiliation(s)
- Gørill Haugan
- NTNU Center for health promotion research, Trondheim, Norway
| | - Eva Rinnan
- NTNU Center for health promotion research, Trondheim, Norway.,NTNU Department of public health and nursing, Trondheim, Norway.,Trondheim municipality, Bergen, Norway
| | - Geir Arild Espnes
- NTNU Center for health promotion research, Trondheim, Norway.,NTNU Department of public health and nursing, Trondheim, Norway
| | - Jorunn Drageset
- University of Bergen, Bergen, Norway.,Western University of Applied Sciences, Bergen, Norway
| | - Toril Rannestad
- NTNU Center for health promotion research, Trondheim, Norway.,NTNU Department of public health and nursing, Trondheim, Norway
| | - Beate André
- NTNU Center for health promotion research, Trondheim, Norway.,NTNU Department of public health and nursing, Trondheim, Norway
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Hwang H, Tu C, Chan H. Self‐transcendence, caring and their associations with well‐being. J Adv Nurs 2019; 75:1473-1483. [DOI: 10.1111/jan.13937] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2017] [Revised: 10/10/2018] [Accepted: 10/23/2018] [Indexed: 12/18/2022]
Affiliation(s)
- Huei‐Lih Hwang
- Department of Nursing National Tainan Junior College of Nursing Tainan Taiwan
| | - Chin‐Tang Tu
- Center for Teacher Education National Kaohsiung Normal University KaohsiungTaiwan
| | - Hui‐Shan Chan
- Applied Cosmetology National Tainan Junior College of Nursing Tainan Taiwan
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Kiljunen O, Partanen P, Välimäki T, Kankkunen P. Older people nursing in care homes: An examination of nursing professionals' self-assessed competence and its predictors. Int J Older People Nurs 2019; 14:e12225. [PMID: 30729686 DOI: 10.1111/opn.12225] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Revised: 11/29/2018] [Accepted: 12/31/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND The need for older people nursing expertise is increasing, and every effort is required to ensure that personnel taking care of older people are capable of providing high-quality care. AIMS To explore care home nursing professionals' self-rated competence in older people nursing and to identify predictors of this competence. DESIGN A cross-sectional survey design. METHOD Data were collected in August-September 2017 via an electronic questionnaire using the newly developed Nurse Competence in Care Home Scale (NCCHS). Participants (n = 781) were recruited via nurses' associations and social media. They were working in care homes either as licensed practical nurses (n = 680) or as registered nurse and/or in managerial position (n = 101). FINDINGS Approximately 65% of the respondents had "adequate competence," and 35% had "inadequate competence" in older people nursing based on self-assessed overall competence. Respondents rated their competence highest in "observation, communication, interaction" and lowest in "group guidance and activities" subscale. Age and further training were predictors of licensed practical nurses' competence, and length of work experience predicted registered nurses' competence. CONCLUSIONS Self-assessments revealed the need for competence development especially in relation to holistic support of a person's well-being. It is recommended that care home nurses, managers, educators and curriculum developers all strive to develop care home staff's ability to support residents' well-being holistically. IMPLICATIONS FOR PRACTICE Nursing personnel should consider all aspects of older people's well-being holistically. In care homes, it is essential to assess nursing staff competence and to provide possibilities for competence development for personnel.
