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Van Der Ploeg-Dorhout MP, Van Den Boogaard C, Reinders-Messelink H, Van Der Cingel M. Patients' experiences of shared decision-making in nursing care: A qualitative study. J Clin Nurs 2024; 33:2274-2286. [PMID: 38284506 DOI: 10.1111/jocn.17032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 12/17/2023] [Accepted: 01/16/2024] [Indexed: 01/30/2024]
Abstract
AIM To explore patients' experiences of shared decision-making, in nursing care during their stay in a healthcare institution. DESIGN This study employed a qualitative descriptive design. METHODS Twenty participants were interviewed from two rehabilitation centres, a nephrology ward of a hospital, and a rehabilitation ward of a long-term care facility. A constant comparative method was used for the inductive analysis. RESULTS The main theme was 'feeling seen and understood', in the context of person-centred care, which served as the unifying thread across five themes. The five themes included the importance of a positive nurse-patient relationship as a foundation for shared decision-making. Next, patients experienced collaboration, and this was influenced by verbal and non-verbal communication. Another theme was that patients often felt overwhelmed during their stay, affecting shared decision-making. The fourth theme was that many decisions were not made through the shared decision-making process but were still perceived as satisfactory. The final theme highlighted patients' perspectives on their role in decision-making and influencing factors. CONCLUSION Patients describe how feeling seen and understood is a prerequisite for shared decision-making as a part of person-centred care. For nurses, this implies that they should focus on aspects such as building a good relationship and acknowledgement of patients' feelings and circumstances, next to empowering patients to feel knowledgeable and valued. This way patient's motivation to participate in shared decision-making will be enhanced. REPORTING METHOD Following the EQUATOR guidelines, reporting was guided by the Consolidated Criteria for Reporting Qualitative Research (COREQ). PATIENT OR PUBLIC CONTRIBUTION Patients were involved in the study through interviews during the research process and member checks during analysis. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE Before initiating shared decision-making processes, prioritise making the patient feel seen and understood. Be mindful that patients often feel overwhelmed during their stay. Use a person-centred approach to make patients feel knowledgeable-this empowers them for shared decision-making. IMPACT Research on patients' experiences of shared decision-making in nursing care is limited, yet crucial for understanding patients' needs in shared decision-making. This study highlights patients' perceptions that shared decision-making is best facilitated within the nurse-patient relationship by nurses who primarily focus on ensuring that patients feel acknowledged and understood.
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Affiliation(s)
| | | | - Heleen Reinders-Messelink
- NHL Stenden University of Applied Sciences, Leeuwarden, The Netherlands
- Rehabilitation Centre 'Revalidatie Friesland', Beetsterzwaag, The Netherlands
- Department of Rehabilitation Medicine, University Medical Center Groningen, Groningen, The Netherlands
| | - Margreet Van Der Cingel
- NHL Stenden University of Applied Sciences, Leeuwarden, The Netherlands
- Medical Centre Leeuwarden, Leeuwarden, The Netherlands
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Davies K, Howe T, Small J, Hsiung GYR. ‛It's all communication': Family members' perspectives on the communication needs for themselves and their relatives with primary progressive aphasia. Int J Lang Commun Disord 2024. [PMID: 38762773 DOI: 10.1111/1460-6984.13042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 04/28/2024] [Indexed: 05/20/2024]
Abstract
BACKGROUND Communication disabilities, such as primary progressive aphasia (PPA), impact family members as well as the individuals with the condition. To provide adequate communication care to people with PPA (PwPPA) and their family members, it is crucial to understand the communication needs from the family members' perspectives. To date, research on the communication needs of people with primary progressive aphasia and their family members from the perspectives of family members has been limited. AIMS The specific research objectives were to explore (a) the communication needs pertaining to PwPPA in the early, middle and late stages; and (b) the communication needs pertaining to family members of PwPPA in the early, middle and late stages, from the perspectives of family members. METHODS & PROCEDURES This study employed a qualitative description approach, underpinned by the pragmatic paradigm. Data collection involved semi-structured qualitative interviews with eight family members (relatives of four individuals with the logopenic variant of PPA, of two individuals with the nonfluent variant of PPA, of one individual with the semantic variant of PPA and of one individual with mixed PPA). Qualitative content analysis was used to identify codes and categories in relation to the research objectives. OUTCOMES & RESULTS Qualitative content analysis revealed eight categories of communication needs pertaining to the PwPPA: person-specific needs; diagnosis and disclosure; general communication difficulties; impact on communication in everyday life; impact on cognition; impact on psychosocial well-being; impact on person's dignity and autonomy; and future planning. Six categories were identified pertaining to the family members: information about and awareness of PPA; impact of communication difficulties on family/others; increased responsibilities for the family in everyday life; impact on psychosocial well-being; and future planning. CONCLUSIONS & IMPLICATIONS This investigation has expanded our knowledge in the area by providing insights about communication needs which speech-language pathologists and other health professionals should be aware of and take into account when providing communication care to PwPPA and their families. WHAT THIS PAPER ADDS What is already known on the subject Person- and family-centred communication care is optimally guided by the person's and family's needs and values. Research on communication care for people with primary progressive aphasia has underscored the inclusion of family members. Previous research has investigated the impact and experiences of living with primary progressive aphasia from the family member perspective. What this paper adds to existing knowledge To date, research focusing on identifying the communication needs of people with primary progressive aphasia and their family members from the perspective of family members is limited. This study adds the family members' perspectives on the communication needs pertaining to themselves and their relatives with primary progressive aphasia in the early, middle and late stages of primary progressive aphasia. What are the potential or clinical implications of this work? Several clinical implications have been raised. Family members experience communication needs for themselves and should be included as recipients of communication care. Clinicians supporting people with primary progressive aphasia should be cognizant of the impact of communication fatigue on everyday life and therapy tasks. Communication care for this population should include communication partner training, support for psychosocial well-being and support with communication around future planning.
