| 1. |
- Aasen, Elin M., et al.
(författare)
-
From open to locked doors - From dependent to independent : Patient narratives of participation in their rehabilitation processes
- 2021
-
Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 30:15-16, s. 2320-2330
-
Tidskriftsartikel (refereegranskat)abstract
- AIMS AND OBJECTIVES: The present study aimed to explore patients' experiences of participating in their rehabilitation process in the context of specialised rehabilitation in Norway.BACKGROUND: The rights of patients to participate in their care and treatment is an ideology that underlines newer international and Norwegian public documents. However, there is a gap between policy statements and clinical practice, and a discrepancy between patients' and professionals' statements about patient participation in rehabilitation.DESIGN: A qualitative approach with a narrative design.METHODS: Eleven patients were individually interviewed to tell their stories about the rehabilitation processes. We utilised narrative analysis with a three-dimensional space narrative structure including temporality, sociality and spatiality. This study followed the COREQ checklist.RESULTS: The analysis identified two throughout plots: 'person-centred culture' and 'time', and three plots which constructed how the patients participate in change through the rehabilitation process: (a) dependent-'open doors'; (b) motivation from within; and (c) independence-'locked doors'.CONCLUSIONS: Patient participation in rehabilitation was dependent on person-centred cultures in the unit and on different aspects of time. The dialogue and the power balance between the patients and the health personnel changed as the rehabilitation progressed. Motivation for rehabilitation had to come from within patients. The paternalistic ideology did not seem to dominate the specialised rehabilitation unit in the present study.RELEVANCE TO CLINICAL PRACTICE: This study gives new insight into how patients participate in change in the rehabilitation process. This can be valuable for healthcare professionals and governments. Insight into how the lack of person-centred focus can harm the rehabilitation process, and a deeper understanding of the meaning of time in the rehabilitation process is essential. These results may provide a stimulus for discussions on how patients might participate in their rehabilitation process.
|
|
| 2. |
- Aass, Lisbeth Kjelsrud, et al.
(författare)
-
Family support and quality of community mental health care : Perspectives from families living with mental illness
- 2022
-
Ingår i: Journal of Clinical Nursing. - : John Wiley & Sons. - 0962-1067 .- 1365-2702. ; 31:7-8, s. 935-948
-
Tidskriftsartikel (refereegranskat)abstract
- Aim and objectives: Describe patients' and family members' perceptions of family support from nurses and other mental healthcare professionals, and quality of care in community mental healthcare service. Further, compare the perceptions of patients and family members.Background: While patients value family involvement, family members feel unprepared and lack the necessary skills to be supportive. Since healthcare professionals predominantly focus on patients, they may fail to understand the complex needs of families. Family perceived support and quality of community mental health care may vary across patients and family members.Design and methods: Cross-sectional study with patients suffering from mental illness and family members in community mental healthcare services in Norway. Altogether 86 participants, of whom 33 patients and 33 family members had a family relationship-paired samples. Participants filled in the translated version of the Iceland Family Perceived Support Questionnaire (FPSQ-N) and Quality in Psychiatric Care-Community Out-Patient (QPC-COP) and Community Out-Patient Next of Kin (QPC-COPNK). STROBE checklist was used.Results: Family members scored family perceived support and quality of community mental health care lower than patients. Family members feel the loss of support. Patient and family members found the Patient-healthcare professionals' relationship to be of high quality, while family members gave low score to being respected and invited to take part in care by nurses and other mental healthcare professionals.Conclusion: Family members' unmet need of support highlights the need for nurses and other community mental healthcare professionals to assess complex family needs and to intervene. Barriers to collaboration exist, and family members need to be respected and invited into community mental health care. Relevance to clinical practice Contributes knowledge of how to meet the family's needs and provides a basis for further care and treatment development in similar contexts nationally and internationally.
|
|
| 3. |
- Adama, Esther Abena, et al.
(författare)
-
Support needs of parents in neonatal intensive care unit : An integrative review.