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Affiliation(s)
- Outi Kiljunen
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Pirjo Partanen
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Tarja Välimäki
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
| | - Päivi Kankkunen
- Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
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Rinnan E, André B, Drageset J, Garåsen H, Espnes GA, Haugan G. Joy of life in nursing homes: A qualitative study of what constitutes the essence of Joy of life in elderly individuals living in Norwegian nursing homes. Scand J Caring Sci 2018; 32:1468-1476. [PMID: 30070384 DOI: 10.1111/scs.12598] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 06/11/2018] [Indexed: 11/27/2022]
Abstract
BACKGROUND Finding new approaches to increase positive health and well-being of elderly individuals living in nursing homes (NH) is highly warranted. Several Norwegian municipalities have implemented the certification scheme framed 'Joy of Life Nursing Home' (JOLNH). JOLNH is based on a health-promoting perspective directing elderly individuals' resources. Through health promotion, preventive and social activities across generations, NH care promotes respect, well-being, health and cultural experiences among elderly individuals. AIMS The aims of this study were to explore the phenomenon of Joy of life (JOL) among elderly individuals living in NHs and to provide a deeper understanding of which dimensions constitute JOL in this population. METHODS The present study explored the JOL phenomenon using qualitative methodology. Data were collected between December 2015 and May 2016 by individual qualitative research interviews of 29 elderly individuals who met the inclusion criteria. The informants were living in ten different NHs in two large municipalities in Norway. Prior approval was obtained from all regulatory institutions dealing with research issues and the management in both municipalities. RESULTS The results showed that (i) positive relations, (ii) a sense of belonging, (iii) sources of meaning, (iv) moments of feeling well, and (v) acceptance constituted the conceptualisation of the JOL phenomenon. CONCLUSION The dimensions constituting the JOL concept correspond to the concepts of well-being and flourishing. Knowledge of the JOL phenomenon may help professionals to target elderly individuals' health and well-being more precisely and thereby increase flourishing, JOL and well-being among them.
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Affiliation(s)
- Eva Rinnan
- Faculty of Medicine and Health Science, Department of Public Health and Nursing, NTNU Norwegian University of Science and Technology, Trondheim, Norway.,Chief Executive Office, Trondheim Municipality, Trondheim, Norway
| | - Beate André
- Faculty of Medicine and Health Science, Department of Public Health and Nursing, NTNU Norwegian University of Science and Technology, Trondheim, Norway
| | - Jorunn Drageset
- Centre for Elderly and Nursing Home Medicine, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Faculty of Health and Social Sciences, Department of Nursing, Western Norway University of Applied Sciences, Bergen, Norway
| | - Helge Garåsen
- Faculty of Medicine and Health Science, Department of Public Health and Nursing, NTNU Norwegian University of Science and Technology, Trondheim, Norway.,Chief Executive Office, Trondheim Municipality, Trondheim, Norway
| | - Geir Arild Espnes
- Faculty of Medicine and Health Science, Department of Public Health and Nursing, NTNU Norwegian University of Science and Technology, Trondheim, Norway
| | - Gørill Haugan
- Faculty of Medicine and Health Science, Department of Public Health and Nursing, NTNU Norwegian University of Science and Technology, Trondheim, Norway
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Haugdahl HS, Eide R, Alexandersen I, Paulsby TE, Stjern B, Lund SB, Haugan G. From breaking point to breakthrough during the ICU stay: A qualitative study of family members’ experiences of long-term intensive care patients’ pathways towards survival. J Clin Nurs 2018; 27:3630-3640. [DOI: 10.1111/jocn.14523] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2018] [Indexed: 12/12/2022]
Affiliation(s)
- Hege S Haugdahl
- Levanger Hospital; Nord-Trøndelag Hospital Trust; Levanger Norway
- Norwegian University of Science and Technology (NTNU); Trondheim Norway
| | - Regina Eide
- St. Olav University Hospital; Trondheim Norway
| | | | | | - Berit Stjern
- Norwegian University of Science and Technology (NTNU); Trondheim Norway
| | - Stine Borgen Lund
- Norwegian University of Science and Technology (NTNU); Trondheim Norway
| | - Gørill Haugan
- Norwegian University of Science and Technology (NTNU); Trondheim Norway
