Scandinavian Journal of Caring Sciences最新文献

Background: Children have a right to express their opinion on all matters concerning them. For children to be seen as actors in healthcare situations, both the child perspective and the child's perspective are needed.

Aim: To explore child participation in healthcare from the child's perspective through the following questions: Question 1: What is considered participation in healthcare among children aged 3-12 years? Question 2: What factors hinder and promote child participation in healthcare?

Methods: Systematic review reported following PRISMA guidelines. Database search was conducted in MEDLINE, Cumulative Index to Nursing and Allied Health Literature and Web of Science Core Collection, and 28 studies were included in the review. The data were analysed using interpretive data synthesis.

Results: Six themes were identified: Question 1: 1 being able to decide how to act in the situation, 2 communicating with health professionals, 3 being adequately informed, 4 being allowed to make decisions; Question 2: 5 unfamiliar venues, parental obstruction and children's needs not being considered and 6 security, comfort and space.

Conclusion: Child participation in healthcare depends on their perception of the situation and opportunities created for their influence. Decision-making on simple practical matters offers meaningful opportunities to acquire and refine decision-making skills and these decisions are therefore developmentally significant. This review identified a gap in knowledge on pre-school-aged children's preferences in participation in healthcare situations.

Implications for care practices: Children should be recognised as unique individuals and asked about their preferences for participation in healthcare situations. They should be handed over a degree of power, as much as they are able and willing to take. Nurses have a central role in facilitating and encouraging participation by listening to and respecting children's views. Digital communication tools are one way to implement child-centred care and increase children's participation, but more research is needed.

Reporting method: This systematic review was conducted and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology.

Patient or public contribution: No Patient or Public Contribution.

Objective: To identify hoarding disorder (HD) screening scales implemented in primary health care and their features.

Methods: A systematic review was conducted according to the Cochrane Handbook and preferred reporting items for systematic reviews and meta-analyses (PRISMA) recommendations. Indexed articles were searched in PubMed/Medline, Web of Science, Scopus, Virtual Health Library, American Psychological Association PsycInfo, and EMBASE. HD screening scale studies in the primary healthcare scenario were included. The DSM-5 criteria and the interprofessional follow-up by the health team were assessed. The Loney scale was applied to verify the studies' methodological quality.

Results: Seventeen articles and 11 scales were identified for HD screening in primary healthcare; 52.9% of the studies were cross-sectional. DSM-5 criteria were used in 76.5%; 45.4% were self-assessed; 29.4% were informed and followed up by the healthcare team. One study was classified as having good methodological quality.

Conclusion: The findings evidenced several HD screening scales as diagnosis and management tools at the primary healthcare level. However, few studies mentioned their follow-up and the effective contribution of the health team. It seems there is a gap in including social determinants approaches to HD screening.

Aim: To develop solutions to address previously identified barriers for oral care among hospitalised patients.

Background: Oral care is a crucial component of nursing practice, which is to promote patients' overall health. Despite recognising the significance of oral care in nursing, the implementation of effective oral care practice is insufficient. In a previous study, we identified four barriers to oral care. Thus, it is relevant to develop solutions in response to these barriers. To our knowledge, there is a lack of research reporting on sustainable interventions to enhance oral care.

Design: A qualitative study using participatory design methodology developed solutions to enhance oral care for hospitalised patients through collaboration between patients and healthcare professionals.

Methods: A participatory design approach was applied, situated in a phenomenological-hermeneutic epistemology. In total, seven workshops were conducted, with the participation of 7 patients and 55 healthcare professionals. Data analysis was based on systematic text condensation, inspired by Malterud.

Results: The study provided two solutions for increasing knowledge of oral care among healthcare professionals and patients.

Conclusions: A 'goodie bag' was developed to provide patients with knowledge and items for oral care. Individual adjustments are needed to tailor the knowledge to individual information needs, support health literacy and prevent information overload. A solution involving an oral care network of key stakeholders from the hospital wards, facilitated by dental hygienists, was developed to enhance healthcare professionals' knowledge, skills and competencies regarding oral care. A structured way to establish the network is by using Kotter's 8-step change model to prepare clinical practice for change and effectively anchor the network. These solutions embody the core aims of the WHO Global Strategy and Action Plan on Oral Health for 2023-2030.

Impact: The solutions will be tested in clinical practice, followed by an evaluation with patients and healthcare professionals.

Background: Application of palliative care has been emphasised in nursing care. Considering the extent of the concept of palliative care over time and its various definitions, this study was carried out with the aim of explaining the concept of palliative care. The aim of this study was to review scientific articles to check the conceptualization of palliative care. The analysis of the evolutionary concept of Rodgers was used as a guiding framework.

Design: A concept analysis paper.

Methods: Search in databases of MAGIRAN, SIENCEDIRECT, CINAHL and PUBMED using keywords of "Palliative care" along with descriptors of "Nursing" and "Medical" was carried out on the published English and Persian studies between the years 2004 and 2024. The data were analysed according to the stages of Rodgers' conceptual model.

