Scandinavian Journal of Caring Sciences最新文献

{"title":"Contextual influences on knowledge translation capacity in a nursing home organisation: A phenomenological hermeneutical study.","authors":"Trine-Lise Dræge Steinskog, Oscar Tranvåg, D. Ciliska, Birgitte Graverholt","doi":"10.1111/scs.13264","DOIUrl":"https://doi.org/10.1111/scs.13264","url":null,"abstract":"INTRODUCTION\u0000The demand for advanced clinical care in nursing homes (NHs) is increasing. Evidence-based practices and knowledge translation (KT) initiatives are growing to bridge the gap between what is known and what is done. However, research on contextual influence on KT has primarily focused on hospital settings.\u0000\u0000\u0000AIM\u0000To expand our understanding of contextual influences on KT capacity in a NH organisation.\u0000\u0000\u0000DESIGN AND METHODS\u0000Lindseth and Norberg's phenomenological hermeneutical method was used to explore and describe practice development nurses' experiences, perspectives and practices regarding how contextual factors influence KT capacity in NHs. Focus group interviews, participant observations, in-depth interviews and non-participant observations provided the data.\u0000\u0000\u0000RESULTS\u0000Two main themes and four subthemes were identified. (1) Continuous limited resources are a cultural condition that inhibits KT readiness; prioritising keeping the NH machinery running at all costs and having contrasting care philosophies undermines KT. (2) Organisational prioritisations leave KT as a missing cogwheel in the machinery; retaining a system of fragmented KT strategies and lacking a structure for collective KT effort.\u0000\u0000\u0000CONCLUSION\u0000The study showed that KT held a minor role in the fast-paced NH machinery. Contradicting values characterise the NH organisation, resulting in a lack of a common vision and priorities. Building a sustainable KT capacity and providing evidence-based practice necessitates explicit responsibilities, dedicated resources and robust organisational support. Management has a critical role in strengthening the position of KT. Incorporating KT in daily NH practice can help staff become adaptable and confident, capable of meeting the increasing challenges of advanced care that alleviates suffering and promote the health and well-being of NH patients.","PeriodicalId":48171,"journal":{"name":"Scandinavian Journal of Caring Sciences","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-04-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140652451","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":"Preparing safe discharge in a complex practice: A qualitative study of nurses' approach to patients with COPD's hospital discharge from two pulmonary medicinal wards","authors":"Nanna Vendelboe Gregersen, Birgit Refsgaard, Dorthe Sørensen","doi":"10.1111/scs.13262","DOIUrl":"https://doi.org/10.1111/scs.13262","url":null,"abstract":"It remains unclear why 17% of patients with acute exacerbations of chronic obstructive pulmonary disease (COPD) treated in Danish hospitals are readmitted within 30 days. Hospital discharge is multifaceted. However, the preparation process and nurses' efforts may be essential in ensuring a successful discharge.","PeriodicalId":48171,"journal":{"name":"Scandinavian Journal of Caring Sciences","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140580226","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":"In the footstep of the old patient from hospital to home: A qualitative field observation study","authors":"Sanne Have Beck, Grethe Eilertsen, Karen Andersen‐Ranberg, Astrid Janssens, Dorthe Susanne Nielsen","doi":"10.1111/scs.13257","DOIUrl":"https://doi.org/10.1111/scs.13257","url":null,"abstract":"BackgroundOlder people often have multiple health conditions and therefore extended care needs. The transition from the hospital back to their home requires careful planning. The fragmented healthcare system and rapid discharge from the hospital can result in limited involvement of the older patient in the discharge planning process. We aimed to explore how older hospitalised patients experienced the transition from hospital to home and how possibilities and constraints in interactions with relevant parties in the transition affected their everyday lives.MethodAn ethnographic participant observation study including interviews was conducted with 10 older hospitalised patients. The theoretical perspective in the study is critical psychology and data were analysed using the condition‐, meaning‐ and reasoning analysis.ResultsThree themes were identified: (1) Lost in transition – the person's ability to act is limited, (2) In transition – the relatives become important, (3) At home – the home transforms into a workplace.ConclusionLack of involvement becomes a condition for older patients as some struggle to create meaning in their transition, affecting their everyday lives. The patients experienced their relatives as important as they ensured that the HCPs got to know their values and wishes. This knowledge is important for HCPs working closely with older people both at the hospital and at home ensuring active involvement of the older person with respect and acknowledgement of the older person's wishes, needs, resources and vulnerability.","PeriodicalId":48171,"journal":{"name":"Scandinavian