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Yaghoobzadeh A, Gorgulu O, Yee BL, Wibisono AH, Pahlevan Sharif S, Sharif Nia H, Allen KA. A Model of Aging Perception in Iranian Elders With Effects of Hope, Life Satisfaction, and Socioeconomic Status: A Path Analysis. J Am Psychiatr Nurses Assoc 2018; 24:522-530. [PMID: 29357723 DOI: 10.1177/1078390317753676] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Aging perception plays a central role in the experience of healthy aging by older people. Research identified that factors such as hope, life satisfaction, and socioeconomic status influence the perception of aging in older populations. OBJECTIVE This study sought to test a hypothetical model to quantitatively evaluate the relationship between hope, life satisfaction, and socioeconomic status with aging perception. DESIGN A cross-sectional design was used with 504 older aged participants who live in Qazvin, Iran. Data were collected using the Barker's Aging Perception Questionnaire, Life Satisfaction Index-Z, and Herth Hope Index. RESULTS The results of path analysis showed that hope was the most important factor affecting aging perception. Results drawn from correlation analysis indicated that there was a positive significant correlation ( r = .383, p < .001) between hope and aging perception. Further analysis found that hope had the strongest impact on aging perception compared with the other variables analyzed (e.g., life satisfaction and socioeconomic status). CONCLUSIONS A model of aging perception in Iranian elders is presented. The findings suggested that hope had a significant and positive impact on aging perception. Implications for clinical practice and research are discussed.
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Affiliation(s)
| | - Ozkan Gorgulu
- 2 Ozkan Gorgulu, PhD, Ahi Evran University, Kırşehir, Turkey
| | - Bit-Lian Yee
- 3 Bit-Lian Yee, MSc, Open University Malaysia, Kuala Lumpur, Malaysia
| | | | | | - Hamid Sharif Nia
- 6 Hamid Sharif Nia, PhD, Mazandaran University of Medical Sciences, Sari, Iran
| | - Kelly A Allen
- 7 Kelly A. Allen, PhD, University of Melbourne. Melbourne, Victoria, Australia
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Kiljunen O, Kankkunen P, Partanen P, Välimäki T. Family members’ expectations regarding nurses’ competence in care homes: a qualitative interview study. Scand J Caring Sci 2017; 32:1018-1026. [DOI: 10.1111/scs.12544] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Accepted: 10/30/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Outi Kiljunen
- Department of Nursing Science; University of Eastern Finland; Kuopio Finland
| | - Päivi Kankkunen
- Department of Nursing Science; University of Eastern Finland; Kuopio Finland
| | - Pirjo Partanen
- Department of Nursing Science; University of Eastern Finland; Kuopio Finland
| | - Tarja Välimäki
- Department of Nursing Science; University of Eastern Finland; Kuopio Finland
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Abstract
BACKGROUND Despite the growing importance of spiritual care, the delivery of spiritual care is still an area of disagreement among healthcare providers. OBJECTIVE To develop a grounded theory about spiritual care delivery based on Iranian nurses' perceptions and experiences. A GROUNDED THEORY APPROACH A qualitative study using the grounded theory approach. PARTICIPANTS AND RESEARCH CONTEXT Data were collected through holding 27 interviews with 25 participants (17 staff nurses, 3 physicians, 3 patients, 1 family member, and 1 nurse assistant). The study setting was the Imam Khomeini Hospital Complex. Sampling was started purposively and continued theoretically. Data analysis was performed by the method proposed by Strauss and Corbin. ETHICAL CONSIDERATION The study was approved by the Ethics Committee of Tarbiat Modares University and the agreement of the administrators of the study setting was got before starting the study. RESULTS The core category of the study was "Trust building" which reflected the nature of spiritual care delivery by nurses. Trust building was the result of eight main categories or strategies including creating a positive mentality at hospital admission, understanding patients in care circumstances, having a caring presence, adhering to care ethics, developing meaningful relationships, promoting positive thinking and energy, establishing effective communication with patients, and attempting to create a safe therapeutic environment. Poor interprofessional coordination negatively affected this process while living toward developing greater cognizance of divinity and adhering to the principles of professional ethics facilitated it. The outcome of the process was to gain a sense of partial psychological security. CONCLUSION The "Trust building" theory can be used as a guide for describing and expanding nurses' roles in spiritual care delivery, developing care documentation systems and clinical guidelines, and planning educational programs for nursing students and staff nurses.
