| 1. |
- Östman, Malin, et al.
(författare)
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The patient's first point of contact in primary care – registered nurses' communication and initial assessment
- 2023
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Konferensbidrag (refereegranskat)abstract
- Overall information:This is a postdoc project that includes three work packages (WP). The purpose of this research is to investigate key principles and conflicts of goals in registered nurses’ (RNs) initial assessments and nurse-patient communication related to the priority of patients’ needs and care provision in primary care. This abstract focuses on the first WP.Background:Primary care is central to the Swedish healthcare system, for “good quality, local health care”, with focus on accessibility and continuity. In primary care, RNs are usually the patient's first point of contact and those who carry out initial assessments and priorities. The RNs communication and interaction with the patient is important for the initial exploration and understanding about patient’s health concerns, and RNs assessment includes data gathering, the interpretation of these data and decision-making on what action needs to be taken. Communication strategies used can optimize RNs assessment and clinical reasoning. However, assessments and priorities are complex, as health problems and illness severity must be weighed against accessibility and available resources. There is a lack of research on RNs communication strategies used to address individual patients’ need in their initial contact with primary care.Aim:To explore nurse-patient communication during initial assessments and RNs’ priorities with focus on expressed needs and concerns.Methods:The first WP is based on observational data, subjects for the project are RNs and patients from primary care units in Region Västra Götaland, Sweden. Data will be gathered on real time nursepatient communication using audio recordings with ten RNs doing five recordings each. A purposeful sampling will be made to collect data related to patients with a first point of contact with different disease conditions and illness complexities. The processing and analysis of data collected on audio recordings will be coded with the Verona Coding Definitions on Emotional Sequences (VR-CoDES). The data will allow for both statistical and qualitative analysis.Expected findings:This study can contribute to more knowledge about RNs communication strategies in relation to RNs’ assessment in patient’s first point of contact in primary care, but also whether gender differences or other inequalities exist.Timeplan:The first WP will start in Spring 2023 and by the end of the year, reporting and dissemination of findings is expected to be possibleRequest for feedback:We have planned to code the data with VR-CoDES. Other methods or approaches that may be suitable?
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| 2. |
- Andersson, Elin, et al.
(författare)
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Prehospital Identification of Patients with a Final Hospital Diagnosis of Stroke.
- 2018
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Ingår i: Prehospital and Disaster Medicine. - 1049-023X .- 1945-1938. ; , s. 63-70
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Tidskriftsartikel (refereegranskat)abstract
- Introduction the early phase of stroke, minutes are critical. Since the majority of patients with stroke are transported by the Emergency Medical Service (EMS), the early handling and decision making by the EMS clinician is important. Problem The study aim was to evaluate the frequency of a documented suspicion of stroke by the EMS nurse, and to investigate differences in the clinical signs of stroke and clinical assessment in the prehospital setting among patients with regard to if there was a documented suspicion of stroke on EMS arrival or not, in patients with a final hospital diagnosis of stroke.METHODS: The study had a retrospective observational design. Data were collected from reports on patients who were transported by the EMS and had a final diagnosis of stroke at a single hospital in western Sweden (630 beds) in 2015. The data sources were hospital and prehospital medical journals.RESULTS: In total, 454 patients were included. Among them, the EMS clinician suspected stroke in 52%. The findings and documentation on patients with a suspected stroke differed from the remaining patients as follows: a) More frequently documented symptoms from the face, legs/arms, and speech; b) More frequently assessments of neurology, face, arms/legs, speech, and eyes; c) More frequently addressed the major complaint with regard to time and place of onset, duration, localization, and radiation; d) Less frequently documented symptoms of headache, vertigo, and nausea; and e) More frequently had an electrocardiogram (ECG) recorded and plasma glucose sampled. In addition to the 52% of patients who had a documented initial suspicion of stroke, seven percent of the patients had an initial suspicion of transitory ischemic attack (TIA) by the EMS clinician, and a neurologist was approached in another 10%.CONCLUSION: Among 454 patients with a final diagnosis of stroke who were transported by the EMS, an initial suspicion of stroke was not documented in one-half of the cases. These patients differed from those in whom a suspicion of stroke was documented in terms of limited clinical signs of stroke, a less extensive clinical assessment, and fewer clinical investigations. Andersson E , Bohlin L , Herlitz J , Sundler AJ , Fekete Z , Andersson Hagiwara M . Prehospital identification of patients with a final hospital diagnosis of stroke.
