Scandinavian Journal of Caring Sciences最新文献

{"title":"Navigating parenthood in the face of amyotrophic lateral sclerosis: A qualitative exploration of partner experiences.","authors":"Anne Kristine Bergem, Trude Aamotsmo","doi":"10.1111/scs.13282","DOIUrl":"10.1111/scs.13282","url":null,"abstract":"<p><strong>Introduction: </strong>Among people diagnosed with Amyotrophic Lateral Sclerosis (ALS), there are parents with children living at home. Children in families experiencing severe illness are exposed to stress and health risks. Since 2010, healthcare personnel in Norway must assess whether patients have children under 18 years of age and make sure the children's needs for support are met. A child's ability to cope with family life affected by a serious illness depends on how the parent without the disease manages the situation. Little is known about how the partner of someone affected by ALS manages being next of kin and a parent simultaneously, and what kind of support they need.</p><p><strong>Methods: </strong>During 2021-2022, six semi-structured interviews were conducted with partners to persons with ALS, whom had children living at home. The interviews were transcribed verbatim and analysed through qualitative content analysis.</p><p><strong>Results: </strong>Three themes with subthemes emerged: (1) Together, yet alone; (a) restricted home life, (b) missing the sharing of responsibilities and tasks as equal parents, and (c) caught between children's and partner's needs; (2) Experience of coping while waiting for death; (a) cherishing the moments, (b) sense of coping and concern, and (c) ensuring to get recharged; and (3) Support in times of need; (a) difficult to ask the network for help and (b) the healthcare system does not see the whole family.</p><p><strong>Conclusions: </strong>Our respondents felt alone, caught between the needs of their children and partner, without necessary support from the services, and were left to handle everyday life with all new challenges on their own. Future healthcare services need to consider the challenges faced by families dealing with life-limiting illnesses. A family-focused perspective is needed, so is peer support and interventions that address both emotional and practical aspects of life with an ill partner.</p>","PeriodicalId":48171,"journal":{"name":"Scandinavian Journal of Caring Sciences","volume":" ","pages":"835-843"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141581199","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":"Meaning-oriented thematic analysis grounded in reflective lifeworld research-A holistic approach for caring science research.","authors":"Elisabeth Lindberg, Lina Palmér, Ulrica Hörberg","doi":"10.1111/scs.13284","DOIUrl":"10.1111/scs.13284","url":null,"abstract":"<p><strong>Background and aim: </strong>The aim of the present article is to describe meaning-oriented thematic analysis grounded in reflective lifeworld research and to illustrate how the thematic analysis can be integrated in the research process. The article is a methodological paper, including ontological and epistemological assumptions for lifeworld theory. Research based on lifeworld theory is directed towards lived experiences and meanings in everyday life. Research that is founded on the epistemology of the lifeworld can present existential issues important for caring and qualitative research can in particular contribute to existential knowledge needed to understand the world of the patient.</p><p><strong>Design: </strong>Theoretical paper.</p><p><strong>Results: </strong>Starting with a phenomenon of relevance for caring science, the article argues for lifeworld interviews as a data collection method that can contribute to depth and meaning, and then presents a description of how structures of meaning can be outlined through a meaning-oriented thematic analysis. The research of lived experiences in caring science demands an approach that includes a reflective attitude during the methodological considerations. This article highlights the importance of ontological and epistemological considerations when conducting a meaning-oriented thematic analysis.</p><p><strong>Conclusion: </strong>The article places meaning-oriented thematic analysis in a wider research process, considering all aspects from collection of data to the creation of meaning-oriented themes.</p>","PeriodicalId":48171,"journal":{"name":"Scandinavian Journal of Caring Sciences","volume":" ","pages":"1072-1081"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141601920","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":"Barriers and facilitators to early initiation of palliative care as perceived by nurses working on pneumology and nephrology, a descriptive qualitative study.","authors":"Kristel Paque, Lars Baudry, Frank Van Fraeyenhove, Bert Heyrman","doi":"10.1111/scs.13296","DOIUrl":"10.1111/scs.13296","url":null,"abstract":"<p><strong>Aims and objectives: </strong>Initiation of palliative care early in the disease trajectory is beneficial for patients with a life-limiting disease. However, palliative care is still introduced rather late or not at all. Therefore, this study aims to explore barriers and facilitators to early initiation of palliative care as perceived by nurses working on pneumology and nephrology.