AIM: To describe the impact of mental health on the ability to function optimally among older adults experiencing mental health issues.
DESIGN: This study had a descriptive qualitative design.
METHODS: Six older females with a Hospital Anxiety and Depression Scale (HADS) score of ≥8 on either of the subscales (depression or anxiety) participated in individual interviews. All data were analysed using a phenomenological approach influenced by Giorgi.
RESULTS: The phenomenological analysis led to a structured synthesis comprising the following three themes: (a) life situations affecting mental health, (b) consequences of mental health in everyday life and (c) strategies for maintaining mental health.
Aim: The aim of this study was to describe how patients with chronic back pain experience encounters with health care. Persons with chronic back pain are a stigmatized group often treated based on stereotypes, which may lead to misunderstandings and create frustrated patients and healthcare personnel. Few studies have examined the generic aspects of quality of care in this context.
Design: A descriptive design with a qualitative approach was used.
Methods: Nine individual interviews were conducted with chronic back pain patients after admission to an orthopaedic hospital ward. Data were analysed using content analysis.
Results: The patients’ experiences of healthcare encounters can be described by the theme “Struggling to be seen and understood as a person,” comprising the categories “Lack of access and trust to care",“A desire to be taken care of and listened to” and “Own strength to handle healthcare situations.”
Aim: The aim of this study was to describe inhaler use in primary health care patients with chronic obstructive pulmonary disease (COPD) and to categorize these patients into those making errors related to devices, those making errors related to inhalation technique and those making errors related to both.
Design: Observational study. Methods COPD nurses used a checklist to assess the use of inhalers by patients with spirometry-verified COPD (N = 183) from primary healthcare centres. The STROBE checklist has been used.
Results: The mean age of the patients was 71 (SD 9) years. Almost half of them (45%) made at least one error; of these, 50% made errors related to devices, 31% made errors related to inhalation technique and 19% made errors related both to devices and to inhalation technique.
Aims and objectives: The aim of this study was to test the theoretical conceptualization of the co-creative process in home care nursing encounters over time.
Method and design: This was a multiple case study with a deductive analysis of qualitative data over time, using interviews and observations collected from three cases.
Results: The co-creative process was complex and contained main, sub- and micro-processes. Time was important and valuable, giving the patient and relatives space to adjust the process to their own pace. Some processes were worked on more intensively in accordance with the patients' and relatives' needs, and these are considered the main-process. The further developed theory of the co-creative process and its main, sub- and microprocesses can be understood as a concretization of how good nursing care can be performed within caring relationships in the context of advanced palliative home care.
Aim: To examine (a) when medication incidents occur and which type is most frequent; (b) consequences for patients; (c) incident reporters' perceptions of causes; and (d) professional categories reporting the incidents.
Design: A descriptive multicentre register study.
Methods: This study included 775 medication incident reports from 19 Swedish hospitals during 2016-2017. From the 775 reports, 128 were chosen to establish the third aim. Incidents were classified and analysed statistically. Perceived causes of incidents were analysed using content analysis.
Results: Incidents occurred as often in prescribing as in administering. Wrong dose was the most common error, followed by missed dose and lack of prescription. Most incidents did not harm the patients. Errors in administering reached the patients more often than errors in prescribing. The most frequently perceived causes were shortcomings in knowledge, skills and abilities, followed by workload. Most medication incidents were reported by nurses.
Aim: The aim was to explore first line nurse managers’ experiences of opportunities and obstacles to support evidence‐based nursing.
Design: A qualitative study with a phenomenographical approach.
Method: Data were collected through focus group interviews with 15 first line nurse managers’ in four settings.
Results: The results are presented in four categories of description headed: Manage the everyday work vs. evidence‐based nursing; Uncertainties about evidence‐based nursing and nursing research; Time as a reality, as an approach; and Shaping awareness—towards an active approach to evidence‐based nursing. The overarching category of description has been formulated as follows: The internal relation—how active leadership influences evidence‐based nursing. The outcome space is presented as: The individual path—how to make vision and reality become a working entity around evidence‐based nursing.