Results: A sample consisting of 45 traces was analysed. Five main features consisting of comprehensive care, supporting the patient and his/her family, clinical decision making based on the patient and his/her family preferences, interdisciplinary coordination of care, and a combination of science and art were identified. In addition to these antecedents, there are some other features as follows: the existence of a need for Palliative care, evidence-based symptom management, awareness of the culture, values, and beliefs of patients, a positive and proactive attitude towards palliative care, dynamic communication and empathy with patients and their families, transparency in the role of the provider of palliative care services, organisational support, identification of adaptation strategies with death, and education based on palliative care. Also, positive and negative outcomes and the related concepts were summarised and discussed.

Conclusion: Palliative care is a comprehensive care and dynamic process that covers all aspects of the client's existence. Sufficient knowledge and experience are required to perform effective palliative care as a clinical skill and qualification. Creating the appropriate substructure in order to educate and develop the skills of palliative care for the core team personnel, especially clinical nurses and physicians, is necessary.

Aim: Post-intensive care syndrome in family (PICS-F) is a complex concept impacting the well-being of patients and their families. Understanding PICS-F is crucial for developing diagnostic criteria and interventions tailored to the needs of these families. However, current definitions are limited, necessitating further exploration. This study aims to advance the understanding of PICS-F through a detailed concept analysis, identifying its key attributes, antecedents, and consequences.

Design: A concept analysis was performed using Walker and Avant's eight-step framework.

Data sources: A systematic literature review across PubMed, Medline, Ovid, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang Data, and the Chinese Science Citation Database included English and Chinese articles published up to 8 May 2024. Key attributes, antecedents, consequences, and empirical referents of PICS-F were identified through qualitative synthesis.

Review methods: Relevant literature was analysed to identify key attributes, antecedents, consequences, and empirical referents of PICS-F through qualitative synthesis.

Results: Of the 7263 reviewed articles, 66 met the inclusion criteria. Six key characteristics of Post-Intensive Care Syndrome in Family were identified: (1) Inclusive definition of family; (2) Onset or worsening of symptoms during ICU admission, transfer, and post-discharge; (3) Emotional and psychological dysfunctions; (4) Physical impairments; (5) Cognitive dysfunctions; and (6) Social dysfunctions. Antecedents included family, patient, and ICU-related factors. Consequences ranged from a decline in health-related quality of life to potential positive outcomes, such as post-traumatic growth.

Conclusion: PICS-F is a multifaceted condition that significantly impacts family members of critically ill patients, encompassing emotional, psychological, physical, cognitive, and social challenges.

Impact: Defining PICS-F enables healthcare professionals to detect and support affected families. Implementing family-centred care and developing specialised interventions can enhance both family and patient outcomes. Furthermore, this analysis highlights the need for training healthcare providers to recognise PICS-F and implement effective care strategies in ICU environments.

Patient or public contribution: This concept analysis did not include any patient or public involvement.

Reporting method: This study utilised the PRISMA reporting checklist.

Background: Shared decision-making aims to ensure that healthcare professionals and patients jointly make decisions regarding the patient's care. However, professionals often find it challenging to implement shared decision-making with older patients who have cognitive impairments or diminished decision-making capacity. Research indicates a significant gap in the understanding of how decision-making processes unfold in prehospital settings.

Aim: The objective of this scoping review was to explore how decision-making involving older patients in acute prehospital situations is characterized.

Design and method: This scoping review is based on the Joanna Briggs Institute's guidelines for scoping reviews and is reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Review (PRISMA-ScR).

Data sources: CINAHL, PubMed, Scopus, PsychINFO and Web of Science were searched to identify relevant studies published between the years 2000 and 2024.

Results: The results are based on 26 studies and indicate that decision-making among older patients is a conditional process, characterised by collaborative support involving the patient, significant others and healthcare professionals. Barriers to this process include hierarchical dynamics, fear of reprisals and uncertainty regarding the risk-benefit ratio. Factors that support decision-making include situationally relevant competence, organisational resources and the presence of specific symptoms and signs.

Conclusion: Shared decision-making with older patients in acute prehospital settings is conditional, often resulting in decisions being made primarily by healthcare professionals. There is considerable room for improvement in how this process is systematically approached. A structured approach is needed-one that assesses the older patient's decision-making capacity, considers the perspectives of family members, and incorporates input from individuals who know the patient well, all while minimizing hierarchical barriers.

Background: Evidence has established that the quality of fluid balance charting is often low, and quality improvement initiatives have had varying success. However, knowledge of the issue from a nursing staff perspective is lacking and has not previously been explored within a Nordic context. This study aimed to explore nursing staff's experiences with fluid balance charting in Denmark and Sweden.

Methods: In this descriptive, qualitative study, data were collected through semi-structured focus group interviews with nurses and healthcare assistants from various clinical departments in Denmark and Sweden. The interviews were analysed using a phenomenological-hermeneutic approach inspired by Paul Ricoeur.

