Scandinavian Journal of Caring Sciences最新文献

{"title":"Patient involvement in interdisciplinary bedside rounds from nursing and medical students' perceptions. A Swedish qualitative interview study.","authors":"Yelyzaveta Hordiienko, Cecilia Fagerström, Hafrún Rafnar Finnbogadóttir","doi":"10.1111/scs.13307","DOIUrl":"https://doi.org/10.1111/scs.13307","url":null,"abstract":"<p><strong>Background: </strong>Patient involvement in the interdisciplinary bedside round (IBR) increases care quality and safety but is influenced and perceived differently by different round participants. Nursing and medical students are still not structurally embedded in the healthcare system, and they participate in interdisciplinary bedside rounds for educational purposes. Thus, the students may give a valuable perspective on patient involvement from the 'outside view'.</p><p><strong>Aim: </strong>This study aimed to describe nursing and medical students' perceptions of patient involvement in IBRs.</p><p><strong>Methods: </strong>This study has a qualitative design with individual interviews. Eighteen informants were recruited with the help of gatekeepers from two sites in Sweden: a university training health clinic and a county hospital. They participated in one-to-one semi-structured interviews, which were analysed with an inductive qualitative content analysis approach.</p><p><strong>Ethical issues and approval: </strong>The study has been approved by the Swedish Ethical Review Authority. Informed consent was received from all participants.</p><p><strong>Results: </strong>The results yielded five categories. Two sub-themes and one theme of meaning emerged as a 'red thread' across the categories. The theme of meaning was: 'In hospital rounds, the patient is a respected guest, but with a disadvantaged \"alien status\" due to the hosts' difficult medical language and unclear routines'. Students perceive patients are not fully involved in IBRs, and the healthcare team controls this involvement due to patients' lack of knowledge and vulnerability, the hectic hospital environment, and complicated medical language. Doctors lead IBRs and encourage or discourage patient involvement and nurses act as patient advocates, supporting their involvement.</p><p><strong>Conclusions: </strong>According to nursing and medical students, patients are seldom involved in IBRs due to multiple interaction barriers and despite communicational facilitators. Their involvement depends on healthcare professionals. Further research should investigate other IBRs stakeholders' perspectives on patient involvement in IBRs to facilitate it.</p>","PeriodicalId":48171,"journal":{"name":"Scandinavian Journal of Caring Sciences","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568883","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Support needed by parents when a child's mental well-being is threatened-A qualitative study of views of experts-by-experience.","authors":"Putkuri Tiina, Latva-Korpela Irene, Häkkinen Mikko","doi":"10.1111/scs.13310","DOIUrl":"https://doi.org/10.1111/scs.13310","url":null,"abstract":"<p><strong>Background: </strong>In situations where a child's mental well-being is threatened, the parents also need support. The available support has been perceived as insufficient by both parents and professionals.</p><p><strong>Aim: </strong>To explore the views of experts-by-experience of the support needed by parents when a child's mental well-being is threatened.</p><p><strong>Methods: </strong>A qualitative study with a phenomenological approach was conducted in Finland. The data were collected in six focus group interviews during the autumn of 2022. The participants (n = 26) were adult experts-by-experience who had experienced either mental well-being challenges in their own childhood (before the age of 18 years) or experienced the mental well-being challenges of a child from the role of a parent. The data were analysed using inductive content analysis.</p><p><strong>Results: </strong>The support needed by parents in situations where the mental well-being of their child is at risk consists of support for parenting, support for sharing and support for surviving.</p><p><strong>Conclusion: </strong>Parents whose child's mental well-being is at risk, need support both for their own well-being and for their ability to support their child's well-being. Support is needed not only from professionals but also from peers.</p>","PeriodicalId":48171,"journal":{"name":"Scandinavian Journal of Caring Sciences","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Embodied suffering: Uncovering the illness experiences of patients with severe psoriasis.","authors":"Lin-Lin Lee, An-Ping Huo, Shu-Ling Chen","doi":"10.1111/scs.13305","DOIUrl":"https://doi.org/10.1111/scs.13305","url":null,"abstract":"<p><strong>Background: </strong>The visibility of skin lesions significantly burdens people with psoriasis, leading to social hostility and numerous emotional and psychological problems. These issues adversely affect self-esteem, can result in chronic mental health challenges and cause numerous life problems. This study aimed to explore patients' long-term experiences with severe psoriasis.</p><p><strong>Methods: </strong>A qualitative study was conducted with 20 patients with psoriasis (PASI ≥12) recruited from general and specialist dermatology practices in a regional teaching hospital in Taiwan. Interviews lasted 60-90 min and data were analysed using content analysis.</p><p><strong>Findings: </strong>A core theme emerged: 'Embodied suffering-life worse than death'. This overarching concept comprised three interrelated themes: (i) Experiencing physical suffering, (ii) Experiencing psychological suffering and (iii) Experiencing the stigma of suffering.