</p><p><strong>Methods: </strong>A descriptive interview-based study was conducted from a critical realist perspective until data sufficiency was reached. Fifteen nurses presented and discussed a patient for whom palliative care was initiated too late. Template analysis was conducted to develop themes and subthemes.</p><p><strong>Results: </strong>Five key themes were extracted: (1) communication, (2) fear, (3) personal beliefs about life and death, (4) ambiguity in terminology and (5) workload and time pressure. Barriers related to poor interdisciplinary communication were therapeutic obstinance, hierarchy, unawareness of the patient's wishes and fear of saying something inappropriate. Other barriers were patients' religious beliefs which often hindered the use of sedatives or morphine and led to discomfort and time restraints. A palliative support team in hospital and advance care planning (ACP) were enablers for early palliative care.</p><p><strong>Study limitations: </strong>This study started from a negative experience, leading to identification of a lot of barriers and only a few facilitators. The limited sample size and the restriction to two wards within one single hospital limit the diversity of perspectives and the generalisability of the findings.</p><p><strong>Conclusion: </strong>More attention is needed for ACP and interdisciplinary communication. Palliative care, including ACP, and interdisciplinary communication should be included in the basic curricula of all healthcare professional courses. Further research is needed to explore barriers and facilitators to early initiation of palliative care in other healthcare settings and patient populations. This is crucial in order to develop and implement sustainable interventions for specific groups of patients.</p>","PeriodicalId":48171,"journal":{"name":"Scandinavian Journal of Caring Sciences","volume":" ","pages":"948-959"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082198","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":"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":" ","pages":"984-995"},"PeriodicalIF":1.9,"publicationDate":"2024-12-01","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":"Managing medication in very old age: A qualitative study among Faroese nonagenarians.","authors":"Maria Í Skorini, Maria Skaalum Petersen, Ása Róin","doi":"10.1111/scs.13311","DOIUrl":"https://doi.org/10.1111/scs.13311","url":null,"abstract":"<p><strong>Background: </strong>Currently, people generally live longer, and consequently, the number of older people experiencing periods of multimorbidity and the need for medication will increase. Managing multiple medications can be a complex and challenging task, especially for older people who may experience a decline in their cognitive and physical abilities. The aim of this study was to gather knowledge on how home-dwelling people who are 90 years or older manage their daily medication, what strategies they use, and what challenges they experience regarding medication. This knowledge is necessary for providing support and care for the oldest old regarding their medication management in daily living.</p><p><strong>Method: </strong>Semi-structured interviews were conducted with 10 men and women aged 91-97 years who were part of the Faroese Nonagenarian Study conducted in 2021. The analysis was conducted by using thematic analysis as suggested by Braun and Clarke.</p><p><strong>Results: </strong>We identified three important themes for understanding how the oldest-old citizens manage medication and the challenges and worries that they sometimes experience. These themes were managing medication in daily living, challenges regarding medication management, and worries among the participating older people and their relatives. The majority of the participants received automated dose dispensing (ADD) services, which they considered a great help. In addition, they developed personal strategies to manage their medication. However, the changing colour and shape of tablets caused concern among the participants, and concern about side effects were not always taken seriously by their general practitioners.</p><p><strong>Conclusion: </strong>In addition to personal strategies, ADD services helped the participants manage medications in daily living. However, user involvement and regular counselling with their doctors appeared to be insufficient and, in some cases, absent. This study points to the necessity of strengthening user involvement by providing sufficient and regular counselling about medication between healthcare providers and people of very old age.</p>","PeriodicalId":48171,"journal":{"name":"Scandinavian Journal of Caring Sciences","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142688874","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":"Challenges for staff encountering older people's existential concerns: Swedish first-line managers' views. A cross-sectional study.","authors":"Malin Sundström, Kerstin Blomqvist, Margareta Rämgård, Anna-Karin Edberg","doi":"10.1111/scs.13300","DOIUrl":"https://doi.org/10.1111/scs.13300","url":null,"abstract":"<p><strong>Aims and objectives: </strong>To describe first-line managers' (FLMs) views of the challenges faced by staff when encountering older people's existential concerns in home and residential care.