{"title":"What can nurses learn from patient's needs and wishes when developing an evidence-based quality improvement learning culture? A qualitative study.","authors":"Jeltje Giesen, Ilse Timmerman, Annick Bakker-Jacobs, Marjolein Berings, Getty Huisman-de Waal, Anneke Van Vught, Hester Vermeulen","doi":"10.1111/scs.13252","DOIUrl":"10.1111/scs.13252","url":null,"abstract":"<p><strong>Background: </strong>Patient participation is fundamental in nursing care and has yielded benefits for patient outcomes. However, despite their compassionate care approach, nurses do not always incorporate patients' needs and wish into evidence-based practice, quality improvement or learning activities. Therefore, a shift to continuous quality improvement based on evidence-based practice is necessary to enhance the quality of care. The patient's opinion is an essential part of this process. To establish a more sustainable learning culture for evidence-based quality improvement, it is crucial that nurses learn alongside their patients. However, to promote this, nurses require a deeper understanding of patients' care preferences.</p><p><strong>Objective: </strong>To explore patients' needs and wishes towards being involved in care processes that nurses can use in developing an evidence-based quality improvement learning culture.</p><p><strong>Methods: </strong>A qualitative study was conducted in two hospital departments and one community care team. In total, 18 patients were purposefully selected for individual semi-structured interviews with an average of 15 min. A framework analysis based on the fundamental of care framework was utilised to analyse the data deductively. In addition, inductive codes were added to patients' experiences beyond the framework. For reporting this study, the SRQR guideline was used.</p><p><strong>Results: </strong>Participants needed a compassionate nurse who established and sustained a trusting relationship. They wanted nurses to be present and actively involved during the care delivery. Shared decision-making improved when nurses offered fair, clear and tailored information. Mistrust or a disrupted nurse-patient relationship was found to be time-consuming and challenging to restore.</p><p><strong>Conclusions: </strong>Results confirmed the importance of a durable nurse-patient relationship and showed the consequences of nurses' communication on shared decision-making. Insights into patients' care preferences are essential to stimulate the development of an evidence-based quality improvement learning culture within nursing teams and for successful implementation processes.</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":"140207959","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}
Elísabet Hjörleifsdóttir, Þórhalla Sigurðardóttir, Guðmundur Kristján Óskarsson, Eva Charlotte Halapi
{"title":"Stress, burnout and coping among nurses working on acute medical wards and in the community: A quantitative study.","authors":"Elísabet Hjörleifsdóttir, Þórhalla Sigurðardóttir, Guðmundur Kristján Óskarsson, Eva Charlotte Halapi","doi":"10.1111/scs.13281","DOIUrl":"10.1111/scs.13281","url":null,"abstract":"<p><strong>Background: </strong>Psychological distress can cause burnout, which affects mental and physical well-being. It is important to identify factors associated with psychological distress and physical discomfort and how nurses deal with these problems.</p><p><strong>Aim: </strong>The aim was to investigate distress, burnout and coping among community nurses (CN) and hospital nurses (HN).</p><p><strong>Approach and methods: </strong>In this cross-sectional study, 409 nurses completed three questionnaires: Perceived Stress Scale (PSS), Copenhagen Burnout Inventory (CBI) and Ways of Coping (WOC).</p><p><strong>Findings: </strong>Participants younger than 40 demonstrated significantly more distress and burnout than those older than 40 years. Participants who had moderate and high distress on the PSS were significantly more at risk for experiencing personal, work-related and patient-related burnout. A significant positive correlation was found between distress and behavioural escape-avoidance, cognitive escape-avoidance and distancing. Significant positive correlations were also seen between all the subscales of the CBI and behavioural escape-avoidance, cognitive escape-avoidance and distancing. Positive significant correlation was also obtained between staff resources and distress and personal-related and work-related burnout. Negative correlation was demonstrated between staff resources and patient-related burnout. Participants with longer work experience were less likely to report moderate or high distress, and those who scored higher on personal burnout and behavioural escape-avoidance were more likely to have moderate or high distress.</p><p><strong>Conclusion: </strong>The results of this study call for increased attention to the younger generation in the nursing profession. The results also validate the need to investigate further the correlation between distress, burnout and coping and how these issues might influence each other among nurses working in the community and hospitals. Findings should be taken with precaution, they do not describe in detail what underlying factors contribute to distress and discomfort found in this study, they do, however, indicate certain coping strategies nurses use to deal with distress and burnout.</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":"141559988","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}
