Scandinavian Journal of Caring Sciences最新文献

Aim: This scoping review aims to describe the literature about the experiences of family caregivers and persons living with dementia transitioning into residential care facilities; and to identify missed opportunities for occupational therapy to support this transition.

Methods: The methodological framework proposed by Arksey and O'Malley guided the review. Six electronic databases were systematically searched for peer-reviewed studies published between Jan 2017 and June 2024 including people with dementia aged 65+ years prior to, during and post-admission to a residential care facility and/or family caregiver.

Results: Twenty-three studies met the inclusion criteria, reporting research from Australia, Europe and North America. Family caregivers and people with dementia face multiple challenges prior to, during, and after admission to a residential care facility. Four overarching themes were identified; (1) Factors during the transition process with two subthemes: caregiver perceptions and heightened emotions; (2) Trying to get help; (3) Effectiveness of transition interventions; and (4) Unmet needs. Families feel overwhelmed, uncertainty about accessing residential care, guilt about relinquishing care and role loss post-admission. Persons living with dementia report experiencing a loss of autonomy and connection with their family, staff and co-residents. The understanding of dynamics and relationships during transitions can impact health and well-being, highlighting the importance of tailored support from various healthcare professionals, including occupational therapists.

Conclusion: Findings suggest that the transition into a residential care facility is complex and filled with emotional, psychological, familial and functional changes. Navigating these changes represents a unique opportunity for occupational therapists to utilise their distinctive skill set to navigate this transition and support the health and well-being of caregivers and persons living with dementia.

Background: The aim of heart transplantation is prolonged survival and improved quality of life. Chronic pain is a common and distressing symptom after heart transplantation. To our knowledge, there are no person-centred interventions aimed at chronic pain and symptom distress after heart transplantation. The aim was to assess the feasibility and acceptability of systematic, person-centred symptom management support for heart recipients with chronic pain to reduce symptom distress.

Methods: A mixed method prospective pilot feasibility study. A one-group, pre-test/post-test design examined the effect of a symptom management support intervention by means of three consecutive 1-h person-centred supportive conversations about the heart recipient's experienced ability to manage her or his symptoms, self-efficacy and transplant-specific well-being. In total, 13 participants completed the intervention, 7 women and 6 men, with a mean age of 54.38 years. The feasibility was evaluated by semi-structured interviews analysed after the intervention in accordance with phenomenological hermeneutics, while four different instruments were used to quantitatively evaluate pain, self-efficacy, person-centeredness and transplant-specific well-being both before and after the intervention.

Results: The intervention constituted a profound experience of being taken seriously based on four themes. The heart recipients experienced both sameness and otherness through reduced asymmetry in the caring encounter; thus, their dignity as persons capable of interpreting their own health was restored. Transplant-specific well-being improved clinically after the intervention, while basic activities of daily life improved significantly (p = 0.014). Although there was no change in self-efficacy, the self-rated experience of being taken seriously improved. There was a moderate relationship between transplant-specific well-being and self-efficacy before the intervention, rho 0.52 (p = 0.066) and a strong relationship after the intervention, rho 0.84 (p = 0.001).

Conclusion: Three 1-h consecutive person-centred conversations to support symptom management after heart transplantation constitute a relevant, feasible and effective intervention.

Background: The theory of human caring is essential as a guiding framework in nursing practice. The theory prioritises the humanistic aspects of healing and well-being. However, none of the studies have applied this theory to developing concepts for pressure ulcer (PU) care.

Aim: This study aimed to develop a concept of PU care based on the theory of human caring.

Method: This study utilised Walker and Avant's approach along with Watson's theory of human caring. A review of English-language publications from 2000 to 2024 was conducted across multiple databases, including Scopus, PubMed, ProQuest, CINAHL, SAGE Journals, SpringerLink and Google Scholar.

Results: The study proposed an operational definition of PU care based on Watson's theory of human caring. The theory's carative factors were integrated to enhance wound healing. This model provides a meaningful philosophical foundation and emphasises the holistic unity of mind, body and spirit in relation to the PU care.

Conclusion: The model encourages nurses to move beyond technical proficiency and integrate the art of caring into their practice. Additionally, close collaboration among healthcare professionals, families and patients is essential for delivering efficient and effective care.

Aims and objectives: To describe first-line managers' (FLMs) views of the challenges faced by staff when encountering older people's existential concerns in home and residential care.

