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Wang Q, Huang X, Liu M, Wang C, Sun Z, Huang C, Tang S. Prevalence and risk factors of depression among elderly people in nursing homes from 2012 to 2022: a systematic review and meta-analysis. Aging Ment Health 2024:1-12. [PMID: 38952191 DOI: 10.1080/13607863.2024.2367044] [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: 04/24/2023] [Accepted: 02/20/2024] [Indexed: 07/03/2024]
Abstract
OBJECTIVES To determine a pooled prevalence of depression and its influencing factors among nursing home residents. METHOD PsycINFO, PubMed, Embase, and Web of Science were searched for studies investigating the prevalence and risk factors of late-life depression among nursing home residents between January 2012 and November 2022. Two reviewers independently completed the literature screening, data extraction and quality assessment. A random-effects model was utilized to pool the prevalence of depression and summarize the influencing factors. RESULTS This meta-analysis included 48 studies involving 28,501 participants. The pooled prevalence of depressive mood and major depressive disorder was 53% and 27%, respectively. The rate of depressive mood is higher in lower-middle-income countries (60.0%), compared with high- (53.0%) and upper-middle-income countries (44.0%). The rate of depressive mood (35.0%) is higher among females than male (19.0%). Depression was influenced by factors, including male (OR = 0.28), insufficient income (OR = 3.53), comorbidities (OR = 2.66), pain (OR = 2.67; r = 0.31), functional disability (r = 0.33), loneliness (r = 0.43), number of chronic health problems (r = 0.18), social support (r = -0.28), activities of daily living (r = -0.43), subjective health (r = -0.28), autonomy (r = -0.41), environment (r = -0.50) and physical (r = -0.57) and psychological health (r = -0.65). CONCLUSION The prevalence of depressive mood is high among nursing home residents, especially in lower-middle-income countries. It is influenced by factors including gender, income, social support, daily activities, environment, physical and psychological health and autonomy. Understanding those factors can provide evidence-based recommendations for improved awareness, prevention and better management of late-life depression.
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Affiliation(s)
- Qing Wang
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Xiaoting Huang
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Minhui Liu
- School of Nursing, Ningxia Medical University, Yinchuan, China
| | - Chunyu Wang
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Zaiqing Sun
- Xiangya School of Nursing, Central South University, Changsha, China
| | - Chongmei Huang
- School of Nursing, Ningxia Medical University, Yinchuan, China
| | - Siyuan Tang
- Xiangya School of Nursing, Central South University, Changsha, China
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Rawson H, Davies S, Ockerby C, Pipson R, Peters R, Manias E, Redley B. Work engagement, psychological empowerment and relational coordination in long-term care: A mixed-method examination of nurses' perceptions and experiences. Nurs Inq 2024; 31:e12598. [PMID: 37656636 DOI: 10.1111/nin.12598] [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: 02/03/2023] [Revised: 08/11/2023] [Accepted: 08/22/2023] [Indexed: 09/03/2023]
Abstract
Nurse engagement, empowerment and strong relationships among staff, residents and families, are essential to attract and retain a suitably qualified and skilled nursing workforce for safe, quality care. There is, however, limited research that explores engagement, empowerment and relational coordination in long-term care (LTC). Nurses from an older persons' mental health and dementia LTC unit in Australia participated in this study. Forty-one nurses completed a survey measuring psychological empowerment, work engagement and relational coordination. Twenty-nine nurses participated in individual interviews to further explore these concepts. Although nurses reported high psychological empowerment and work engagement, their relationships with key stakeholders varied. Our findings suggest that nurses in LTC require both supports and opportunities to contribute as active members of the multiprofessional care team that includes tailored education, professional development and positive interactions within the care team. Regular support is needed to enable nurses to feel empowered, foster relationships and communication, and facilitate work engagement. Based on these findings, we suggest that it is important to find ways to ensure that all who provide care perceive that they are part of the whole care team and able to contribute to the care and well-being of people in LTC.