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Affiliation(s)
- Katharine Davies
- School of Audiology and Speech Sciences, The University of British Columbia, Vancouver, Canada
| | - Tami Howe
- School of Audiology and Speech Sciences, The University of British Columbia, Vancouver, Canada
| | - Jeff Small
- School of Audiology and Speech Sciences, The University of British Columbia, Vancouver, Canada
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de Lange S, Heyns T, Filmalter C. Reaching consensus on the definition of person-centred handover practices in emergency departments: A modified online Delphi. J Clin Nurs 2024; 33:1751-1761. [PMID: 38414111 DOI: 10.1111/jocn.16967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 10/21/2023] [Accepted: 12/04/2023] [Indexed: 02/29/2024]
Abstract
AIM To reach consensus on the definition and attributes of 'person-centred handover practices' in emergency departments. BACKGROUND Handover practices between emergency care practitioners and healthcare professionals in emergency departments are important and should be conducted meticulously. Person-centred handover practices may enhance the delivery of person-centred care in emergency departments. DESIGN A three-round online Delphi survey. METHODS Nine experts participated in a three round Delphi survey. The expert panel comprised experts from nine countries. Quantitative data were descriptively analysed, and qualitative data were thematically analysed. A consensus of 80% had to be reached before an attribute and definition could be accepted. RESULTS Experts reached a consensus of 79% in round one, 95% in round two and 95% in round three. A final set of six attributes were agreed upon and the final concept definition was formulated. CONCLUSION Person-centred handover practices have not been implemented in emergency departments. Yet, person-centred handover practices may enhance the delivery of person-centred care, which has multiple benefits for patients and healthcare practitioners. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE Person-centred care is not generally implemented in emergency departments. Person-centred handover practices can lead to person-centred care. Handover practices in emergency departments are a high-risk activity. Despite numerous calls to standardise and improve handover practices, they remain a problem. Developing a standardised definition could be a first step towards implementing person-centred handover practices in emergency departments. REPORTING METHOD The study adhered to the relevant EQUATOR reporting guidelines: Guidance on Conducting and Reporting Delphi Studies (CREDES) checklist. IMPACT (ADDRESSING) Improve handover practices and patient care. Improve person-centred care in emergency departments. PATIENT OR PUBLIC CONTRIBUTION Emergency care practitioners and nurses experienced in handover practices and/or person-centred care, working in clinical and academic fields, participated in the study by sharing their expert knowledge during each of the Delphi rounds.
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Affiliation(s)
- Santel de Lange
- Department of Nursing Science, University of Pretoria, Pretoria, South Africa
| | - Tanya Heyns
- Department of Nursing Science, University of Pretoria, Pretoria, South Africa
| | - Celia Filmalter
- Department of Nursing Science, University of Pretoria, Pretoria, South Africa
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Porth AK, Huberts AS, Rogge A, Bénard AHM, Forbes A, Strootker A, Del Pozo CH, Kownatka D, Hopkins D, Nathanson D, Aanstoot HJ, Soderberg J, Eeg-Olofsson K, Hamilton K, Delbecque L, Ninov L, Due-Christensen M, Leutner M, Simó R, Vikstrom-Greve S, Rössner S, Flores V, Seidler Y, Hasler Y, Stamm T, Kautzky-Willer A. Standardising personalised diabetes care across European health settings: A person-centred outcome set agreed in a multinational Delphi study. Diabet Med 2024; 41:e15259. [PMID: 38017616 DOI: 10.1111/dme.15259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 11/06/2023] [Indexed: 11/30/2023]
Abstract
OBJECTIVE Standardised person-reported outcomes (PRO) data can contextualise clinical outcomes enabling precision diabetes monitoring and care. Comprehensive outcome sets can guide this process, but their implementation in routine diabetes care has remained challenging and unsuccessful at international level. We aimed to address this by developing a person-centred outcome set for Type 1 and Type 2 diabetes, using a methodology with prospects for increased implementability and sustainability in international health settings. METHODS We used a three-round questionnaire-based Delphi study to reach consensus on the outcome set. We invited key stakeholders from 19 countries via purposive snowball sampling, namely people with diabetes (N = 94), healthcare professionals (N = 65), industry (N = 22) and health authorities (N = 3), to vote on the relevance and measurement frequency of 64 previously identified clinical and person-reported outcomes. Subsequent consensus meetings concluded the study. RESULTS The list of preliminary outcomes was shortlisted via the consensus process to 46 outcomes (27 clinical outcomes and 19 PROs). Two main collection times were recommended: (1) linked to a medical visit (e.g. diabetes-specific well-being, symptoms and psychological health) and (2) annually (e.g. clinical data, general well-being and diabetes self management-related outcomes). CONCLUSIONS PROs are often considered in a non-standardised way in routine diabetes care. We propose a person-centred outcome set for diabetes, specifically considering psychosocial and behavioural aspects, which was agreed by four international key stakeholder groups. It guides standardised collection of meaningful outcomes at scale, supporting individual and population level healthcare decision making. It will be implemented and tested in Europe as part of the H2O project.
