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Martínez-Angulo P, Rich-Ruiz M, Jiménez-Mérida MR, López-Quero S. Active listening, shared decision-making and participation in care among older women and primary care nurses: a critical discourse analysis approach from a gender perspective. BMC Nurs 2024; 23:401. [PMID: 38886702 PMCID: PMC11181639 DOI: 10.1186/s12912-024-02086-6] [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: 01/31/2023] [Accepted: 06/10/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Nursing care for older women represent a challenge worldwide due to its characteristics. When communication is impaired between primary care nurses and older women living alone, an imbalance in power relations occurs. The main objective of this study is to analyse the power relations between older women and primary care nurses in situations of active listening, shared decision-making and participation in care. METHODS We developed a qualitative study in southern Spain using a discursive and gender approach. We used purposeful sampling to interview older women who lived alone and received home nursing care. Simultaneously, we conducted focus groups with primary care nurses who provided home care to older women. A linguistic analysis of the transcripts was carried out. RESULTS Nine semi-structured face-to-face interviews were conducted with older women who lived alone and two face-to-face focus groups with four primary care nurses in each. The discourse of the participants demonstrated an imbalance in power relations. Influenced by work overload, active listening was considered a privilege in primary care nurses´ discourse. Regarding shared decision-making, older women´s discourses revealed "mirages" of real situations where they thought they were deciding. Participation in care was difficult since older women saw themselves as a nuisance in nurses´ presence, and primary care nurses did not facilitate older women's engagement. Older women weren´t considered when organising home visits and had interiorised a subordinated feeling. Similarly, a strict sense of identity made primary care nurses feel powerful in their relationships with older women. CONCLUSIONS The discourse of older women represented them as victims of a hostile panorama whilst they were sometimes satisfied with the deficient care received. The discourse of primary care nurses used more discursive strategies to represent themselves as professionals committed to caring. However, it also revealed deficiencies in care, discriminatory elements, and feelings of being limited by their working conditions. Active listening to older women and engagement in decision-making readjust empower the older women. Attending to the needs and concerns of primary care nurses could recalibrate the power imbalance between them and healthcare organisations.
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Affiliation(s)
- Pablo Martínez-Angulo
- Department of Nursing, Pharmacology, and Physiotherapy, Faculty of Medicine and Nursing, University of Córdoba (UCO), Edificio Servicios Múltiples. 1St Floor. Avda. Menéndez Pidal S/N, 14004, Córdoba, Andalucía, Spain
- Interdisciplinary Research Group in Discourse Analysis (HUM380), University of Córdoba (UCO), 14071, Córdoba, Spain
| | - Manuel Rich-Ruiz
- Department of Nursing, Pharmacology, and Physiotherapy, Faculty of Medicine and Nursing, University of Córdoba (UCO), Edificio Servicios Múltiples. 1St Floor. Avda. Menéndez Pidal S/N, 14004, Córdoba, Andalucía, Spain.
- Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Universitario Reina Sofía (HURS), 14004, Córdoba, Spain.
- Ciber Fragility and Healthy Aging (CIBERFES), Nursing and Healthcare Research Unit (Investén-Isciii), Instituto de Salud Carlos III, 28029, Madrid, Spain.
| | - M Rocío Jiménez-Mérida
- Department of Nursing, Pharmacology, and Physiotherapy, Faculty of Medicine and Nursing, University of Córdoba (UCO), Edificio Servicios Múltiples. 1St Floor. Avda. Menéndez Pidal S/N, 14004, Córdoba, Andalucía, Spain
| | - Salvador López-Quero
- Interdisciplinary Research Group in Discourse Analysis (HUM380), University of Córdoba (UCO), 14071, Córdoba, Spain
- Faculty of Philosophy and Letters, University of Córdoba (UCO), 14003, Córdoba, Spain
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Ahn YS, Oh PJ. [Development and Validation of a Dignity in Care Scale of Terminally Ill Patients for Nurses]. J Korean Acad Nurs 2023; 53:340-358. [PMID: 37435764 DOI: 10.4040/jkan.23039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 06/01/2023] [Accepted: 06/13/2023] [Indexed: 07/13/2023]
Abstract
PURPOSE This study aimed to develop an instrument to showcase Dignity in Care of Terminally Ill Patients for Nurses and to examine its validity and reliability. METHODS A total of 58 preliminary items on dignity in care of terminally ill patients for nurses were selected using content validity analysis and expert opinions on 97 candidate items derived through a literature review and qualitative focus group interviews. Questionnaires were administered to 502 nurses caring for terminally ill cancer patients at hospice and palliative care institutions. The data were analyzed using item analysis, exploratory and confirmatory factor analysis, convergent and discriminant validity, and Pearson correlation for criterion validity, reliability was tested using Cronbach's alpha. RESULTS The final instrument consisted of 25 items, with four factors identified through confirmatory factor analysis. Four factors-ethical values and moral attitudes, interaction-based communication, maintaining comfort, professional insight and competence-accounted for 61.8% of the total variance. Cronbach's α for total items was .96, and test-retest reliability of intraclass correlation coefficient was .90. CONCLUSION Since its validity and reliability have been verified through various methods, the Dignity in Care Scale of Terminally Ill Patients for Nurses can be used for develop nursing interventions and improve dignity in care of terminally ill patients.
