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- Aasa, Agneta, et al.
(author)
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The importance of preoperative information for patient participation in colorectal surgery care
- 2013
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In: Journal of Clinical Nursing. - : John Wiley & Sons. - 0962-1067 .- 1365-2702. ; 22:11-12, s. 1604-1612
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Journal article (peer-reviewed)abstract
- Aims and objectivesTo identify and describe patients' experiences of a preoperative information session with a nurse, as part of the enhanced recovery after surgery (ERAS) concept, and its impact on patient participation in their own care.BackgroundEnhanced recovery after surgery is a standardised, multimodal treatment programme for elective colorectal surgery, leading to faster recovery and shorter hospital stays via interprofessional collaboration. The ERAS concept is initiated for patients a week before surgery when the patient receives detailed information about the care process during a meeting with a nurse.DesignThe study is a qualitative interpretive study based on interviews.MethodsTwelve patients, nine men and three women, were interviewed. The interviews were transcribed verbatim and analysed using interpretive phenomenological analysis (IPA).ResultsThe analysis identified and formulated five themes: being seen, security, trust, responsibility and participation. All themes are closely related and illustrate positive and negative sides of the patient's experience. They hang together and form a complete set of experiences: ERAS conversation and its impact on patients' participation.ConclusionsThe results show that patients feel confirmed in the ERAS conversation. Healthcare professionals need to be bonding more information call during hospitalisation. It is important to confirm the patient in order for them to participate and take responsibility. Reliance on caregivers is important for patients to feel safe and to participate in their own care. This study shows that the ERAS conversation was experienced as being structured and individually tailored, but the information must apply to the patients throughout the period of care.Relevance to clinical practiceSome shortcomings have been revealed, which should enable improvement in the care of patients. Healthcare professionals need to raise awareness of patients' responsibilities for participation in their own recovery and care. Healthcare professionals and patients need to be aware of each other's responsibilities.
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- Aasen, Elin M., et al.
(author)
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From open to locked doors - From dependent to independent : Patient narratives of participation in their rehabilitation processes
- 2021
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In: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 30:15-16, s. 2320-2330
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Journal article (peer-reviewed)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.
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- Aass, Lisbeth Kjelsrud, et al.
(author)
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Family support and quality of community mental health care : Perspectives from families living with mental illness
- 2022
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In: Journal of Clinical Nursing. - : John Wiley & Sons. - 0962-1067 .- 1365-2702. ; 31:7-8, s. 935-948
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Journal article (peer-reviewed)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.
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- Abrahamsen Grøndahl, Vigdis, 1964-, et al.
(author)
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Quality of care from patients' perspective : impact of the combination of person-related and external objective care conditions
- 2011
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In: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 20:17/18, s. 2540-2551
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Journal article (peer-reviewed)abstract
- Aims and objectives. To describe patients' perceptions of quality of care and to explore combinations of person-related and external objective care conditions as potential predictors of these perceptions. Background. Several studies have examined various single factors of person-related and external objective care conditions in relation to quality of care. None of these has included the effect of over-occupancy on patients' perception of quality of care. Furthermore, little is known about how combinations of different factors are related to each other and to the perception of quality of care using multivariate analysis. Design. A cross-sectional design. Method. A total of 528 patients (83·7%) from 12 medical, surgical or medical-surgical wards in five hospitals in Norway participated. Perceptions of quality of care and person-related conditions were measured with the 'Quality from Patient's Perspective' instrument. Data on external objective care conditions was collected from ward statistics provided by head nurses. Multivariate general linear modelling was used ( p < 0·05). Results. The combination of person-related and external objective care conditions revealed five factors that predict patients' perception of quality of care. Three of these are person-related conditions: sex, age and self-reported psychological well-being and two of them are external objective care conditions: RNs (headcount) on the wards and frequency of over-occupancy. These five factors explained 55% of the model. Patients rated the quality of care high. Conclusions. Sex, age, psychological well-being, frequency of over-occupancy and the number of RNs are important factors that must be emphasised if patients are to perceive the quality of care as high. Relevance to clinical practice. Head nurses and healthcare authorities must continually prepare the wards for over-occupancy and they must consider the number of RNs working on the wards.
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- Adama, Esther Abena, et al.
(author)
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Support needs of parents in neonatal intensive care unit : An integrative review.
- 2022
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In: Journal of Clinical Nursing. - : Wiley-Blackwell Publishing Inc.. - 0962-1067 .- 1365-2702. ; 31:5-6, s. 532-547
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Journal article (peer-reviewed)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.