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Affiliation(s)
- Ann-Kristin Porth
- Department of Internal Medicine III, Divison of Endocrinology and Metabolism, Medical University Vienna, Vienna, Austria
| | - Anouk Sjoukje Huberts
- Department of Quality and Patientcare, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Alizé Rogge
- Charité Center for Patient-Centered Outcomes Research, Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | | | - Angus Forbes
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, Kings College London, London, UK
| | - Anja Strootker
- Medtronic International Trading Sàrl, Tolochenaz, Switzerland
| | | | | | - David Hopkins
- Department of Diabetes, King's College London, London, UK
- Institute for Diabetes, Endocrinology and Obesity, King's Health Partners, London, UK
| | - David Nathanson
- Department of Medicine, Karolinska Institutet, Karolinska University Hospital Huddinge, Huddinge, Sweden
| | - Henk-Jan Aanstoot
- Diabeter, Center for Focussed Diabetes Care and Research, Rotterdam, The Netherlands
| | | | - Katarina Eeg-Olofsson
- Department of Molecular and Clinical Medicine, Institute of Medicine, University of Gothenburg, Göteborg, Sweden
- National Diabetes Register, Göteborg, Sweden
| | - Kathryn Hamilton
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, Kings College London, London, UK
| | | | | | - Mette Due-Christensen
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, Kings College London, London, UK
| | - Michael Leutner
- Department of Internal Medicine III, Divison of Endocrinology and Metabolism, Medical University Vienna, Vienna, Austria
| | - Rafael Simó
- Vall d'Hebron Institute of Research (VHIR), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
- Centro de Investigación Biomédica en Red Instituto de Salud Carlos III (CIBERDEM (ISCIII)), Madrid, Spain
- Vall d'Hebron University Hospital, Barcelona, Spain
- Autonomous University of Barcelona, Barcelona, Spain
| | - Sara Vikstrom-Greve
- Department of Medicine, Karolinska Institutet, Karolinska University Hospital Huddinge, Huddinge, Sweden
| | - Sophia Rössner
- Department of Medicine, Karolinska Institutet, Karolinska University Hospital Huddinge, Huddinge, Sweden
| | - Vanesa Flores
- Vall d'Hebron Institute of Research (VHIR), Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
- Vall d'Hebron University Hospital, Barcelona, Spain
| | - Yuki Seidler
- Section for Outcomes Research, Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - Yvonne Hasler
- Medtronic International Trading Sàrl, Tolochenaz, Switzerland
| | - Tanja Stamm
- Section for Outcomes Research, Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria
- Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Vienna, Austria
| | - Alexandra Kautzky-Willer
- Department of Internal Medicine III, Divison of Endocrinology and Metabolism, Medical University Vienna, Vienna, Austria
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Geddis-Regan A, Fisal ABA, Bird J, Fleischmann I, Mac Giolla Phadraig C. Experiences of dental behaviour support techniques: A qualitative systematic review. Community Dent Oral Epidemiol 2024. [PMID: 38680013 DOI: 10.1111/cdoe.12969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 03/27/2024] [Accepted: 04/17/2024] [Indexed: 05/01/2024]
Abstract
BACKGROUND Little is known about patients' or carers' reported experiences of dental care provided using dental behaviour support (DBS) techniques. Qualitative literature can provide unique insight into these experiences. AIM To explore and synthesize qualitative literature related to patient experience of dental behaviour support. METHODS A PROSPERO-registered systematic review of qualitative articles was undertaken. Studies were identified through MEDLINE, Embase and PsycINFO. Abstracts were screened by two reviewers and data were extracted to summarize the qualitative findings included within them. A thematic summary approach was used to synthesize the qualitative data identified. RESULTS Twenty-three studies were included. Studies primarily explored experiences of dental care of children by speaking to their parents (n = 16), particularly regarding paediatric dental general anaesthesia (DGA) (n = 8). Studies of adults' experiences of DBS (n = 7) covered a range of techniques. Nine studies explored broader dental care experiences and did not study specific DBS approaches. A thematic synthesis identified five themes applicable across the studies identified: Trust and the therapeutic alliance supporting effective care delivery; considered information sharing often alleviated anticipatory anxiety; control and autonomy-reduced anxieties; variations in the perceived treatment successes and failures of DBS techniques; and DBS techniques produced longer positive and negative impacts on patients beyond direct care provision. CONCLUSION Qualitative research has been under-utilized in research on DBS techniques. Care experiences of most DBS techniques outside of paediatric DGA are poorly understood. Building trust with patients and enabling autonomy appear to support positive patient-reported experiences of care.
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Affiliation(s)
| | - Aisyah Binti Ahmad Fisal
- Department of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, Universiti Malaya, Kuala Lumpur, Malaysia
| | - James Bird
- The Rotherham NHS Foundation Trust, Rotherham, UK
- School of Clinical Dentistry, The University of Sheffield, Sheffield, UK
| | | | - Caoimhin Mac Giolla Phadraig
- Department of Child and Public Dental Health, Dublin Dental University Hospital, School of Dental Sciences, Trinity College Dublin, Dublin, Ireland
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Davison E, Semlyen J, Lindqvist S. Mentoring medical students as a means to increase healthcare assistant status: A qualitative study. Nurs Open 2024; 11:e2149. [PMID: 38622906 PMCID: PMC11019241 DOI: 10.1002/nop2.2149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 06/16/2023] [Accepted: 03/19/2024] [Indexed: 04/17/2024] Open
Abstract
AIM To offer a practical way in which the status of healthcare assistants (HCAs) can be increased by drawing on their experience, knowledge and skillset, whilst mentoring medical students during an HCA project. DESIGN Qualitative, reflexive thematic analysis. METHODS One-to-one semi-structured interviews were conducted between April and June 2019, with 13 participants. Participants included five healthcare assistants; three practice development nurses, two of whom were former HCAs; one registered general nurse and four clinical educators. RESULTS Two themes were identified: HCAs as silent, invisible caregivers (theme 1) and the formation of an HCA identity through mentoring (theme 2). HCAs are often silent performers of complex patient care with limited opportunity to engage in the interprofessional team dialogue. Social perceptions of HCAs describe them as a marginalised, poorly understood, 'unqualified' group with 'lowly status'. Mentoring medical students allows HCAs to draw on their experience, knowledge and skillset by actively contributing to the learning and development of future doctors. CONCLUSION The mentoring of medical students gave HCAs an active voice within the interprofessional team, instilling their confidence and self-worth. Mentoring allowed HCAs to move from a homogenous, group-based social identity to a role-based one that enabled HCAs to reveal the true extent of their work whilst negotiating their place and identity within the interprofessional team. IMPACT Leaders in healthcare will see that a re-evaluation of HCAs as performers of basic, hands-on patient care is needed to breakdown ingrained beliefs, eliminating a 'us and them' mentality. Involving HCAs in the mentoring of medical students will impact on the personal development of both HCAs and medical students in the cultivation of a future, person-centred, inclusive and collaborative workforce. REPORTING METHOD COREQ guidelines to enhance methodological rigour were strictly adhered to. PATIENT AND PUBLIC INVOLVEMENT There is no patient or public involvement.