</p><p><strong>Methodological design and justification: </strong>This cross-sectional study uses a combination of qualitative and quantitative methods.</p><p><strong>Ethical issues and approval: </strong>The study was approved by the Swedish Ethical Review Authority (ref. number 2014/652 ) and followed the guidelines of the Helsinki Declaration.</p><p><strong>Research methods: </strong>FLMs in home and residential care were randomly selected and invited to participate. A self-administered questionnaire was distributed online to 467 managers, 136 (29%) of whom completed it.</p><p><strong>Results: </strong>About 80% of the FLMs reported that their staff members sometimes or frequently had conversations with the older people in their care about existential concerns, including the following topics: thoughts and feelings about meaning in life; losses and longing for meaningful relations; death, fears and uncertainty and supporting meaningful everyday life. About 75% of the managers also reported that their staff sometimes or often had conversations about existential concerns with one another. Major hindrances to existential conversations were reportedly cognitive impairment and aphasia among the older people and insecurity and unwillingness among the staff. Most managers (73%) reported that their staff received support when encountering existential concerns, mostly as individual support from managers or registered nurses.</p><p><strong>Study limitations: </strong>The main limitation of this study is its low response rate, which is common for digital surveys. Nevertheless, the sample is considered to be representative; therefore, the study holds exploratory value.</p><p><strong>Conclusion: </strong>Regular conversations among staff, improved conversational skills and the ability to listen reflect on and perceive older people's perspective and life world are needed when encountering older people's existential concerns. FLMs play a crucial role in emphasising and planning staff support on a regular basis.</p>","PeriodicalId":48171,"journal":{"name":"Scandinavian Journal of Caring Sciences","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677298","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":"Clinical gerontological nursing competence among licensed practical nurses in healthcare services-A descriptive cross-sectional study.","authors":"Suonnansalo Petra, Pramila-Savukoski Sari, Meriläinen Merja, Siira Heidi, Sneck Sami, Tohmola Anniina, Karsikas Eevi, Tuomikoski Anna-Maria","doi":"10.1111/scs.13312","DOIUrl":"https://doi.org/10.1111/scs.13312","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to describe self-assessed clinical gerontological nursing competence and its associated factors among licensed practical nurses.</p><p><strong>Design: </strong>A descriptive cross-sectional design was adopted for the study.</p><p><strong>Methods: </strong>Data were collected in Autumn 2023 from 394 licensed practical nurses working in healthcare services for older people in one well-being services county in Finland. The nurses, recruited through convenience sampling, were surveyed using a 40-item self-assessment clinical gerontological nursing competence instrument (on a Likert scale from 1 = poor to 5 = excellent). Descriptive statistical methods were used to analyse the results.</p><p><strong>Results: </strong>Participants mainly assessed their clinical gerontological competence as good. Competence in using assistive devices to support functional ability was assessed as very good, while competence in postoperative wound care was assessed as the weakest. Participants working in 24-h services assessed their competence as the weakest among the three clinical gerontological nursing areas. Participants under 40 years of age with 5-10 years of work experience self-assessed statistically significantly stronger competence in disease-specific nursing than those over 40 with less work experience.</p><p><strong>Conclusion: </strong>The self-assessed competence of licensed practical nurses varies across different service and care units. Competence in wound care requires more focus and education in the future. Attention should also be paid to competence development in different educational areas, for example, through continuous education and competence development models. The results could facilitate licensed practical nurses' competence development and management in clinical gerontological nursing. The study's insights can also guide allocating resources and education to ensure high-quality care in different service areas.</p>","PeriodicalId":48171,"journal":{"name":"Scandinavian Journal of Caring Sciences","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-11-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142649358","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":"Exploring the experience of family members caring for a relative with alcohol use disorder: A phenomenological inquiry.","authors":"Clarene E Brown-King, Beth A Pratt, Kyndall Mammah, Wanda Morancy","doi":"10.1111/scs.13306","DOIUrl":"https://doi.org/10.1111/scs.13306","url":null,"abstract":"<p><strong>Introduction: </strong>Alcohol use disorder (AUD) is a global concern with negative physical, psychological and social consequences. The ramifications of AUD extend beyond the individual and affect their family caregivers. Yet, the majority of existing research has primarily focused on individuals with AUD and interventions to encourage their abstinence rather than on their support systems.