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Affiliation(s)
- Helen Rawson
- Monash Nursing and Midwifery, Monash University, Clayton, Victoria, Australia
| | - Sarah Davies
- Residential Services, Monash Health, Cheltenham, Victoria, Australia
| | - Cherene Ockerby
- Centre for Quality and Patient Safety Research, Monash Health Partnership, Monash Health, Clayton, Victoria, Australia
- School of Nursing and Midwifery, Deakin University, Burwood, Victoria, Australia
| | - Ruby Pipson
- Residential Services, Monash Health, Cheltenham, Victoria, Australia
| | - Ruth Peters
- Residential Services, Monash Health, Cheltenham, Victoria, Australia
| | - Elizabeth Manias
- Monash Nursing and Midwifery, Monash University, Clayton, Victoria, Australia
| | - Bernice Redley
- School of Nursing and Midwifery, Deakin University, Burwood, Victoria, Australia
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Hynnekleiv II, Jensen JK, Giske T, Lausund H, Maeland E, Heggdal K. Patients' and Nurses' experiences of caring in nursing: An integrative literature review across clinical practices. J Clin Nurs 2024; 33:1233-1255. [PMID: 38093547 DOI: 10.1111/jocn.16964] [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: 04/24/2023] [Revised: 10/12/2023] [Accepted: 11/01/2023] [Indexed: 03/08/2024]
Abstract
AIM To summarise, interpret and synthesize research findings on patients' and nurses' experiences of caring in nursing across clinical practices. BACKGROUND Caring is a universal element of nursing; however, economic restrictions often negatively impact health services, and time shortages and limited numbers of staff may characterize care encounters. It is unclear how these contextual conditions affect patients' and nurses' experiences of caring. DESIGN AND METHODS This integrative literature review covers papers published between 2000 and 2022. Four databases-PubMed, PsycINFO (via Ovid), MEDLINE (via Ovid) and CINAHL (via EBSCO)-were systematically searched for eligible papers in May 2022. The included studies were critically appraised. Content analysis was performed to interpret and synthesize the findings. In accordance with the EQUATOR guidelines, the PRISMA 2020 and PRISMA-S checklists were used. An Integrative review methodology guided the process. FINDINGS In total, 33 studies were included in the review. Three themes captured the experiences of caring in nursing: (1) the complexity of the nursing care context, (2) the professionalism of the nurse, and (3) the trusting patient-nurse relationship. CONCLUSION The experience of caring in nursing depended on nurses' competence and discretion in the personal encounter framed by the nursing context. The caring relationship was based on reciprocity, but it remains asymmetrical, as the nurse had the power and responsibility to empower the patient. Barriers, such as increased demands for efficiency and resource scarcity, may hinder the experience of caring in nursing. IMPLICATIONS FOR THE PROFESSION AND PATIENT CARE By promoting an ongoing discussion of caring in nursing, nurse management can systematically support nurses in reflecting on their practice in diverse and complex clinical contexts. PATIENT OR PUBLIC CONTRIBUTION No patient or public contribution was made due to the study design.
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Affiliation(s)
| | - Jørghild K Jensen
- Faculty of Health Sciences, VID Specialized University, Oslo, Norway
| | - Tove Giske
- Faculty of Health Sciences, VID Specialized University, Bergen, Norway
| | - Hilde Lausund
- Faculty of Health Sciences, VID Specialized University, Oslo, Norway
| | - Elisabeth Maeland
- Faculty of Health Sciences, VID Specialized University, Oslo, Norway
| | - Kristin Heggdal
- Faculty of Health Sciences, VID Specialized University, Oslo, Norway
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Gilbert R, Lillekroken D. Nurses' perceptions of how their professional autonomy influences the moral dimension of end-of-life care to nursing home residents- a qualitative study. BMC Nurs 2024; 23:216. [PMID: 38549064 PMCID: PMC10976790 DOI: 10.1186/s12912-024-01865-5] [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: 12/06/2023] [Accepted: 03/13/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND Over the years, caring has been explained in various ways, thus presenting various meanings to different people. Caring is central to nursing discipline and care ethics have always had an important place in nursing ethics discussions. In the literature, Joan Tronto's theory of ethics of care is mostly discussed at the personal level, but there are still a few studies that address its influence on caring within the nursing context, especially during the provision of end-of-life care. This study aims to explore nurses' perceptions of how their professional autonomy influences the moral dimension of end-of-life care provided to nursing home residents. METHODS This study has a qualitative descriptive design. Data were collected by conducting five individual interviews and one focus group during a seven-month period between April 2022 and September 2022. Nine nurses employed at four Norwegian nursing homes were the participants in this study. Data were analysed by employing a qualitative deductive content analysis method. RESULTS The content analysis generated five categories that were labelled similar to Tronto's five phases of the care process: (i) caring about, (ii) caring for, (iii) care giving, (iv) care receiving and (v) caring with. The findings revealed that nurses' autonomy more or less influences the decision-making care process at all five phases, demonstrating that the Tronto's theory contributes to greater reflectiveness around what may constitute 'good' end-of-life care. CONCLUSIONS Tronto's care ethics is useful for understanding end-of-life care practice in nursing homes. Tronto's care ethics provides a framework for an in-depth analysis of the asymmetric relationships that may or may not exist between nurses and nursing home residents and their next-of-kin. This can help nurses see and understand the moral dimension of end-of-life care provided to nursing home residents during their final days. Moreover, it helps handle moral responsibility around end-of-life care issues, providing a more complex picture of what 'good' end-of-life care should be.