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Affiliation(s)
- Elizabeth Davison
- Faculty of Medicine and Health Sciences, Centre for Interprofessional PracticeUniversity of East AngliaNorwichUK
| | - Joanna Semlyen
- Faculty of Medicine and Health Sciences, Norwich Medical SchoolUniversity of East AngliaNorwichUK
| | - Susanne Lindqvist
- Faculty of Medicine and Health Sciences, Centre for Interprofessional PracticeUniversity of East AngliaNorwichUK
- Faculty of Medicine and Health Sciences, Norwich Medical SchoolUniversity of East AngliaNorwichUK
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Byrne AL, Harvey C, Baldwin A. The discourse of delivering person-centred nursing care before, and during, the COVID-19 pandemic: Care as collateral damage. Nurs Inq 2024; 31:e12593. [PMID: 37583275 DOI: 10.1111/nin.12593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 07/27/2023] [Accepted: 07/28/2023] [Indexed: 08/17/2023]
Abstract
The global COVID-19 pandemic challenged the world-how it functions, how people move in the social worlds and how government/government services and people interact. Health services, operating under the principles of new public management, have undertaken rapid changes to service delivery and models of care. What has become apparent is the mechanisms within which contemporary health services operate and how services are not prioritising the person at the centre of care. Person-centred care (PCC) is the philosophical premise upon which models of health care are developed and implemented. Given the strain that COVID-19 has placed on the health services and the people who deliver the care, it is essential to explore the tensions that exist in this space. This article suggests that before the pandemic, PCC was largely rhetoric, and rendered invisible during the pandemic. The paper presents an investigation into the role of PCC in these challenging times, adopting a Foucauldian lens, specifically governmentality and biopolitics, to examine the policies, priorities and practical implications as health services pivoted and adapted to changing and acute demands. Specifically, this paper draws on the Australian experience, including shifting nursing workforce priorities and additional challenges resulting from public health directives such as lockdowns and limitations. The findings from this exploration open a space for discussion around the rhetoric of PCC, the status of nurses and that which has been lost to the pandemic.
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Affiliation(s)
- Amy-Louise Byrne
- School of Nursing Midwifery and Social Sciences, Central Queensland University, Townsville, Queensland, Australia
| | - Clare Harvey
- School of Nursing, Massey University, Wellington, New Zealand
| | - Adele Baldwin
- School of Nursing Midwifery and Social Sciences, Central Queensland University, Townsville, Queensland, Australia
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Giesen J, Timmerman I, Bakker-Jacobs A, Berings M, Huisman-de Waal G, Van Vught A, Vermeulen H. What can nurses learn from patient's needs and wishes when developing an evidence-based quality improvement learning culture? A qualitative study. Scand J Caring Sci 2024. [PMID: 38525853 DOI: 10.1111/scs.13252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 02/02/2024] [Accepted: 02/24/2024] [Indexed: 03/26/2024]
Abstract
BACKGROUND Patient participation is fundamental in nursing care and has yielded benefits for patient outcomes. However, despite their compassionate care approach, nurses do not always incorporate patients' needs and wish into evidence-based practice, quality improvement or learning activities. Therefore, a shift to continuous quality improvement based on evidence-based practice is necessary to enhance the quality of care. The patient's opinion is an essential part of this process. To establish a more sustainable learning culture for evidence-based quality improvement, it is crucial that nurses learn alongside their patients. However, to promote this, nurses require a deeper understanding of patients' care preferences. OBJECTIVE To explore patients' needs and wishes towards being involved in care processes that nurses can use in developing an evidence-based quality improvement learning culture. METHODS A qualitative study was conducted in two hospital departments and one community care team. In total, 18 patients were purposefully selected for individual semi-structured interviews with an average of 15 min. A framework analysis based on the fundamental of care framework was utilised to analyse the data deductively. In addition, inductive codes were added to patients' experiences beyond the framework. For reporting this study, the SRQR guideline was used. RESULTS Participants needed a compassionate nurse who established and sustained a trusting relationship. They wanted nurses to be present and actively involved during the care delivery. Shared decision-making improved when nurses offered fair, clear and tailored information. Mistrust or a disrupted nurse-patient relationship was found to be time-consuming and challenging to restore. CONCLUSIONS Results confirmed the importance of a durable nurse-patient relationship and showed the consequences of nurses' communication on shared decision-making. Insights into patients' care preferences are essential to stimulate the development of an evidence-based quality improvement learning culture within nursing teams and for successful implementation processes.
