| 1. |
- Oxelmark, Lena, et al.
(author)
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Patients prefer clinical handover at the bedside; Nurses do not: Evidence from a Discrete Choice Experiment
- 2020
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In: International Journal of Nursing Studies. - : Elsevier BV. - 0020-7489. ; 105:May
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Journal article (peer-reviewed)abstract
- Background Shift-to-shift bedside handover is advocated as a patient-centred approach, yet its enactment is challenging. Objectives To describe and compare the preferences of both patients and nurses in the implementation of bedside handover in a Swedish University Hospital. Design A discrete choice experiment (DCE) survey. Settings University setting, four medical wards in two hospitals. Participants Adult medical patients (n=218) and registered nurses (n=101) Methods The survey was administered by an electronic tablet-assisted face-to-face survey. Respondents made repeated choices between two hypothetical bedside handover alternatives and a third alternative of ‘handover away from the bedside’. Handover alternatives were described according to six attributes: invitation to participate, number of nurses present at the handover, family member, carer or trusted friend (of the patient) allowed to be present, level of (patient) involvement, what information related to your (patient) care is discussed. Choice data were analysed using a mixed logit model. Results A total of 1308 (patients) and 909 (nurses) choice observations were included in the preference models. Patients showed a strong preference for handover at the bedside compared to nurses. Nurses generally preferred handover away from the bedside. Patients perceived their level of involvement in handover as highly important, being able to speak, hear what was said being the most important characteristic, closely followed by being invited to participate and asked questions as well as being heard. Nurses considered patients being invited to participate most important, followed by level of involvement. Different options for handing over sensitive information were not perceived of importance by patients or nurses. There was substantial variation at the individual level across both patients and nurses for where and how handover is delivered. Conclusions In this study, patients strongly preferred handover at the bedside, while the nurses considered patients to be invited to participate to be the most important preference but generally preferred handover to take place away from the bedside, all else equal. When implementing bedside handover in a Swedish context this must be considered, although participation is a prerequisite for bedside handover. Differences between patients and nurses’ preferences could jeopardize future introduction of bedside handover in Swedish health care, and might explain why bedside handover is still not very common in hospital wards.
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| 2. |
- Oxelmark, Lena, et al.
(author)
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Registered Nurses' experiences of patient participation in hospital care: Supporting and hindering factors patient participation in care
- 2018
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In: Scandinavian Journal of Caring Sciences. - : Wiley. - 0283-9318 .- 1471-6712. ; 32:2, s. 612-621
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Journal article (peer-reviewed)abstract
- © 2017 Nordic College of Caring Science. Background: Promoting patient participation in care is an international priority identified by the World Health Organization and various national bodies around the world and an important aspect of person-centred care. Aim: The aim of this study was to describe Registered Nurses' experiences with patient participation in nursing care including their barriers and facilitators for participation. Method: The study setting was a University Hospital in Sweden. Interviews were conducted with twenty Registered Nurses working at medical wards in 2013. Thematic data analysis was used to analyse the transcribed interview data. Results: Twenty nurses from four wards in two hospitals were included. Five themes emerged from the analysis including listening to the patient, engaging the patient, relinquishing some responsibility, sharing power and partnering with patients. The core theme 'partnering with patients' was enacted when nurses listened to and engaged patients and when they relinquished responsibility and shared power with patients. In addition, hindering and facilitating factors to participation were identified, such as patients wanted to take on a passive role, lack of teamwork which participants understood would enhance interprofessional understanding and improve patient safety. Patient participation was hindered by medical jargon during the ward round, there was a risk of staff talking over patients' heads but sometimes inevitable having conversations at the patient's bedside. However, nurses preferred important decisions to be made away from bedside. Conclusions: It all came down to partnering with the patient and participants described how they made an effort to respect the patients' view and accept patient as a part of the care team. Identified hindering factors for participation were lack of teamwork, patients' taking on passive roles and communication during ward rounds having conversations at the patient's bedside. Nurses wished for a change but lacked strategies on how. Nurses preferred important decisions to be made away from bedside.
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| 3. |
- Ringdal, Mona, 1955, et al.
(author)
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Patient preferences for participation in patient care and safety activities in hospitals
- 2017
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In: Bmc Nursing. - : Springer Science and Business Media LLC. - 1472-6955. ; 16
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Journal article (peer-reviewed)abstract
- Background: Active patient participation is a patient safety priority for health care. Yet, patients and their preferences are less understood. The aim of the study was to explore hospitalised patients' preferences on participation in their care and safety activities in Sweden. Methods: Exploratory qualitative study. Data were collected over a four-month period in 2013 and 2014. Semi-structured interviews were conducted with 20 patients who were admitted to one of four medical wards at a university hospital in Sweden. Data were analysed using thematic analysis. Results: Nine men and eleven women, whose median age was 72 years (range 22-89), were included in the study. Five themes emerged with the thematic analysis: endorsing participation; understanding enables participation; enacting patient safety by participation; impediments to participation; and the significance of participation. This study demonstrated that patients wanted to be active participants in their care and safety activities by having a voice and being a part of the decision-making process, sharing information and possessing knowledge about their conditions. These factors were all enablers for patient participation. However, a number of barriers hampered participation, such as power imbalances, lack of patient acuity and patient uncertainty. Patients' participation in care and patient safety activities seemed to determine whether patients were feeling safe or ignored. Conclusion: This study contributes to the existing literature with fundamental evidence of patients' willingness to participate in care and safety activities. Promoting patient participation begins by understanding the patients' unique preferences and needs for care, establishing a good relationship and paying attention to each patient's ability to participate despite their illness.
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| 4. |
- Werbart, Andrzej, et al.
(author)
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Changes in the representations of mother and father among young adults in psychoanalytic psychotherapy
- 2011
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In: Psychoanalytic psychology. - : American Psychological Association (APA). - 0736-9735 .- 1939-1331. ; 28:1, s. 95-116
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Journal article (peer-reviewed)abstract
- The present study explores the changes in young adult patients’ representations of their parents from prior to psychotherapy through long-term follow-up. Twenty-five women and 16 men from the Young Adult Psychotherapy Project (YAPP) were interviewed according to Sidney Blatt’s unstructured Object Relations Inventory prior to psychoanalytic psychotherapy, at termination and at the 1.5-year follow-up, comprising 123 interviews in all. Typologies of the 246 parental descriptions were constructed by means of ideal-type analysis for male and female patients separately, and for representations of mother and father separately. The analysis resulted in 5 to 7 ideal types of mother and father representations. Prior to psychotherapy, women’s representations of their fathers and men’s representations of their mothers seemed most problematic. As to the content, the most common descriptions of the parent were the emotionally or physically absent parent, and the parent with his or her own problems. In most cases, the descriptions of the parent changed over time in terms of belonging to different ideal-type clusters. There were important improvements in the quality of the descriptions, and the changes continued after termination of psychotherapy. However, most of the parental representations were negative in all three interviews. The possible explanations of these findings are discussed.
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