</p><p><strong>Aim: </strong>In order to advance a holistic approach, research to address this gap is imperative to understand family caregiver concerns and needs for added support.</p><p><strong>Method: </strong>We conducted a qualitative study using van Manen's hermeneutic phenomenological approach to uncover the meaning of family caregivers' lived experiences and capture the essence of their involvement in caring for a relative with AUD. A purposeful and snowball sample of family members (N = 10) living within the United States participated in a face-to-face or virtual, one-on-one audio-recorded interview and a second meeting for member checking the transcribed data. Participants received a $20.00 gift card as a token for their participation.</p><p><strong>Results: </strong>Six major themes emerged from the description of participants' lived experiences: (1) traversing the peaks and valleys, (2) wandering in the unknown, (3) pointing fingers, (4) weathering the storm, (5) drawing a line and (6) looking back, looking in. Although participants experienced many challenges, they never relinquished and remained committed to their caregiver role. Steadfastly staying with their relatives through crises exemplifies commitment as described by Sister Simone Roach's Theory of Caring. Through the ups and downs, each participant found meaning from the experience, which aligned closely with Starck's Theory of Meaning.</p><p><strong>Conclusion: </strong>This study has implications for nursing practice, public health policy and highlights the need for collaboration to address the existing challenges for family caregivers of relatives with AUD.</p>","PeriodicalId":48171,"journal":{"name":"Scandinavian Journal of Caring Sciences","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142630609","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":"Addressing parental bereavement after suicide: Insights and initiatives from Taiwan.","authors":"Lien-Chung Wei, En-Liang Wu","doi":"10.1111/scs.13309","DOIUrl":"https://doi.org/10.1111/scs.13309","url":null,"abstract":"","PeriodicalId":48171,"journal":{"name":"Scandinavian Journal of Caring Sciences","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607019","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":"Team behaviour in interprofessional collaboration during trauma alerts: A critical incident study from the perspective of radiographers.","authors":"Marice Bäckström, Katarina Leijon-Sundqvist, Lise-Lott Lundvall, Karin Jonsson, Åsa Engström","doi":"10.1111/scs.13308","DOIUrl":"https://doi.org/10.1111/scs.13308","url":null,"abstract":"<p><strong>Introduction: </strong>Challenges in mutual awareness in interprofessional collaboration (IPC) along with relational and cultural barriers among professionals disrupt flow and delay decision-making in trauma care. Thus, this study explores team behaviours within IPC in trauma teams during trauma alerts from the perspective of radiographers.</p><p><strong>Methods: </strong>A qualitative approach was used with a critical incident technique (CIT) design applying interviews with radiographers within three hospitals in Sweden from May 2022 to May 2023. CIT analysis was conducted with an abductive approach, applying an IPC core competency framework.</p><p><strong>Results: </strong>The results present collaborative requirements in trauma care from radiographers' perspective narrating a distribution of team behaviours within trauma team collaboration and fundamental skills in IPC. Behaviours within interprofessional values and ethics were the most reported incidents related to valuing radiographers' contributions to IPC in acute trauma care.</p><p><strong>Conclusion: </strong>Exploring behaviour through critical incidents associated with core competencies of IPC highlights the importance of interprofessional values as a foundation for successful IPC in the trauma team. The results show deficiencies in inclusive behaviour, influenced by the hierarchical environment of IPC. Power imbalances in this setting are traced to differences in perceived value and shared understanding among team members, possibly rooted in professional identity and culture. A dedicated leader is argued, as the recognition of radiographers' scope of practice in trauma imaging, emphasising the significance of shared decision-making.</p><p><strong>Clinical implications: </strong>The findings highlight organisational and relational coordination challenges for optimising competencies in IPC. IPC's success requires reinforcing values and ethics by empowering members' contributions and shared decision-making. This involves clarifying and recognising responsibilities, particularly for radiographers, ensuring their role in trauma imaging is respected and integrated into decision-making.</p>","PeriodicalId":48171,"journal":{"name":"Scandinavian Journal of Caring Sciences","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592091","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}