Journal of Caring Sciences","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140580301","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":"Informal caregivers' experiences of support from a tailored primary healthcare unit for older adults – A focus group study","authors":"Ulrika Westerling, Mikko Hellgren, Liselotte Hermansson, Emma Nilsing Strid","doi":"10.1111/scs.13260","DOIUrl":"https://doi.org/10.1111/scs.13260","url":null,"abstract":"BackgroundInformal caregivers are an essential part of health and social care systems worldwide. As such, they may need professional support.AimThe aim of this study was to describe informal caregivers’ experiences and need for support from a tailored primary health care (PHC) unit.MethodsThis is a qualitative descriptive study using data collected from five semi‐structured focus group discussions with a purposeful sample of 16 informal caregivers of older relatives. Respondents were recruited from a tailored PHC unit for people aged 75 years or older in a region in central Sweden. The data were analysed by qualitative content analysis with an abductive approach, based on the principles of the patient‐ and family‐centred care framework.ResultsThe overarching theme was ‘<jats:italic>Striving for partnership</jats:italic>’. The findings indicate that informal caregivers to some extent felt supported by the healthcare professionals. However, the caregivers expressed a need to be further acknowledged by the professionals in order to participate in the care of their older relatives in the way they wanted. Moreover, insufficient information regarding the older adult's health condition and care provided by the professionals had a negative impact on the caregiver's participation in care.ConclusionsInformal caregivers have unmet needs for support and strive for a partnership with the PHC professionals. PHC professionals should be more attentive and invite informal caregivers to participate in the care of the older adult in order to meet their support needs and build an equal partnership. The patient‐ and family‐centred care framework may be of guidance when providing care for older adults in a PHC context.","PeriodicalId":48171,"journal":{"name":"Scandinavian Journal of Caring Sciences","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140580343","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":"‘Like a torch that enlightens new parents along a narrow and winding path into parenthood’ – Midwives' experiences by an interview study","authors":"Margareta Johansson, Li Thies‐Lagergren","doi":"10.1111/scs.13261","DOIUrl":"https://doi.org/10.1111/scs.13261","url":null,"abstract":"BackgroundThe core of postnatal care is that midwives recognise the needs of women and new‐born babies and provide the highest possible quality of care and medical safety to optimise the health and well‐being of new families. The study aimed to describe midwives' experiences in providing postnatal care for families during the first week after the birth of their baby.MethodsAn interview study included 18 midwives who interchangeably worked within the models of traditional hospital care, hotel‐based care, home‐based care, hospital‐based check‐ups, and specialist care at a breastfeeding clinic at one university hospital in Sweden. Data collected were analysed using thematic analysis according to Braun and Clarke.FindingsThe main theme: ‘Like a torch that enlightens new parents along a narrow and winding path into parenthood – a midwife's transitional support’ was explored and comprised two themes: (1) <jats:italic>Strengthening parents' self‐confidence in their parental role by handling over parental responsibility</jats:italic>; and (2) <jats:italic>Challenging to facilitate parents' understanding of their parental role</jats:italic>.ConclusionsMidwives expressed that supporting parents in the parental transition was a delicate task and included balancing mothers', babies', and partners' needs. The midwives guided parents into parenthood during postnatal care in a strategic manner by strengthening parents in their parental role. Postnatal care delivered by midwives is crucial for new parents and their babies.","PeriodicalId":48171,"journal":{"name":"Scandinavian Journal of Caring Sciences","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140580020","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":"Experiences of caring after religious disaffiliation: A qualitative study based on the DEW model","authors":"Maria Björkmark, Malin Andtfolk, Linda Nyholm","doi":"10.1111/scs.13259","DOIUrl":"https://doi.org/10.1111/scs.13259","url":null,"abstract":"Background and AimLeaving a religious community may occasionally lead to suffering in a human being's life and difficult existential life issues, such as loss of social relationships, identity and well‐being. Only a few studies have been conducted on what kind of care and support human beings who are suffering need in this context. The aim of this study was to increase the understanding of what a human being perceives as caring after religious disaffiliation.MethodsIn‐depth interviews were conducted with 18 participants who had left different religious communities in Finland. The material was analysed through a deductive thematic analysis according to Braun and