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| 3. |
- Darcy, Laura, 1967-, et al.
(författare)
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A qualitative analysis of child and family complaints related to child mental health services
- 2023
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Ingår i: Journal of Child and Adolescent Psychiatric Nursing. - : John Wiley & Sons. - 1073-6077 .- 1744-6171.
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Tidskriftsartikel (refereegranskat)abstract
- Problem: Little is known about issues of patient-reported problems, in particular within psychiatric services for children with mental ill health. Child and family complaints related to child mental health services can be analyzed and discussed in light of the universal human right to health and healthcare. Therefore, the aim of this study was to analyze child and family complaints related to child mental health services. Methods: A retrospective, descriptive design was used. Child and family complaints were analyzed with a qualitative thematic analysis. Findings: The findings were described in three themes describing lack of access to care, inadequate communication between services and children with mental ill health and their families, and lack of clarity of who is responsible for care, leading to neglect of children's needs. These issues place a huge responsibility on parents or relatives. Conclusion: Better communication within mental health services, and better collaboration with other services such as school and social services, could limit children's suffering. Healthcare services with named professionals who specialize in child mental health and provide continuity in care, are required. General human rights principles should guide planning and care of children.
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| 4. |
- Gustafsson, Tanja, PhD student, 1980-, et al.
(författare)
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ACTION: A Person-centred Communication Intervention Targeting Nurse Assistants in Home Care for Older Persons
- 2019
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Konferensbidrag (refereegranskat)abstract
- Background: The aging population and the number of older persons living at home are increasing. Some have extensive needs for care, which leads to increased demands on professionals in home care settings. Professionals’ need to have sufficient competency to promote health and wellbeing among older persons. For sustainable care, there is a need for efficient educational efforts in the home care context. Person-centred communication may increase the quality of care and improve older persons independence.Aim: To develop, test and evaluate a web based educational intervention on person-centred communication targeting nurse assistants (NA) in home care setting.Method: A stepwise web based education, consisting of eight modules, was developed and tested. The education was evaluated using both quantitative and qualitative data.Results: In all, 23 NAs participated in the education. The majority of the NAs (n=21) participated in five or more modules. Overall, the education was experienced as feasible and accessible. Challenges emerged during the time of the intervention, such as time constrains, technical problems, and participants´ engagement.Conclusion: The web-based education was found to be a feasible way to offer education to home care staff, although successful implementation requires adaptations to the current context. Engagement from managers, especially considering the NAs motivation to complete the education is important for accomplishment by participants.Implications: This study can contribute to the knowledge regarding how to develop, test and evaluate an educational intervention, and considerations found to be important during the implementation process for success.
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| 5. |
- Gustafsson, Tanja, PhD student, 1980-, et al.
(författare)
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An educational intervention to improve communication skills in home care – a feasibility study
- 2022
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Konferensbidrag (refereegranskat)abstract
- An educational intervention to improve communication skills in home care – a feasibility studyBackgroundAn educational intervention focused on person-centred communication with older persons in home care was developed. Twenty-three nursing assistants (NAs) from two home care units were offered the intervention. This feasibility study was conducted to capture benefits and pit falls with study processes before large scale interventions, such as acceptability and appropriateness of evaluation methods.AimTo explore the feasibility of proposed methods for evaluating a novel educational intervention on person-centered communication for NAs in home care.MethodFeasibility study with pre- and post-assessments, including evaluation of data collection procedures, completion rates, and missing data for two questionnaires: Self-efficacy Questionnaire measuring communication skills and Measure of Job Satisfaction. Descriptive and statistical analysis was conducted. ResultsThe results showed a completion rate of 83% and 61% in pre- and post-assessment respectively, and a low proportion of missing data. The questionnaires were feasible and acceptable for NAs to complete and understand. Stress due to staff shortages and high workload negatively affected NAs’ participation in data collection. Overall, NAs rated their communication skills as high with a tendency towards higher communication self-efficacy after the intervention, however, this difference was not statistically significant. Job satisfaction remained unchanged pre- and post-intervention.ConclusionLow follow-up rates suggest that the data collection procedures need refinement. Although the outcomes are preliminary at this point, they indicate a ceiling effect in NAs’ self-efficacy ratings. The ceiling effect limits possibilities for improvement and suggests that studies with a larger sample is needed.Implications for caring in a changing worldIn a changing world, where a rapid aging population challenges home care services, there is a need for innovative interventions that support and strengthen health care professionals’ communication skills, aiming at improving older persons’ well-being This study contributes with knowledge to the complexity of developing and evaluating complex interventions on communication in home care.