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Affiliation(s)
- Jeltje Giesen
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Ilse Timmerman
- Psychiatry Department, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Annick Bakker-Jacobs
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marjolein Berings
- Radboudumc Health Academy, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Getty Huisman-de Waal
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands
- Surgical Department, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Anneke Van Vught
- Department on Health and Vitality, HAN University of Applied Sciences, School of Allied Health, Nijmegen, The Netherlands
| | - Hester Vermeulen
- Radboud Institute for Health Sciences, IQ Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands
- Department on Health and Vitality, HAN University of Applied Sciences, School of Allied Health, Nijmegen, The Netherlands
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Tierney AP, Milnes S, Phillips A, Simpson N, Bailey M, Corke C, Orford NR. Effect of a person-centred goals-of-care form and clinical communication training on shared decision-making and outcomes in an acute hospital: a prospective longitudinal interventional study. Intern Med J 2024. [PMID: 38520171 DOI: 10.1111/imj.16381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Accepted: 02/09/2024] [Indexed: 03/25/2024]
Abstract
BACKGROUND Patients with a life-limiting illness (LLI) requiring hospitalisation have a high likelihood of deterioration and 12-month mortality. To avoid non-aligned care, we need to understand our patients' goals and values. AIM To describe the association between the implementation of a shared decision-making (SDM) programme and documentation of goals of care (GoC) for hospitalised patients with LLI. METHODS A prospective longitudinal interventional study of patients admitted to acute general medicine wards in an Australian tertiary hospital over 5 years was conducted. A SDM programme with a new GoC form, communication training and clinical support was implemented. The primary outcome was the proportion of patients with a documented person-centred GoC discussion (PCD). Clinical outcomes included hospital utilisation and 90-day mortality. RESULTS 1343 patients were included. The proportion of patients with PCDs increased from 0% to 35.4% (adjusted odds ratio (aOR), 2.38; 95% confidence interval (CI), 2.01-2.82; P < 0.001). During this time, median hospital length of stay decreased from 8 days (interquartile range (IQR), 4-14) to 6 days (IQR, 3-11) (adjusted estimate effect, -0.38; 95% CI, -0.64 to -0.11; P = 0.005) and rapid response team activation from 28% to 13% (aOR, 0.87; 95% CI, 0.78-0.97; P value = 0.01). Documented treatment preference of high-dependency unit care decreased from 39.7% to 24.4% (aOR, 0.81; 95% CI, 0.73-0.89; P value < 0.001), and ward-based care increased from 31.9% to 55.1% (aOR, 1.24; 95% CI, 1.14-1.36; P value < 0.001). CONCLUSION The implementation of a SDM programme was associated with increased documentation of person-centred GoC, changed patient treatment preference to lower intensity care and reduced hospital utilisation.
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Affiliation(s)
- Andrew P Tierney
- Intensive Care Department, University Hospital Geelong, Barwon Health, Geelong, Victoria, Australia
| | - Sharyn Milnes
- Intensive Care Department, University Hospital Geelong, Barwon Health, Geelong, Victoria, Australia
- School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Anita Phillips
- Intensive Care Department, University Hospital Geelong, Barwon Health, Geelong, Victoria, Australia
- School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Nicholas Simpson
- Intensive Care Department, University Hospital Geelong, Barwon Health, Geelong, Victoria, Australia
- School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Michael Bailey
- Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), School of Public Health and Preventative Medicine (SPHPM), Monash University, Melbourne, Victoria, Australia
| | - Charlie Corke
- Intensive Care Department, University Hospital Geelong, Barwon Health, Geelong, Victoria, Australia
- School of Medicine, Deakin University, Geelong, Victoria, Australia
| | - Neil R Orford
- Intensive Care Department, University Hospital Geelong, Barwon Health, Geelong, Victoria, Australia
- School of Medicine, Deakin University, Geelong, Victoria, Australia
- Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), School of Public Health and Preventative Medicine (SPHPM), Monash University, Melbourne, Victoria, Australia
- Department of Critical Care, University of Melbourne, Melbourne, Victoria, Australia
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Swedberg K, Cawley D, Ekman I, Rogers HL, Antonic D, Behmane D, Björkman I, Britten N, Buttigieg SC, Byers V, Börjesson M, Corazzini K, Fors A, Granger B, Joksimoski B, Lewandowski R, Sakalauskas V, Srulovici E, Törnell J, Wallström S, Wolf A, Lloyd HM. Testing cost containment of future healthcare with maintained or improved quality-The COSTCARES project. Health Sci Rep 2021; 4:e309. [PMID: 34141903 PMCID: PMC8180514 DOI: 10.1002/hsr2.309] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 04/24/2021] [Accepted: 05/06/2021] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Increasing healthcare costs need to be contained in order to maintain equality of access to care for all EU citizens. A cross-disciplinary consortium of experts was supported by the EU FP7 research programme, to produce a roadmap on cost containment, while maintaining or improving the quality of healthcare. The roadmap comprises two drivers: person-centred care and health promotion; five critical enablers also need to be addressed: information technology, quality measures, infrastructure, incentive systems, and contracting strategies. METHOD In order to develop and test the roadmap, a COST Action project was initiated: COST-CARES, with 28 participating countries. This paper provides an overview of evidence about the effects of each of the identified enablers. Intersections between the drivers and the enablers are identified as critical for the success of future cost containment, in tandem with maintained or improved quality in healthcare. This will require further exploration through testing. CONCLUSION Cost containment of future healthcare, with maintained or improved quality, needs to be addressed through a concerted approach of testing key factors. We propose a framework for test lab design based on these drivers and enablers in different European countries.