Results: We included 25 nurses and healthcare assistants in eight focus group interviews. We found a notable discrepancy between the perceived importance and accuracy of fluid balance charting. Nursing staff perceived fluid balance charting as a fundamental nursing task and recognized that the quality of charting could directly impact patient outcomes. However, the involvement of multiple persons and high patient-nurse ratios caused nursing staff to experience the charting procedures as beyond their control and consider the results inaccurate. Quality may potentially be enhanced by following routines and responsibilities being clearly established. Digital technologies were suggested as a means of easing workflows.

Conclusion: Although fluid balance charting is perceived as an essential nursing task potentially reducing mortality and morbidity, nursing staff lacked control over charting, which was frequently inaccurate. Enhanced charting procedures may be achieved through consensus on responsibilities, well-established routines and the support of digital technologies.

Background: Patient safety competencies, which encompass the knowledge, skills and attitudes essential for safe healthcare delivery, are both vital and measurable. The Health Professional Education in Patient Safety Survey (H-PEPSS) is a validated instrument, that enables consistent comparison and assessment of these competencies in different countries. Although culturally and linguistically different, Estonia and Norway have comparable healthcare and education systems and a shared focus on strengthening patient safety. Consequently, a need to validate a relevant instrument for assessing patient safety in both contexts was identified.

Objective: To translate, validate and pilot the H-PEPSS for measuring patient safety competencies among nurses in Estonia and Norway.

Methods: A cross-sectional, multicentre study design was employed. The study was conducted in Estonia and Norway, at one university hospital and one higher education institution in each country, during 2021. The study utilised a blinded back-translation technique, cross-cultural adaptation, psychometric validation through confirmatory factor analysis, and pilot testing. There were 438 respondents: 226 from Estonia, including 178 nurses and 48 nursing master's students, and 212 from Norway, including 164 nurses and 48 master's students.

Results: The measurement model of the translated instruments demonstrated a good fit. Convergent validity was confirmed by the variance of indicators and their strong relationship with the construct across all domains. Internal consistency was maintained in all domains, except understanding human and environmental factors in the Norwegian H-PEPSS. Discriminant validity could not be established across all constructs. Both Estonian and Norwegian samples reported having the least confidence in the working in teams domain.

Conclusions: The 16-item H-PEPSS, in its Estonian and Norwegian versions, is a valid and reliable instrument for measuring self-perceived patient safety competencies among nurses in these countries. The study highlights the instrument's applicability across diverse cultural contexts and its potential for comparing patient safety competencies on an international scale.

Objective: To explore what has been published in peer-reviewed journals on patients' experiences of the interpersonal relationship between the patient and the nurse when the patient's health data are remotely monitored in an out-of-clinic setting.

Introduction: Interpersonal relationships are considered a cornerstone in person-centred care and nursing. These relationships can be influenced by context and environment. Remote patient monitoring is increasing within healthcare, with the potential to impact on the relationship between the patient and the nurse. So far, there has been limited knowledge on a general basis of how remotely monitored patients experience this relationship.

Inclusion criteria: Original peer-reviewed studies in English, published year 2014-2024. Patients 18 years and over in an out-of-clinic setting, having their health data collected through remote patient monitoring by nurses exclusively or as part of a multiprofessional team. Patients' experiences/attitudes/perspectives/perceptions of the patient-nurse relationship.

Methods: The research method was based on the Joanna Briggs Institute's method for scoping reviews and the PRISMA checklist for scoping reviews was used when reporting the review. In total, four databases were used in the literature search. Thematic analysis was used for analysing the results.

Results: Out of 9001 articles, 31 studies were included in the review. Thematic analysis resulted in three clusters covering relational aspects and emotional responses of the patient-nurse relationship during remote monitoring. These clusters were Relational aspects of patient-nurse communication and interaction, Emotional aspects of the patient-nurse relationship and Patient participation.

Conclusions: Remote patient monitoring is primarily a human-to-human activity. In general, but not solely, patients perceive positive relational experiences with nurses during remote monitoring. Remote patient monitoring can and should be delivered with a person-centred and ethically aware approach. Thus, the acts and efforts of the monitoring nurse play a central role in providing a positive relationship-based experience during remote patient monitoring.

Purpose: This study aimed to determine the influence of nurses' personal characteristics and attitudes towards evidence-based nursing on caring behaviours in surgical clinics.

Design: Descriptive and regressional study.

Method: The study was conducted with 380 nurses working in surgical clinics using a descriptive regression design. Data were collected using a descriptive characteristics form, the Caring Behaviours Inventory-24 (CBI-24), and the Evidence-Based Nursing Attitude Questionnaire (EBNAQ). Descriptive statistical methods were used to analyse the data, and the Mann-Whitney U test and Kruskal-Wallis test were used for group comparisons. The correlational relationship between the scales was assessed using Pearson correlation analysis. Stepwise multiple linear regression analysis was used to assess the factors influencing all sub-dimensions of the nurses' caring behaviour scale.

Findings: Working as an intensive care nurse was found to positively influence caring behaviour, while having a high school qualification was found to negatively influence it. Sub-dimensions of beliefs and expectations about, and feelings towards, evidence-based care were also found to be associated with caring behaviour.

Conclusion: Surgical nurses' caring behaviours are related to their attitudes towards evidence-based practice.