Methodological design and justification: This cross-sectional study uses a combination of qualitative and quantitative methods.

Ethical issues and approval: The study was approved by the Swedish Ethical Review Authority (ref. number 2014/652 ) and followed the guidelines of the Helsinki Declaration.

Research methods: FLMs in home and residential care were randomly selected and invited to participate. A self-administered questionnaire was distributed online to 467 managers, 136 (29%) of whom completed it.

Results: About 80% of the FLMs reported that their staff members sometimes or frequently had conversations with the older people in their care about existential concerns, including the following topics: thoughts and feelings about meaning in life; losses and longing for meaningful relations; death, fears and uncertainty and supporting meaningful everyday life. About 75% of the managers also reported that their staff sometimes or often had conversations about existential concerns with one another. Major hindrances to existential conversations were reportedly cognitive impairment and aphasia among the older people and insecurity and unwillingness among the staff. Most managers (73%) reported that their staff received support when encountering existential concerns, mostly as individual support from managers or registered nurses.

Study limitations: The main limitation of this study is its low response rate, which is common for digital surveys. Nevertheless, the sample is considered to be representative; therefore, the study holds exploratory value.

Conclusion: Regular conversations among staff, improved conversational skills and the ability to listen reflect on and perceive older people's perspective and life world are needed when encountering older people's existential concerns. FLMs play a crucial role in emphasising and planning staff support on a regular basis.

Background: Compared to children or older adults, young adults (age 18-29) who undergo liver transplantation are more likely to have poor psychological health and a higher risk of graft failure. Understanding patient needs and perspectives is important for caring for young adults and improving long-term health outcomes.

Aims and objectives: To (1) understand young liver recipients' experiences, needs and views throughout the transplantation process and (2) identify possible improvements in their care.

Methodological design and justification: Three focus group interviews were conducted to investigate young people's experiences.

Ethical issues and approval: The study was performed in compliance with the Helsinki Declaration and was approved by the Danish Data Protection Agency (P-2020-559).

Research methods: Ten young liver recipients (aged 19-34) who had received a liver transplantation aged 18-29 at Rigshospitalet, Copenhagen University Hospital, Denmark were divided into three focus groups. The focus groups were carried out and transcribed.

Instruments and/or interventions: We have adhered to relevant EQUATOR guidelines in accordance with COREQ.

Results: Data was analysed thematically. We identified three main themes: (1) Balancing illness and youth, (2) Being mentally resourceful and (3) Facing a new kind of chronic illness. We found that young liver recipients struggled with the conflict between youth and chronic illness, even after transplantation. To address this, they emphasised the need for more age-appropriate information and improved mental support from healthcare professionals or peers.

Study limitations: Because liver transplantation is a rare outcome, especially among the younger population, this study could include only a small group of participants.

Conclusion: Our findings indicate that young liver transplant recipients are a vulnerable group who would benefit from specialised care, emphasising mental support before and after the transplant, along with transparent and honest communication.

Background: The rising prevalence of multi-morbidity increases treatment complexity and caregiving demands, often necessitating involvement of family members as informal caregivers. While essential, this involvement can be burdensome, causing distress for family members. Shared decision-making facilitates communication and supports the alignment of patients' and families' preferences and needs with care and treatment decisions. Involving family during patient hospitalisation can be essential as the whole family is affected by illness.

Aim: This project aimed to develop and test a decision aid to systematise family involvement during patient hospitalisation.

Research methods: The project was based on the theoretical framework of family nursing, and the Danish Patient Decision Aid template guided the process. The decision options, pros and cons were based on 22 patient and 16 family interviews, which were thematically analysed. Six patients, two family members and nine healthcare professionals alpha tested the decision-aid prototype, which was later beta tested in real-life clinical settings at five internal medical wards.

Findings: Three themes emerged: (A) 'involving family when needed', (B) 'waiting for ward rounds' and (C) 'involving family with technology', informing the decision-aid prototype which consisted of five option cards: (1) 'I will involve my family myself', (2) 'I do not want to involve my family', (3) 'Family wants to be present physically', (4) 'Family wants to participate by phone' and (5) 'Family wants to participate by video'. The cards included pros/cons of each option. Alpha testing showed high acceptability and usability, and no alterations were made to the prototype.

Conclusion: The structured patient decision aid enabled a systematic approach to involve the patient's family. It facilitated meaningful conversations between healthcare professionals, patients and family members. The decision aid identified and addressed patients' and family members' specific needs and preferences during hospitalisation.

