Scandinavian Journal of Caring Sciences最新文献

Introduction: First-line managers in Swedish communities have responsibility for that care to older people is provided, staffing is sufficient and the budget is balanced in their unit. It is a struggle with limited resources due to a growing population in need of care. This can lead to missed nursing care. The aim was to describe first-line managers´ perceptions of missed nursing care in community health care for older people.

Methods: A qualitative design with a phenomenographic approach, interviewing 24 first-line managers. Ethics approval for the study was received from the Research Ethics Committee at Karlstad University (Dnr HNT 2020/566).

Results: The results are shown in six descriptive categories containing 15 perceptions. The descriptive categories are 'occurrence of missed nursing care', 'becoming aware of missed nursing care', 'reasons for missed nursing care', 'missed nursing care has consequences for the older persons', 'missed nursing care has consequences for the staff' and 'taking action to decrease missed nursing care'.

Conclusions: It is important for first-line managers to become aware of the existence and reasons for missed nursing, as it has consequences for older people and staff. Managers need to take missed nursing care seriously in order to work with improvements for maintaining good quality of care and patient safety.

Background: Health and education are interrelated and influence social, economic and lifestyle perspectives. Children with chronic illnesses experience barriers in the educational system regarding school attendance and social isolation. Gaining knowledge of compulsory education and how children with chronic illnesses are supported is crucial for the implications of future education policy and legislation in Scandinavia. This study compares Scandinavian legislation frameworks on compulsory education, chronic illness and school absence to form the basis of future research on education for children with chronic illness.

Methods: The study uses a comparative approach to explore the support of children with chronic illnesses in compulsory education across Norway, Sweden and Denmark. The documents included are 3 education acts and 15 secondary documents, which are notes and guidelines for the education acts. The data were analysed using a manifest content analysis.

Findings: We found four categories and six subcategories: (1) school obligation and rights; (2) chronic illness; (3) school absence: (a) categorisation of absence; (b) registration of absence; and (c) sanction; and (4) education support: (a) Hospital school support; (b) Home instruction support; and (c) technological support.

Conclusion: This study's findings demonstrate the similarities and differences in the Scandinavian compulsory education legislation and guidelines regarding chronic illness and school absence. We found similarities across the countries regarding chronic illness and school absence. Still, the findings showed differences in the systematic registration of school absence and requirements for attendance with compulsory education in Norway and Denmark compared with compulsory schooling in Sweden. This knowledge will inform and enlighten future discussions and decisions in education and public health. The results can contribute to awareness of the opportunities for educational support and perspectives about education for children with chronic illnesses. Future research focusing on the experience of children with chronic illness and educational support is needed.

Background: Although caring is a core principle of the nursing profession, students often lack the knowledge, comprehension and ability to integrate care into all aspects of nursing practice. Students may have few opportunities to practise caring behaviours on patients who create the impression of providing care and elicit a feeling of receiving care. Studies of strategies to enhance caring behaviours in nursing education are limited.

Aim: This experimental study aimed to examine the effect of nursing caring behaviours course based on interactive learning strategies on the caring behaviours and decision-making abilities of nursing students.

Methods: A purposive sample of 50 undergraduate students was recruited from a faculty of nursing. Students in the intervention group (n = 24) received 2 h of training per week for 14 weeks in accordance with caring behaviours course based on interactive learning strategies including discussion, brainstorming, concept mapping, reflection and simulation training. Nursing students in the control group (n = 26) received training according to other elective courses in the curriculum. Data were measured at the baseline time point, 7th week and 14th week with the Caring Behaviours Inventory and Nursing Decision-Making Instrument. Chi-square test, Mann-Whitney U-test, Friedman test and mixed repeated measures ANOVA were used to assess the data.

Results: No significant difference was determined in terms of baseline caring behaviours and decision-making scores between the intervention and control groups (p > 0.05). A significant difference in caring behaviours between the two groups and time effect was not found (p > 0.05). However, there was a significant interaction between time and groups (F = 3.484, p = 0.047). There was a significant increase in the decision-making in intervention groups over time (F = 9.372, p < 0.001) and interaction between time and groups (F = 4.160, p = 0.019).

