Scandinavian Journal of Caring Sciences最新文献

{"title":"Experiences of managers and staff working in community‐based mental health with people ageing with severe mental health problems","authors":"Carina Tordai, Steven M. Schmidt, Mona Eklund, Elisabeth Argentzell","doi":"10.1111/scs.13269","DOIUrl":"https://doi.org/10.1111/scs.13269","url":null,"abstract":"BackgroundExisting research shows that older people with severe mental health problems need different forms of support in daily life and in the community to lead an active and meaningful life. A common form of support for people with severe mental health problems in Sweden is attendance at community‐based day centres (DCs). However, knowledge of staff and managers’ experiences of how people ageing with severe mental health problems are supported in DCs is scarce.AimThe aim was to explore DC staff and managers' experiences of how people ageing with severe mental health problems are supported in DCs during the retirement process.Method/ProcedureTelephone interviews were conducted with managers in 27 municipalities in southern Sweden. In addition, focus groups were held with personnel from a total of nine different DCs. The material was analysed using content analysis.ResultsThe results showed that older people who receive support in community‐based mental health care were viewed as a neglected group with complex needs, and the informants (managers and staff) had few policies to guide them when providing support. This made the informants desire more knowledge about best practices to support the target group. One theme emerged, <jats:italic>Minding the gap between ideal and reality while working with a neglected group with complex needs</jats:italic>, with three categories: <jats:italic>Reasoning around unmet needs</jats:italic>, <jats:italic>Navigating in a muddled organisation</jats:italic>, and <jats:italic>Wishing for an enriched service</jats:italic>.Conclusion/Practical ApplicationTogether with previous research, the results can contribute to increase awareness about an overlooked group at risk of being neglected and the pitfalls that impact the possibility to guide this target group in their recovery journey. Further research focusing on the target group's own experience of their everyday life situations is also needed.","PeriodicalId":48171,"journal":{"name":"Scandinavian Journal of Caring Sciences","volume":"15 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140829264","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":"Detection of delirium in older patients—A point prevalence study in surgical and non‐surgical hospital wards","authors":"Irene Instenes, Leslie S. P. Eide, Hege Andersen, Nina Fålun, Trond Pettersen, Anette H. Ranhoff, James L. Rudolph, Ole Martin Steihaug, Tore Wentzel‐Larsen, Tone M. Norekvål","doi":"10.1111/scs.13270","DOIUrl":"https://doi.org/10.1111/scs.13270","url":null,"abstract":"Aims and ObjectivesTo (i) determine the prevalence of delirium and identify delirium subtypes in surgical and non‐surgical patients aged ≥65 years, (ii) determine whether certain precipitating factors affect the prevalence of delirium and (iii) review patients' medical records for description of delirium symptoms and the presence of International Classification of Diseases (ICD‐10) coding for delirium in discharge summaries.Methodological Design and JustificationsDespite being a robust predictor of morbidity and mortality in older adults, delirium might be inadequately recognised and under‐reported in patients' medical records and discharge summaries. A point prevalence study (24‐h) of patients ≥65 years from surgical and non‐surgical wards was therefore conducted in a tertiary university hospital.Ethical Issues and ApprovalThe study was approved by the Data Protection Officer at the university hospital (2018/3454).Research Methods, Instruments and/or InterventionsPatients were assessed for delirium with 4AT and delirium subtypes with the Delirium Motor Subtype Scale. Information about room transfers, need and use of sensory aids and medical equipment was collected onsite. Patients' medical records were reviewed for description of delirium symptoms and of ICD‐10 codes.ResultsOverall, 123 patients were screened (52% female). Delirium was identified in 27% of them. Prevalence was associated with advanced age (≥85 years). The uncharacterised delirium subtype was most common (36%), followed by hypoactive (30%), hyperactive (24%) and mixed (9%). There were significant associations between positive screening tests and the need and use of sensory aids. Delirium symptoms were described in 58% of the patients who tested positive for delirium and the ICD‐10 code for delirium was registered in 12% of these patients' discharge summaries.ConclusionsThe high prevalence of delirium and limited use of discharge codes highlight the need to improve the identification of delirium in hospital settings and at discharge. Increased awareness and detection of delirium in hospital settings are vital to improve patient care.","PeriodicalId":48171,"journal":{"name":"Scandinavian Journal of Caring Sciences","volume":"31 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140829359","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 urge for a caritative caring science in a wider perspective","authors":"Susanne Knutsson","doi":"10.1111/scs.13266","DOIUrl":"https://doi.org/10.1111/scs.13266","url":null,"abstract":"","PeriodicalId":48171,"journal":{"name":"Scandinavian Journal of Caring Sciences","volume":"82 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140829427","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":"Enhancing nurse retention: Insights from “SHOULD I STAY OR SHOULD I GO”","authors":"Shu‐Mei Wang, Lien‐Chung Wei","doi":"10.1111/scs.13265","DOIUrl":"https://doi.org/10.1111/scs.13265","url":null,"abstract":"","PeriodicalId":48171,"journal":{"name":"Scandinavian Journal of Caring Sciences","volume":"7 1","pages":""},"PeriodicalIF":1.9,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140812877","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":"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":"6 3","pages":""},"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":"45 1","pages":""},"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":"85 1","pages":""},"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":"35 1","pages":""},"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":"18 1","pages":""},"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":"30 1","pages":""},"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}