Catharina Sjödahl Hammarlund, Atika Khalaf, Albert Westergren, Petra Lilja Hagell, Peter Hagell
{"title":"Facing and dealing with emotional turbulence: Living with newly diagnosed Parkinson's disease.","authors":"Catharina Sjödahl Hammarlund, Atika Khalaf, Albert Westergren, Petra Lilja Hagell, Peter Hagell","doi":"10.1111/scs.13258","DOIUrl":"10.1111/scs.13258","url":null,"abstract":"<p><strong>Introduction: </strong>The experiences of living with Parkinson's disease (PD) from the perspective of newly diagnosed persons with PD (PwPD) have not been previously described.</p><p><strong>Aim: </strong>This study aimed to gain a better understanding of the impact of living with the early stages of PD.</p><p><strong>Methods: </strong>A qualitative interview study was conducted among nine persons, seven men and two women, from southern Sweden. Participants had a median age of 71 (min-max, 64-77) years and had been diagnosed with PD for a median of 5 (min-max, 2-12) months. Interviews were recorded and analysed using systematic text condensation.</p><p><strong>Results: </strong>The analysis resulted in one core category, Facing and dealing with emotional turbulence, and four categories with 2-3 subcategories each: Something is wrong (Vague signs of change; Losing control); The going gets tough (Recalling; Lack of motivation); Losing direction (Uncertainties; Frightened of disease progression) and Dealing with life (Avoiding social situations; Hope and despair; Ease worries).</p><p><strong>Conclusion: </strong>Newly diagnosed PwPD face emotional turbulence with increasing challenges in managing everyday basic needs. Impaired functioning affects self-esteem and identity, which calls for strategies to overcome emotional reactions of embarrassment, frustration and worry. A sense of lost control and direction increased as the future became more uncertain. The participants' emotional burden and struggle to find a reason to go on or some solution to their new situation left them with both hope and despair. Our results suggest that a person-centred needs-based approach may help newly diagnosed PwPD deal with their new life situation.</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":"140294927","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}
Wing Ki Agnes Yip, Pui Man Betty Chung, Martin Christensen
{"title":"End-of-life conversations for the older person: A concept analysis.","authors":"Wing Ki Agnes Yip, Pui Man Betty Chung, Martin Christensen","doi":"10.1111/scs.13263","DOIUrl":"10.1111/scs.13263","url":null,"abstract":"<p><strong>Aim: </strong>The aim of this concept analysis is to seek clarity as to what end-of-life conversations involve by developing a clear working definition and using model cases to conceptualise the defining attributes of an end-of-life conversations with the older person.</p><p><strong>Design: </strong>Walker and Avant's eight step approach to Concept Analysis.</p><p><strong>Data sources: </strong>Four databases were searched, including PubMed, CINAHL, PsycINFO, and Scopus. A total of 339 publications were identified with 30 papers meeting the inclusion criteria and put forward for the final conceptual analysis.</p><p><strong>Results: </strong>The defining attributes associated with end-of life conversations included (1) an ongoing process of older person empowerment, (2) discussion's concerning values and preferences concerning end-of-life issues, and (3) maintaining an open dialogue between all concerned individuals. Antecedents were associated with the older person is their readiness to talk openly about death and dying. Consequences were identified as having a better understanding of what death and dying may mean to the older person in a more specific manner.</p><p><strong>Conclusions: </strong>End-of-life conversations are vital in understanding an individual's values and preferences at the end of life, and yet, the concept of the end-of-life conversation has not been well defined in the literature. End-of-life conversations with the older person encompass ongoing discussions and maintaining open dialogue around end-of-life care while developing strategies to promote individual empowerment in making informed choices. Using a conceptual model, aides in addressing aspects of end-of-life conversations and an acknowledgment of the dynamic process of end-of-life conversations.</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":"141082734","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}
Lisa Granat, Sofia Andersson, Daniel Åberg, Emina Hadziabdic, Anna Sandgren