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Affiliation(s)
- Monir Ramezani
- Mashhad University of Medical Sciences, Mashhad, Iran; Tarbiat Modares University, Tehran, Iran
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Abstract
Background Clinical nurses have multiple challenges in conducting high-quality nursing research to inform practice. Theoretically, the development of a community of practice on nursing research centered on the concept of hope is an approach that may address some of the challenges. Purpose This article describes the delivery and evaluation of a hope research community of practice (HRCoP) approach to facilitate research expertise in a group of advanced practice nurses in one hospital. It addressed the question: Does the establishment of a HRCoP for master’s prepared nurses increase their confidence and competence in leading nursing research? Method Using interpretive descriptive qualitative research methodology, five participants were interviewed about their experiences within the HRCoP and facilitators engaged in participant observation. Results At 13 months, only four of the original seven participants remained in the HRCoP. While all participants discussed positive impacts of participation, they identified challenges of having protected time to complete their individual research projects, despite having administrative support to do so. Progress on individual research projects varied. Conclusion Nurse-led research remains a challenge for practicing nurses despite participating in an evidence-based HRCoP. Lessons learned from this project can be useful to other academic clinical partnerships.
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Affiliation(s)
| | | | - Winnifred Doyle
- McMaster University, Hamilton, Ontario, Canada
- St. Joseph’s Healthcare Hamilton, Ontario, Canada
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Chen YH, Lin LC, Chuang LL, Chen ML. The Relationship of Physiopsychosocial Factors and Spiritual Well-Being in Elderly Residents: Implications for Evidence-Based Practice. Worldviews Evid Based Nurs 2017; 14:484-491. [PMID: 28510288 DOI: 10.1111/wvn.12243] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND Older adults in residential settings frequently suffer from functional decline, mental illness, and social isolation, which make them more vulnerable to spiritual distress. However, empirical evidence of the interrelationships between physiopsychosocial variables and spiritual well-being are still lacking, limiting the application of the biopsychosocial-spiritual model in institutional healthcare practice. AIMS To explain the mechanisms by which these variables are linked, this cross-sectional study tested a causal model of predictors of spiritual well-being among 377 institutionalized older adults with disability using a structural equation modeling approach. METHODS The primary variables in the hypothesized model were measured using the Barthel Index for functional ability, the Geriatric Depression Scale-short form for depression, the Personal Resources Questionnaire 85-Part 2 for perceived social support, and the Spiritual Well-Being Scale for spiritual well-being. RESULTS The model fit indices suggest that the hypothesized model had a reasonably adequate model fit (χ2 = 12.18, df = 6, p = .07, goodness-of-fitness index [GFI] = 0.99, adjusted GIF index [AGFI] = 0.93, nonnormed fit index [NFI] = 0.99, comparative fit index [CFI] = 0.99). In this study, perceived social support and depression directly affected spiritual well-being, and functional ability indirectly affected spiritual well-being via perceived social support or depression. In addition, functional ability influenced perceived social support directly, which in turn influenced depression and ultimately influenced spiritual well-being. DISCUSSION This study results confirm the effect of physiopsychosocial factors on institutionalized older adults' spiritual well-being. However, the presence and level of functional disability do not necessarily influence spiritual well-being in late life unless it is disruptive to social relationships and is thus bound to lead to low perceived social support and the onset of depression. LINKING EVIDENCE TO ACTION The findings address the fact that the practice of spirituality is multidimensional and multileveled. Psychosocial interventions for institutionalized elders with disabilities should focus on increasing nurse-patient interaction and providing access to meaningful social activities to improve mental health and spiritual well-being.
