Mid Sweden University

This study aims to describe how nurses perceive their professional roles in providing meal support for adult inpatients with anorexia nervosa. A qualitative design and reflexive thematic analysis were used, as well as the SRQR (i.e. Standards for Reporting Qualitative Research) reporting guidelines for accuracy and completeness. Personal interviews were conducted with 11 nursing staff in a general psychiatric inpatient ward. The results revealed an overarching theme: performing meal support – fluent shifting between roles, with two themes: acting as a supervisor, monitoring food intake, and getting into the supportive and helping role. Both themes further consisted of three subthemes each. The results show nurses’ ability to shift between roles and adapt to patients’ needs at the same time as maintaining treatment structure during meal support. Moving between differences in approach is important in fostering a therapeutic relationship and facilitating patient recovery. Balancing this is especially vital in nursing and involves meeting challenging responsibilities at the same time as addressing individual patient requirements.

Background Ensuring safe and personalized healthcare requires that patients have opportunities to express their concerns and influence their treatment decisions, which is a core value in healthcare. Such involvement is crucial for realizing the ideal of ageing in place. Despite efforts to increase patient participation, significant challenges persist, especially among older people with complex health needs.Aim The aim of this study was to explore an older adult's experiences of patient participation within a care triad, as reflected in the interactions and perspectives of the older person, healthcare professionals, and a family caregiver in the Norwegian home-care context.Methods This study employed a longitudinal single-case study with embedded units. Over 1 year, repeated interviews were performed with an older adult, his daughter, his general practitioner, and his responsible home-care nurse. Content analysis was used to analyze the data.Findings The analysis resulted in three themes representing the participants' experiences and points of view regarding the older adult's participation in care: to experience participation, to refrain from participation, and to lose one's participation.Conclusions The findings indicate that the older adult desired involvement despite occasional reluctance and that his participation was affected by interactional and contextual factors. Professionals must realize that the starting point of patient involvement is the patient's perspective and understanding of care needs, which the professionals have a joint responsibility to meet.

Aim

The aim of this study was to describe registered nurses' experience of person-centred care through digital media during the COVID-19 pandemic. The first wave of COVID-19 took healthcare services worldwide by surprise and affected all levels of care. Registered nurses within primary care settings had to adjust to new meeting forums with patients and in collaborations with other organisations to transfer patients from hospital to home care in a safe and secure manner using digital aids.

Design

Interviews with 17 registered nurses within primary care settings were conducted. Interviews were transcribed verbatim and analysed using qualitative content analysis.

Methods

Qualitative using semi-structured interviews.

Results

Digitalisation requires organisational changes, with four subcategories. The second category, digitalisation, facilitates person-centred care, with two subcategories. Main findings showed digitalisation as a possibility to enhance person-centred care to benefit the individual. The patients would have the possibility of obtaining professional care in their own home, enhancing the continuation of care. Digitalisation of primary care tasks demanded organisational changes of different kinds. This meant implementing innovative digital tools or artificial intelligence and developing a mental frame of mind that embraces new ways and activities to perform primary care through technology.

Public Contribution

Registered nurses saw enhancement of person-centred care through digital media as something positive. However, they also voiced concerns that some patients, such as self-damaging teenagers, new patients and multi-sick patients, would be unsuitable for digital meetings. They also emphasised that the digitalisation of person-centred care requires organisational changes. The study addressed the problems faced by the rapid conversion from traditional face-to-face care to digital care in the beginning of the COVID-19 pandemic within a primary care setting. There is a need for continued education on best communication practices with a primary focus on person-centred care. Since communication is key in the continuation of care, this needs to be addressed by both health centre management and educators.

ABSTRACT Aim To explore and gain a deeper understanding of older persons' experiences of care encounters when their home becomes a workplace. Background Worldwide healthcare services are increasingly being provided in older persons' homes by registered nurses. This presents new challenges as the home environment of older persons now doubles as a workplace for healthcare professionals. However, there is limited research available on how older persons experience care encounters when their homes serve as workplaces and how this influences their overall well-being and quality of life. Design A qualitative hermeneutic study. Methods In-depth face-to-face interviews were conducted in Sweden from October 2023 to January 2024 with 10 purposefully selected older persons (aged 65+). Each participant received regular visits from a home care nurse in their home to address specific care needs, such as wound care, medication administration, blood sampling and general supervision. The interviews were audiotaped, transcribed verbatim and analysed using a hermeneutic interpretation. Findings The hermeneutic analysis emerged with one main theme: ?Experiencing care encounters at home as a lottery?, with two underlying themes: ?Adapting to loss of control in the private sphere? and ?Striving for independence while navigating daily living?. Conclusions Older persons try to control their lives despite the challenges associated with ageing and receiving care at home. They strive to maintain their independence and autonomy, which reflects their desire for self-determination. Supporting these efforts in an interdependent relationship can enhance their well-being and quality of life. Reporting Method Findings were reported following the Consolidated Criteria for Reporting Qualitative Research guidelines. Patient or Public Contribution Data were collected by patient interviews. Implications for the Profession and Patient Care This study emphasises the importance of supporting older persons in maintaining control over their lives while being cared for in their homes. In the care encounters with home care nurses, their well-being and quality of life can be improved by respecting their autonomy, involving them in decision-making and offering tailored support.