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Affiliation(s)
- Rachel Gilbert
- Department of Nursing and Health Promotion, Oslo Metropolitan University, PB 4, St. Olavs Plass, N-0130, Oslo, Norway
| | - Daniela Lillekroken
- Department of Nursing and Health Promotion, Oslo Metropolitan University, PB 4, St. Olavs Plass, N-0130, Oslo, Norway.
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Mathiesen KL, Lindberg E, Nässén K, Cowdell F, Palmér L. Home care nurses lived experiences of caring relationships with older adults: A phenomenological study. Scand J Caring Sci 2024; 38:150-158. [PMID: 37750377 DOI: 10.1111/scs.13217] [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: 03/29/2023] [Revised: 07/26/2023] [Accepted: 09/12/2023] [Indexed: 09/27/2023]
Abstract
BACKGROUND This paper describes registered nurses' lived experiences of caring relationships in the context of homecare provision for older adults living in Denmark. With the growing ageing population throughout Europe, more older adults will require complex care solutions within already overburdened care systems. This development places demands on the competencies and organisation of homecare nurses, as they become key players in healthcare systems. Fostering caring relationships in homecare is a rewarding and valuable process that enhances the holistic and humanising aspects of caring for older adults. For a caring relationship to be truly caring, we must understand not only the subjective experience of such a relationship but also how it is experienced in relation to and shared with others. AIM This study aimed to describe the essential meaning of the phenomenon of caring relationships in homecare for older adults based on the lived experiences of homecare nurses. APPROACH AND METHODS Registered nurses working in homecare for older adults were interviewed, and a phenomenological analysis was conducted according to the methodological principles of the reflective lifeworld research approach. FINDINGS The essential meaning of the phenomenon is described as creating an existential and embodied space in which each patient's world is the foundation of caring. The constituents are as follows: caring for the whole person, a sense of 'at-homeness' through trusting 'the other', experiencing continuity as caring and prioritising the time to care. CONCLUSION Caring competence in homecare for older adults relies on a nurse's ability to intertwine physical and existential care needs and articulate them in their daily work. A focus on the phenomenon of caring relationships brings value to and adds an extra layer to the discussion on caring competence.
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Affiliation(s)
| | - Elisabeth Lindberg
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
| | - Kristina Nässén
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
| | | | - Lina Palmér
- Faculty of Caring Science, Work Life and Social Welfare, University of Borås, Borås, Sweden
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Keane J, Ryan C, Usher R. Leisure and social occupational choice within nursing home facilities in Ireland: Residents perspectives. Scand J Occup Ther 2024; 31:2259222. [PMID: 37918009 DOI: 10.1080/11038128.2023.2259222] [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: 11/29/2021] [Accepted: 09/12/2023] [Indexed: 11/04/2023]
Abstract
BACKGROUND National standards for nursing homes in Ireland require that residents are offered a choice of recreational and stimulating activities to meet their needs and preferences. AIMS/OBJECTIVES To investigate residents' perceptions of leisure and social occupational choice in nursing homes in Ireland to determine if occupational choice is facilitated. MATERIALS AND METHOD Qualitative-descriptive design - nursing home residents completed two semi-structured interviews that explored their experiences of leisure and social occupational engagement. RESULTS Two overarching themes with six associated sub-themes emerged. From residents' perspectives, social and leisure occupational choice was dependent on: Environmental factors (nursing homes' Cultural, Social, Physical, and Temporal Environments) and Personal factors (residents' Health Status and Personal Attitudes). CONCLUSION The cultural environment had the most significant influence on residents' leisure and social occupational choice, highlighting the importance of person-centred care within nursing homes, to promote occupational choice. Resident's health status was also identified as a contributing factor. SIGNIFICANCE Occupational therapists could play a critical role in supporting the leisure and social occupational choices of nursing home residents by developing residents' skills, educating staff and adapting tasks and the environment to limit/reduce occupational deprivation.