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Affiliation(s)
- Yi-Heng Chen
- Associate Professor, Department of Nursing & Institute of Long-Term Care, Mackay Medical College, Taiwan, ROC
| | - Li-Chan Lin
- Professor, School of Nursing, National Yang-Ming University, Taiwan, ROC
| | - Li-Lan Chuang
- Associate Professor, Department of Nursing, Chang Gung University of Science and Technology, Taiwan, ROC
| | - Mei-Li Chen
- Doctoral Candidate and Lecturer, School of Nursing, National Taipei University of Nursing and Health Science, Taiwan, ROC
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McCarthy VL, Hall LA, Crawford TN, Connelly J. Facilitating Self-Transcendence: An Intervention to Enhance Well-Being in Late Life. West J Nurs Res 2017; 40:854-873. [PMID: 28322667 DOI: 10.1177/0193945917690731] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This randomized controlled pilot study evaluated the effects of the Psychoeducational Approach to Transcendence and Health (PATH) Program, an 8-week intervention hypothesized to increase self-transcendence and improve well-being in community-dwelling women aged 60 years and older ( N = 20). The PATH combined mindfulness exercises, group processes, creative activities, and at-home practice using community engaged research methods. Findings provided some support for the effectiveness of PATH. Although there was no significant Group × Time interaction, self-transcendence, psychological well-being, and life satisfaction differed significantly pre- and postintervention in the wait-listed control group, which received a revised version of the program. Further study is needed with a larger sample to determine the effectiveness of PATH. Potentially, PATH may be a convenient and affordable activity to support personal development and improve well-being among older adults at senior centers, retirement communities, nursing homes, church groups, and other places where older adults gather.
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Mesquita AC, Caldeira S, Chaves E, Carvalho ECD. An Analytical Overview of Spirituality in NANDA-I Taxonomies. Int J Nurs Knowl 2017; 29:200-205. [DOI: 10.1111/2047-3095.12172] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Ana Cláudia Mesquita
- Nursing at the Ribeirão Preto School of Nursing; University of São Paulo, Fellow doctorate by Brazilian Scientific and Technological Development Council (CNPq)
| | - Sílvia Caldeira
- Nursing, Assistant Professor and Researcher at the Centre for Interdisciplinary Research in Health; Universidade Católica Portuguesa, Instituto de Ciências da Sáude; Lisbon Portugal
| | - Erika Chaves
- Nursing, Associate Professor at the College of Nursing; Federal University of Alfenas
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Haugan G, Moksnes UK, Løhre A. Intrapersonal self-transcendence, meaning-in-life and nurse-patient interaction: powerful assets for quality of life in cognitively intact nursing-home patients. Scand J Caring Sci 2016; 30:790-801. [DOI: 10.1111/scs.12307] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2015] [Accepted: 10/08/2015] [Indexed: 11/27/2022]
Affiliation(s)
- Gørill Haugan
- Faculty of Nursing Science; Center for Health Promotion Research; HIST; Sør-Trøndelag University College; Trondheim Norway
| | - Unni Karin Moksnes
- Faculty of Nursing Science; Center for Health Promotion Research; HIST; Sør-Trøndelag University College; Trondheim Norway
| | - Audhild Løhre
- Center for Health Promotion Research; Faculty of Teaching and Sign Language Interpretation; HiST, Sør-Trøndelag University College; Trondheim Norway
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Edwards TM, Jovanovski A. Hope as a Therapeutic Target in Counselling – In General and in Relation to Christian Clients. INTERNATIONAL JOURNAL FOR THE ADVANCEMENT OF COUNSELLING 2016. [DOI: 10.1007/s10447-016-9257-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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McCarthy VL, Bowland S, Hall LA, Connelly J. Assessing the Psychoeducational Approach to Transcendence and Health Program: An Intervention to Foster Self-Transcendence and Well-Being in Community-Dwelling Older Adults. Int J Aging Hum Dev 2016; 82:3-29. [PMID: 26718794 DOI: 10.1177/0091415015623549] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The late-life developmental process of self-transcendence shapes elders' perspectives on self, others, the nature of this world, and of a dimension beyond the here and now. This qualitative pilot study evaluated the Psychoeducational Approach to Transcendence and Health (PATH) Program, a psychoeducational intervention to promote self-transcendence and well-being in community-dwelling women at a senior center. The intervention involved eight weekly group sessions using group processes, mindfulness practices, creative experiences, and independent at-home practice. The findings supported the underlying theory-based structure and content of the intervention and indicated the intervention may empower elders to attend to self-care, develop acceptance, and learn new skills associated with health and well-being, thus merits further study. Based on insights gained from facilitators' and participants' experiences and perceptions, the intervention will be revised and strengthened.