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Affiliation(s)
- Karl Swedberg
- Centre for Person Centred CareUniversity of GothenburgGothenburgSweden
- Department of Molecular and Clinical MedicineUniversity of GothenburgGothenburgSweden
| | - Desmond Cawley
- Department of Nursing and Healthcare, Faculty of Science and HealthAthlone Institute of TechnologyAthloneIreland
| | - Inger Ekman
- Centre for Person Centred CareUniversity of GothenburgGothenburgSweden
- Institute of Health and Care SciencesUniversity of GothenburgGothenburgSweden
| | - Heather L. Rogers
- Biocruces Bizkaia Health Research InstituteBarakaldoSpain
- Ikerbasque Basque Foundation for ScienceBilbaoSpain
| | | | - Daiga Behmane
- Institute of Public HealthRiga Stradins UniversityRigaLatvia
| | - Ida Björkman
- Centre for Person Centred CareUniversity of GothenburgGothenburgSweden
- Institute of Health and Care SciencesUniversity of GothenburgGothenburgSweden
| | - Nicky Britten
- Institute of Health and Care SciencesUniversity of GothenburgGothenburgSweden
- College of Medicine and HealthUniversity of Exeter Medical SchoolExeterUK
| | - Sandra C. Buttigieg
- Department of Health Services Management, Faculty of Health SciencesUniversity of MaltaMsidaMalta
| | - Vivienne Byers
- Environmental Sustainability & Health InstituteTechnological University DublinDublinIreland
| | - Mats Börjesson
- Department of Neuroscience and PhysiologyUniversity of GothenburgGothenburgSweden
- Department of Food, Nutrition and Sports Science, Center for Health and PerformanceUniversity of GothenburgGothenburgSweden
| | - Kirsten Corazzini
- Duke University School of NursingDurhamNorth Carolina
- Duke University Center for the Study of Aging and Human DevelopmentDurhamNorth Carolina
| | - Andreas Fors
- Centre for Person Centred CareUniversity of GothenburgGothenburgSweden
- Institute of Health and Care SciencesUniversity of GothenburgGothenburgSweden
| | - Bradi Granger
- Duke University Heart and Vascular ServicesDurhamNorth Carolina
| | - Boban Joksimoski
- Faculty of Computer Science and EngineeringSkopjeNorth Macedonia
| | - Roman Lewandowski
- Management FacultyUniversity of Social SciencesLodzPoland
- Voivodeship Rehabilitation Hospital for Children in AmerykaOlsztynekPoland
| | | | | | - Jan Törnell
- Centre for Person Centred CareUniversity of GothenburgGothenburgSweden
- Department of Neuroscience and PhysiologyUniversity of GothenburgGothenburgSweden
| | - Sara Wallström
- Centre for Person Centred CareUniversity of GothenburgGothenburgSweden
- Institute of Health and Care SciencesUniversity of GothenburgGothenburgSweden
| | - Axel Wolf
- Centre for Person Centred CareUniversity of GothenburgGothenburgSweden
- Institute of Health and Care SciencesUniversity of GothenburgGothenburgSweden
| | - Helen M. Lloyd
- Faculty of Health and Human Sciences, School of PsychologyUniversity of PlymouthPlymouthUnited Kingdom
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11
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Hedqvist AT, Pennbrant S, Karlsson M. Older persons and relatives' experience of coordinated care planning via a video meeting. Nurs Open 2020; 7:2047-2055. [PMID: 33072390 PMCID: PMC7544883 DOI: 10.1002/nop2.600] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 07/10/2020] [Accepted: 07/29/2020] [Indexed: 11/12/2022] Open
Abstract
Aim The study aimed to describe coordinated care planning via a video meeting from the perspective of older persons and their relatives. Design A qualitative inductive research design was used to describe older persons and relatives’ experience of care planning via video meeting. Methods Eight unstructured interviews were conducted. Purposive sampling resulted in a sample of four older persons and four relatives. The material was analysed by qualitative content analysis. Results The theme being excluded illustrates how the older persons and their relatives experienced care planning via a video meeting as lack of a personal relationship, meaninglessness and lack of participation. The older persons and their relatives had a feeling of being excluded and in an unfamiliar situation. Lack of information about the meeting's structure and content impaired their ability to prepare for it beforehand, which led to uncertainty.
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Affiliation(s)
| | - Sandra Pennbrant
- Department of Health Sciences University West Trollhättan Sweden
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12
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Summer Meranius M, Holmström IK, Håkansson J, Breitholtz A, Moniri F, Skogevall S, Skoglund K, Rasoal D. Paradoxes of person-centred care: A discussion paper. Nurs Open 2020; 7:1321-1329. [PMID: 32802352 PMCID: PMC7424463 DOI: 10.1002/nop2.520] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 05/04/2020] [Indexed: 12/30/2022] Open
Abstract
Aim Previous research has mainly focused on the advantages of PCC and less on its disadvantages. Hence, there is a need to further explore the recent research regarding PCC from both sides. Therefore, the aim of this paper is to elucidate the advantages and disadvantages of PCC. Design Discussion paper. Methods We searched relevant literature published January 2000-March 2018 in PubMed, Medline, CHINAL, Scopus and Web of Science. Results The results showed that PCC can contribute to improved health and well-being, improved mutual interaction in relationships, improved cost-effectiveness and improved work environment, while the disadvantages can involve increased personal and financial costs, exclusion of certain groups, increased personal and financial costs, exclusion of staff's personhood and unfairness due to empathy. An analysis of the existing literature on PCC showed paradoxes, which call for further investigation.