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Affiliation(s)
- Jenna Keane
- Department of Occupational Therapy and Occupational Science, University College, Cork, Ireland
| | - Ciara Ryan
- Department of Occupational Therapy and Occupational Science, University College, Cork, Ireland
| | - Ruth Usher
- Department of Occupational Therapy and Occupational Science, University College, Cork, Ireland
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Hernández-Padilla JM, Dobarrio-Sanz I, Correa-Casado M, Del Mar Jiménez-Lasserrotte M, Fernández-Sola C, Ruiz-Fernández MD. Spanish version of the Maastricht Personal Autonomy Questionnaire: A validation study among community-dwelling older adults with chronic multimorbidity. Int J Older People Nurs 2024; 19:e12595. [PMID: 38102809 DOI: 10.1111/opn.12595] [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: 03/23/2023] [Accepted: 11/27/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND Loss of personal autonomy in older adults with chronic multimorbidity is associated with worsened biopsychosocial health. In order to facilitate the standardised assessment of personal autonomy in older adults with chronic conditions, nurses could use the Maastricht Personal Autonomy Questionnaire (MPAQ). OBJECTIVE To translate, culturally adapt and psychometrically assess the Spanish version of the MPAQ in community-dwelling older adults with chronic multimorbidity (MPAQ-Sp). METHODS Observational cross-sectional study. A convenience sample of 884 community-dwelling older adults was recruited from 10 community centres in five health districts in southeastern Spain. Data were collected between January 2021 and September 2022. The study was completed in four phases. Phase 1: The MPAQ was translated into Spanish. Phase 2: A pilot test of reliability and content validity was conducted. Phase 3: To test the dimensionality of the tool, an exploratory factor analysis (EFA) was conducted. Phase 4: a final validation study was conducted which included a confirmatory factor analysis (CFA) and assessed the validity (content, criterion and construct), reliability and readability of the MPAQ-Sp. RESULTS The average age of the sample was 75.89 years (SD = ±8.04). Their mean number of chronic conditions was 4.84 (SD = ±2.19) and 67% were women. The MPAQ-Sp is comprised of 16 items distributed in four subscales: [1] the 'Degree of autonomy' scale, [2] the 'Working on autonomy' scale, [3] the 'Dilemmas: health over preferences' scale and [4] the 'Dilemmas: preferences over health' scale. CONCLUSIONS The Spanish version of the MPAQ-Sp is a valid and reliable instrument to assess personal autonomy in Spanish-speaking, community-dwelling older adults with chronic multimorbidity. IMPLICATIONS FOR PRACTICE The use of the MPAQ-Sp would allow researchers and healthcare professionals to identify a loss of personal autonomy among Spanish-speaking community-dwelling older adults with chronic multimorbidity.
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Affiliation(s)
| | - Iria Dobarrio-Sanz
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, Almeria, Spain
| | - Matías Correa-Casado
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, Almeria, Spain
| | | | - Cayetano Fernández-Sola
- Department of Nursing, Physiotherapy and Medicine, University of Almeria, Almeria, Spain
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Santiago, Chile
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Nyende A, Ellis-Hill C, Mantzoukas S. A Sense of Control and Wellbeing in Older People Living with Frailty: A Scoping Review. JOURNAL OF GERONTOLOGICAL SOCIAL WORK 2023; 66:1043-1072. [PMID: 37139581 DOI: 10.1080/01634372.2023.2206438] [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: 07/18/2022] [Revised: 04/19/2023] [Accepted: 04/20/2023] [Indexed: 05/05/2023]
Abstract
A sense of control is important for supporting older people living with frailty to develop adaptive functioning to optimize wellbeing. This scoping review examined the literature on the sense of control and wellbeing in older people living with frailty within their everyday life and care service use. Nine databases were searched using the timeframe 2000 to 2021 to identify key ideas regarding control and wellbeing in older people with frailty. The review highlighted three major themes: a) Control as conveyed in bodily expressions and daily activities, b) Sense of control and influence of place of residence, and c) Control within health and social care relationships. Maintaining a sense of control is not only an internal feeling but is impacted by physical and social environments. Greater focus is needed on the nature of relationships between older people living with frailty and those who work alongside them, which support control and wellbeing.
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Affiliation(s)
- Adam Nyende
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, UK
| | - Caroline Ellis-Hill
- Faculty of Health and Social Sciences, Bournemouth University, Bournemouth, UK
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Morgan S, Hansen TEA, Nørgaard B. Perspectives on residential involvement and engagement in everyday life-a qualitative study. Scand J Occup Ther 2023; 30:1143-1152. [PMID: 37270769 DOI: 10.1080/11038128.2023.2218570] [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: 01/05/2023] [Revised: 05/23/2023] [Accepted: 05/23/2023] [Indexed: 06/06/2023]
Abstract
Background: Worldwide, the population is ageing, and the need for nursing homes is increasing. institutionalization and a culture change from task-orientated care delivery towards increased involvement and engagement in a meaningful everyday life are evolving and, thus, contributing to nursing home residents' quality of life and well-being.Aims/Objectives: To explore nursing home staff's and local managers' perspectives on everyday life with a specific focus on involvement and engagement.Material and Methods: Positioned within interpretivism and hermeneutics, a qualitative exploratory design was applied using individual and group interviews for data generation and abductive thematic analysis as the analytical method.Results: Through the analyses, three main themes appeared-A good day-Everyday life in a nursing home, Doing together-involvement in Everyday life and Involvement in Everyday life-difficult to practice-together with four subthemes-Home and people within, Knowing and relating to the person, If they can - they must and Service and Habits.Conclusions: Fulfilling the needs of both residents and the institution was found to be challenging by nursing home staff and local managers.Significance: A different approach to care, facilitated by, for example, occupational therapists, might be required to enable increased involvement and engagement in everyday life.