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Affiliation(s)
- Yun Sil Ahn
- College of Nursing, Sahmyook University, Seoul, Korea
| | - Pok Ja Oh
- College of Nursing, Sahmyook University, Seoul, Korea.
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Martínez-Angulo P, Rich-Ruiz M, Ventura-Puertos PE, López-Quero S. Analysing Power Relations among Older Norwegian Patients and Spanish Migrant Nurses in Home Nursing Care: A Critical Discourse Analysis Approach from a Transcultural Perspective. Healthcare (Basel) 2023; 11:1282. [PMID: 37174824 PMCID: PMC10178409 DOI: 10.3390/healthcare11091282] [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: 03/01/2023] [Revised: 04/14/2023] [Accepted: 04/27/2023] [Indexed: 05/15/2023] Open
Abstract
Power relations in care are the link between patients and nurses regarding communication and the ability to act in this context. It can be affected when there is cultural interference between members, putting mutual understanding at risk in healthcare situations. This study analyses power relations in healthcare situations between older Norwegian patients and Spanish migrant nurses regarding active listening, shared decision-making, and patient participation. We performed a hermeneutical study endorsed in critical discourse studies framework from a transcultural perspective. A purposive sampling included older Norwegian patients living alone and Spanish migrant nurses working in Norway. Eleven face-to-face semi-structured interviews were conducted with older patients and four via videoconference with migrant nurses. The analysis followed hermeneutic considerations by Crist and Tanner, and linguistic analysis was performed. Shared decision-making and active listening situations sometimes showed a power imbalance that negatively influenced older Norwegian patients. However, Spanish migrant nurses were also conditioned by care organising institutions. This power triangle negatively affected the relationship between the older patients and migrant nurses, resulting in a lack of communication, personnel, time and trust. The migratory experience influenced the care provided by Spanish migrant nurses, shaping a series of cultural competencies acquired through the migratory process.
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Affiliation(s)
- Pablo Martínez-Angulo
- Department of Nursing, Pharmacology, and Physiotherapy, Faculty of Medicine and Nursing, University of Córdoba (UCO), 14004 Córdoba, Spain; (P.M.-A.)
- Interdisciplinary Research Group in Discourse Analysis (HUM380), University of Córdoba (UCO), 14071 Córdoba, Spain
| | - Manuel Rich-Ruiz
- Department of Nursing, Pharmacology, and Physiotherapy, Faculty of Medicine and Nursing, University of Córdoba (UCO), 14004 Córdoba, Spain; (P.M.-A.)
- Maimonides Biomedical Research Institute of Córdoba (IMIBIC), Hospital Universitario Reina Sofía (HURS), 14004 Córdoba, Spain
- Ciber Fragility and Healthy Aging (CIBERFES), 28029 Madrid, Spain
- Nursing and Healthcare Research Unit (Investén-isciii), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Pedro E. Ventura-Puertos
- Department of Nursing, Pharmacology, and Physiotherapy, Faculty of Medicine and Nursing, University of Córdoba (UCO), 14004 Córdoba, Spain; (P.M.-A.)