AIMS: To describe leaders' perspectives on what is important to create a meaningful daily life for older persons receiving municipal elderly care.
DESIGN: This study combined the Participatory Appreciative Action Reflection approach and qualitative methods.
METHODS: Focus Group Discussions were performed with eighty leaders that was analysed with qualitative content analysis.
RESULTS: One overall theme emerged "We have to turn a transatlantic liner". The leaders proposed a need to change from an institutional care to a more person-centered care approach on all levels of the healthcare system. This meant that everyone in the organization needed to think outside the box and find new ways to provide care to older persons. They needed to hire the right persons with the right values and knowledge. The leaders would need to provide for and support staff empowerment. There was also a need to see the older person and their relatives as co-participants. No Patient or Public Contribution.
AIM: To describe and compare the clinical learning environment in community-based home care and primary health care in postgraduate district nursing students' education.
DESIGN: Cross-sectional study design.
METHODS: A convenience sample of postgraduate district nursing students was derived from five Swedish universities in 2016 and 2017.
RESULTS: The postgraduate district nursing students were generally satisfied with the clinical learning environment in their clinical placement. In clinical placement, several factors affected the students' opportunities to learn, such as sufficiently meaningful learning situations with multidimensional content. A working environment that imposed psychosocial strain and high levels of stress among the staff negatively affected the students' learning. To further improve their learning from clinical practices, the students need preceptors who have the skills and competence required to support more advanced reflections and critical thinking on caring situations.
AIM AND OBJECTIVES: To describe young children's experiences of valuable support in managing their fears about treatment for acute lymphoblastic leukaemia. The focus was specifically on support from parents and healthcare professionals.
DESIGN: The study had a qualitative descriptive longitudinal design.
METHODS: The study analysed 35 interviews with 13 children at three different times during their treatment period. Data were analysed using a matrix-based method. The Consolidated criteria for reporting qualitative research (COREQ) guidelines have been followed.
RESULTS: Parents and healthcare professionals provide important support to children undergoing treatment for acute lymphoblastic leukaemia, although their roles differ. Children valued their parents' closeness and advocacy, being able to participate in their own care, and being given pain relief during procedures known to create pain. Valued support from healthcare professionals changed over time, from providing information and showing the tools that would be used in procedures, to paying attention to the child's needs and desires. It was more important for children to be able to choose between different alternatives in medical procedures than deciding on major treatment issues.
Aim: The aim of this study was to describe how nurses and occupational therapists in municipal care of older people define and implement patient participation in their daily work.
Design: This study had a cross-sectional design. Data were collected using an online questionnaire.
Methods: The questionnaire had both closed and open-ended questions. One-hundred and fourteen nurses and occupational therapists responded. Data were analysed with descriptive statistics and thematic analysis.
Results: Two main themes were identified as follows: "The professionals' perspective at the centre - Patient participation to enhance compliance" and "The patients' perspective at the centre - Patient participation as an ongoing process." The themes covered a continuum. On one extreme, patient participation was equated with making the patient comply with what the professionals wanted to do. On the other extreme, all power was transferred to the patient. The first theme was restricted to the decision-making process. The second theme covered the entire care or, rehabilitation, process.
PATIENT OR PUBLIC CONTRIBUTION: Patients, relatives and nurses were involved in this study.
AIM: The aim was to explore patients', relatives' and nurses' experiences of palliative care on an advanced care ward in a nursing home setting after implementation of the Coordination Reform in Norway.
DESIGN: Secondary analysis of qualitative interviews.
METHODS: Data from interviews with 19 participants in a nursing home setting: severely ill older patients in palliative care, relatives and nurses. Data triangulation influenced by Miles and Huberman was used.