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Holmsen LC, Tveit B, Skar AMS, Hem MH. Professional caregivers' participation in the International Caregiver Development Programme: A qualitative study of psychosocial care in nursing homes. Nurs Open 2023. [PMID: 37186514 DOI: 10.1002/nop2.1775] [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: 08/10/2022] [Revised: 03/15/2023] [Accepted: 04/16/2023] [Indexed: 05/17/2023] Open
Abstract
AIM This paper aims to explore professional caregivers' experiences of psychosocial care for older persons living in nursing homes following the professional caregivers' participation in the International Caregiver Development Programme (ICDP). DESIGN A qualitative study. METHODS About 15 focus group interviews and 25 participatory observations of five ICDP group courses were conducted with 31 employees in nursing homes, including registered nurses, enrolled nurses and nursing aids. The findings emerged through hermeneutic analysis. RESULTS Main findings: (i) Adjusting the communication to the residents' psychosocial needs, (ii) Seeing the residents as individuals and (iii) Adjusting to individual interaction with the residents. The professional caregivers experienced that the residents participated more in communication, interaction and activities, in addition to be more satisfied, calm, happy and thankful in interaction with the caregivers. Furthermore, they described that the environment in the units became calmer and that they were considering psychosocial care before medication. Work-related stress seems to impact ICDP participation and may be a barrier to implementation.
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Affiliation(s)
- Line Constance Holmsen
- Centre of Diaconia and Professional Practice, VID Specialized University (VID), Oslo, Norway
| | - Bodil Tveit
- Faculty of Health Studies, VID Specialized University (VID), Oslo, Norway
| | | | - Marit Helene Hem
- Faculty of Health Studies, VID Specialized University (VID), Oslo, Norway
- Department of Mental Health Work, NTNU Social Research, Trondheim, Norway
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Nejat N, Zand S, Taheri M, Khosravani M. Understanding lived experiences of nurse managers about managerial ethics. Nurs Ethics 2023; 30:162-179. [PMID: 36314258 DOI: 10.1177/09697330221130599] [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: 11/05/2022]
Abstract
INTRODUCTION Expressions of Managerial ethics as a clinical phenomenon in Nursing Ethics as expressed by nurse managers were investigated. A coherence could be detected between the concepts and phenomena of Managerial ethics and nurse managers as a context. BACKGROUND Managerial ethics as a new approach has emerged in the perspective and by prioritizing ethics in the organization has provided the basis for creating and promoting individual and organizational effectiveness. Managers' and staff's adherence to professional ethics helps hospitals to achieve their intended goals. AIM The present study aimed to explain nurse managers' experience of managerial ethics. RESEARCH DESIGN This qualitative study was conducted based on a phenomenological design in 2022. PARTICIPANTS AND RESEARCH CONTEXT The participants included 20 nurse managers working in hospitals in Arak, Iran. They were selected by the purposive sampling method which continued until data saturation. Data were collected through semi-structured individual interviews (30-90 min); subsequently, the obtained results were analyzed using the Van Manen six-step approach. ETHICAL CONSIDERATIONS The confidentiality and the right of participants to take part or withdraw from the study were observed during this research. RESULTS The results of the present study were able to demonstrate nurse managers' lived experience of managerial ethics in the form of five themes of professional ethics, people-oriented management, professional empowerment, excellencism, and patient-centered care. CONCLUSIONS As evidenced by the obtained results, nurse managers held a positive view of managerial ethics. They were striving to strongly adhere to ethical principles in nursing management since they contribute greatly to the improved quality of nursing services in care and health settings. Therefore, appropriate policy-making and planning for managerial ethics training are indispensable for all nurses and nursing students.
