| 1. |
- Hafskjold, Linda, et al.
(författare)
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Older persons' worries expressed during home care visits : Exploring the content of cues and concerns identified by the Verona coding definitions of emotional sequences
- 2016
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Ingår i: Patient Education and Counseling. - : Elsevier BV. - 0738-3991 .- 1873-5134. ; 99:12, s. 1955-1963
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Tidskriftsartikel (refereegranskat)abstract
- Objective: Little is known about how older persons in home care express their concerns. Emotional cues and concerns can be identified by the Verona coding definitions of emotional sequences (VR-CoDES), but the method gives no insight into what causes the distress and the emotions involved. The aims of this study are to explore (1) older persons' worries and (2) the content of these expressions. Methods: An observational exploratory two-step approach was used to investigate audiotaped recordings from 38 Norwegian home care visits with older persons and nurse assistants. First, 206 cues and concerns were identified using VR-CoDES. Second, the content and context of these expressions were analysed inductively. Results: Four main categories emerged: worries about relationships with others, worries about health care-related issues, worries about aging and bodily impairment, and life narratives and value issues, with several subcategories showing the causes of worry and emotions involved. Conclusion: The two-step approach provides an in-depth knowledge of older persons' worries, causes of worries, and their related emotions. Practice implications: The subcategories described in a language close to the experience can be useful in practice development and communication training for students and health care providers.
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| 2. |
- Ernesäter, Annica, 1970-
(författare)
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National Telephone Advice Nursing in Sweden : Patient Safety and Communication
- 2012
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The overall aim of this thesis was to investigate patient safety and communication within national telephone advice nursing (SHD) in Sweden. Four empirical studies with different perspectives were conducted. The aim of Study I was to describe telenurses’ experiences of working with computerized decision support systems and how such systems could influence their work. The telenurses described a duality of perceptions: the CDSS both supported and inhibited their work. Study II aimed at describing medical errors that had led to an incident report within the context of SHD. Incident reports sent to and from the SHD during 2007 were collected. The results showed that telenurses have limited possibilities to refer callers to the appropriate level of care, and that other healthcare providers reported that telenurses had made an incorrect assessment regarding callers’ need for care. Study III aimed at describing the actual communication between telenurses and callers expecting a higher level of care than recommended by telenurses, and at investigating relationships within the communication between telenurses and callers. The results showed that telenurses were more prone to use closed-ended questions and did not follow up on callers’ understanding of the advice given. There was also a statistically significant positive relationship between callers’ expressions of Concern and telenurses’ expressions of Criticism, and also between utterances of Criticism between the parties. The aim of Study IV was to describe the characteristics of all malpractice claims following telephone calls to SHD, including the identified causes, the healthcare providers’ measures, and the actual communication between the telenurses and callers. The results showed that among the cases, 13 of 33 patients died and 12 were admitted to intensive care. The National Board of Health and Welfare’s (NBHW) investigations most commonly reported communication failure as the cause of the malpractice claims. The measures reported by SHD most commonly involved discussion in work groups and education of staff. Communication analysis showed a positive correlation between the callers’ expressions of Concern and the telenurses’ expressions of Reassurance. The results also showed communication patterns similar to those found in Study III. Hence, telenurses’ communicative strategies are not in line with the “dialogue process” they are educated in and could be regarded as a threat to patient safety.In conclusion, the importance of high quality communication is undoubted within telephone advice nursing, and specific training and supervision in communication for telenurses might contribute to improving their communicative competence as well as patient safety. Adapting the CDSS into encourage telenurses to explore callers’ reasons for calling and to follow up on understanding might facilitate patient safety. Organizations also need to take a system-wide approach when addressing patient safety issues and ensure that telenurses are given the resources they need to fulfill their work.
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| 3. |
- Foss, Stein, et al.