- Interdisciplinary Research Group in Discourse Analysis (HUM380), University of Córdoba (UCO), 14071 Córdoba, Spain
| | - Salvador López-Quero
- Interdisciplinary Research Group in Discourse Analysis (HUM380), University of Córdoba (UCO), 14071 Córdoba, Spain
- Department of Language Sciences, Faculty of Philosophy and Letters, University of Córdoba (UCO), 14003 Córdoba, Spain
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Walker VG. Elder's life course theory and person-centered research: A lens for conducting ethical nursing research and mental health nursing practice with older adults aging with the diagnosis of schizophrenia. J Psychiatr Ment Health Nurs 2022; 29:904-914. [PMID: 35020244 DOI: 10.1111/jpm.12819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 12/17/2021] [Accepted: 01/07/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Older adults diagnosed with schizophrenia are a vulnerable population owing to the manifestations of their illness, which can include decreased reality orientation, paranoia, hallucinations and delusions. This paper presents ethical principles of vulnerability, veracity, non-maleficence and autonomy for person-centered care in mental health nursing research and practice, focused with the lens of Elder's life course theory (LCT). AIM To present Elder's LCT as an ethical lens for person-centered care as nurses engage with older adults aging with the diagnosis of schizophrenia in clinical practice and/or research. METHOD Four ethical principles fundamental to nursing research and mental health practice are presented, with Elder's LCT as a theoretical lens for person-centered care. RESULTS A model for ethical research and mental health practice with older adults diagnosed with schizophrenia. DISCUSSION Nursing research and mental health nursing practice with an ethical LCT lens for person-centered can help nurses envision, explore and generate interventions to address the special needs of older adults aging with schizophrenia. IMPLICATIONS FOR PRACTICE The use of a LCT lens for person-centered care can encourage nurses in research and mental health practice to seek information collaboratively with older adults diagnosed with schizophrenia in a thoughtful, ethical manner, to inform the improvement of their health outcomes and health policy.
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O'Sullivan A, Alvariza A, Öhlén J, Ex Håkanson CL. The influence of care place and diagnosis on care communication at the end of life: bereaved family members' perspective. Palliat Support Care 2021; 19:664-671. [PMID: 33781369 DOI: 10.1017/s147895152100016x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To investigate the influence of care place and diagnosis on care communication during the last 3 months of life for people with advanced illness, from the bereaved family members' perspective. METHOD A retrospective survey design using the VOICES(SF) questionnaire with a sample of 485 bereaved family members (aged: 20-90 years old, 70% women) of people who died in hospital was employed to meet the study aim. RESULTS Of the deceased people, 79.2% had at some point received care at home, provided by general practitioners (GPs) (52%), district nurses (36.7%), or specialized palliative home care (17.9%), 27.4% were cared for in a nursing home and 15.7% in a specialized palliative care unit. The likelihood of bereaved family members reporting that the deceased person was treated with dignity and respect by the staff was lowest in nursing homes (OR: 0.21) and for GPs (OR: 0.37). A cancer diagnosis (OR: 2.36) or if cared for at home (OR: 2.17) increased the likelihood of bereaved family members reporting that the deceased person had been involved in decision making regarding care and less likely if cared for in a specialized palliative care unit (OR: 0.41). The likelihood of reports of unwanted decisions about the care was higher if cared for in a nursing home (OR: 1.85) or if the deceased person had a higher education (OR: 2.40). SIGNIFICANCE OF RESULTS This study confirms previous research about potential inequalities in care at the end of life. The place of care and diagnosis influenced the bereaved family members' reports on whether the deceased person was treated with respect and dignity and how involved the deceased person was in decision making regarding care.
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Affiliation(s)
- Anna O'Sullivan
- Department of Healthcare Sciences, Palliative Research Centre, Ersta Sköndal Bräcke University College, Stockholm, Sweden
| | - Anette Alvariza
- Department of Healthcare Sciences, Palliative Research Centre, Ersta Sköndal Bräcke University College, Stockholm, Sweden
- Capio Palliative Care, Stockholm, Sweden
| | - Joakim Öhlén
- Institute of Health and Care Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
- Centre for Person-Centred Care, University of Gothenburg, Gothenburg, Sweden
- The Palliative Centre, Sahlgrenska University Hospital Västra Götaland Region, Gothenburg, Sweden
| | - Cecilia Larsdotter Ex Håkanson
- Department of Healthcare Sciences, Palliative Research Centre, Ersta Sköndal Bräcke University College, Stockholm, Sweden
- Department of Nursing Science, Sophiahemmet University, Stockholm, Sweden
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Walker VG, Walker EK. Older Adults Diagnosed With Schizophrenia in Long-term Care Facilities: Life Course Theory for Holistic Nursing Research and Practice. J Holist Nurs 2021; 40:181-192. [PMID: 34106020 DOI: 10.1177/08980101211025372] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Older adults diagnosed with schizophrenia (OADWS) often enter long-term care facilities with unique challenges related to trauma and stress experienced throughout their life course. Health care workers often report that when they work with this population, they feel unprepared due to limited training. In this article, life course theory is presented as a lens for holistic nursing research and as a way for nurses to adapt interventions already used with cognitively impaired older adults (e.g., those diagnosed with Alzheimer's disease) for OADWS in long-term care. It is hoped that these ideas will facilitate discussion of ways to inform training for holistic long-term care of OADWS. Holistic principles of nursing addressed with life course theory as a lens include the following: (a) accounting for strengths and challenges; (b) honoring experiences, values, and health beliefs; (c) viewing interrelationships with the environment; and (d) nurturing of peace, wholeness, and healing.