</p><p><strong>Conclusion: </strong>This study highlights the holistic nature of suffering among individuals with severe psoriasis. It emphasises the need for healthcare professionals to consider the entirety of a patient's circumstances when addressing their suffering.</p>","PeriodicalId":48171,"journal":{"name":"Scandinavian Journal of Caring Sciences","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142337142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A journey through transitional care-family members' experiences post a life-threatening situation: A qualitative study.","authors":"Theresa Gyllander, Ulla Näppä, Marie Häggström","doi":"10.1111/scs.13304","DOIUrl":"https://doi.org/10.1111/scs.13304","url":null,"abstract":"<p><strong>Background: </strong>Being a family member to someone who suffers from a serious illness can change one's perspectives about life. A sudden and severe illness can result in a demanding journey that involves acute admission to hospital, intensive care, post-care, and finally, returning home.</p><p><strong>Aim: </strong>To describe the experience of staying beside a next of kin throughout the healthcare journey, from the onset of illness at home, to the intensive care unit, post-care, and returning home.</p><p><strong>Methods: </strong>The study employed a qualitative design, with data collected via semi-structured interviews and analysed using reflexive thematic analysis. A purposive sampling was used to recruit participants (n = 14), who had experiences of staying beside a next of kin throughout the healthcare journey from the onset of illness to discharge from the hospital.</p><p><strong>Findings: </strong>Family members' experiences were captured under the overarching theme Journey through an emotional turmoil and the themes Entering a new world, Continuing the journey towards something unknown, and Striving for the new normal at home. They described going through a non-linear process, characterised by transitions or changes in several aspects. The transitions included shifts in the roles that the family members played, in the various environments they found themselves in, and in the progression of the patient's illness or injury.</p><p><strong>Conclusion: </strong>The study suggested that family members with a next of kin who experienced life-threatening situations undergo challenging transitions. The informal caregiver role placed on family members of intensive care unit-survivors significantly impacts their lives and the healthcare systems should prioritise providing high-quality support to family members throughout the entire healthcare journey. Elevating the importance of nursing care within the healthcare system can contribute to delivering holistic care and facilitating transitions. Further research should focus on understanding the support that family members perceive as necessary to facilitate their transition and enhance their well-being.</p>","PeriodicalId":48171,"journal":{"name":"Scandinavian Journal of Caring Sciences","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142337141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"On a healing journey together and apart: A Swedish critical incident technique study on family involvement from a patient perspective in relation to elective open-heart surgery.","authors":"Anna Drakenberg, Ann-Sofie Sundqvist, Bengt Fridlund, Elisabeth Ericsson","doi":"10.1111/scs.13303","DOIUrl":"https://doi.org/10.1111/scs.13303","url":null,"abstract":"<p><strong>Background: </strong>As family members affect patient outcomes following open-heart surgery, the objective was to provide updated knowledge on family involvement in to guide future interventions facilitating family involvement.</p><p><strong>Aim: </strong>The aim was to explore and describe the experiences and actions of important situations of family involvement asexpressed by patients who underwent elective open-heart surgery in Sweden.</p><p><strong>Methodological design and justification: </strong>The critical incident technique (CIT) was used, which is a qualitative research method suitable for clinical problems when a phenomenon is known but the experiences and consequences of it are not.</p><p><strong>Ethical issues and approval: </strong>Considerations for patient integrity were made during the recruitment phase by ensuring that voluntary informed consent was obtained in two steps.</p><p><strong>Research methods: </strong>Individual interviews were conducted with 35 patients who underwent open-heart surgery in Sweden in 2023. Important situations were analysed according to the CIT method.</p><p><strong>Results: </strong>Two main areas emerged: Patients described important situations of family involvement as experiences of mutual dependency while also being independent individuals. These experiences led to balancing healing and risk-taking activities as a family. The positive consequences of family involvement described by patients included improved recovery through practical help at home and emotional support.</p><p><strong>Conclusions: </strong>As complements to preserving the existing positive aspects of family involvement, social support screening, the establishment of individualised visitation policies and the provision of professional and peer support earlier can improve patient recovery following open-heart surgery.