Scandinavian Journal of Caring Sciences最新文献

Aim: This study aimed to explore nursing personnel's health while working in end-of-life care.

Introduction: End-of-life care is challenging both for nursing personnel and for the healthcare organisation, as retaining nursing staff is difficult. Although end-of-life care involves the risk of burnout, it also encompasses protective factors that can lead to personal and professional development and satisfaction, and that can enable personnel to encounter their own inner selves. In order to focus on the health of nursing personnel we chose the theory of caritative caring as our theoretical perspective.

Method: A qualitative inductive research design with a hermeneutical approach was chosen to explore nursing personnel's health while working in end-of-life care. Two assistant nurses and six registered nurses with experience in end-of-life care at a palliative care unit participated. The study was approved by a Regional Ethical Review Board.

Results: The results are presented on three levels: rational, structural and existential. In the rational level, fellowship and togetherness with colleagues, as well as being able to distinguish between private life and work were important for nursing personnel's strategies for maintaining their health. At the structural level, social togetherness, sharing emotions and being involved in each other's emotions were important for nursing personnel's health. The existential level showed that the nursing personnel's own existential situation was affected when their inner self was emotionally affected by the patients' suffering. The awareness of suffering, life and death made the nursing personnel feel inner security, both as nursing professionals and as human beings.

Conclusion: A common perspective based on a theory of caritative care may be helpful for retaining nursing personnel. While the study highlights nursing personnel's health while working in an end-of-life care context, the results may also be applicable to nursing professionals' health in other contexts.

Background: During the developmental transition from childhood to adulthood, young people living with type 1 diabetes (T1D) are more likely to take less care of their chronic disease. Alongside the developmental transition, young people with T1D also experience an organisational transition in which the care responsibility changes from a family-based approach in paediatric care to an individualised approach in adult care. Little is known from the perspective of the young people about what their interactions with the healthcare providers mean during these transitions.

Aim: The aim of this study is to explore how young people living with T1D experience interactions with their care providers, and what it means for their developmental transition.

Method: Semi-structured interviews with 10 respondents aged 18-20 living with T1D who were recruited from a youth outpatient diabetes clinic in Denmark. Recorded audio data were transcribed and analysed using an interpretative phenomenological analysis approach.

Results: Young people experience continuity in the relationship with the diabetes nurse from the paediatric clinic and a personal patient-provider relationship with their well-known and new care providers. This creates a feeling of familiarity and contributes to a seamless transition. The young people express that becoming more involved in diabetes treatment increases their willingness to take more responsibility for their own health. They also express that care providers should support them in managing their diabetes and talk about sensitive topics.

Conclusion: Continuity in the relationship with the diabetes nurse makes the transition from paediatric to adult care more satisfying and seamless. To support the developmental transition, care providers should gradually involve young people more in diabetes management and be supportive as they become more independent during the developmental transition.

Aim: To explore the experiences of family members of adult persons with type 1 diabetes concerning both the approach of healthcare professionals and feelings of alienation in encounters with professional diabetes care.

Methods: A cross-sectional explorative quantitative and qualitative design. The Family Involvement and Alienation Questionnaire-Revised (FIAQ-R), including an open-ended question, was answered by 37 family members of adult persons with type 1 diabetes. Analyses included descriptive statistics and qualitative analysis. The study has received ethical approval.

Results: Family members rated the approach of the healthcare professionals as being somewhat positive and considered that the approach towards them is important. They only felt partially alienated from the professional care. Qualitative data revealed that the family members often lacked direct access to the professional care and that their involvement was dependent on their relationship with the person with diabetes. Findings highlighted that the family members' wish to be involved in the care was sometimes unanswered.

Conclusion: Based on the findings, it is reasonable to stress the importance of considering family members' perspectives and involving them in diabetes care to improve overall patient support.

Background: This paper describes registered nurses' lived experiences of caring relationships in the context of homecare provision for older adults living in Denmark. With the growing ageing population throughout Europe, more older adults will require complex care solutions within already overburdened care systems. This development places demands on the competencies and organisation of homecare nurses, as they become key players in healthcare systems. Fostering caring relationships in homecare is a rewarding and valuable process that enhances the holistic and humanising aspects of caring for older adults. For a caring relationship to be truly caring, we must understand not only the subjective experience of such a relationship but also how it is experienced in relation to and shared with others.

Aim: This study aimed to describe the essential meaning of the phenomenon of caring relationships in homecare for older adults based on the lived experiences of homecare nurses.

Approach and methods: Registered nurses working in homecare for older adults were interviewed, and a phenomenological analysis was conducted according to the methodological principles of the reflective lifeworld research approach.

Findings: The essential meaning of the phenomenon is described as creating an existential and embodied space in which each patient's world is the foundation of caring. The constituents are as follows: caring for the whole person, a sense of 'at-homeness' through trusting 'the other', experiencing continuity as caring and prioritising the time to care.

Conclusion: Caring competence in homecare for older adults relies on a nurse's ability to intertwine physical and existential care needs and articulate them in their daily work. A focus on the phenomenon of caring relationships brings value to and adds an extra layer to the discussion on caring competence.

Aim: The aim of this article was to introduce Fairclough's critical discourse analysis (CDA) in caring and nursing science, to provide a guide on how to perform such an analysis, and to describe the wider context of discourse epistemology.

Design: The article is designed as a methodological paper, including (a) epistemological roots of discourse analysis, (b) an overview of discourse analytical research within caring and nursing science which points out an increased trend, and (c) a guide to conducting a CDA.