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| 6. |
- Gustafsson, Tanja, PhD student, 1980-, et al.
(författare)
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Communication in home care—A feasibility study of an educational intervention in self‐efficacy and job satisfaction
- 2023
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Ingår i: Nursing Open. - : John Wiley & Sons. - 2054-1058. ; 10:3, s. 1375-1382
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Tidskriftsartikel (refereegranskat)abstract
- AimTo explore the feasibility of evaluating a novel educational intervention on person-centered communication for nursing assistants (NAs) in home care.DesignA feasibility study with pre- and post-assessments.MethodsFeasibility was assessed pre- and post-intervention, including evaluation of data collection procedures, completion rates and missing data in two questionnaires: Self-efficacy Questionnaire measuring communication skills and Measure of Job Satisfaction, analysed descriptively and statistically.ResultsThe questionnaires were feasible and acceptable for the NAs to complete and understand. The pre- and post-assessments showed 83% and 61% completion rates, respectively, and a low proportion of missing data. Barriers for not participating in data collection were stress caused by staff shortages and high workload. Preliminary analysis of the questionnaires showed no significant difference pre- and post-intervention, even though an overall tendency of increased communication self-efficacy was observed. The NAs' self-efficacy ratings also revealed a ceiling effect.
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| 7. |
- Gustafsson, Tanja, PhD student, 1980-, et al.
(författare)
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Development and process evaluation of an educational intervention on communication targeting nurse assistants in home care
- 2019
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Konferensbidrag (refereegranskat)abstract
- BackgroundPerson-centred communication is important to assure the quality of home care services and to promote older persons´ independence and influence over their lives. Previous research indicates challenges regarding communication between professionals and home care recipients, and how to deliver efficient educational efforts in the home care context.AimThe aim was to describe the development and process evaluation of a web-based education intervention in person-centred communication for nurse assistants (NA) in home care.MethodThe intervention consisted of a step-wise education, with eight modules that included short video based lectures and movies, one group supervision, and reflective assignments. The content was based on previous research on health care communication and person-centred care. Data were collected from multiple sources before, during and after the implementation, and analysed by a combination of quantitative and qualitative approaches.ResultsA complex intervention was conducted to improve the communication competency wanted for person-centred care. The intervention was offered to 23 nurse assistants (NA). Of those, 91% (n=21) participated, in total or in parts, in five or more modules. The findings address participants’ experiences of expectations and worries before the intervention, experiences from the implementation process, and their experiences from taking part of the intervention. During the implementation changes were made according to local circumstances. Overall, the education was experienced as feasible. The web-based design was found to be accessible and the content relevant.ConclusionFrom this study, it can be concluded that the key features for successful implementation of the intervention was the format, educational content, and technical facilities provided. In addition to this, participant involvement, resources and constructive practical circumstances for NAs to participate in the intervention are crucial.
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| 8. |
- Gustafsson, Tanja, PhD student, 1980-, et al.