Background: In a changing world where populations are ageing and older people need assistance to live at home, caring for an older relative can be challenging and have various consequences for caregivers.

Methods: In this cross-sectional study, caregiver distress in six European countries-Iceland, Belgium, Finland, Germany, Italy and the Netherlands-was examined and compared. The study aimed to determine the prevalence of distress among caregivers of older people receiving home care in these six countries and identify if factors related to the older person's condition, such as health or function, predict it. The analysis drew on data collected from 2014 to 2016 for the IBenC study (Identifying Best Practices for care-dependent elderly by Benchmarking Costs and Outcomes of Community Care), using the interRAI-Home Care (HC) instrument. A total of 2884 home care clients > 65 years from the six countries participated in the study. Descriptive statistics indicated the characteristics of the sample, and bivariate and multivariate logistic regression models established predictive independent variables for caregiver distress.

Results: The percentage of caregiver distress was highest among Icelandic caregivers (34%). In the other countries, it varied from 9% to 22% and was lowest in Finland. Caregivers of clients with signs of depression, clients who have bladder incontinence or who had stayed in hospital in the last 90 days were more likely to experience caregiver distress. Caregiver distress was more prevalent if a client was at risk of severe health decline and had increased care needs.

Conclusion: Using data from interRAI-HC assessments makes it possible to relate indications of caregiver distress to the characteristics of the older person cared for. Hence, improving their condition might have favourable effects on caregivers. Alertness to caregiver distress is crucial.

Aim: This study examined how the difficulties experienced by palliative care nurses while providing care affect the quality of palliative care perceived by nurses.

Background: The increase in chronic diseases with the ageing population has brought about a greater need for palliative care. Palliative care nurses play a central role in improving patients' quality of life, while also facing emotional and physical challenges. The impact of these challenges on nurses' job satisfaction and the quality of care provided constitutes a critical area of research for understanding the effectiveness of palliative care services.

Method: The study was conducted in a descriptive, cross-sectional and correlational design with nurses working in palliative care services (N = 243) in Türkiye between October 2023 and March 2024. The data were collected through an introductory form, The Palliative Nursing Care Quality Scale and the Palliative Care Difficulties Scale. The relationship between the two variables was examined using Pearson correlation analysis, while the impact of palliative care challenges and education level on perceived palliative care quality was investigated through multiple linear regression analysis.

Results: In this study, the data were normally distributed and it was found that the nurses' total mean score was 72.42 ± 8.26 (min: 18-max: 90) on the Palliative Nursing Care Quality Scale and 40.85 ± 10.50 (min: 15-max: 75) on the Palliative Care Difficulties Scale. Total mean palliative care quality score was found to be significantly higher among nurses with postgraduate degrees. Moreover, the palliative care difficulty scores were significantly higher for males, nurses with palliative experience of 1 year or less, and those who did not select the palliative care unit willingly. A negative correlation was observed between the nurses' quality of palliative care and their palliative care difficulties.

Conclusion: It was seen that perceived quality of palliative care decreased as the difficulties encountered in palliative care increased. It is recommended to develop training programmes tailored for nurses and ensure continuous professional development to reduce the difficulties nurses face in palliative care and enhance the perceived quality of palliative care.

Background: According to the community-based model, caregivers play a major role in the care of patients with chronic mental illness. However, caregivers have little time to attend to their own health needs and tend to ignore their health. Caregivers with healthy lifestyle behaviours are likely to achieve greater physical and psychological well-being.

Aim: This study aims to assess the healthy lifestyle behaviours and associated factors for the caregivers of patients with chronic mental illnesses.

Methods: This cross-sectional study was conducted at the psychiatry outpatient clinic of a hospital in Northwest Turkey, and the sample consisted of 122 caregivers. Data were collected using both a personal information form and the Healthy Lifestyle Behaviours Scale II.

Results: The Healthy Lifestyle Behaviours Scale II score of the caregivers was 124.37 ± 28.02. The mean total Healthy Lifestyle Behaviour Score significantly varied depending on the caregiver's education level, income, caregiving experience and burnout experiences, the number of psychiatric hospitalisations of their patients in their lifetime and the perceived financial impact and social impact of their care (p < 0.05).

Conclusion: The results suggest that psychiatric nurses should play a more active role in protecting and improving caregivers' health and well-being by developing psychoeducational programmes that could help caregivers adopt healthy lifestyle behaviours.