Conclusions: A deliberate strategy to raise students' awareness of caring behaviours and incorporate interactive learning methods into education enhances both caring behaviours and clinical decision-making.

Background: Being a family member to someone who suffers from a serious illness can change one's perspectives about life. A sudden and severe illness can result in a demanding journey that involves acute admission to hospital, intensive care, post-care, and finally, returning home.

Aim: To describe the experience of staying beside a next of kin throughout the healthcare journey, from the onset of illness at home, to the intensive care unit, post-care, and returning home.

Methods: The study employed a qualitative design, with data collected via semi-structured interviews and analysed using reflexive thematic analysis. A purposive sampling was used to recruit participants (n = 14), who had experiences of staying beside a next of kin throughout the healthcare journey from the onset of illness to discharge from the hospital.

Findings: Family members' experiences were captured under the overarching theme Journey through an emotional turmoil and the themes Entering a new world, Continuing the journey towards something unknown, and Striving for the new normal at home. They described going through a non-linear process, characterised by transitions or changes in several aspects. The transitions included shifts in the roles that the family members played, in the various environments they found themselves in, and in the progression of the patient's illness or injury.

Conclusion: The study suggested that family members with a next of kin who experienced life-threatening situations undergo challenging transitions. The informal caregiver role placed on family members of intensive care unit-survivors significantly impacts their lives and the healthcare systems should prioritise providing high-quality support to family members throughout the entire healthcare journey. Elevating the importance of nursing care within the healthcare system can contribute to delivering holistic care and facilitating transitions. Further research should focus on understanding the support that family members perceive as necessary to facilitate their transition and enhance their well-being.

Background: As family members affect patient outcomes following open-heart surgery, the objective was to provide updated knowledge on family involvement in to guide future interventions facilitating family involvement.

Aim: The aim was to explore and describe the experiences and actions of important situations of family involvement asexpressed by patients who underwent elective open-heart surgery in Sweden.

Methodological design and justification: The critical incident technique (CIT) was used, which is a qualitative research method suitable for clinical problems when a phenomenon is known but the experiences and consequences of it are not.

Ethical issues and approval: Considerations for patient integrity were made during the recruitment phase by ensuring that voluntary informed consent was obtained in two steps.

Research methods: Individual interviews were conducted with 35 patients who underwent open-heart surgery in Sweden in 2023. Important situations were analysed according to the CIT method.

Results: Two main areas emerged: Patients described important situations of family involvement as experiences of mutual dependency while also being independent individuals. These experiences led to balancing healing and risk-taking activities as a family. The positive consequences of family involvement described by patients included improved recovery through practical help at home and emotional support.

Conclusions: As complements to preserving the existing positive aspects of family involvement, social support screening, the establishment of individualised visitation policies and the provision of professional and peer support earlier can improve patient recovery following open-heart surgery.

Background: Persons suffering from a substance use disorder (SUD) in need of help from low-threshold centres have complex and severe conditions together with uncontrolled use of mainly illicit substances. Their sufferings are all-encompassing and demand ethically aware nurses with competence to take care of somatic, existential and spiritual needs.

Aim: To explore and describe a new understanding of the ethical and ontological values upon which nurses base their work when caring for persons suffering from SUD.

Methodology: The study had a hermeneutical approach. A focus-group interview was conducted with five nurses working at a low-threshold centre in Norway. Data analysis was carried out through a hermeneutical reading based on Gadamer's hermeneutics.

Ethical considerations: The study was approved by the Norwegian Agency for Shared Services in Education and Research (SIKT). Oral and written consent was obtained from the participants.

Results: The hermeneutical reading revealed three dimensions; A wish to be useful; Nurses' motive for caring for persons suffering from SUD is a wish to be useful and needed. Nurses are fighting a battle against injustice and stigmatisation. Neighbourly love, the core value; Neighbourly love serves as the basis for the nurses` work. Nurses feel humble towards their clients, they feel privileged to have the opportunity to help others through compassionate care. The value of being clients` advocate; Nurses are trying to ensure that clients receive the help they need. A large part of nurses` job is to monitor and take care of the clients` condition. This involves working close to death, trying to save lives.

Conclusion: Nurses wish to care in accordance with their ethos of usefulness. Sacrifice stands out as the ultimate form of neighbourly love, empowering nurses with moral authority to act as advocates for their clients.