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- Afua Quaye, Angela, et al.
(author)
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Children's active participation in decision‐making processesduring hospitalisation : An observational study
- 2019
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In: Journal of cilinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 28:23¨24, s. 4525-4537
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Journal article (peer-reviewed)abstract
- Aims and objectives: The aim was to explore and describe the child's active participationin daily healthcare practice at children's hospital units in Sweden.Objectives: (a) Identify everyday situations in medical and nursing care that illustratechildren's active participation in decision‐making, (b) identify various ways of activeparticipation, actual and optimal in situations involving decision‐making and (c) explorefactors in nursing and medical care that influence children's active participation indecision‐making.Background: Despite active participation being a fundamental right for children, theyare not always involved in decision‐making processes during their health care. Therestill remains uncertainty on how to support children to actively participate in decisionsconcerning their health care.Design: A qualitative study with overt, nonparticipant observations fulfilling theCOREQ checklist criteria.Methods: Observations of interactions between children aged 2 and 17 years withboth acute and chronic conditions, their parents, and healthcare professionals wereconducted at three paediatric hospitals in Sweden. The Scale of Degrees of SelfDetermination was used to grade identified situations. The scale describes five levelsof active participation, with level one being the least and level five being the mostactive level of participation. Normative judgements were also made.Results: Children's active participation was assessed as being generally at levels fourand five. Children demonstrated both verbal and nonverbal ways of communicationduring decision‐making. Findings indicated that children's, parents' and healthcareprofessional's actions influenced children's active participation in decision‐makingprocesses involving healthcare.Conclusions: Healthcare professionals specialised in paediatrics need to embrace botha child perspective and a child's perspective, plan care incorporating key elements of achild‐centred care approach, to ensure children's active participation at a level of theirchoosing.
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- Afua Quaye, Angela, et al.
(author)
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How are children’s best interests expressed during their hospital visit? : An observational study
- 2021
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In: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 30:23-24, s. 3644-3656
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Journal article (peer-reviewed)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.
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- Ahlander, Britt-Marie, 1954-, et al.
(author)
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Positive effect on patient experience of video-information given prior to cardiovascular magnetic resonance imaging, a clinical trial
- 2018
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In: Journal of Clinical Nursing. - : Wiley-Blackwell Publishing Inc.. - 0962-1067 .- 1365-2702. ; 27:5-6, s. 1250-1261
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Journal article (peer-reviewed)abstract
- Aims and objectives: To evaluate the effect of video information given before cardiovascular magnetic resonance imaging on patient anxiety and to compare patient experiences of cardiovascular magnetic resonance imaging versus myocardial perfusion scintigraphy. To evaluate whether additional information has an impact on motion artefacts.Background: Cardiovascular magnetic resonance imaging and myocardial perfusion scintigraphy are technically advanced methods for the evaluation of heart diseases. Although cardiovascular magnetic resonance imaging is considered to be painless, patients may experience anxiety due to the closed environment.Design: A prospective randomised intervention study, not registered.Methods: The sample (n = 148) consisted of 97 patients referred for cardiovascular magnetic resonance imaging, randomised to receive either video information in addition to standard text-information (CMR-video/n = 49) or standard text-information alone (CMR-standard/n = 48). A third group undergoing myocardial perfusion scintigraphy (n = 51) was compared with the cardiovascular magnetic resonance imaging-standard group. Anxiety was evaluated before, immediately after the procedure and 1 week later. Five questionnaires were used: Cardiac Anxiety Questionnaire, State-Trait Anxiety Inventory, Hospital Anxiety and Depression scale, MRI Fear Survey Schedule and the MRI-Anxiety Questionnaire. Motion artefacts were evaluated by three observers, blinded to the information given. Data were collected between April 2015–April 2016. The study followed the CONSORT guidelines.Result: The CMR-video group scored lower (better) than the cardiovascular magnetic resonance imaging-standard group in the factor Relaxation (p =.039) but not in the factor Anxiety. Anxiety levels were lower during scintigraphic examinations compared to the CMR-standard group (p <.001). No difference was found regarding motion artefacts between CMR-video and CMR-standard.Conclusion: Patient ability to relax during cardiovascular magnetic resonance imaging increased by adding video information prior the exam, which is important in relation to perceived quality in nursing. No effect was seen on motion artefacts.Relevance to clinical practice: Video information prior to examinations can be an easy and time effective method to help patients cooperate in imaging procedures.
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