This study aimed to describe how older adults with complex health problems manage their everyday lives in their own homes and how they interact with given home care. In this multiple-case study, a total of 14 individual interviews were conducted with five older adults over the course of one year. Deductive and inductive content analyses were performed. Three descriptive categories were each identified in the deductive (‘home care as interpersonal continuity’, ‘home care as information continuity’ and ‘home care as management continuity’) and inductive analyses (‘Lack of social contact with carers’, ‘Desire to be heard throughout the care process’ and ‘Carers are short on time’). Quality home care services are difficult to realize if interpersonal interaction is subordinated to effective task-solving.

Aim

To explore and describe older persons' unique experiences of care encounters with home care nurses in a real-life context.

Background

The increasing number of older persons in society contributes to increases in age-related impairments compromising their quality of life. Future care consists of “hospitals at home” where care encounters occur in a person's private domain, partly becoming a clinical workplace. Scant research has focused on how older persons experience care encounters with home care nurses and needs to be highlighted.

Design

Multiple-case study.

Methods

The cases relied on replication logic and five purposive sampled older persons were interviewed. Data were analysed using qualitative content analysis and differences within and between cases were explored and findings across the cases were replicated.

Findings

The cross-analysis emerged in three categories: “Nursing routine rules the care encounters”, “Lack of knowledge and information” and “Dependency on support from others”.

Conclusions

Our research has found that older persons face challenges while receiving home care, including limited engagement in their care and the need for enhanced support. Implementing person-centred care in homes poses ethical challenges that require careful consideration. Home care nurses should prioritise understanding each patient individually, recognising them beyond their patient role, which necessitates more thorough and time-sensitive care encounters.

Reporting Method

Findings were reported using COREQ guidelines.

Patient or Public Contribution

Patients were interviewed and contributed with data for this study.

Implications for the Profession and Patient Care

This study emphasises the need to prioritise individualised care in home settings and listen to the voices of older individuals to enhance quality.

Denne kunnskapsoppsummeringen identifiserer, beskriver og sammenfatter forsknings- og utviklingsarbeid som omhandler selvmordsrisiko og tiltak i kommunale helse- og omsorgstjenester for å forebygge selvmord hos eldre. Oppsummeringen gir også et overblikk over juridiske, faglige og politiske dokumenter som regulerer og gir føringer for selvmordsforebyggende arbeid i kommunale helse- og omsorgstjenester. Kunnskapsoppsummeringen har fulgt de metodiske trinnene beskrevet for scoping reviews av Arksey og O’Malley (2005). Oppsummeringen inkluderer 28 publikasjoner, hvorav 21 er vitenskapelige artikler og 7 er andre typer faglige publikasjoner som beskriver forsknings- og utviklingsarbeid. De fleste (19) publikasjonene beskriver arbeid gjennomført med deltakere eller datainnsamling i Norge, mens seks av publikasjonene viser arbeid utført i Sverige og én i Danmark. I tillegg er det inkludert en internasjonal oversiktsartikkel og en europeisk populasjonsstudie, begge funnet relevante for skandinavisk kontekst. De vitenskapelige artiklene er publisert i tidsrommet 2018–2023. De identifiserte studiene viser den økte sårbarheten for selvmord blant eldre og vektlegger viktigheten av å ta tak i unike utfordringer, inkludert fysisk og psykisk uhelse og sosioøkonomiske forhold. Publikasjonene understreker at helsepersonell rapporterer mangel på kunnskap om selvmordsforebygging, noe som viser et stort behov for opplæring og bevisstgjørende tiltak. Den oppsummerte kunnskapen peker også på behovet for å forbedre kommunikasjonen og dialogen mellom helsepersonell og eldre, for å kunne identifisere faresignaler og tilby tilstrekkelig eksistensiell støtte. For å møte disse utfordringene foreslås ulike tiltak, blant annet opplæringsprogrammer for helsepersonell, implementering av forebyggingsstrategier og bevisstgjøring om eksisterende hjelperessurser som Helsedirektoratets veiledningsmateriell. Samtidig understrekes viktigheten av å involvere og støtte pårørende og skape et mer inkluderende og støttende lokalmiljø for eldre, noe som motvirker ensomhet. Resultatene viser at det er nødvendig å styrke det selvmordsforebyggende arbeidet blant eldre og iverksette tiltak som tar hensyn til deres spesifikke behov og utfordringer. Det trengs strategier som sikrer samarbeid mellom ulike aktører, inkludert helsepersonell, pårørende og samfunnet ellers, for å skape et tryggere og mer støttende miljø for eldre mennesker.