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Okinaka Y. Desired Lifestyle of Older Adults with Dementia Living at Home from Their Perspective and That of Their Families with Support from Care Providers. Health (London) 2021. [DOI: 10.4236/health.2021.1312104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Siewert JS, Alvarez AM, Santos SMAD, Brito FA, Hammerschmidt KSDA. Institutionalized elderly people with dementia: an integrative review on nursing care. Rev Bras Enferm 2020; 73 Suppl 3:e20180419. [PMID: 32756799 DOI: 10.1590/0034-7167-2018-0419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 05/11/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To ascertain the characteristics of the nursing care provided to institutionalized elderly people with dementia. METHODS Integrative review of studies published between 2013 and 2017, in English, Spanish, and Portuguese, from the databases BDENF, LILACS, CINAHL, PubMed, SciELO, TRIP, and National Guideline Clearing House. Thematic data analysis was used. RESULTS From the data collected in the 41 included studies, three themes emerged: Care with a focus on the needs of elderly people in LTCIEs; Care based on the work process of the nursing team; and Shared care. Final considerations: Elderly care can take place from different perspectives: that of the elderly; the nursing team; and it can be shared among the different parties involved. The importance of communication must be stressed, as do the development of skills and attitudes of the team, as well as proper training and support, good environment in the care process, and an approach centered on the institutionalized elderly.
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Lood Q, Sjögren K, Bergland Å, Lindkvist M, Kirkevold M, Sandman PO, Edvardsson D. Effects of a staff education programme about person-centred care and promotion of thriving on relatives' satisfaction with quality of care in nursing homes: a multi-centre, non-equivalent controlled before-after trial. BMC Geriatr 2020; 20:268. [PMID: 32738880 PMCID: PMC7395407 DOI: 10.1186/s12877-020-01677-7] [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] [Received: 03/24/2020] [Accepted: 07/27/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND As part of a nursing home intervention study, the aim of this paper was 1) to evaluate the effects of a staff education programme about person-centred care and promotion of thriving on relatives' satisfaction with quality of care and their perceptions of the person-centredness of the environment, and 2) to outline factors of importance to explain the variance in relatives' satisfaction with quality of care. Relatives are often referred to as vital for the operationalisation of person-centredness in nursing homes, representing an important source of information for care planning and quality of care assessments. However, the evidence for effects of person-centredness in nursing homes on relatives' experiences is sparse and little is known on what could explain their satisfaction with the quality of care. METHODS A multi-centre, non-equivalent controlled group before-after design with study sites in Australia, Norway and Sweden. Staff in the intervention group participated in a 14-month education on person-centredness, person-centred care, thriving and caring environment. Staff in the control group received a one-hour lecture before the intervention period. Data were collected at baseline, after the intervention and six months after the end of the intervention, and analysed using descriptive statistics, a generalised linear model and hierarchical multiple regression. RESULTS In general, relatives from both the intervention and control nursing homes were satisfied with the quality of care, and no statistically significant overall between-group-effects of the intervention were revealed on satisfaction with quality of care or perceptions of the person-centredness of environment. A person-centred environment in terms of safety and hospitality were identified as factors of prominent importance for the relatives' satisfaction with the quality of care. CONCLUSION The findings of this paper provide a foundation for future research in terms of intervention design in nursing home contexts. Staff availability, approachability, competence and communication with relatives may be important factors to consider to improve quality of care from the perspective of relatives, but more research both with and for relatives to people living in nursing homes is necessary to identify the keys to success. TRIAL REGISTRATION ClinicalTrials.gov- NCT02714452 . Registered on March 19, 2016.