Analysis: It is important that discourse analysis is available and accessible to nursing and caring researchers. Through the process of encircling discourses, valuable insight is given into fields that otherwise would be lost or would not be available.

Conclusion: Our summary stance is that discourse analysis as it is presented in this article is strongly advisable for use in nursing and caring sciences.

Background: Knowledge is lacking about the effects of COVID-19 on nursing students' burnout symptoms. Burnout can lead to negative feelings and behaviours towards learning and poor mental health.

Aims: To describe and compare nursing/midwifery students' burnout, explore differences and detect predictors at two time points through COVID-19.

Methods: Students were offered participation in the spring semesters of 2020 and 2021 (N = 2046), during COVID-19. The response rate was 30-33%. By using reliable and valid instruments, the students' stress and burnout were analysed as well as the students' health and perceived support.

Results: Symptoms of academic burnout were higher among 1st and 2nd year BSc students in 2021. On the contrary, 3rd and 4th year students had higher academic and personal burnout than graduate students as well as than 1st and 2nd year students. Regarding academic burnout, 47% of the variability was explained by educational level, support, stress and the interactional effect of stress and support. Collaborational burnout, predicted by the students' educational level and support, explained 7% of the variability in the outcome. Additionally, educational level, and stress, predicted 52% of the variability in personal burnout.

Conclusion: Educators or student counsellors need to facilitate effective learning practices and offer academic support, specifically during 3rd and 4th year to boost helpful coping strategies and handle uncertainty and stressors related to crises such as COVID-19.

Background: Safety in home healthcare has garnered increased attention as more people are receiving care for complex conditions at home. The prerequisites for providing safe care at home differ from those in hospitals. Malnutrition, falls, pressure ulcers and inappropriate medication commonly follow poor risk assessments, causing unnecessary suffering and costs. Therefore, risk prevention in home healthcare needs to be prioritised and studied more closely.

Aim: To describe nurses' experiences of performing risk prevention in municipal home healthcare.

Methods: Qualitative inductive approach, using semi-structured interviews with 10 registered nurses in a municipality in southern Sweden. Data underwent qualitative content analysis.

Findings: The analysis resulted in three main categories and one overarching theme describing nurses' experiences of risk prevention in home healthcare. Getting everyone onboard comprises the categories: Managing safety while respecting the patient's self-determination, which covers patient participation, the strategic importance of respecting different views of risks and information and the fact that healthcare workers are guests in the patient's home. Finding ways to make it work touches upon the relational aspect, including next-of-kin and promoting a common understanding to prevent risks. Being squeezed between resources and requirements refers to ethical dilemmas, teamwork, leadership and organisational prerequisites.

Conclusion: Patient habits, living conditions and limited awareness of risks is a challenge in risk prevention in home healthcare, where patient participation plays a pivotal role. Risk prevention in home healthcare needs to be initiated at an early stage of disease and ageing and should be seen as a process where early health-promoting interventions can prevent the development and accumulation of risks over time. Long-term cross-organisational collaborations and patients' physical, mental and psychosocial conditions also need to be taken into account.

Aim: To analyse how family members participate in hospital inpatient palliative care, and how their participation could be supported.

Methods: This review followed a methodology outlined in the literature for integrative reviews. A literature search supplemented by a manual search was conducted on four electronic databases during 2020 to 2021: PubMed, CINAHL, PsycINFO, and Cochrane Library. A critical appraisal of the included studies was performed, and data were analysed using inductive content analysis.

Results: The literature search resulted in 4990 articles, of which 14 articles were included in this review. Four main categories were identified concerning the participation of family members in hospital inpatient palliative care: participation in the physical care, provision of emotional support, promoting good patient care, and support provided by healthcare professionals for family members' participation. Family members' participation can be supported in different ways, including active communication and adequate information.

Conclusion: Family members' participation in hospital inpatient palliative care has been an important part of palliative care in hospital settings. Family members should be offered the opportunity to participate in patient care, and their presence in the hospital should be accommodated. Research on the topic is still scarce, and future research is needed from different perspectives, including intervention research.

Background: Rehabilitation that supports the individual on the journey back to their usual selves after cancer treatment becomes increasingly important. Studies have shown that a focus on the connection between body and mind might be beneficial. Consequently, Whole Person Care and initiatives that fall in line with this holistic approach to health care, such as a dance-like intervention needs further examination. The aim of this study was to explore the qualitative aspects of 5Rhythms® as experienced by people diagnosed with cancer.

Method: A total of 29 (17 in 2017) participants were recruited through purposeful sampling. Participants underwent one 5Rhythms® session per week for 2 months. This qualitative study with a phenomenological approach used diaries and individual interviews as its methods for data collection. Data were analysed using Giorgi's phenomenological framework and Maurice Merleau-Ponty's theoretical perspectives on phenomenological approaches to the body, perception and consciousness were applied.

Results: Three main themes ('(now) I sense my entire body', 'Something liberating is happening inside my body' and 'We travel together') and five connecting sub-themes were identified through the analysis process.

Conclusion: Participating in 5Rhythms® contributed to reconnecting body and soul during or after battling cancer. It evoked thoughts and feelings of existential matter. Results suggest that participating in 5Rhythms® can assist in personal growth. The benefit of being among peers while on the path to recovery was also illuminated. In regard to rehabilitation, this study underlines the importance of being aware of the connection between body and mind.