Clarke, based on the Dressing an existential wound model by Rehnsfeldt and Arman.Results and ConclusionThe results show that what human beings experience as caring after religious disaffiliation is encountering a care professional who understands the needs of someone in this life situation. Based on these needs, caring is described through seven themes.Care professionals need to understand the impact religious disaffiliation may have on clients' lives and respond to their needs. Understanding the suffering of a human being calls for a care professional's holistic view and caring for the whole human being, including spiritual dimensions. This new knowledge can be used by care professionals to develop caring for clients after religious disaffiliation.","PeriodicalId":48171,"journal":{"name":"Scandinavian Journal of Caring Sciences","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140580304","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":"For the good of the children-Life and ethical values when undergoing paternal alienation and involuntary loss of paternity.","authors":"C Koskinen, G C Wallgren, K M Thorkildsen, K Kaldestad","doi":"10.1111/scs.13191","DOIUrl":"10.1111/scs.13191","url":null,"abstract":"<p><strong>Background and aim: </strong>Today there is an aspiration and desire for fathers to be caring masculinities that build long-term father-child relationships and emotional presence with their children. Previous research shows that life changes where fathers are deprived of the opportunity for equal parenting and close contact with their children affect the fathers' lives and mental health. The aim of this caring science study is thereby to gain a deeper understanding of life and ethical values when undergoing paternal alienation and experiencing involuntary loss of paternity.</p><p><strong>Design, research methods, and participants: </strong>The study has a qualitative design. The data collection was carried out in 2021 through individual in-depth interviews according to Kvale and Brinkmann. The five fathers who participated in the interviews had experiences of undergoing paternal alienation and involuntary loss of paternity. The interviews were analysed with a reflexive thematic analysis according to Braun and Clarke.</p><p><strong>Results: </strong>Three main themes emerged. Putting yourself aside includes forgetting one's own needs and prioritising the children's and being the best version of oneself for them. In playing with the cards you have been dealt lies an acceptance of life as it has become and also a responsibility not to let the grief take over, by creating new patterns for everyday life and holding up hope. Keeping your dignity as a human being includes being heard, affirmed and consoled, and a form of re-awakening one's dignity as a human being.</p><p><strong>Conclusion: </strong>It is fundamental to understand the grief, longing and sacrifice that paternal alienation and involuntary loss of paternity cause human life and how every day can be a struggle to hold on to hope, find comfort and reconcile with the situation. The fundamental foundation that makes life worth living is love and responsibility for the good of the children.</p>","PeriodicalId":48171,"journal":{"name":"Scandinavian Journal of Caring Sciences","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9761608","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":"Value-based care of older people-The impact of an acute outreach service unit on emergency medical service missions: A quasi-experimental study.","authors":"Lauri J Mäki, Perttu J Kontunen, Johanna M Kaartinen, Maaret K Castrén","doi":"10.1111/scs.13220","DOIUrl":"10.1111/scs.13220","url":null,"abstract":"<p><strong>Background: </strong>Transfers to the emergency department can be burdensome for the residents of long-term residential care facilities (LTRCFs) and often lead to adverse effects. Since March 2019, a nurse-led acute outreach service unit \"Mobile hospital\" (in Finnish, Liikkuva sairaala, LiiSa) has been providing on-site care to LTRCF residents to reduce transfers to the emergency department.</p><p><strong>Methods: </strong>This study compares the numbers and acuities of emergency medical service (EMS) missions carried out in the LTRCFs of Espoo and Kauniainen during two six-month periods: before the implementation of LiiSa and with LiiSa in use. In Finland, EMS missions are divided into four categories (A-D), with category A missions being the most urgent. These categories were used to investigate the impact on mission acuities.</p><p><strong>Results: </strong>Due to the implementation of LiiSa, the number of EMS missions decreased by 16.8% (95% confidence interval 10.6%-22.6%, p < 0.001), the number of category D missions by 19.8% (7.1%-30.8%, p = 0.003) and the number of category C missions by 30.3% (17.3%-41.3%, p < 0.001). Changes in the numbers of category A and B missions were not statistically significant.</p><p><strong>Conclusions: </strong>LiiSa helped to avoid many transfers of frail LTRCF patients to the emergency department, and it did not hinder the care of patients with true emergencies by EMSs.