Aim

The aim of this review was to synthesise qualitative research into how nurses perceive and experience encountering patients in forensic inpatient care.

Review method

This review followed the steps of meta-ethnography developed by Noblit and Hare.

Data sources

Twelve studies, published from 2011 to 2021, were identified through a search of relevant databases in December 2021.

Findings

The synthesis revealed three third-order and 10 second-order constructs during the translation of concepts in the studies. These are: Adopting the patient’s perspective (liberation, comprehension and resistance), Action (security, trust, flexibility and predictability) and Activation (afraid or safe, involved or indifferent and boundaries). Further, a line of argument was developed which indicates that in forensic psychiatry inpatient care, nurses experience having to deal with internal and external resistance that affects their freedom of choice in the creation of a caring relationship.

Conclusion

The encounter is experienced as a continuous process in which the foundation is laid for the encounter (approach), the encounter unfolds and develops (action) and the nurse experiences the encounter (activation). The process is intertwined with and takes place in a context where care is influenced by the duality of the task (task), the culture of care (context), the patient’s expression (patient) and the nurse’s own impression of the patient’s expression (oneself).

Implications

Professional communities should support initiatives that can strengthen nurses’ self-awareness and provide opportunities for reflection on practice, which will both benefit the resilience of the nursing staff and the quality of care for patients in this setting.

The concept of dementia‐friendly communities focuses on the lived experience of people who have dementia and is most relevant to addressing their needs and the needs of those people who live with and provide support for them. The goal of communities becoming dementia‐friendly is for dementia to be normalized and recognized as a disabling condition. People with dementia find being connected to self, to others, and to the environment by meaningful activities as important. According to the concept underlying dementia-friendly communities, people with dementia or cognitive decline can continue to live in the community if their residential community has sufficiently strong social capital. The aim of this study is to explore staff and leaders’ experiences in implementing interventions to enhance a more inclusive dementia-friendly community. A municipality in northern Sweden with a population of approx. 100 000 inhabitants decided to create a dementia friendly municipality. As part of the initiative, a Centre for support was established. The Centre offered support for both individuals and groups, did home visits, and provided information about Dementia. Interviews were conducted with staff who had undergone training in a structured form of multidimensional support, the PER-model®, and worked at the Centre for support. The staff consisted of registered nurses, occupational therapists, and specialized nurses who had worked there for more than five years, and all had training in dementia. All interviews were audio-recorded and transcribed verbatim. The transcribed data were analyzed using qualitative content analysis. Results suggest that implementing the PER-model® of support for persons in the early stages of dementia and their next of kin added a much-needed form of support and perceived possibilities to enhance daily life in the early stages of dementia. The staff appreciated that the structure of PER-model® was evidenced based. They also realized that they never even considered that the person with dementia also needed support in the early stages but that they now had tools for that as well. Creating a dementia friendly municipality offering different kinds of support for all stages of dementia is a challenge. However, evidence-based tools and a broad spectrum of different types of support, whether individual or group, are needed to tailor to everyone’s needs. A conviction that all citizens are equal and should all be involved in the community is a strong motivator.

Many ill people want to be cared for at home, and home care nurses face an infinite number of encounters when providing that service. Despite the rising prominence of home care organizations worldwide, little research has been conducted on the encounters between home care nurses and patients and how encounters influence the nursing care provided. The aim of the present study was to describe home care nurses’ experiences of encounters with patients in their homes. In total, 11 home care nurses were selected through purposive sampling. The data consisted of individual interviews, which were analyzed through qualitative content analysis, and reported using COREQ reporting guidelines. The results were based on two categories describing the importance of adapting to each patient's needs and collaborating with the person being cared for. Implementing the findings could enable nurses to care for the patients without reducing them to recipients of objectified care.