- 2022
-
Ingår i: Journal of Clinical Nursing. - : Wiley-Blackwell Publishing Inc.. - 0962-1067 .- 1365-2702. ; 31:5-6, s. 532-547
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Having an infant in the neonatal intensive care unit (NICU) is associated with intense emotional stress for both mothers and fathers. However, with the right support from staff, this stress can be reduced significantly. Although evidence on needs of parents in the neonatal unit exists, there is lack of a systematic integrative review on the support needs of parents in the neonatal unit. Current review evidence is needed to support busy neonatal unit clinicians in their practice.AIM AND OBJECTIVES: The purpose of this integrative review is to explore the current available evidence to describe and understand the support needs of parents of infants in the NICU.METHODS: The integrative review process of Whittemore and Knafl (2005) was used to guide this study. Six databases-MEDLINE, CINHAL, PubMed, Scopus, Google Scholar and PsycINFO-were searched for eligible studies using relevant keywords. Primary studies published in English language from 2010 to 2021 were reviewed following a pre-determined inclusion criteria. Studies that met the inclusion criteria were critically appraised using the Mixed Methods Appraisal Tool (MMAT). The review report is guided by the PRISMA 2020 checklist for systematic reviews.RESULTS: Overall, 24 primary qualitative, quantitative and mixed methods studies were included in the review. Analysis of included studies resulted in six themes that demonstrate the support needs of parents in the NICU; 1. Information needs; 2. Emotionally intelligent staff; 3. Hands-on support; 4. Targeted support; 5. Emotional needs; and 6. Practical needs.CONCLUSION: This review has presented the current evidence on the needs of parents from their own perspective. Healthcare workers' understanding and supporting these needs in the NICU is likely to increase parental satisfaction and improve health outcomes for parents, infants and their family.RELEVANCE TO CLINICAL PRACTICE: Parents of infants in the NICU require staff support to enhance their experiences, well-being, caring and parenting confidence during admission and post-discharge. As parents are in constant need for informational, emotional and practical support, continuing professional development for NICU staff should place emphasis on effective communication strategies, enhancing emotional intelligence and empathy among staff. NICU staff should build positive ongoing relationships with parents and provide targetted support for mothers and fathers.
|
|
| 4. |
- Afua Quaye, Angela, et al.
(författare)
-
How are children’s best interests expressed during their hospital visit? : An observational study
- 2021
-
Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 30:23-24, s. 3644-3656
-
Tidskriftsartikel (refereegranskat)abstract
- Aims and objectives: To describe ways in which children's best interests were observed to be expressed in paediatric settings during their hospital visit. Background: The best interests of the child are embodied in national and international legal systems, although the definition remains problematic. The child's limited autonomy mandates duty bearers to have both a child perspective and the child's perspective when considering what the best interest of the child entails in care situations. Design: A qualitative descriptive study with overt, non-participant observations fulfilling the COREQ criteria. Methods: Thirty-two observations of interactions between children aged 2 to 17 years with both acute and chronic conditions, their parents and healthcare professionals were conducted at three paediatric hospitals in Sweden. Inductive and abductive reasoning were used in the content analysis of data, which followed the identification, coding, categorising and abstraction of observed patterns of the best interest of the child. Results: Findings reveal facilitating and obstructing factors for the child's best interests to be safeguarded in healthcare situations. Children were guided in or hindered from exercising their competence. The observations showed a variation in actions taken by both parents and healthcare professionals to safeguard the best interests of the child. Conclusions: Determining the best interest of the child requires a case-by-case basis, as it is context-dependent, situational, flexible and dependent on all actors involved and actual decisions made. Relevance to clinical practice: Healthcare professionals’ actions can facilitate or obstruct observed expressions of the child's best interest. It is essential to enhance healthcare professionals’ communication skills, knowledge awareness and continuing education about the rights of children receiving healthcare services. Reflections and discussions on how to protect the best interests of children may help healthcare professionals to uphold children's best interest in daily clinical practice.
|
|
| 5. |
- Allemann, Hanna, et al.
(författare)
-
The co-design of an online support programme with and for informal carers of people with heart failure : A methodological paper
- 2023
-
Ingår i: Journal of Clinical Nursing. - : John Wiley & Sons. - 0962-1067 .- 1365-2702. ; 32:19-20, s. 7589-7604
-
Tidskriftsartikel (refereegranskat)abstract
- Abstract AimTo describe the co-designing process of an online support programme with and for informal carers of people with heart failure.DesignA co-design process built on core concepts and ideas embedded in co-design methodology.Data sources Our co-design process included three phases involving 32 informal caregivers and 25 content creators; (1) Identification of topics and content through literature searches, focus group interviews and user group sessions; (2) Development of the online support programme and; (3) Refinement and finalization which included testing a paper prototype followed by testing the online version and testing and approval of the final version of the support programme.Outcomes The co-design process resulted in a support programme consisting of 15 different modules relevant to informal carers, delivered on a National Health Portal.Conclusion Co-design is an explorative process where researchers need to balance a range of potentially conflicting factors and to ensure that the end users are genuinely included in the process.Relevance to clinical practice Emphasizing equal involvement of end users (e.g. carers or patients) in the design and development of healthcare interventions aligns with contemporary ideas of person-centred care and provides a valuable learning opportunity for those involved. Furthermore, a co-designed online support programme has the capacity to be both accessible and meet end users' information and support needs, thereby optimizing their self-care abilities. Additionally, an online support programme provides the opportunity to address current challenges regarding scarce resources and the lack of healthcare personnel.Reporting methodsConsolidated criteria for reporting qualitative research (COREQ).Patient or public contributionBoth informal carers and content creators were involved in developing the support programme.
|
|
| 6. |
- Alvariza, Anette, et al.