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Affiliation(s)
- Nazi Nejat
- 48412Arak University of Medical Sciences, Iran
| | | | - Majid Taheri
- 556492Shahid Beheshti University of Medical Sciences, Iran
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12
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Klemmt M, Henking T, Teti A, Neuderth S. [Factors of endangering and violation of autonomy in residential nursing homes: results of a scoping review]. HEILBERUFESCIENCE 2023; 14:28-36. [PMID: 36687805 PMCID: PMC9841482 DOI: 10.1007/s16024-022-00397-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 12/06/2022] [Indexed: 05/07/2023]
Abstract
Background Respecting autonomy is one of the guiding principles of medical and nursing ethics. Nursing home residents represent a particularly relevant target group whose autonomy can be endangered or violated. Aim The study aimed to identify factors that endanger or violate the nursing home residents' autonomy and to determine specific life situations and contexts in which these factors are located. Methods A scoping review was carried out according to the Joanna Briggs Institute-method. Empirical results from journal articles from the publication period 2000-2021 were included. The articles were analyzed using qualitative content analysis. Results A total of 75 articles were finally included in the review. Identified factors of the endangerment and violation of autonomy are assigned to topic areas located at the level of actors, (care) relationships and structures. Factors that can violate or endanger the residents' autonomy were found in the entire everyday life of the residents. Conclusion The localization of the identified endangerments/violations on various actor and structural levels indicates the need for comprehensive preservation and promotion of residents' autonomy in nursing homes.
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Affiliation(s)
- Malte Klemmt
- Institut für Angewandte Sozialwissenschaften, Hochschule für angewandte Wissenschaften Würzburg-Schweinfurt, Münzstraße 12, 97070 Würzburg, Deutschland
| | - Tanja Henking
- Institut für Angewandte Sozialwissenschaften, Hochschule für angewandte Wissenschaften Würzburg-Schweinfurt, Münzstraße 12, 97070 Würzburg, Deutschland
| | - Andrea Teti
- Institut für Gerontologie, Universität Vechta, Driverstraße 22, 49377 Vechta, Deutschland
| | - Silke Neuderth
- Institut für Angewandte Sozialwissenschaften, Hochschule für angewandte Wissenschaften Würzburg-Schweinfurt, Münzstraße 12, 97070 Würzburg, Deutschland
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13
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Lemos R, Lopes A, Dias I, Barros H. Portuguese Older Persons' Views about Living in a Nursing Home: Challenges to the Rehabilitation of the Image of LTC in Post-Pandemic Times. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10566. [PMID: 36078281 PMCID: PMC9517809 DOI: 10.3390/ijerph191710566] [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: 07/29/2022] [Revised: 08/19/2022] [Accepted: 08/20/2022] [Indexed: 06/15/2023]
Abstract
This paper addresses the broad topic of what older people think about nursing homes in Portugal. In the aftermath of the COVID-19 pandemic and considering the tragic events taking place in nursing homes, the challenge of reimagining the sector involves not only improving procedures and models of care, making sure they meet what citizens consider adequate, but also rehabilitating the image people have about nursing homes and rebuilding trust. Current and future decisions about how one meets LTC needs is influenced by the extent to which individuals see the alternatives as adequate. The paper presents evidence collected from a qualitative study run just before the COVID-19 pandemic began, with a sample of 45 community-dwelling individuals aged 60 plus, in Portugal. Opinions and views about nursing homes were collected and the results point to enduring negative aspects that are considered at odds with what constitutes adequate care. The paper discusses in length what those aspects are and concludes that future reforms of the nursing homes sector in Portugal need to consider what current and future users think and feel about that specific type of service. Debates in Portugal tend to be more focused on discussions about expanding the sector and less on aspects of quality of care. Views and opinions of interviewed participants, however, suggest that people may be more worried about quality of care.
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Affiliation(s)
- Rute Lemos
- PhD Program in Sociology, Department of Sociology, Faculty of Arts and Humanities, University of Porto, 4150-564 Porto, Portugal
| | - Alexandra Lopes
- Centre for English, Translation and Anglo-American Studies (CETAPS), 4150-564 Porto, Portugal
- Department of Sociology, Faculty of Arts and Humanities, University of Porto, 4150-564 Porto, Portugal
| | - Isabel Dias
- Department of Sociology, Faculty of Arts and Humanities, University of Porto, 4150-564 Porto, Portugal
- Institute of Sociology, University of Porto, 4150-564 Porto, Portugal
| | - Henrique Barros
- Epidemiology Research Unit, Institute for Public Health, University of Porto, 4050-600 Porto, Portugal
- Department of Public Health and Forensic Sciences, and Medical Education, Medical School, University of Porto, 4200-319 Porto, Portugal
- Laboratory for Integrative and Translational Research in Public Health, 4050-600 Porto, Portugal
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14
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Moilanen T, Suhonen R, Kangasniemi M. Nursing support for older people's autonomy in residential care: An integrative review. Int J Older People Nurs 2021; 17:e12428. [PMID: 34601784 DOI: 10.1111/opn.12428] [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: 08/07/2020] [Revised: 08/14/2021] [Accepted: 09/13/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Nurses play a crucial role in enabling older people's autonomy in residential care. However, there is a lack of synthesised knowledge about how nurses can support older people. OBJECTIVE The aim of this study was to identify and synthesise nursing support for older people's autonomy in residential care. METHODS An integrative review was carried out by searching the CINAHL, Philosopher's index, PubMed, SocINDEX, Scopus and Web of Science databases, supplemented by manual searches. The searches focused on peer-reviewed scientific empirical research papers published in English, without date limitations. The constant comparison method was used for the analysis. RESULTS The review identified 24 papers, and these showed that older people's autonomy was based on dignity. Nurses protected older people's autonomy in eight different ways. They protected their right to make their own decisions, acted as advocates, respected their wishes, provided opportunities for autonomy, fostered independence, gave information to residents and relatives, provided individualised care practices and protected older people's safety. However, there were also barriers that needed to be overcome. CONCLUSIONS Nurses used multiple, individually tailored activities to support older people's autonomy, but they also had different reasons for supporting or hindering it. Work and leadership structures are needed to ensure that older people's autonomy is driven by ethical practices. IMPLICATIONS FOR PRACTICE The results of this review can help nurses who provide residential care for older people to recognise the different nursing activities that can be used to support older people's autonomy and to develop strategies to apply them in different daily care situations. However, further research is needed to determine how these activities can be realised in daily care and how they cover different aspects of older people's lives in residential care.