{"title":"Evaluation of the Swedish Self-Efficacy in Palliative Care Scale and exploration of nurses' and physicians' self-efficacy in Swedish hospitals: A cross-sectional study.","authors":"Lisa Granat, Sofia Andersson, Daniel Åberg, Emina Hadziabdic, Anna Sandgren","doi":"10.1111/scs.13244","DOIUrl":"10.1111/scs.13244","url":null,"abstract":"<p><strong>Background: </strong>Previous research found that healthcare professionals had low preparedness for palliative care. Thus, it is necessary to explore healthcare professionals' self-efficacy. The Swedish Self-Efficacy in Palliative Care Scale (SEPC-SE) evaluates readiness in communication, patient management and multidisciplinary teamwork; however, it should be tested on a larger population. Furthermore, the constructs of the SEPC-SE should be compared to that of the original SEPC.</p><p><strong>Aim: </strong>This study aimed to evaluate the consensus between the construct validity and reliability of the SEPC and the translated and adapted SEPC-SE. Furthermore, it aimed to describe and compare the self-efficacy of nurses and physicians in hospitals and explore the associated factors.</p><p><strong>Methods: </strong>The nurses (n = 288) and physicians (n = 104) completed the SEPC-SE. Factor analysis with Cronbach's alpha evaluated validity and reliability, and an analysis using the Mann-Whitney U test compared self-efficacy and multiple linear regression-associated factors.</p><p><strong>Results: </strong>The SEPC-SE revealed three factors with high reliability. Education or experience in specialised palliative care was minor, especially for nurses. Self-efficacy was highest in patient management (nurses, median [md] = 74.57, physicians md = 81.71, p = 0.010) and communication (nurses md = 69.88, physicians md = 77.00, p = 0.141) and lowest in multidisciplinary teamwork (nurses md = 52.44, physicians md = 62.88, p = 0.001). The strongest associations with self-efficacy were education at work and advanced homecare experiences. In addition, there were significant associations between years in the profession, male sex, physicians and university education.</p><p><strong>Conclusion: </strong>The SEPC-SE is valid and reliable for measuring self-efficacy. Nurses had lower self-efficacy than physicians. Physicians were associated with higher self-efficacy and had more education and experience in palliative care settings, which may explain their levels of self-efficacy.</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":"140060805","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":"Implementation of nutritional care in hospitals: A qualitative study of barriers and facilitators using implementation theory.","authors":"Lærke Prietzel Nielsen, Krista Horsholt Thomsen, Camilla Alleslev, Sabina Mikkelsen, Mette Holst","doi":"10.1111/scs.13255","DOIUrl":"10.1111/scs.13255","url":null,"abstract":"<p><strong>Background: </strong>Disease-related malnutrition is prevalent among hospitalised patients, but not all patients achieve the needed nutritional care. At a Danish University Hospital, focus has been on implementing nutritional practices based on clinical guidelines, but there is continuously variation between the wards regarding the quality of nutritional care.</p><p><strong>Aim: </strong>The aim of this study was to identify the potential barriers and facilitators for implementation of the clinical guidelines for nutritional practices and to recommend suggestions for development of nutritional practices, using a theoretical implementation strategy.</p><p><strong>Method: </strong>The design was a qualitative interview study of employees at a Danish University Hospital, using a semi-structured interview guide. The participants were nurses, nurse's assistant, nurse nutrition expert, head nurse and dieticians. We recruited 11 employees, representing eight different wards.</p><p><strong>Findings: </strong>The analysis identified six themes: (1) clear allocation of responsibilities and committed management enhances nutrition practices, (2) leadership support is essential, (3) physical settings and tools affect possibilities for action, (4) selection of equivalent staff is core, (5) teaching promotes the knowledge and skills and (6) a dietitian in the ward facilitates implementation of nutritional care. Barriers and facilitators among the themes were identified and has led to suggestions to strengthen nutritional care, based on implementation theory.</p><p><strong>Conclusion: </strong>Various factors were identified as having impact on the implementation of nutrition practices and different suggestions have emerged to accommodate those factors, as well as to apply an implementation strategy to facilitate change in practice.</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":"140194841","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":"Why should we care? The new editors' perspectives of the importance of caring, caring science and the further development of the journal.","authors":"Oscar Tranvåg, Carina Elmqvist","doi":"10.1111/scs.13285","DOIUrl":"10.1111/scs.13285","url":null,"abstract":"","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":"141749351","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}
Helen Gräs Højgaard, Kirsten Frederiksen, Annete Langager Høgh, Bodil Rasmussen, Marie Dahl