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Affiliation(s)
| | - Inger K. Holmström
- School of Health, Care and Social WelfareMälardalen UniversityVästeråsSweden
- Department of Public Health and Caring SciencesUppsala UniversityUppsalaSweden
| | - Jakob Håkansson
- School of Health, Care and Social WelfareMälardalen UniversityVästeråsSweden
| | - Agneta Breitholtz
- School of Health, Care and Social WelfareMälardalen UniversityVästeråsSweden
| | - Farah Moniri
- School of Health, Care and Social WelfareMälardalen UniversityVästeråsSweden
| | - Sofia Skogevall
- School of Health, Care and Social WelfareMälardalen UniversityVästeråsSweden
| | - Karin Skoglund
- School of Health, Care and Social WelfareMälardalen UniversityVästeråsSweden
| | - Dara Rasoal
- School of Health, Care and Social WelfareMälardalen UniversityVästeråsSweden
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13
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Ree E. What is the role of transformational leadership, work environment and patient safety culture for person-centred care? A cross-sectional study in Norwegian nursing homes and home care services. Nurs Open 2020; 7:1988-1996. [PMID: 33072384 PMCID: PMC7544868 DOI: 10.1002/nop2.592] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 07/03/2020] [Accepted: 07/23/2020] [Indexed: 11/08/2022] Open
Abstract
Aim To examine how transformational leadership, job demands, job resources and patient safety culture contribute in explaining person-centred care in nursing homes and home care services. Design Cross-sectional study. Methods Healthcare professionals in four Norwegian nursing homes (N = 165) and four home care services (N = 139) participated in 2018. Multiple regression analyses were used to examine to what degree transformational leadership, job demands, job resources and patient safety culture dimensions predicted person-centred care. Results Transformational leadership, job demands and job resources explained 41% of the variance in person-centred care, with work pace as the strongest predictor (β = 0.39 p < .001). The patient safety culture dimensions explained 57.5% of the variance in person-centred care, with staffing being the strongest predictor (β = 0.31 p < .001). There were small differences between nursing homes and home care. In total, transformational leadership, pace of work, staffing and factors related to communication were the strongest predictors for person-centred care.
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Affiliation(s)
- Eline Ree
- SHARE - Centre for Resilience in Healthcare Faculty of Health Sciences University of Stavanger Stavanger Norway
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14
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Vassbø TK, Bergland Å, Kirkevold M, Lindkvist M, Lood Q, Sandman P, Sjögren K, Edvardsson D. Effects of a person-centred and thriving-promoting intervention on nursing home staff job satisfaction: A multi-centre, non-equivalent controlled before-after study. Nurs Open 2020; 7:1787-1797. [PMID: 33072363 PMCID: PMC7544881 DOI: 10.1002/nop2.565] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 06/03/2020] [Accepted: 06/26/2020] [Indexed: 12/02/2022] Open
Abstract
Aim To evaluate the effects of a person‐centred and thriving‐promoting intervention in nursing homes on staff job satisfaction, stress of conscience and the person‐centredness of care and of the environment. Design A multi‐centre, non‐equivalent control group, before–after trial design. Methods Staff (N = 341) from six nursing homes in Australia, Norway and Sweden were assigned to the intervention or the control group and both groups were evaluated before the intervention, immediately after and by 6 months follow‐up. Staff completed a questionnaire about job satisfaction (primary endpoint), stress of conscience and the person‐centredness of care and of the environment (secondary endpoints). Linear regression models were used to identify the mean scores and to analyse group differences to test the effects of the intervention. Results The intervention had no statistically significant effects on staff job satisfaction, level of stress of conscience or the perceived person‐centredness of care and of the environment.
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Affiliation(s)
- Tove Karin Vassbø
- Faculty of MedicineInstitute of Health and SocietyOslo UniversityOsloNorway
- Lovisenberg Diaconal University CollegeOsloNorway
| | | | - Marit Kirkevold
- Faculty of MedicineInstitute of Health and SocietyOslo UniversityOsloNorway
- Institute of Nursing and Health PromotionOslo Metropolitan UniversityOsloNorway
| | - Marie Lindkvist
- Department of Epidemiology and Global HealthUmeå UniversityUmeåSweden
| | - Qarin Lood
- Department of Health and RehabilitationInstitute of Neuroscience and PhysiologySahlgrenska AcademyCentre for Ageing and Health (AgeCap)University of GothenburgGothenburgSweden
- Department of NursingUmeå UniversityUmeåSweden
- School of Nursing and MidwiferyLa Trobe UniversityMelbourneVic.Australia
| | - Per‐Olof Sandman
- Department of NursingUmeå UniversityUmeåSweden
- NVSDepartment of NursingKarolinska InstitutetStockholmSweden
| | | | - David Edvardsson
- Department of NursingUmeå UniversityUmeåSweden
- School of Nursing and MidwiferyLa Trobe UniversityMelbourneVic.Australia
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15
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Bökberg C, Behm L, Wallerstedt B, Ahlström G. Evaluating person-centredness for frail older persons in nursing homes before and after implementing a palliative care intervention. Nurs Open 2020; 7:439-448. [PMID: 31871729 PMCID: PMC6917927 DOI: 10.1002/nop2.408] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 09/25/2019] [Accepted: 10/07/2019] [Indexed: 11/05/2022] Open
Abstract
Aim To evaluate person-centeredness in nursing homes from the perspective of frail older persons, before and after implementing an educational intervention about palliative care. Design A crossover design. Methods Forty-four older persons living in nursing homes were interviewed. A convergent mixed-method was used to analyse data. Results The older persons expressed feelings of unsafety related to shortcomings in staff. These shortcomings implied that the responsibilities of everyday activities and making the residents' existence more bearable were transferred to the next of kin. The dropout rate related to death and not enough energy was considerably high (51%) even though one of the inclusion criteria was to have enough energy to manage a 1-hr interview. This result supports previous research describing the difficulties in retaining older persons in research and indicated that the dose of the intervention was not sufficient to improve person-centred care.