(författare)
-
Palliative care nurses' strategies when working in private homes : A photo-elicitation study
- 2020
-
Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 29:1-2, s. 139-151
-
Tidskriftsartikel (refereegranskat)abstract
- AIMS AND OBJECTIVES: To explore palliative care nurses' work experiences caring for patients at the end of life in private homes.BACKGROUND: The home continues to be a desired place for care and dying; however, professional competence is needed and specialist palliative care nurses play a crucial role, often highly valued by patients and their family members. The private home as a physical work environment for nurses is explored, with both positive and negative aspects being described. To ensure future high-quality end-of-life care, there is a need to describe how palliative care nurses work in private homes.DESIGN: Interpretative descriptive.METHODS: Participant-generated photographs were used in conjunction with follow-up interviews with ten palliative home care nurses. Interpretive description was used for analysis. This study follows the COREQ checklist.RESULTS: The analysis process resulted in four constructed themes, presented here as strategies used by palliative care nurses: adjusting interactions and actions depending on the environment when entering each unique private home; supporting patients and family members in finding a balance between self-care, independence and safe care; guiding patients and family members towards and through environmental changes supporting end-of-life care at home; and using transitions between homes to reflect, recuperate and prepare.CONCLUSION: Working as a palliative care nurse in private homes clearly requires a variety of skills and competences, here operationalised in different strategies used to promote high-quality care.RELEVANCE TO CLINICAL PRACTICE: Palliative care nurses' considerations, insights and competence when performing end-of-life care in the diverse environments of private homes can contribute to the development of clinical practice. Knowledge about strategies can be used in nursing practice during everyday work, in nursing education and in the organisation of care, and can inform policy to ensure future high-quality palliative home care.
|
|
| 7. |
- Andersen-Hollekim, Tone, et al.
(författare)
-
Narratives of patient participation in haemodialysis
- 2020
-
Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 29:13/14, s. 2293-2305
-
Tidskriftsartikel (refereegranskat)abstract
- Aim and objective: To explore how working-age adults experience patient participation in hospital haemodialysis. Background: End-stage kidney disease is a progressive, chronic condition imposing patients with high treatment burdens and low health-related quality of life. Patients face multiple medical decisions related to living with kidney failure. Given their frequent interaction with health services, patient participation may be of special value. Design: Qualitative design with a narrative approach. Methods: In 2018, eleven patients aged 35–64 years undergoing hospital haemodialysis participated in individual interviews. All interviews were analysed using a narrative approach. Reporting followed the Consolidated criteria for Reporting Qualitative Research guidelines. Findings: The patients’ narratives of participation comprised three themes following their healthcare trajectory: Informed, but not involved in treatment choices; Duality of care and control; and Frail trust reflecting collaborative deficiencies. The patients received good information about dialysis, but were not involved in choice of treatment modality. Professional work, as well as the nature of treatment, contributed to restricted patient autonomy. Patients’ trust suffered from collaborative deficiency generating delays in their treatment trajectories, and patients extended their responsibility into the coordination of transitions as a way of coping with these issues. Conclusions: The study identified challenges related to patient involvement and interdisciplinary collaboration. Involving patients through dialogue and acknowledging their experiences, preferences and lifestyles may strengthen the mutual patient–professional understanding of treatment. Despite increased focus on seamless trajectories, patients face obstacles regarding interdisciplinary collaboration and coordination of health services. Relevance to clinical practice: The findings indicate a want of individually customised care for people requiring dialysis. Patients need to be involved in the choice of treatment modality as well as decisions related to the current treatment. Information must include potential consequences of the different treatment modalities. Health services need to strengthen collaboration in order to secure treatment continuity and patient involvement.
|
|
| 8. |
- Andersson, Lisbet, et al.
(författare)
-
The interplay between children, their parents and anaesthesia staff during the child's anaesthesia - An observational study
- 2022
-
Ingår i: Journal of Clinical Nursing. - : John Wiley & Sons. - 0962-1067 .- 1365-2702. ; 31:15-16, s. 2240-2251
-
Tidskriftsartikel (refereegranskat)abstract
- Aims and objectives To interpret and understand the interplay between children, their parents, and anaesthetic staff to gain a greater understanding of children being anaesthetised. Background Anaesthesia induction is a stressful procedure for the child and parents in the technologically advanced environment in the operating room (OR). Anaesthesia staff are a key resource for ensuring safety and interplays, but the meeting is often short, intensive, and can affect the child and the parent. Design A qualitative observational design with a hermeneutic approach. Methods Twenty-seven non-participant observations were conducted and videotaped when children were being anaesthetised. The SRQR checklist was used. Results The result is presented as a theatre play with three headings; the scene, the actors, and the plot. The scene was not designed for the child or the parent's comfort and could lead to anxiety and insecurity. Four themes described the interplays: The need to be inviting and to be invited, The need for varying compliance, The need for mutual dependence, and The need to give and to receive emotional support. The plot could lead to uncertainty, and the interplay could change between being caring and uncaring depending on the actors. Conclusions The technologically advanced environment in the OR constituted an emotional obstacle, but the anaesthesia staff themselves can be a powerful resource creating a caring environment. The outcome of the plot may depend on the anaesthesia staff's bearing. Relevance to clinical practice A caring approach in the OR requires a willingness from the anaesthesia staff to invite the child to participate and find a balance between helping the parents to find their place in the OR and support them in supporting their child. The findings can start reflections in the unit on how to create a more caring environment.