</p>","PeriodicalId":48171,"journal":{"name":"Scandinavian Journal of Caring Sciences","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142337143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The feasibility of a Swiss complex interprofessional intervention to improve the management of procedural pain in neonates in the Finnish context: A qualitative study","authors":"Mariaana Mäki‐Asiala, Colette Balice‐Bourgois, Anna Axelin, Tarja Pölkki","doi":"10.1111/scs.13298","DOIUrl":"https://doi.org/10.1111/scs.13298","url":null,"abstract":"AimTo evaluate the feasibility of the Swiss complex interprofessional intervention, NEODOL© (NEOnato DOLore), for improving the management of procedural pain in neonates in the Finnish context.BackgroundInterprofessional collaboration is important for all professionals involved in the care of neonates and for neonates' parents, to understand the appropriate use of non‐pharmacological and/or pharmacological methods for each pain situation and how to assess pain in real‐life situations. Appropriate methods of pain relief for neonates should be preferred as they protect the development of the neonate's brain.DesignA descriptive qualitative design.MethodData were collected through semi‐structured focus group discussions following the Medical Research Council's framework for evaluation of complex interventions, in this case NEODOL© which aims to improve the procedural pain management of neonates. A purposive sample (<jats:italic>n</jats:italic> = 13) included eleven professionals representing various professions within Finnish Neonatal Intensive Care Units and two parents of infants who have received care in a Neonatal Intensive Care Unit. Data were analysed using inductive content analysis, and the results were reported in accordance with the COREQ guidelines.ResultsProfessionals' and parents' evaluations suggest that NEODOL© is feasible, because it is consistent and addresses a current need. They assessed its overall content to be relevant and accessible, and its components to be internally coherent. However, they emphasise the need for further evaluation and refinement of the intervention to achieve the desired outcomes and cost‐effectiveness.ConclusionsWhile NEODOL© is considered feasible, it requires further evaluation and refinement in the local context of each hospital before implementation.","PeriodicalId":48171,"journal":{"name":"Scandinavian Journal of Caring Sciences","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142201277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"I felt so small\": A qualitative study of migrant nursing assistants' experiences in Norway.","authors":"Heng Wei Khor, Magalie El Hajj, David Lackland Sam, Karen Marie Moland","doi":"10.1111/scs.13302","DOIUrl":"https://doi.org/10.1111/scs.13302","url":null,"abstract":"<p><strong>Background: </strong>In the wake of an increasingly ageing population, Norway has a growing need for healthcare workers, especially in nursing homes. This study explored the employment experiences of migrant nursing assistants working in elderly care in Norway.</p><p><strong>Methods: </strong>A qualitative interview-based study was carried out between March and August 2020. In-depth, semi-structured interviews were performed with 13 purposively selected immigrant nursing assistants working in a nursing home within Western Norway. Data were thematically analysed.</p><p><strong>Results: </strong>Migrant nursing assistants working in Norwegian elderly care faced mixed experiences. On the one hand, study participants experienced several barriers in their workplace, resulting from insufficient command of the Norwegian language, heavy workload and mistreatment and discrimination by both patients and colleagues. On the other hand, participants cited the financial compensation from work, the meaningfulness derived from helping others and the flexible day-off requests as workplace facilitators. Participants also made continuous efforts to learn the Norwegian language and to build good relations with their co-workers.</p><p><strong>Conclusion: </strong>There is a need to enhance migrant nursing assistants' positive experiences in the Norwegian eldercare sector by making targeted workplace reforms and fostering a supportive and inclusive environment.</p>","PeriodicalId":48171,"journal":{"name":"Scandinavian Journal of Caring Sciences","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142120926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-clinician interactions in shared diabetes/nephrology consultations - A qualitative observation study.","authors":"Leah Sejrup Christensen, Eithne Hayes Bauer, Jette Primdahl","doi":"10.1111/scs.13299","DOIUrl":"https://doi.org/10.1111/scs.13299","url":null,"abstract":"<p><strong>Background: </strong>The incidence of chronic disease is increasing worldwide which, in turn, increases the demand for healthcare services. To meet these demands, healthcare systems are adapting their services in order to reduce treatment costs and ensure coherence for patients with multiple diseases. One form of adaptation is shared outpatient consultations between internal medical specialties. However, little is known about how patients interact with multiple clinicians in shared consultations.</p><p><strong>Aim: </strong>This project aimed to explore how patients with diabetes and chronic kidney disease interact with multiple clinicians in a shared outpatient setting.</p><p><strong>Research methods: </strong>We performed a qualitative ethnographic study, combining focused participant observations with informal field interviews. We included 17 participants, nine males and eight females with a mean age of 67.3 in the project. The data analysis was guided by Braun and Clarke's reflexive thematic analysis and Arthur Kleinman's theory of illness and disease.</p><p><strong>Results: </strong>We found one over-arching theme: 'A consultation which encompassed both illness and disease' and four subthemes: (1) 'The medical focal point' pertained to the focus on physiological measurements in dialogue between patients and clinicians. (2) 'The possibility of negotiations' illustrated how decisions about dialysis and pharmacological treatment were based on negotiations. (3) 'Speaking different languages' displayed how patients used alternative illness-based explanations whereas clinicians tended to use biomedical language. (4) 'Perceptions of everyday life' concerned what patients considered was best for them when managing their illness and everyday lives.