</p>","PeriodicalId":48171,"journal":{"name":"Scandinavian Journal of Caring Sciences","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41173901","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":"Searching for a brighter future-Lived experiences of ongoing recovery processes following COVID-19 infection.","authors":"Ingrid C Andersen, Nina Nissen, Hanne Agerskov, Malene Beck, Uffe Bodtger, Lars Tang, Søren T Skou, Charlotte Simonÿ","doi":"10.1111/scs.13213","DOIUrl":"10.1111/scs.13213","url":null,"abstract":"<p><strong>Background: </strong>Research in Denmark indicates that approximately 30% of people with confirmed COVID-19 infection experience at least one physical symptom 6-12 months after the acute infection. The lived experiences of undergoing prolonged recovery processes and how these processes unfold need further attention.</p><p><strong>Aim: </strong>To contribute in-depth knowledge about recovery, as experienced over time by people living with the post COVID-19 condition.</p><p><strong>Methods: </strong>Within a qualitative research design, nine women and six men were interviewed. Ten of them gave a follow-up interview. Prompt cards and participant-generated photographs were included. A phenomenological-hermeneutic approach inspired by Ricoeur's theory of interpretation guided the data analysis.</p><p><strong>Findings: </strong>Living with long-term health problems associated with the post COVID-19 condition involved recovery processes where participants struggled with reduced capacity, new unpredictability and uncertainty in everyday life. Participants continuously searched for improvement and aimed for regaining former health and well-being. Lack of knowledge, acknowledgement and support made it difficult to find clear directions for improvement. Participants created a protective shield and struggled, often jointly with family and friends, to cope with bodily, cognitive, emotional, existential and social challenges. Over time, some participants realised that they might not be able to fully return to their earlier habitus. However, some of them gained a new foothold and sense of hope for the future.</p><p><strong>Conclusion: </strong>This study provides in-depth insight into the experience of changing and open-ended recovery processes while living with the post COVID-19 condition. Over time, some participants learned to rebuild their lives, adapting to their reduced capacities. Future care and rehabilitation models for these patients must address the complex and challenging nature of recovery processes associated with living with post-COVID-19 condition.</p>","PeriodicalId":48171,"journal":{"name":"Scandinavian Journal of Caring Sciences","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41216254","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 informal caregivers' well-being during COVID-19 through online discussion forums.","authors":"Anni Lindroos, Nicola Douglas-Smith","doi":"10.1111/scs.13199","DOIUrl":"10.1111/scs.13199","url":null,"abstract":"<p><strong>Background: </strong>COVID-19 has increased pressures on caregivers, disruptions to health services and increased health concerns during COVID-19. Reports have been made on informal carers' increased workload and limited support services during the pandemic.</p><p><strong>Aims: </strong>This study aimed to explore how informal caregivers experienced their well-being during COVID-19 through online discussion forums.</p><p><strong>Materials and methods: </strong>A reflexive thematic analysis characterised by theoretical flexibility, organic inductive coding processes and theme development was conducted on online discussion forums. The method highlighted theme reviewing which was done twice to encourage data reflection. The project was conducted on a novel topic which was a new area of research interest. Semantic coding where participants' words were used directly in the interpretation and construction of themes was used.</p><p><strong>Results: </strong>In the theme 'Locked in or locked away' caregivers worried about continuing care at home, due to limited freedom and worries of hiring help during a pandemic. Some expressed worries about visitation rights and grief of not being present with a loved one if they would reside in a care home. The theme 'Nothing left to give' suggested that COVID-19 exasperated caregivers' loneliness, social isolation and increased responsibilities and challenges with other roles. Bitterness, resentment and anger were felt towards lack of social support and workload. Theme 'Celebrating a virtual way of life' described how caregivers used online forums when other support services were disrupted.</p><p><strong>Discussion: </strong>We discuss the role of informal caregiver that was described as all-encompassing during COVID-19. We highlight the importance of advanced planning for care home transitions and the use of online forums as a form of support. We suggest further exploration into informal caregivers' role balancing.</p><p><strong>Conclusion: </strong>COVID-19 seemed to affect informal caregivers negatively, but they reframed their situations and sought online support. With COVID-19-related restrictions and increased workload, COVID-19 added an all-or-nothing aspect to care home transition decisions.</p>","PeriodicalId":48171,"journal":{"name":"Scandinavian Journal of Caring Sciences","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9888793","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}