Background: Patient involvement in the interdisciplinary bedside round (IBR) increases care quality and safety but is influenced and perceived differently by different round participants. Nursing and medical students are still not structurally embedded in the healthcare system, and they participate in interdisciplinary bedside rounds for educational purposes. Thus, the students may give a valuable perspective on patient involvement from the 'outside view'.

Aim: This study aimed to describe nursing and medical students' perceptions of patient involvement in IBRs.

Methods: This study has a qualitative design with individual interviews. Eighteen informants were recruited with the help of gatekeepers from two sites in Sweden: a university training health clinic and a county hospital. They participated in one-to-one semi-structured interviews, which were analysed with an inductive qualitative content analysis approach.

Ethical issues and approval: The study has been approved by the Swedish Ethical Review Authority. Informed consent was received from all participants.

Results: The results yielded five categories. Two sub-themes and one theme of meaning emerged as a 'red thread' across the categories. The theme of meaning was: 'In hospital rounds, the patient is a respected guest, but with a disadvantaged "alien status" due to the hosts' difficult medical language and unclear routines'. Students perceive patients are not fully involved in IBRs, and the healthcare team controls this involvement due to patients' lack of knowledge and vulnerability, the hectic hospital environment, and complicated medical language. Doctors lead IBRs and encourage or discourage patient involvement and nurses act as patient advocates, supporting their involvement.

Conclusions: According to nursing and medical students, patients are seldom involved in IBRs due to multiple interaction barriers and despite communicational facilitators. Their involvement depends on healthcare professionals. Further research should investigate other IBRs stakeholders' perspectives on patient involvement in IBRs to facilitate it.

Background: Parents' low health literacy (HL) has negative impacts on child health. Parental interventions may improve parents' HL and thus impact child health positively.

Objectives: This study aimed to gain knowledge about associations between parents' comprehensive HL (CHL) and child health after an extended postnatal home visiting program in Swedish multicultural, disadvantaged settings compared to parents receiving regular child healthcare (CHC).

Materials and methods: This quasi-experimental study used a case-control sampling method to recruit first-time parents through two CHC centres in Stockholm (2017-2020). Participants (N = 151) were interviewed twice through structured questionnaires when their child was <2 months and 15-18 months old. HLS-EU-Q16 assessed parents' CHL. Children's medical records (0-18 months) were reviewed regarding breastfeeding, children's exposure to smoking, language development and healthcare utilisation. Data were analysed with regression models and non-parametric tests.

Results: No significant association was found between parents' CHL and child health. However, significantly fewer unplanned visits to the CHC centre were observed among children (0-18 months) in the intervention group irrespective of CHL, compared with children to parents with improved CHL in the comparison group (F = 3.856, p = 0.011).

Conclusions: Postnatal home visiting interventions practicing proportional universalism and family-centred care may reduce unplanned visits within CHC in disadvantaged settings despite parents' CHL. Further studies with long-term follow-up are suggested to explore associations between parents' CHL and child health.

Trial registration: As a clinical study (not a clinical trial) with appropriate ethical permission with participants' consents, this study was retrospectively registered (18 February 2020) in the ISRCTN registry (ISRCTN10336603).

Background: The visibility of skin lesions significantly burdens people with psoriasis, leading to social hostility and numerous emotional and psychological problems. These issues adversely affect self-esteem, can result in chronic mental health challenges and cause numerous life problems. This study aimed to explore patients' long-term experiences with severe psoriasis.

Methods: A qualitative study was conducted with 20 patients with psoriasis (PASI ≥12) recruited from general and specialist dermatology practices in a regional teaching hospital in Taiwan. Interviews lasted 60-90 min and data were analysed using content analysis.

Findings: A core theme emerged: 'Embodied suffering-life worse than death'. This overarching concept comprised three interrelated themes: (i) Experiencing physical suffering, (ii) Experiencing psychological suffering and (iii) Experiencing the stigma of suffering.

Conclusion: This study highlights the holistic nature of suffering among individuals with severe psoriasis. It emphasises the need for healthcare professionals to consider the entirety of a patient's circumstances when addressing their suffering.