</p><p><strong>Conclusion: </strong>Patients present information on how they balance life with physiological and psychosocial challenges. When clinicians employ a biomedical perspective, opportunities to gain information on patients' illness behaviours or cues to negotiate are missed. Patients prioritise functioning on a daily level over following treatment regimes. These findings are tenuous and require verification in similar studies in similar settings.</p><p><strong>Short phrases: </strong>Shared Outpatient Clinic, Patient-clinician interactions.</p>","PeriodicalId":48171,"journal":{"name":"Scandinavian Journal of Caring Sciences","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142120927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Excruciating existential suffering and complicated grief: The essence of surviving the suicide of a son or daughter.","authors":"E A Bjornsdottir, S Sigurdardottir, S Halldorsdottir","doi":"10.1111/scs.13289","DOIUrl":"https://doi.org/10.1111/scs.13289","url":null,"abstract":"<p><strong>Background: </strong>Suicide is the fourth most common cause of death for the 15-29 age group. Research on the impact of suicide on parents is scarce and, therefore, poorly understood.</p><p><strong>Aim: </strong>To explore parents' experiences who have lost a son or a daughter due to suicide and their experience of the services available to them.</p><p><strong>Methods: </strong>This phenomenological study involved 1-2 interviews with ten parents aged 40-65, seven mothers and three fathers in all 13 interviews. The age range of their sons and daughters was 17-37 years when they died.</p><p><strong>Results: </strong>For the parents, losing a son or a daughter to suicide is an overwhelming life experience characterised by Excruciating existential suffering and complicated grief where they are confronted with deep meaning-making and existential questions without answers since the person who can answer most of them is no longer alive. They, therefore, felt stuck in their grief for up to 4 years. The initial experience was an immense paralysing shock and sense of unreality. The subsequent period was a blur, and they were numb. Then, their psyche and bodies collapsed, and for a long time, they felt no grief processing was taking place. They sorely needed long-term professional trauma-informed support and felt that, in too many cases, they had to reach out for help themselves. They would have liked to see the healthcare system embrace them with more open arms, offer help and be met with information and individualised support.</p><p><strong>Conclusions: </strong>Standard operating procedures must be installed to support suicide-bereaved parents better. Long-term professional support and trauma-focused care are required following such major trauma, and providing such support could help to reduce their adverse health impacts. Nurses and other health professionals must be better educated on existential suffering in this context.</p>","PeriodicalId":48171,"journal":{"name":"Scandinavian Journal of Caring Sciences","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142113451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SHOULD I STAY OR SHOULD I GO-A rapid qualitative study of principal deteriorating factors experienced by nurses relating to their intentions to leave their current position in a medical hospital department.","authors":"Connie Berthelsen, Carrinna Aviaja Hansen","doi":"10.1111/scs.13246","DOIUrl":"10.1111/scs.13246","url":null,"abstract":"<p><strong>Background: </strong>High nurse turnover in hospitals is a worldwide problem with dire consequences for patient care such as increased mortality and a decrease in patient safety. A specific effort to retain nurses is urgently needed due to the many vacant nursing positions, especially across the Medical hospital departments.</p><p><strong>Aim: </strong>To identify the principal deteriorating factors experienced by nurses relating to their intentions to leave the medical department at a university hospital.</p><p><strong>Methods: </strong>A rapid qualitative research methodology was used. Participants comprised 22 registered nurses employed in five university hospital medical department units. The Rigorous and Accelerated Data Reduction (RADaR) technique was therefore used for data collection through qualitative semi-structured interviews and analysis. COREQ was used for reporting the study.</p><p><strong>Results: </strong>The RADaR analysis detected a downward spiral of five principal deteriorating factors influencing nurses' intentions to leave their position in the medical department. The factors were resignations from several nursing colleagues combined with too few and inexperienced nurses present during shifts, additional tasks assigned, a management refraining from improving the problematic issues, leading to decisive consequences for patient care and a declining feeling of professional care.</p><p><strong>Conclusions: </strong>The lack of nurses in the department caused missed nursing care, which affected the nurses' job satisfaction and intentions to leave their positions. Future research initiatives must focus on evaluating successful interventions to maintain the nurses in the positions. Further knowledge, is also needed, to investigate how we can change the downward spiral to a story of retention success.</p>","PeriodicalId":48171,"journal":{"name":"Scandinavian Journal of Caring Sciences","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140294928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}