Mid Sweden University

Background

Mental health problems are increasing among children and adolescents. Parents play a pivotal role in care, and intervention programmes have been introduced directed towards children with mild to moderate mental health problems. Due to long waiting times for specialised psychiatric care, such programmes could serve as means to ease the burden on mental health clinics for children 6-14 years. The aim of this study was to evaluate parents' assessments of the quality of care of an intervention programme and associations with the children's physical and mental health after treatment.

Methods

Parents' assessment of the quality of care was investigated through a questionnaire. Outcome variables were parents' perceptions of the children's physical and mental health after treatment. Explanatory variables were background factors, care organisation and the content of care.

Findings

31% of the parents assessed their child's physical health as less than good, and 46% their child's mental health as less than good, after treatment. Long waiting times (OR 2.50; 1.17-5.30), parents' ability to have private conversations with the therapist (OR 0.45; 0.22-0.94), and deficiencies in the content of care were associated with less good physical health after treatment. Less good mental health after treatment was associated with older age of children (OR 2.01; 1.01-3.99) and deficiencies in care content.

Conclusion

Age of the child, long waiting time, and perceived deficiencies in the content of care were associated with less physical and mental well-being of the child after the intervention. These findings call for improvement of care.

I forskningsprogrammet Framtidens Välfärd: Vård och Skola samarbetar Mittuniversitetet och fem kommuner för att utveckla vård och skola. Genom att förena forskning och praktik tas långsiktiga lösningar fram för att möta samhällsutmaningar som kompetensförsörjning, demografiska förändringaroch behovet av starka välfärdstjänster i både stad och glesbygd.

Denna antologi samlar forskningsprojekt inom programmet och belyser hur akademi och kommuner tillsammans kan skapa ny kunskap som stärker både utbildningar och yrkesverksamheter inom vård och skola. Bidragen speglar en bred palett av forskningsområden – från tekniska innovationer och organisatoriska förändringar till sociala och kulturella perspektiv.

Genom denna samling av resultat, tankar och idéer hoppas vi inspirera till fortsatt utveckling och fördjupad samverkan mellan forskning och praktik. Antologin visar på vikten av lokala samarbeten, forskningsdriven utveckling och innovativa metoder för att hantera framtidens välfärdsutmaningar.

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.

Our study seeks to elucidate meanings of healthcare encounters for women with chronic obstructive pulmonary disease stage III or IV. We conducted 12 narrative interviews which were analyzed using phenomenological hermeneutic interpretation. Our analysis revealed one theme; being met as a person and not as a diagnosis with three subthemes: getting sufficient time and feeling involved in care; fulfillment of personal needs; and experiencing disrespect and injustice. We found that meanings of healthcare encounters center on the expectation of being seen as a person. Feeling disrespected and injust leaves women unsupported and could pose serious health risks.

This study aims to investigate and evaluate nursing students' perceptions of their learning gains and identify the factors that contribute to academic integration and student learning within the one-week IP course within the Nordplus Programme. The programme, established in 1993, promotes student and teacher mobility and curriculum development in higher education across the Nordic and Baltic countries. The research utilizes a short-term mobility program organized by eight nursing education institutions. To assess the students' experiences, an evaluation form inspired by the Student Assessment of Learning Gains (SALGs) questionnaires was developed. Results reveal positive feedback from students regarding the IP course, particularly in terms of interaction with national and international peers and teachers. The study's findings contribute by demonstrating the benefits of a short-term IP course in providing concentrated and flexible learning experiences. The IP course introduces students to additional nursing topics and foster active engagement. The implications suggest that nursing education institutions should consider incorporating more short-term mobility programs to enhance student learning and intercultural experiences. By investing in such initiatives, institutions can cultivate an enriching and supportive learning environment.

Background

Living with chronic obstructive pulmonary disease stage III or IV involves unpredictability dominated by an ever-present breathlessness. This often results in frequent and or long-lasting healthcare. Research shows that in encounters women are more often affected by and suffer from poor care quality, unequal access to provision of care, experience stigma, and a lack of information.

Aim

The aim was to elucidate meanings of healthcare encounters for women with COPD stage III or IV.

Methods

Phenomenological hermeneutical design where personal narrative interviews were conducted with 12 women with chronic obstructive pulmonary disease stage III or IV.

Results

The analysis resulted in one theme; being met as a person and not as a diagnosis with three subthemes: getting sufficient time and feeling involved in care; fulfillment of personal needs; and experiencing disrespect and injustice. Women with chronic obstructive pulmonary disease stage III or IV expressed feeling taken seriously and involved in decision-making when being actively listened to, engaged in a meaningful dialogue, and allocated time encountered by calm, reflective, and gentle healthcare professionals. Continuity of care fulfills personal needs, promoting relaxation, especially vital for those with limited energy due to severe illness. Participants expressed enhanced well-being when healthcare professionals were familiar with their medical history and observed changes between visits. Not being seen as a whole person, women with COPD stage III or IV felt not being taken seriously, especially when denied antibiotics. Fears of inadequate support arise, exacerbated by uninterested or disrespectful healthcare encounters, leading to reluctance to seek care. Prioritizing expertise over patient preferences intensifies frustration, causing feelings of disappointment, unsafety, anger, and offense. Geographic disparities, particularly in rural areas, contribute to a sense of injustice and disappointment in available healthcare choices.

Conclusion

Women with chronic obstructive pulmonary disease stage III or IV experienced meanings of healthcare encounters that focus on the expectation of being seen as a person. Feeling disrespected and unjust leaves women unsupported could pose serious health risks. Generic person-centered care could lead to confirming healthcare encounters.

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.