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Affiliation(s)
- Qarin Lood
- The Medical Faculty, Department of nursing, Umeå University, Vårdvetarhuset, Hus A, plan 5, 90187, Umeå, Sweden. .,Institute of Neuroscience and Physiology, Department of Health and Rehabilitation, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Box 455, 40530, Gothenburg, Sweden. .,College of Science, Health and Engineering, School of Nursing and Midwifery, La Trobe University, Level 4 Austin Tower, PO Box 5555, Heidelberg, VIC, 3084, Australia.
| | - Karin Sjögren
- The Medical Faculty, Department of nursing, Umeå University, Vårdvetarhuset, Hus A, plan 5, 90187, Umeå, Sweden
| | - Ådel Bergland
- Lovisenberg Diaconal University College, Lovisenberggaten 15b, 0456, Oslo, Norway
| | - Marie Lindkvist
- Department of Epidemiology and Global Health, Umeå University, Försörjningsvägen 7D, 907 37, Umeå, Sweden
| | - Marit Kirkevold
- Faculty of Medicine, Institute of Health and Society, Oslo University, Nedre Ullevål 9, 0850, Oslo, Norway.,Institute of Nursing and health promotion, Oslo Metropolitan University, Pilestredet 32, 0130, Oslo, Norway
| | - Per-Olof Sandman
- The Medical Faculty, Department of nursing, Umeå University, Vårdvetarhuset, Hus A, plan 5, 90187, Umeå, Sweden.,NVS, Department of Nursing, Karolinska Institutet, Stockholm, Sweden
| | - David Edvardsson
- The Medical Faculty, Department of nursing, Umeå University, Vårdvetarhuset, Hus A, plan 5, 90187, Umeå, Sweden.,College of Science, Health and Engineering, School of Nursing and Midwifery, La Trobe University, Level 4 Austin Tower, PO Box 5555, Heidelberg, VIC, 3084, Australia
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Kulju K, Suhonen R, Puukka P, Tolvanen A, Leino-Kilpi H. Self-evaluated ethical competence of a practicing physiotherapist: a national study in Finland. BMC Med Ethics 2020; 21:43. [PMID: 32471504 PMCID: PMC7257238 DOI: 10.1186/s12910-020-00469-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 04/01/2020] [Indexed: 11/22/2022] Open
Abstract
Background Patients have the right to equal, respectful treatment. Nowadays, one third of patient complaints concern health care staff’s behavior towards patients. Ethically safe care requires ethical competence, which has been addressed as a core competence in physiotherapy. It has been defined in terms of character strength, ethical awareness, moral judgment skills in decision-making, and willingness to do good. The purpose of this study was to analyze the ethical competence of practicing physiotherapists. Method A self-evaluation instrument (Physiotherapist’s Ethical Competence Evaluation Tool) based on an analysis of a concept “ethical competence” was constructed in 2016 and physiotherapists (n = 839), working in public health services or private practice responded to the questionnaire. Results Based on the results, most of the physiotherapists evaluated themselves highly ethically competent in all areas of ethical competence, subscales being Strength, Awareness, Skills and Will. Willingness to do good was evaluated as highest, while character strength, including the strength to support ethical processes and speak on behalf of the patient, was evaluated the lowest. Physiotherapists most commonly consult a colleague when encountering an ethical problem. Other methods for problem solving are not very familiar, neither are the international or national ethical codes of conduct. Conclusions This was the first attempt to assess all aspects of ethical competence empirically in a clinical environment in physiotherapy, using a novel self-evaluation instrument. Even if physiotherapists evaluate themselves as competent in ethics, further exploration is needed for ethical awareness. Also the patients’ viewpoints about ethically competent care should be considered, to better ensure ethical safety of the patient.