RESULTS: The overall theme was "Being in an unfamiliar and uncaring culture leaves end-of-life patients in desperate need of holistic, person-centred and co-creative care". The main themes were: "Desire for engaging palliative care in a hopeless and lonely situation", "Patients seeking understanding of end-of-life care in an unfamiliar setting" and "Absence of sufficient palliative care and competence creates insecurity". The patients and relatives included in this study experienced an uncaring culture, limited resources and a lack of palliative care competence, which is in direct contrast to that which is delineated in directives, guidelines and recommendations. Our findings reveal the need for policymakers to be more aware of the challenges that may arise when healthcare reforms are implemented. Future research on palliative care should include patients', relatives' and nurses' perspectives.
AIMS: To explore registered nurses' experiences as disaster preparedness coordinators of hospital incident command groups' during a major incident.
DESIGN: A qualitative descriptive design using semi-structured interview.
METHODS: This was a qualitative study based on one focus group discussion and six individual follow-up interviews. Participants were registered nurses in their capacity as disaster preparedness coordinators with experience from Major Incident simulations and a real-life Major Incident. The interviews were transcribed verbatim and analysed using content analysis. The COREQ checklist was used for reporting the findings.
RESULTS: The analysis of data generated the main category: Expectations, previous experience and uncertainty affect hospital incident command group response during a Major Incident and three categories, (I) Gaining situational awareness (containing two subcategories), (II) Transitioning to management (containing three subcategories) and (III) Actions taken during uncertainty (containing two subcategories).
Aim: To illuminate the experience of an altered social context for patients with primary brain tumours living away from home while undergoing proton beam therapy.
Design: A descriptive, qualitative cross-sectional interview study.
Methods: Nineteen patients were interviewed between December 2015-August 2016, either during (N = 7) or before and after (N = 12) their proton beam therapy. A hermeneutical analysis was performed.
Results: Participants made adjustments to achieve control and well-being during the treatment period. The analysis also revealed two interrelated patterns that helped participants adjust: being part of the family from a distance and seeking affinity.
Conclusion: It is important that patients receiving treatment far from home find a way to remain a part of their family and find affinity in the altered social context. Health professionals can prepare patients for the treatment period and can implement interventions to promote well-being for both patients and their relatives.
Aim: A shift of focus on older persons' nutrition has occurred, from focusing on nutrition status to focusing on the whole meal. There is lack of studies on how older persons experience meals. Knowledge is needed to enhance a meal with dignity and pleasure, but also to prevent deterioration in nutrition. The aim was to describe meals from the perspective of older persons in need of elderly care.
Design: A descriptive qualitative study.
Method: Semi-structured interviews (N = 18) were conducted and analysed using thematic analyses.
Result: Three themes were identified: The meal is an activity which involves at least two persons, The meal relates to habits and traditions and The meal seldom gives possibilities to make individual choices. It was obvious that older persons who live in nursing homes miss the opportunity to decide what to eat, when to eat and with whom to eat. Attention must be paid to listening to older persons to enhance mealtime with dignity and autonomy.
Aims: To describe how nurses perceive and promote inpatients' needs for physical activity during their stay at the ward.
Design: A qualitative descriptive design was employed providing an exploration of how nurses perceive and promote inpatients' need for physical activity.
Methods: Seven semi-structured focus group discussions were held between November 2016 and February 2017 with 29 nurses in three hospitals in Sweden. Both interaction analysis and content analysis of the data were conducted.
Results: Patients are dependent on nurses' prioritizations and promotions to be sufficiently physically active during their stay at the ward. The external environment and the integration of physical activity affected the promotion of physical activity. The nurses perceived that understanding the patient's expectations was important and that promotion of physical activity was a joint responsibility of patient, relatives and healthcare professionals. The interaction analysis revealed no clear hierarchical pattern as all members in each focus group took initiative to open the discussions. The Registered Nurses contributed with more new ideas.