{"title":"Danish citizens' perspectives on the preventive medication recommended after screen-detected cardiovascular disease: A qualitative study.","authors":"Helen Gräs Højgaard, Kirsten Frederiksen, Annete Langager Høgh, Bodil Rasmussen, Marie Dahl","doi":"10.1111/scs.13274","DOIUrl":"10.1111/scs.13274","url":null,"abstract":"<p><strong>Background: </strong>The rationale for screening for cardiovascular disease (CVD) is debated as a prevention strategy. However, research shows that when preventive medication is initiated after screening for CVD, mortality rates decrease, especially among men. When implementing screening programmes, facilitating citizens' informed decisions and empowering their autonomy in the decision-making process are crucial. We therefore aimed to explore citizens' perspectives on and decisions regarding initiating cardiovascular preventive medication for screen-detected CVD.</p><p><strong>Methods: </strong>We employed an exploratory qualitative design using semi-structured interviews to investigate participants' perspectives on and decisions regarding initiating cardiovascular preventive medication for screen-detected CVD. Twelve interviews were conducted and analysed using thematic analysis following Braun and Clarke's six-step approach.</p><p><strong>Findings: </strong>We found one overall theme, Being on a continuum between wellness and illness, with two underlying sub-themes. Sub-theme (1) Navigating mixed feelings and pathways reflects participants' perspectives on CVD preventive medication, which were positioned on a continuum with shifting perspectives. The state between wellness and illness was experienced as liminal and characterised by uncertainty and concerns about CVD risk. (2) Navigating medication decisions: a negotiated process. Pivotal medical decisions hinged on trust in authorities or own judgement, influenced by attitudes towards the need for medication, perception of meaningfulness, asymptomatic condition, age, family responsibility and predisposition. Participants' medical decisions were supported and impacted by significant others.</p><p><strong>Conclusion: </strong>We uncovered a continuum of shifting perspectives ranging from feeling improved health to experiencing fear of CVD. For certain citizens, it is like navigating between these contrasting feelings. The perceived necessity and meaningfulness, in particular, shape medical decisions. Providing support for informed decisions is crucial and includes significant others. Shared decision-making with healthcare professionals as facilitators is needed. Future research is warranted to investigate how to embrace the various perspectives on initiating CVD preventive medication in clinical practice.</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":"141285077","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":"Process evaluation of the CO-WORK-CARE model: Collaboration and a person-centred dialogue meeting for patients with common mental disorder in primary health care.","authors":"Eva-Lisa Petersson, Karin Törnbom, Cecilia Björkelund, Margaretha Jerlock, Dominique Hange, Camilla Udo, Irene Svenningsson","doi":"10.1111/scs.13268","DOIUrl":"10.1111/scs.13268","url":null,"abstract":"<p><strong>Rationale: </strong>To ensure optimal patient care based on evidence, it is crucial to understand how to implement new methods in practice. However, intervention studies often overlook parts of the implementation process. A comprehensive process evaluation is necessary to understand why interventions succeed or fail in specific contexts and to integrate new knowledge into daily practice. This evaluation examines the full implementation of the Co-Work-Care model in Swedish primary healthcare to identify strengths and weaknesses.</p><p><strong>Aim: </strong>This study aimed to evaluate the process of implementing the CO-WORK-CARE model that focuses on close collaboration and the use of a person-centred dialogue meeting in primary healthcare for patients on sick leave due to common mental disorders.</p><p><strong>Method: </strong>The CO-WORK-CARE model emphasises collaboration among the GP, rehabilitation coordinator and care manager, along with person-centred dialogue meetings involving employers. Following UK Medical Research Council guidelines, we conducted a process evaluation. Data from previous studies were reanalysed. We also analysed field notes and meeting notes using Malterud's qualitative method.</p><p><strong>Results: </strong>The evaluation identified key facilitators for model implementation, including regular visits by facilitators and guidance from the research physician. Peer support meetings also bolstered implementation. However, challenges emerged due to conflicts with existing structures and limitations in person-centred dialogue meetings.</p><p><strong>Conclusion: </strong>Adapting the CO-WORK-CARE model to Swedish primary care is feasible and beneficial, with collaboration among the care manager, rehabilitation coordinator and GP and person-centred dialogue meetings. Thorough preparations, ongoing facilitator and peer support and integrated information enhanced implementation efficiency, despite challenges posed by existing structures.</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":"140892378","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}