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Affiliation(s)
- Kati Kulju
- Department of Nursing Science, University of Turku, FI-20014, Turku, Finland.
| | - Riitta Suhonen
- Department of Nursing Science/ Turku University Hospital and City of Turku, Welfare Division, University of Turku, Turku, Finland
| | - Pauli Puukka
- National Institute for Health and Welfare, Turku, Finland
| | - Anna Tolvanen
- Department of Nursing Science, University of Turku, FI-20014, Turku, Finland
| | - Helena Leino-Kilpi
- Department of Nursing Science, Turku University Hospital, University of Turku, Turku, Finland
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Boumans J, van Boekel LC, Baan CA, Luijkx KG. How Can Autonomy Be Maintained and Informal Care Improved for People With Dementia Living in Residential Care Facilities: A Systematic Literature Review. THE GERONTOLOGIST 2020; 59:e709-e730. [PMID: 30239712 PMCID: PMC6858830 DOI: 10.1093/geront/gny096] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Indexed: 11/22/2022] Open
Abstract
Background and Objectives For people with dementia living in residential care facilities, maintaining autonomy and receiving informal care are important. The objective of this review is to understand how caregiving approaches and physical environment, including technologies contribute to the maintenance of autonomy and informal care provision for this population. Research Design and Methods A literature review of peer-reviewed articles published between January 1995 and July 2017 was performed. Realist logic of analysis was used, involving context, mechanism and outcome configurations. Results Forty-nine articles were included. The improvement of the relationship between residents and formal/informal caregivers is important. This increases the knowledge (sharing) about the resident and contributes to their autonomy. A social, flexible, and welcoming attitude of the formal caregiver improves the provision of informal care. Specially designed spaces, for instance, therapeutic gardens, create activities for residents that remind them of themselves and contribute to their autonomy. Use of technologies reduces caregiver’s time for primary tasks and therefore enables secondary tasks such as interaction with the residents. Discussion and Implications The results revealed how residential care facilities could maintain autonomy of their residents and improve informal care delivery using caregiving approaches and the physical environment including technologies. The results are supporting toward each other in maintaining autonomy and also helped in enhancing informal care provision. For residential care facilities that want to maintain the autonomy of their residents and improve informal care delivery, it is important to pay attention to all aspects of living in a residential care facility.
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Affiliation(s)
- Jogé Boumans
- Tranzo, Scientific Center for Care and Welfare, Tilburg School of Social and Behavioral Sciences, Tilburg University, The Netherlands
| | - Leonieke C van Boekel
- Tranzo, Scientific Center for Care and Welfare, Tilburg School of Social and Behavioral Sciences, Tilburg University, The Netherlands
| | - Caroline A Baan
- Tranzo, Scientific Center for Care and Welfare, Tilburg School of Social and Behavioral Sciences, Tilburg University, The Netherlands.,Department of Quality of Care and Health Economics, Centre for Nutrition, Prevent and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Katrien G Luijkx
- Tranzo, Scientific Center for Care and Welfare, Tilburg School of Social and Behavioral Sciences, Tilburg University, The Netherlands
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12
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Koskenniemi J, Leino‐Kilpi H, Puukka P, Suhonen R. Respect and its associated factors as perceived by older patients. J Clin Nurs 2019; 28:3848-3857. [DOI: 10.1111/jocn.15013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 06/09/2019] [Accepted: 06/30/2019] [Indexed: 02/03/2023]
Affiliation(s)
| | - Helena Leino‐Kilpi
- Department of Nursing Science, Turku University Hospital University of Turku Turku Finland
| | - Pauli Puukka
- National Institute for Health and Welfare Turku Finland
| | - Riitta Suhonen
- Department of Nursing Science, Turku University Hospital and City of Turku, Welfare Division University of Turku Turku Finland
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Vaartio-Rajalin H, Näsman Y, Santamäki-Fischer R, Hemberg J. Working in home healthcare and suggestions for development. Home Health Care Serv Q 2019; 38:257-269. [PMID: 31295058 DOI: 10.1080/01621424.2019.1641450] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
In order to describe nurses' experiences of working in home health care and their suggestions for the development of this public health-care sector, interviews with 18 home health-care nurses were analyzed with qualitative thematic content analysis. The nurses perceived the working shifts either affirmative or non-affirmative, depending on the contextual and organizational factors affecting nurses' workload. The more the nurses perceived they could influence their work, the more engaged they were in patient-related nursing activities, patient-centeredness, collaboration, and forward planning. Several concrete suggestions for the development of home healthcare on the organizational, interprofessional, team and individual levels were given.