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Eldh AC, van der Zijpp T, McMullan C, McCormack B, Seers K, Rycroft-Malone J. ‘I have the world's best job’ - staff experience of the advantages of caring for older people. Scand J Caring Sci 2015; 30:365-73. [DOI: 10.1111/scs.12256] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Accepted: 05/16/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Ann Catrine Eldh
- School of Education; Health and Social Studies; Dalarna University; Falun Sweden
- Department of Neurobiology; Care Sciences and Society; Division of Nursing; Karolinska Institutet; Stockholm Sweden
| | | | - Christel McMullan
- Public Health; Epidemiology and Biostatistics; School of Health and Population Sciences; University of Birmingham; Birmingham UK
| | - Brendan McCormack
- School of Health Sciences; Queen Margaret University; Musselburgh UK
| | - Kate Seers
- Warwick Medical School; University of Warwick; Coventry UK
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McCarthy VL, Ling J, Bowland S, Hall LA, Connelly J. Promoting self-transcendence and well-being in community-dwelling older adults: A pilot study of a psychoeducational intervention. Geriatr Nurs 2015; 36:431-7. [PMID: 26166003 DOI: 10.1016/j.gerinurse.2015.06.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 06/09/2015] [Accepted: 06/15/2015] [Indexed: 11/30/2022]
Abstract
Self-transcendence changes how older adults perceive themselves, their relationships with others, the material world, and the metaphysical or spiritual dimension. It is associated with multiple indicators of well-being. The purpose of this pilot study (N = 20) was to examine the feasibility and effectiveness of a psychoeducational intervention to increase self-transcendence and well-being in older adults. Data were analyzed using generalized estimating equations. All variables trended in the directions hypothesized. Self-transcendence increased in the intervention group and decreased in the control group but not significantly. The group × time interaction for life satisfaction was significant (z = 2.89, p = .004). This feasibility study supports further investigation to assess the effectiveness of the intervention in a larger sample.
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Abstract
PURPOSE To report the results of an evolutionary concept analysis of caring in facilities that provide care for elders. SOURCES Cumulative indices for CINAHL, ERIC, Academic Search Complete, PsychINFO, Medline, and CEPTS. RESULTS Caring is an interactive process characterized by seeing, helping, and communicating, which are analogous to two wheels with one axle. Caring is preceded by individuality and followed by well-being. CONCLUSION The findings explicate the core components of caring in facilities that provide care for elders. IMPLICATIONS The metaphor of an axle and wheel can guide caregivers in delivering effective care as the demand for improved well-being of residents of eldercare facilities increases.