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Affiliation(s)
- Tanja Moilanen
- Department of Nursing Science, Faculty of Medicine, University of Turku, Turku, Finland
| | - Riitta Suhonen
- Department of Nursing Science, Faculty of Medicine, Turku University Hospital, University of Turku, Turku, Finland
| | - Mari Kangasniemi
- Department of Nursing Science, Faculty of Medicine, University of Turku, Turku, Finland
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15
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Samartini RS, Cândido VC. Reflections on elderly autonomy and its meaning for the practice of nursing care. Rev Bras Enferm 2021; 74:e20200723. [PMID: 34161499 DOI: 10.1590/0034-7167-2020-0723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 10/31/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To reflect on autonomy in health care, its perspective on the lives of the elderly, and its meaning for the practice of nursing care. METHODS Theoretical essay on the practice of nursing care to promote autonomy and self-care for the elderly. RESULTS It is necessary to qualify the practice of nursing care to consider the aging process and maintain the autonomy of the elderly. Three parts emerged: "The autonomy of the elderly and the care plan", "Nursing in the self-care process", and "Challenges to the practice of caring for the elderly in nursing". FINAL CONSIDERATIONS There is still a deficiency in promoting autonomy for the elderly due to the need for a review of the practice of nursing care, which, considering aging in Brazil, needs to undertake new actions in order to encourage self-care and autonomy in this population.
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16
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Perceptions and experiences of person-centered care among nurses and nurse aides in long term residential care facilities: A systematic review of qualitative studies. Geriatr Nurs 2021; 42:816-824. [PMID: 34090225 DOI: 10.1016/j.gerinurse.2021.04.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 04/05/2021] [Accepted: 04/06/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVE The aim of this study is to report the findings of meta-synthesis of the experiences and perceptions of person-centered care among nurses and nurse aides in long term care facilities to help managers and policy makers in providing and improving health services. METHODS This is a meta-synthesis of qualitative studies guided by seven steps process of meta-ethnography developed by Noblit and Hare. Systematic literature searching was conducted in CINAHL, MEDLINE, Web of Science, PubMed, PsycINFO, Scopus, Cochrane library and ProQuest dissertations databases. We assessed quality of the studies using Critical Appraisal Skills Program tool. RESULTS Eleven studies and one dissertation were identified as relevant for the review. The analysis of this systematic review was resulted in three categories: Recognizing resident's emotional needs and preferences under the task-based workload; holistic understanding to build relationship and participation; teamwork, being recognized and ongoing training to overcome the challenges. CONCLUSION The concept of PCC in direct care level is perceived well with majority of the study participants but the reality between perceived and practicing PCC is different which indicates mostly lack of organizational rearrangements and support.
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17
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Sandgren A, Arnoldsson L, Lagerholm A, Bökberg C. Quality of life among frail older persons (65+ years) in nursing homes: A cross-sectional study. Nurs Open 2021; 8:1232-1242. [PMID: 34482652 PMCID: PMC8046081 DOI: 10.1002/nop2.739] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 09/28/2020] [Accepted: 11/11/2020] [Indexed: 11/09/2022] Open
Abstract
AIM To assess the quality of life in frail older persons (65+ years) living in nursing homes and to examine differences between quality of life perceptions among different gender and age groups. DESIGN Cross-sectional. METHODS Data were collected during 2015-2017 based on two questionnaires (WHOQOL-OLD and WHOQOL-BREF). Seventy-eight older persons living in nursing homes in southern Sweden answered the questionnaires in structured interviews. Descriptive and comparative statistics were used to analyse the data. The study was guided by Transparent Reporting of Evaluations with Nonrandomized Designs (TREND) guidelines. RESULTS The frail older persons reported low autonomy related to few opportunities to engage in everyday activities and were unable to do the things they liked to do and not feeling in control of their future. Another important result was that frail older persons seemed to have no or little fear of death and dying. No significant differences between gender or age on quality of life were revealed.