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Affiliation(s)
- Heli Vaartio-Rajalin
- Faculty of Education and Welfare Studies, Åbo Akademi University , Vasa , Finland.,Bachelor of Healthcare, Nursing, Novia University of Applied Sciences , Åbo , Finland
| | - Yvonne Näsman
- Faculty of Education and Welfare Studies, Åbo Akademi University , Vasa , Finland
| | | | - Jessica Hemberg
- Faculty of Education and Welfare Studies, Åbo Akademi University , Vasa , Finland
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Waidley EK. The Importance of Patients' Perceptions of Technology: Reminders for Nursing Care Delivery. J Contin Educ Nurs 2019; 50:263-267. [PMID: 31136669 DOI: 10.3928/00220124-20190516-06] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2018] [Accepted: 11/27/2018] [Indexed: 11/20/2022]
Abstract
BACKGROUND This study investigates hospitalized patients' perceptions of nurses' use of technology in care delivery and provides an overview of the professional debate regarding high-touch versus high-technology nursing practice. METHOD A mixed-methods qualitative study combined concepts from phenomenology and narrative analysis to allow the nurse researcher to engage with the patient to solicit patient stories. This approach acknowledges the researcher's role as a nurse, which cannot be fully eliminated from the patient stories and analysis of their experiences. The combined methodology also focuses on a phenomenological approach that uses a semistructured interview as a mechanism to gather data specific to questions about the patients' perspective of the influence of technology on patient care. RESULTS Five main themes were identified from patient interviews: Noise/Lack of Sleep, Emotional/Patient Engagement, Individualized Care, Patient and Nurse Knowledge Levels (related to technology), and the Benefits/Challenges of Care (related to technology). CONCLUSION Nurses are missing opportunities to improve their practice and the quality of patient care when using technology as an adjunct to care delivery. [J Contin Educ Nurs. 2019;50(6):263-267.].
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Koskenniemi J, Leino-Kilpi H, Puukka P, Stolt M, Suhonen R. Being respected by nurses: Measuring older patients’ perceptions. Int J Older People Nurs 2018; 13:e12197. [DOI: 10.1111/opn.12197] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 03/24/2018] [Indexed: 11/29/2022]
Affiliation(s)
| | - Helena Leino-Kilpi
- Department of Nursing Science; University of Turku; Turku Finland
- Turku University Hospital; Turku Finland
| | - Pauli Puukka
- National Institute for Health and Welfare; Turku Finland
| | - Minna Stolt
- Department of Nursing Science; University of Turku; Turku Finland
| | - Riitta Suhonen
- Turku University Hospital; Turku Finland
- Welfare Division; City of Turku; Turku Finland
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Choe K, Kang H, Lee A. Barriers to ethical nursing practice for older adults in long-term care facilities. J Clin Nurs 2018; 27:1063-1072. [PMID: 29076196 DOI: 10.1111/jocn.14128] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2017] [Indexed: 11/29/2022]
Abstract
AIMS AND OBJECTIVES To explore barriers to ethical nursing practice for older adults in long-term care facilities from the perspectives of nurses in South Korea. BACKGROUND The number of older adults admitted to long-term care facilities is increasing rapidly in South Korea. To provide this population with quality care, a solid moral foundation should be emphasised to ensure the provision of ethical nursing practices. Barriers to implementing an ethical nursing practice for older adults in long-term care facilities have not been fully explored in previous literature. DESIGN A qualitative, descriptive design was used to explore barriers to ethical nursing practice as perceived by registered nurses in long-term care facilities in South Korea. METHODS Individual interviews were conducted with 17 registered nurses recruited using purposive (snowball) sampling who care for older adults in long-term care facilities in South Korea. Data were analysed using qualitative content analysis. RESULTS Five main themes emerged from the data analysis concerning barriers to the ethical nursing practice of long-term care facilities: emotional distress, treatments restricting freedom of physical activities, difficulty coping with emergencies, difficulty communicating with the older adult patients and friction between nurses and nursing assistants. CONCLUSIONS This study has identified methods that could be used to improve ethical nursing practices for older adults in long-term care facilities. Because it is difficult to improve the quality of care through education and staffing alone, other factors may also require attention. RELEVANCE FOR CLINICAL PRACTICE Support programmes and educational opportunities are needed for nurses who experience emotional distress and lack of competency to strengthen their resilience towards some of the negative aspects of care and being a nurse that were identified in this study.
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Affiliation(s)
- Kwisoon Choe
- Department of Nursing, Chung-Ang University, Seoul, Korea
| | - Hyunwook Kang
- Department of Nursing, Kangwon National University, Chuncheon-si, Korea
| | - Aekyung Lee
- Chuncheon Seoin Hospital, Chuncheon-si, Korea
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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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