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Affiliation(s)
- Huei-Lih Hwang
- National Tainan College of Nursing, Nursing Department, Tainan, Taiwan
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Haugan G, Drageset J. The hospital anxiety and depression scale--dimensionality, reliability and construct validity among cognitively intact nursing home patients. J Affect Disord 2014; 165:8-15. [PMID: 24882171 DOI: 10.1016/j.jad.2014.04.042] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2014] [Revised: 04/14/2014] [Accepted: 04/15/2014] [Indexed: 11/19/2022]
Abstract
BACKGROUND Depression and anxiety are particularly common among individuals living in long-term care facilities. Therefore, access to a valid and reliable measure of anxiety and depression among nursing home patients is highly warranted. AIM To investigate the dimensionality, reliability and construct validity of the Hospital Anxiety and Depression scale (HADS) in a cognitively intact nursing home population. METHODS Cross-sectional data were collected from two samples; 429 cognitively intact nursing home patients participated, representing 74 different Norwegian nursing homes. Confirmative factor analyses and correlations with selected constructs were used. RESULTS The two-factor model provided a good fit in Sample1, revealing a poorer fit in Sample2. Good-acceptable measurement reliability was demonstrated, and construct validity was supported. LIMITATIONS Using listwise deletion the sample sizes were 227 and 187, for Sample1 and Sample2, respectively. Greater sample sizes would have strengthen the statistical power in the tests. The researchers visited the participants to help fill in the questionnaires; this might have introduced some bias into the respondents׳ reporting. The 14 HADS items were part of greater questionnaires. Thus, frail, older NH patients might have tired during the interview causing a possible bias. CONCLUSION Low reliability for depression was disclosed, mainly resulting from three items appearing to be inappropriate indicators for depression in this population. Further research is needed exploring which items might perform as more reliably indicators for depression among nursing home patients.
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Affiliation(s)
- Gørill Haugan
- Sør-Trøndelag University College, Faculty of Nursing and Research Centre for Health Promotion and Resources, HIST, Norway.
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James I, Blomberg K, Kihlgren A. A meaningful daily life in nursing homes - a place of shelter and a space of freedom: a participatory appreciative action reflection study. BMC Nurs 2014; 13:19. [PMID: 25050083 PMCID: PMC4105099 DOI: 10.1186/1472-6955-13-19] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Accepted: 07/03/2014] [Indexed: 12/03/2022] Open
Abstract
Background Shortcomings in elderly care have been reported in many parts of the world, including Sweden. However, national guidelines for elderly care have been introduced in Sweden, which contain core values and local guarantees of dignity. These highlight the need for dignity and well-being, and organising the older person’s daily life so that they perceive it as meaningful. Therefore, the aim of the present study was to describe older persons’ experience and knowledge about obstacles, opportunities and solutions to developing a meaningful daily life for those living in nursing homes. Methods This study combined the Participatory Appreciative Action Reflection (PAAR) and hermeneutic approaches. Twenty-five older persons participated and persons with dementia or cognitive impairments were included. Repeated interviews were carried out as reflective conversations, leaving 50 interviews in total, wherein the older persons provided their analyses and reflections on a meaningful daily life. Finally, an analysis of the data was completed based on a life-world hermeneutic approach. Results We identified five tentative interpretations that describe obstacles, opportunities and solutions for a meaningful daily life. Themes 2 and 4 outline obstacles for a meaningful daily life, and Themes 1, 3 and 5 describe opportunities and solutions for a meaningful daily life: (1) Having space to be yourself; (2) No space to be yourself; (3) Belonging and security; (4) A feeling of insecurity; and (5) Longing for something to happen. In the main interpretation, we found that the five tentative interpretations are related to Tuan’s concepts of space and place, where place can be described as security and stableness, and space as freedom and openness. Conclusions The reciprocal relationship is a solution for a meaningful daily life and occurs in the interaction between staff and older persons in nursing homes. It is the balance of power, and constitutes a place of shelter and a space of freedom for a meaningful daily life. The older person must have balance between shelter and freedom to have a meaningful daily life.
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Affiliation(s)
- Inger James
- School of Health and Medical Sciences, Örebro University, Örebro, Sweden
| | - Karin Blomberg
- School of Health and Medical Sciences, Örebro University, Örebro, Sweden
| | - Annica Kihlgren
- School of Health and Medical Sciences, Örebro University, Örebro, Sweden
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