(författare)
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Development and process evaluation of an educational intervention on person-centred communication targeting nurse assistants in home care
- 2020
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Konferensbidrag (refereegranskat)abstract
- BACKGROUNDPerson-centred communication is important to assure the quality of home care services and to promote older persons´ independence and influence over their lives. Previous research indicates challenges regarding communication between professionals and home care recipients, and how to deliver efficient educational efforts in the home care context.AIMThe aim was to describe the development and process evaluation of a web-based education intervention in person-centred communication for nurse assistants (NA) in home care.METHODSThe intervention consisted of a step-wise education, with eight modules that included short video based lectures and movies, one group supervision, and reflective assignments. The content was based on previous research on health care communication and person-centred care. Data were collected from multiple sources before, during and after the implementation, and analysed by a combination of quantitative and qualitative approaches.RESULTSA complex intervention was conducted to improve the communication competency wanted for person-centred care. The intervention was offered to 23 nurse assistants (NA). Of those, 91% (n=21) participated, in total or in parts, in five or more modules. The findings address participants’ experiences of expectations and worries before the intervention, experiences from the implementation process, and their experiences from taking part of the intervention. During the implementation changes were made according to local circumstances. Overall, the education was experienced as feasible. The web-based design was found to be accessible and the content relevant. CONCLUSIONOur findings show that the benefits of the web-based educational intervention included the short and focused lectures as well as its accessibility. Challenges with the implementation process included gaining access to the NAs and motivating and involving the NAs. This study emphasizes the environmental support needed to successfully conduct complex interventions, including physical, organizational and cultural aspects.
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| 9. |
- Gustafsson, Tanja, PhD student, 1980-, et al.
(författare)
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Nurse assistants´ perceptions of developing person-centred communication
- 2021
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Konferensbidrag (refereegranskat)abstract
- Background: Communication is important for nurse assistants (NAs) when caring for older persons. There is limited research about how to improve the communication competence of NAs in home care. The aim was to describe NAs perception on learning in relation to an educational intervention on person-centred communication.Methods: A qualitative descriptive study was conducted. Data consisted of four group interviews, five individual in-depth interviews and written reflection assignments from participants gathered during the web-based intervention. In total 23 NAs at two home care units participated. The data were analysed using a phenomenographic approach. This is a qualitative method for analysis developed from Nordic traditions of phenomenology. Phenomenography aims to describe individual perceptions of a certain phenomenon.Preliminary findings points to the nurse assistants perceiving that the education supported their development of person-centred communication. They pointed out self-reflections as important for their learning as well as to get confirmation on what was already known. The NAs described that the intervention added to their knowledge and skills. Even though, there was more to learn and challenges that remained regarding communication in challenging situations such as caring for persons in end-of-life and supporting their relatives, caring for persons being aggressive or violent.Preliminary implications of research: This study can provide knowledge on participants’ perspective on their learning process, which may be important to consider when conducting educational interventions in home care as well as other health care contexts.
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| 10. |
- Gustafsson, Tanja, PhD student, 1980-, et al.
(författare)
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Process evaluation of the ACTION programme : a strategy for implementing person‐centred communication in home care
- 2021
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Ingår i: BMC Nursing. - : Springer Nature. - 1472-6955. ; 20:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: There is currently a strong emphasis on person-centred care (PCC) and communication; however, little research has been conducted on how to implement person-centred communication in home care settings. Therefore, the ACTION (A person-centred CommunicaTION) programme, which is a web-based education programme focusing on person-centred communication developed for nurse assistants (NAs) providing home care for older persons, was implemented. This paper reports on the process evaluation conducted with the aim to describe and evaluate the implementation of the ACTION programme. Methods: A descriptive design with a mixed method approach was used. Twenty-seven NAs from two units in Sweden were recruited, and 23 of them were offered the educational intervention. Quantitative and qualitative data were collected from multiple sources before, during and after the implementation. Quantitative data were used to analyse demographics, attendance and participation, while qualitative data were used to evaluate experiences of the implementation and contextual factors influencing the implementation. Results: The evaluation showed a high degree of NA participation in the first five education modules, and a decrease in the three remaining modules. Overall, the NAs perceived the web format to be easy to use and appreciated the flexibility and accessibility. The content was described as important. Challenges included time constraints; the heavy workload; and a lack of interaction, space and equipment to complete the programme. Conclusions: The results suggest that web-based education seems to be an appropriate strategy in home care settings; however, areas for improvement were identified. Our findings show that participants appreciated the web-based learning format in terms of accessibility and flexibility, as well as the face-to-face group discussions. The critical importance of organizational support and available resources are highlighted, such as management involvement and local facilitation. In addition, the findings report on the implementation challenges specific to the dynamic home care context. Trial registration: This intervention was implemented with nursing assistants, and the evaluation only involved nursing staff. Patients were not part of this study. According to the ICMJE, registration was not necessary (). © 2021, The Author(s).
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