(författare)
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Doctors' attitudes to organ donation
- 2014
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Ingår i: Tidsskrift for Den norske legeforening. - : Norwegian Medical Association. - 0029-2001. ; 134:11, s. 1142-1146
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUNDThere is an increasing need for organs for transplantation purposes. Knowledge and attitudes among the medical team may affect the donation process. When respiration and cardiac activity are being sustained by artificial means, Norwegian law requires angiographic evidence of cessation of cerebral circulation as well as clinical examination before an organ donation can be carried out. We wished to survey Norwegian doctors’ attitudes to organ donation and how donation processes are being addressed.MATERIAL AND METHODA questionnaire with pre-defined response alternatives was distributed to doctors in intensive-care units as well as to specialists and junior registrars in neurosurgery in Norwegian donor hospitals in 2008 – 2009.RESULTSAltogether 435 doctors (55 %) returned a completed questionnaire. A total of 315 of 420 (75 %) responded that they would consider initiating organ-preserving treatment when there is no more hope for the patient, while 18 % were uncertain and 7 % responded that they would not consider this option. Altogether 68 of 424 (16 %) maintained that if an organ donation was relevant and current legislation could be disregarded, clinical diagnostics would be sufficient to establish a diagnosis of death. Another 22 % were uncertain, while 62 % were of the opinion that clinical diagnostics would be insufficient. A total of 258 of 416 (62 %) reported that in their opinion, the next of kin most often could understand the implications of total destruction of the brain when this was explained to them.INTERPRETATIONFuture teaching should emphasise the opportunity for organ-preserving treatment in cases where a fatal outcome is expected.
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| 4. |
- Foss, Stein, et al.
(författare)
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Legers holdninger till organdonasjon
- 2014
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Ingår i: Tidsskrift for Den norske lægeforening. - Oslo : Norwegian Medical Association. - 0029-2001 .- 0807-7096. ; 134:11, s. 1142-1145
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Tidskriftsartikel (refereegranskat)abstract
- BAKGRUNN Behovet for organer til transplantasjon øker. Behandlingsteamets kunnskap om og holdninger til organdonasjon kan påvirke donasjonsprosessen. Når åndedrett og hjertevirksomhet blir opprettholdt med kunstige midler, krever norsk lov angiografisk påvist opphevet cerebral sirkulasjon i tillegg til klinisk undersøkelse før organdonasjon kan gjennomføres. Vi ønsket å kartlegge norske legers holdning til organdonasjon og hvordan donasjonsprosessen håndteres.MATERIALE OG METODE Et spørreskjema med definerte svaralternativer ble sendt til leger ved intensivavdelinger og til spesialister og utdanningskandidater i nevrokirurgi ved landets donorsykehus i 2008/09.RESULTATER 435 leger (55 %) returnerte spørreskjemaet. 315 av 420 (75 %) svarte at de kunne tenke seg å starte organbevarende behandling når det ikke finnes håp for pasienten, mens 18 % var i tvil og 7 % svarte at de ikke kunne tenke seg dette. 68 av 424 (16 %) mente at dersom organdonasjon var aktuelt og de så bort fra eksisterende lovverk, var klinisk diagostikk tilstrekkelig til å kunne stille dødsdiagnosen. 22 % var i tvil, mens 62 % mente at klinisk diagostikk ikke var tilstrekkelig. 258 av 416 (62 %) svarte at de trodde pårørende som oftest forsto hva total ødeleggelse av hjernen innebar etter at de var blitt det forklart.FORTOLKNING I fremtidig undervisning bør man legge vekt på muligheten for organbevarende behandling når man forventer dødelig utgang.
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| 5. |
- Hafskjold, Linda, et al.
(författare)
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A cross-sectional study on person-centred communication in the care of older people : the COMHOME study protocol.
- 2015
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 5:4
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: This paper presents an international cross-sectional study on person-centred communication with older people receiving healthcare (COMHOME). Person-centred care relies on effective communication, but few studies have explored this with a specific focus on older people. The main aim of the COMHOME study is to generate knowledge on person-centred communication with older people (>65 years) in home healthcare services, radiographic and optometric practice.METHODS AND ANALYSIS: This study will explore the communication between care providers and older persons in home care services. Home healthcare visits will be audiorecorded (n=500) in Norway, the Netherlands and Sweden. Analyses will be performed with the Verona Coding Definitions for Emotional Sequences (VR-CoDES), the Roter Interaction Analysis System (RIAS) and qualitative methods. The content of the communication, communicative challenging situations as well as empathy, power distance, decision-making, preservation of dignity and respect will be explored. In Norway, an additional 100 encounters, 50 in optometric practice (video recorded) and 50 in radiographic practice (audiorecorded), will be analysed. Furthermore, healthcare providers' self-reported communication skills, empathy, mindfulness and emotional intelligence in relation to observed person-centred communication skills will be assessed using well-established standardised instruments.ETHICS AND DISSEMINATION: Depending on national legislation, approval of either the central ethical committees (eg, nation or university), the national data protection officials or the local ethical committees (eg, units of home healthcare) was obtained. Study findings will be disseminated widely through peer-reviewed publications and conference presentations. The research findings will add knowledge to improve services provided to this vulnerable group of patients. Additionally, the findings will underpin a training programme for healthcare students and care providers focusing on communication with older people.