Aim: To describe how Registered Nurses in a municipal home care context experience adverse event reports.
Design: A qualitative design was used.
Method: Twelve semistructured individual interviews with Registered Nurses in a municipal home care context were collected on two occasions and analysed with qualitative content analysis.
Results: The results show that conflicts exist between being able to trust the managers and their feedback, being loyal to colleagues and retaining professional pride. These are described in the theme "Contradiction" and the three categories: "Awareness"; "Uncertainty"; and "Concealment."
Aim: To describe patients' and radiographers' experiences of abdominal compression using conventional and patient-controlled compression methods.
Design: Qualitative descriptive design.
Methods: Forty-five patients who had used both a conventional and a patient-controlled compression device answered questionnaires. Five radiographers were interviewed. The data-collection took place between September 2015 and February 2017. Data were analysed by qualitative content analysis.
Results: Patient-controlled compression was preferred by slightly more patients because of fear of pain due to excessively hard pressure, maintaining control over the pressure and shorter duration. It was more comfortable, and patients felt they could participate in the examinations. Conventional compression was preferred by some because of more stable pressure and uncertainty of own capacity to provide the optimal compression. Discomfort was more often mentioned concerning the conventional compression method. The radiographers experienced the patient-controlled method as less time-consuming and more comfortable, but uncertainty about correct compression technique and its effect on radiation dose and image quality was reported.
AIM: The aim of the study was to evaluate the psychometric properties and factor structure of the Quality in Psychiatric Care-Addiction Outpatient (QPC-AOP) instrument and to describe the experiences with the quality of care among addiction outpatients.
DESIGN: The study has a cross-sectional design.
METHODS: A sample of 244 patients with addiction and psychiatric disorders completed the QPC-AOP.
RESULTS: Confirmatory factor analysis showed adequate to excellent goodness-of-fit indices supporting the 9-factor structure of the QPC-AOP. The results thus demonstrate that the concept of quality of care to a large extent is equivalent among outpatients from general psychiatry and from outpatient addiction services. Internal consistency for the full QPC-AOP was adequate, but poor for some of the separate factors. The patients' ratings of quality of care were generally high; the highest rating was for Encounter and the lowest for Discharge.
Aim: The aim was to evaluate emotional experiences of gentle skin massage, combined with regular rehabilitation in patients shortly after being diagnosed with stroke.
Design: A randomized study with two groups: standard individualized rehabilitation and tactile massage for 20 min three times per week (max nine times) or individual standardized rehabilitations.
Methods: This study applied a qualitative approach using semi-structured questions to evaluate experiences of receiving tactile massage among patients with first-time-ever stroke. The interviews lasted between 6-25 min and analysed using manifest content analysis. Data was collected between 2015-2017. This study applies to the COREQ checklist.
Results: Eight patients >18 years of age participated. The participants experienced emotional worries especially during the night hours affecting their sleep negatively. Receiving tactile massage was reported to relax and to ease worries and anxiety momentarily, during the session and for a longer period. The results also show that physical touch generates feelings of closeness. The findings will be presented in two categories: Human touch and The future.
Aim: To discuss specialist operating theatre nurses' competence in relation to the general six core competencies and patient safety.
Design: A discursive analysis of legal statutes and scientific articles.
Methods: Swedish legal statutes and an overview of scientific articles on operating theatre nursing were deductively analysed and classified into healthcare providers' general six core competencies.
Results: All healthcare professionals should possess the general core competencies, regardless of their discipline. The specific content within these competencies differs between disciplines. The specialized operating theatre nurse is the only healthcare professional having the competence to be responsible for asepsis, instrumentation, infection and complication, control and management of biological specimens during the surgical procedure. Besides operating theatre nurses, no other healthcare profession has the formal education, competence or skills to perform operating theatre nursing care in the theatre during the surgical procedure. Operating theatre nurse competence is therefore indispensable to ensure patient safety during surgery.