|
|
| 9. |
- Angelini, Eva, 1964, et al.
(författare)
-
Healthcare practitioners’ experiences of postoperative pain management in lumbar spine surgery care—A qualitative study
- 2020
-
Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 29, s. 1662-1672
-
Tidskriftsartikel (refereegranskat)abstract
- © 2020 The Authors. Journal of Clinical Nursing published by John Wiley & Sons Ltd Aims and objective: To explore and describe healthcare practitioners’ experiences of postoperative pain management to patients undergoing planned lumbar spine surgery by identifying the healthcare practitioners’ behaviours, attitudes and strategies. Background: Poorly managed postoperative pain continues to cause suffering and prolong hospital care and may affect individual and team practitioners’ strategies and attitudes. The impact of these strategies and attitudes needs greater understanding. Design: Descriptive qualitative study. Methods: In-depth interviews were conducted at a university hospital in Sweden during January–March 2016 with 9 healthcare practitioners (ages: 29–61years; gender: male 3 and female 6; professions: medical doctor 3, registered nurse 3 and physiotherapist 3; professional experience: 1.5months to 25years). The interviews were analysed using Braun and Clarke's thematic analysis. The study adhered to the Consolidated Criteria for Reporting Qualitative Research COREQ. Results: The interviews revealed healthcare practitioners’ attitudes and strategies. Three themes were identified: (a) Connecting with the person was recognised as the key component in postoperative pain management; (b) Professionalism: a balancing act, accentuated health care practitioners’ duality in being both vulnerable and strong in delicate care situations; and (c) Collaboration: being constantly responsive, the necessity for healthcare practitioners to be constantly responsive to their environment. Conclusions: The findings pinpoint the need for healthcare organisations to build structures enabling practitioners to deliver adequate pain management in acknowledging the practitioners’ delicate situation when facing patients in pain. Relevance to clinical practice: Given the global need for postoperative pain management, our findings have international relevance. Preconceived expectations on specific pain need to be depicted and postoperative pain taken seriously to protect the patient as well as the healthcare practitioners.
|
|
| 10. |
- Arvidsson, Lisa, et al.
(författare)
-
Healthcare personnel's working conditions in relation to risk behaviours for organism transmission : A mixed-methods study
- 2022
-
Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 31:7-8, s. 878-894
-
Tidskriftsartikel (refereegranskat)abstract
- AIMS AND OBJECTIVES: To investigate healthcare personnel's working conditions in relation to risk behaviours for organism transmission.BACKGROUND: Healthcare personnel's behaviour is often influenced by working conditions that in turn can impact the development of healthcare-associated infections. Observational studies are scarce, and further understanding of working conditions in relation to behaviour is essential for the benefit of the healthcare personnel and the safety of the patients.DESIGN: A mixed-methods convergent design.METHODS: Data were collected during 104 h of observation at eight hospital units. All 79 observed healthcare personnel were interviewed. Structured interviews covering aspects of working conditions were performed with the respective first-line manager. The qualitative and quantitative data were collected concurrently and given equal priority. Data were analysed separately and then merged. The study follows the GRAMMS guidelines for reporting mixed-methods research.RESULTS: Regardless of measurable and perceived working conditions, risk behaviours frequently occurred especially missed hand disinfection. Healthcare personnel described staffing levels, patient-level workload, physical factors and interruptions as important conditions that influence infection prevention behaviours. The statistical analyses confirmed that interruptions increase the frequency of risk behaviours. Significantly higher frequencies of risk behaviours also occurred in activities where healthcare personnel worked together, which in the interviews was described as a consequence of caring for high-need patients.CONCLUSIONS: These mixed-methods findings illustrate that healthcare personnel's perceptions do not always correspond to the observed results since risk behaviours frequently occurred regardless of the observed and perceived working conditions. Facilitating the possibility for healthcare personnel to work undisturbed when needed is essential for their benefit and for patient safety.RELEVANCE FOR CLINICAL PRACTICE: The results can be used to enlighten healthcare personnel and managers and when designing future infection prevention work.
|
|