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Affiliation(s)
- Christina Bökberg
- Department of Health SciencesFaculty of MedicineLund UniversityLundSweden
| | - Lina Behm
- Department of Health SciencesFaculty of MedicineLund UniversityLundSweden
| | - Birgitta Wallerstedt
- Department of Health and Caring SciencesFaculty of Health and Life SciencesCentre for Collaborative Palliative Care Linnaeus UniversityVäxjöSweden
| | - Gerd Ahlström
- Department of Health SciencesFaculty of MedicineLund UniversityLundSweden
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16
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Allvin R, Fjordkvist E, Blomberg K. Struggling to be seen and understood as a person - Chronic back pain patients' experiences of encounters in health care: An interview study. Nurs Open 2019; 6:1047-1054. [PMID: 31367430 PMCID: PMC6650668 DOI: 10.1002/nop2.290] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 03/27/2019] [Accepted: 03/29/2019] [Indexed: 11/15/2022] Open
Abstract
AIM The aim of this study was to describe how patients with chronic back pain experience encounters with health care. Persons with chronic back pain are a stigmatized group often treated based on stereotypes, which may lead to misunderstandings and create frustrated patients and healthcare personnel. Few studies have examined the generic aspects of quality of care in this context. DESIGN A descriptive design with a qualitative approach was used. METHODS Nine individual interviews were conducted with chronic back pain patients after admission to an orthopaedic hospital ward. Data were analysed using content analysis. RESULTS The patients' experiences of healthcare encounters can be described by the theme "Struggling to be seen and understood as a person," comprising the categories "Lack of access and trust to care," "A desire to be taken care of and listened to" and "Own strength to handle healthcare situations."
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Affiliation(s)
- Renée Allvin
- Clinical Skills CenterÖrebro University HospitalÖrebroSweden
- Faculty of Medicine and Health, School of Health SciencesÖrebro UniversityÖrebroSweden
| | - Erika Fjordkvist
- Departments of OrthopedicsÖrebro University HospitalÖrebroSweden
| | - Karin Blomberg
- Faculty of Medicine and Health, School of Health SciencesÖrebro UniversityÖrebroSweden
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17
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Öberg U, Hörnsten Å, Isaksson U. The Self-Management Assessment Scale: Development and psychometric testing of a screening instrument for person-centred guidance and self-management support. Nurs Open 2019; 6:504-513. [PMID: 30918701 PMCID: PMC6419131 DOI: 10.1002/nop2.233] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 11/19/2018] [Indexed: 11/07/2022] Open
Abstract
AIM To develop and psychometrically test the Self-Management Assessment Scale (SMASc), a screening instrument for person-centred guidance and self-management support of persons with type 2 diabetes (T2D). BACKGROUND T2D is a common and globally increasing chronic condition. Improved self-management is a vital and integral component of diabetes care to prevent complications from poorly managed diabetes. For diabetes nurses to better understand persons with diabetes experienced challenges and needs regarding self-management and further for persons with T2D to take an active role in managing their condition, an instrument measuring this is needed. DESIGN Instrument development and psychometric testing of the content and construct validity, factor structure and reliability. METHOD The SMASc was psychometric tested on a sample of participants (September 2017-November 2017) with a confirmed diagnosis of T2D (N = 104). RESULTS Psychometric findings were satisfactory and supported the scale´s reliability. Cronbach's alpha, CVI and goodness-of-fit were acceptable. CONCLUSION Self-Management Assessment Scale is a short validated screening instrument, which can indicate possible barriers for self-management that ought to be approached during the conversation between the person with T2D and the primary healthcare nurses. Therefore, it is a promising instrument to be used to facilitate person-centred guidance and to improve self-management of people living with T2D.
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18
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Andersson EK, Dellkvist H, Bernow Johansson U, Skär L. Relatives' experiences of sharing a written life story about a close family member with dementia who has moved to residential care: An interview study. Nurs Open 2019; 6:276-282. [PMID: 30918679 PMCID: PMC6419116 DOI: 10.1002/nop2.208] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 05/30/2018] [Accepted: 09/03/2018] [Indexed: 11/10/2022] Open
Abstract
AIM The aim of this study was to describe relatives' experiences of sharing a written life story about a close family member with dementia who has moved to residential care. DESIGN An explorative descriptive qualitative design was used. METHODS The data were collected using semi-structured interviews with a purposeful sample of eight relatives and analyzed using a qualitative content analysis. RESULTS Results show that creating and sharing the life story of a close family member could help relatives handle grief and stress. It was perceived as an important, yet difficult, task to ensure that the close family member got good quality care. The creation of a meaningful life story takes time and requires cooperation with family members and other significant people.
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Affiliation(s)
| | - Helén Dellkvist
- Department of HealthBlekinge Institute of TechnologyKarlskronaSweden
- Karlskrona MunicipalityKarlskronaSweden
| | - Ulrika Bernow Johansson
- Department of HealthBlekinge Institute of TechnologyKarlskronaSweden
- Karlskrona MunicipalityKarlskronaSweden
| | - Lisa Skär
- Department of HealthBlekinge Institute of TechnologyKarlskronaSweden
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19
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Gjesdal K, Dysvik E, Furnes B. Living with chronic pain: Patients' experiences with healthcare services in Norway. Nurs Open 2018; 5:517-526. [PMID: 30338097 PMCID: PMC6178358 DOI: 10.1002/nop2.160] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2017] [Accepted: 04/13/2018] [Indexed: 01/05/2023] Open
Abstract
AIM To explore the experiences with healthcare received by people living with chronic nonmalignant pain in Norway. DESIGN A descriptive and explorative qualitative design. METHODS A total of 18 individual semistructured interviews was conducted in 2015. Qualitative content analysis was applied. RESULTS The findings revealed challenges related to a multifaceted pain condition. Participants described interactions with a supportive health care where being listened to, believed in and experiencing mutual trust were emphasized. When interactions with healthcare professionals made the participants feel insignificant, they found it difficult to express their needs, which seemed to reinforce practical difficulties and unfulfilled expectations and make them lose hope in their recovery. This implies the importance of a holistic understanding of and support for more person-centred practice to accommodate patients' expectations and expressed needs. Here, the nurses have an essential role in having a positive impact on future healthcare services.
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Affiliation(s)
- Kine Gjesdal
- Faculty of Health SciencesUniversity of StavangerStavangerNorway
| | - Elin Dysvik
- Faculty of Health SciencesUniversity of StavangerStavangerNorway
| | - Bodil Furnes
- Faculty of Health SciencesUniversity of StavangerStavangerNorway
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