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| 6. |
- Heyn, Lena Günterberg, et al.
(författare)
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Understanding the role of positive emotions in healthcare communication – A realist review
- 2023
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Ingår i: Nursing Open. - : Wiley. - 2054-1058.
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Forskningsöversikt (refereegranskat)abstract
- AimTo explore how the expression of positive emotions during the interaction between patients and providers can cultivate the patient-provider relationship.DesignWe conducted a realist review guided by the Realist and Meta-narrative Evidence Syntheses: Evolving Standards.MethodsWe systematically searched CINAHL, MEDLINE, PsychINFO and Scopus from inception to March 2019. Study selection and data extraction were performed blinded in pairs. From 3146 abstracts blinded in pairs, 15 papers were included and analysed. From each included paper, we extracted contexts, mechanisms and outcomes that were relevant to answer our research questions, creating a configuration between these elements (CMO configuration).ResultsOur findings suggest that in the contexts of person orientation and positive outlook, patient-provider relationships improve by communication conveying and eliciting positive emotions. We found six underlying mechanisms for this that form either direct or indirect pathways between the context and the outcome.
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| 7. |
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| 8. |
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| 9. |
- Höglander, Jessica, et al.
(författare)
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Emotional communication with older people : A cross-sectional study of home care.
- 2019
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Ingår i: Nursing and Health Sciences. - : Wiley. - 1441-0745 .- 1442-2018. ; 21:3, s. 382-389
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to explore the influence of characteristics of nurses and older people on emotional communication in home care settings. A generalized, linear, mixed model was used to analyze 188 audio-recorded home care visits coded with Verona Coding Definitions of Emotional Sequences. The results showed that most emotional distress was expressed by older females or with female nurses. The elicitation of an expression of emotional distress was influenced by the nurses' native language and profession. Older women aged 65-84 years were given the most space for emotional expression. We found that emotional communication was primarily influenced by sex for nurses and older people, with an impact on the frequency of expressions of and responses to emotional distress. Expressions of emotional distress by older males were less common and could risk being missed in communication. The results have implications for students' and health professionals' education in increasing their knowledge of and attentiveness to the impacts of their and others' characteristics and stereotypes on emotional communication with older people.
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| 10. |
- Höglander, Jessica, et al.
(författare)
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Exploring patient-centered aspects of home care communication : a cross-sectional study.
- 2020
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Ingår i: BMC Nursing. - : Springer Nature. - 1472-6955. ; 19
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Tidskriftsartikel (refereegranskat)abstract
- Background: Communication is a cornerstone in nursing and aims at both information exchange and relationship building. To date, little is known about the naturally occurring communication between older persons and nurses in home care. Communication might heal through different pathways and a patient- or person-centered communication could be important for health and well-being of older persons. However, the delivery of individualized home care is challenged by routines and organizational demands such as time constraints. Therefore, the aim of this study was to explore the patient-centered aspects of home care communication between older persons and registered nurses.Methods: In total 37 older persons (aged 65 years or older) and eleven RNs participated in 50 audio-recorded home care visits. Roter Interaction Analysis System (RIAS) was used to code verbal communication. A ratio from these codes, establishing the degree of patient-centeredness, was analyzed using a Generalized Linear Mixed Model.Results: The present home care communication contained more socio-emotional than task-oriented communication and the emotional tone was largely positive. The global affect ratings reflected an overall positive tone (m = 39.88, sd = 7.65), with higher ratings on dimensions of, for example, responsiveness/engagement and interactivity or interest were more frequent than those that may be considered as less-positive emotions (m = 15.56, sd = 3.91), e.g. hurried, dominance or anger. The ratio of the degree of patient-centered communication in the home care visits was an average of 1.53, revealing that the communication could be considered as patient-centered. The length of the visits was the only characteristic significantly associated with the degree of patient-centeredness in the communication, with a peak in patient-centeredness in visits 8-9 min long. Sex, age or procedural focus showed no significant effects on the degree of patient-centeredness.Conclusion: Overall, the degree of patient-centeredness and a positive emotional tone, which might have a positive outcome on older persons' health, was high. Longer visits provided a higher degree of patient-centeredness, but no linear increase in patient-centeredness due to length of visit could be observed. The findings can be used for education and training of nurses, and for providing individualized care, e.g. patient- or person-centered care.
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