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Affiliation(s)
- Anna Sandgren
- Department of Health and Caring SciencesFaculty of Health and Life SciencesCenter for Collaborative Palliative CareLinnaeus UniversityVäxjöSweden
| | - Lisa Arnoldsson
- Department of Health SciencesFaculty of MedicineLund UniversityLundSweden
| | - Annika Lagerholm
- Department of Health SciencesFaculty of MedicineLund UniversityLundSweden
| | - Christina Bökberg
- Department of Health SciencesFaculty of MedicineLund UniversityLundSweden
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18
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Moilanen T, Kangasniemi M, Papinaho O, Mynttinen M, Siipi H, Suominen S, Suhonen R. Older people's perceived autonomy in residential care: An integrative review. Nurs Ethics 2020; 28:414-434. [PMID: 33000683 PMCID: PMC8151558 DOI: 10.1177/0969733020948115] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Autonomy has been recognised as a key principle in healthcare, but we still need to develop a consistent understanding of older people’s perceived autonomy in residential care. This study aimed to identify, describe and synthesise previous studies on the perceived autonomy of older people in residential care. Ethical approval was not required, as this was a review of published literature. We carried out an integrative review to synthesise previous knowledge published in peer-review journals in English up to September 2019. Electronic and manual searches were conducted using the CINAHL, Philosopher’s Index, PubMed, SocINDEX, Scopus and Web of Science databases. The data were analysed using the constant comparison method. The review identified 46 studies. Perceived autonomy referred to the opportunities that older people had to make their own choices about their daily life in residential care, and achieving autonomy promoted both health and quality of life. Autonomy was linked to older people’s individual capacities, including their level of independence, physical and mental competence, personal characteristics, and whether relatives shared and supported their perceived autonomy. Professionals could facilitate or hinder older peoples’ autonomy in a number of ways, including providing opportunities for autonomy, how daily care needs and activities were managed, and controlling older people’s choices. Professionals’ characteristics, such as education and attitudes, and the older people’s living environments were also associated with their perceived autonomy and included organisational characteristics and physical and social care facilitators. Older people’s perceived autonomy promoted health and quality of life in residential care. However, their autonomy was associated with a number of protective and restrictive individual and environmental factors, which influenced whether autonomy was achieved.
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Affiliation(s)
| | | | - Oili Papinaho
- 8058University of Turku, Finland; Oulu University Hospital, Finland
| | | | | | | | - Riitta Suhonen
- 8058University of Turku, Finland; Turku University Hospital, Finland; City of Turku Welfare Division, Finland
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19
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Hoteit S, Babacanli A, Babacanli MR, Šikić A, Olujić V, Radovanić S, Radeljić V, Zeljković MK, Manola Š, Zeljković I. Impact of mobility on degree of hydration in octogenarian population examined in the emergency department. Am J Emerg Med 2020; 46:681-683. [PMID: 32933809 DOI: 10.1016/j.ajem.2020.08.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 08/13/2020] [Indexed: 11/16/2022] Open
Affiliation(s)
- Sara Hoteit
- Duga Resa Long-term Care Hospital, Ulica Jozefa Jeruzalema 7, Duga Resa 47250, Croatia
| | - Alen Babacanli
- Department of Emergency Medicine, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia
| | | | - Aljoša Šikić
- Department of Emergency Medicine, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia
| | - Vida Olujić
- Department of Internal Emergency Medicine, Split University Hospital Centre, Split, Croatia
| | - Sandra Radovanić
- Department of Internal Emergency Medicine, Split University Hospital Centre, Split, Croatia
| | - Vjekoslav Radeljić
- Department of Cardiology, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia
| | - Matea Kolačević Zeljković
- Unit of Clinical Pharmacology and Toxicology, Department of Internal Medicine, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia
| | - Šime Manola
- Department of Cardiology, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia
| | - Ivan Zeljković
- Department of Cardiology, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia.
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20
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Karlsson M, Pennbrant S. Ideas of caring in nursing practice. Nurs Philos 2020; 21:e12325. [PMID: 32876398 DOI: 10.1111/nup.12325] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Revised: 06/14/2020] [Accepted: 07/30/2020] [Indexed: 11/28/2022]
Affiliation(s)
| | - Sandra Pennbrant
- Department of Health Sciences University West Trollhättan Sweden
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