Scandinavian Journal of Caring Sciences最新文献

Background: Evolving healthcare needs require more technical and specialised care. However, a holistic and empathetic approach remained a nursing priority. Innovative and complementary solutions were implemented in clinical practice, such as Caring Contact. While research has primarily focused on the impact of physical contact, the combined physical and psychological connection between nurses and patients, defined as Caring Contact, has been less explored.

Aims: To identify and synthesise the current knowledge on caring contact, as a physical and mental intentional gesture performed by nurses and to define its benefits in terms of healthcare outcomes, such as pain, anxiety, stress, relaxation and patient satisfaction.

Method: From 2000 and 2024, a mixed-methods systematic review was conducted on PubMed, SCOPUS and the Cochrane Library. The Joanna Briggs Institute (JBI) methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist guided the review. A convergent-integrated approach was chosen to analyse and combine data.

Results: Nine studies were included in the review, with participants consisting of patients, nurses and caregivers. Caring contact influenced patients when provided in touch interactions during nursing care and specific sessions. The benefits of caring contact were the reductions in pain, anxiety, stress, along with increased tranquillity, comfort, relaxation and complete well-being. Patients reported higher satisfaction with nursing care and improved communication and relationship with their nurses, and caregivers and nurses benefited from caring contact.

Limitations: The small number of studies that met the inclusion criteria, along with the heterogeneity in the evaluated outcomes and described techniques, made it difficult to generalise the results.

Conclusion: Caring Contact is an essential component of nursing. This literature review showed that it improves communication, the nurse-patient relationship and patients' satisfaction. Although these benefits exist, future research should focus on overcoming the heterogeneity of the interventions and examining patient and nursing outcomes.

Objective: This study aimed to evaluate the application of anticipatory nursing care in pulmonary embolism (PE) and its impact on treatment adherence.

Methods: This was a randomised controlled trial. Seventy patients diagnosed with PE were randomly divided into two groups (n = 35 each). The control group received standard nursing care, while the observation group received anticipatory nursing care (this is proactive care that nurses provide by predicting and preparing for potential health issues or needs of patients before they arise). The outcomes compared between both groups included vital sign levels (diastolic blood pressure, systolic blood pressure, respiratory rate, heart rate), clinically relevant time parameters (time to thrombolytic therapy, length of hospital stay), Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), treatment adherence, incidence of complications, quality of life (physical pain, physiological function, social function, mental health) and nursing care quality (nursing attitude, psychological support, management measures and technical skills).

Results: After nursing, the observation group demonstrated lower blood pressure (diastolic blood pressure: 90.54 ± 4.22 vs. 93.66 ± 4.15 mmHg; systolic blood pressure: 129.00 ± 3.14 vs. 135.46 ± 4.02 mmHg), respiratory rate (18.54 ± 2.41 vs. 22.17 ± 2.48 breaths/min), and heart rate (88.20 ± 3.14 vs. 90.54 ± 3.14), shorter time to thrombolytic therapy (5.31 ± 1.10 vs. 5.86 ± 1.00 days) and length of hospital stay (11.20 ± 1.94 vs. 15.09 ± 2.05 days), lower SAS (40.89 ± 3.47 vs. 44.49 ± 4.18 points) and SDS (39.46 ± 3.45 vs. 34.86 ± 3.24 points) scores, higher treatment adherence (97.14% vs. 71.43%), and higher scores of quality of life (physical pain: 80.57 ± 4.16 vs. 77.14 ± 4.19 points; physiological function: 79.94 ± 5.22 vs. 76.83 ± 5.55 points; social function: 80.20 ± 5.37 vs. 75.54 ± 5.52 points; mental health: 77.69 ± 5.32 vs. 72.71 ± 5.47 points) and nursing care quality (nursing attitude: 81.37 ± 4.84 vs. 77.57 ± 5.20 points; psychological support: 74.95 ± 4.28 vs. 66.28 ± 4.46 points; management measures: 83.52 ± 3.20 vs. 75.49 ± 4.42 points; technical skills: 88.11 ± 3.13 vs. 79.65 ± 3.05 points) compared to the control group (p < 0.05).

Conclusion: Anticipatory nursing care enhances treatment adherence and improves the quality of life in PE patients.

Introduction: A cancer diagnosis may have negative consequences on family members' health and well-being. Although support for family members has been stressed for decades, family members continue to report unmet needs for support. Suggested explanations are the lack of individualisation and the lack of implementation. Therefore, the overall aim of this project is to develop and evaluate a support model for individualised support in routine cancer care. The objective of this paper is to describe the support model's development and validation.

Method: To address the complex phenomenon of offering individualised support for family members in routine cancer care, we applied a dynamic multi-method approach, guided by the Medical Research Council's Framework for Development and Evaluation of Complex Interventions. The support model was developed with healthcare professionals, family members, and stakeholders to ensure relevance and applicability. The development and validation involved a literature review, qualitative interviews, and repeated consultations. Ethical approval and written informed consent were obtained.

Results: The FamCASP support model is a nurse-led, interprofessional model for structured yet individualised support for family members to prevent cancer-related illnesses in routine cancer care. It consists of two parts-one generic model and diagnosis-specific modules-and is adaptable to local contexts and allows for the integration of existing support.

Limitations: Throughout the support model development, local (national) fit was emphasised, which may limit international application. Further, to this date, only one diagnose-specific module has been developed (colorectal cancer). Hence, the applicability of the support model in other contexts needs further exploration.

Conclusion: Through concurrent consideration of family members' needs and prerequisites for support in routine care, a tailored support model was developed and assessed as relevant, usable and implementable by healthcare professionals, family members and stakeholders. Evaluations of feasibility and effectiveness are warranted prior to implementation.

Aims and objectives: To evaluate the outcomes and acceptability of the Community-based Participatory Occupational Well-being Intervention for Educators.

Methodological design and justification: This pilot study used a sequential explanatory mixed-method intervention study design in which the post-intervention qualitative data were embedded in the quasi-experimental pre-test-post-test data to explain and expand the intervention outcomes and to evaluate intervention acceptability.

Ethical issues and approval: This study received an ethical statement from the UEF Committee on Research Ethics (7/2021 15.4.2021) and followed the ethical principles of the Declaration of Helsinki.

Research methods and intervention: The quantitative pre-and post-test data were collected using an electronic questionnaire among health care educators (intervention n = 19, comparison n = 22). The 1-year intervention included (i) an online course, formation of (ii) an occupational well-being development team, which (iii) planned and (iv) implemented community-specific development actions. Qualitative interview data were collected from participants (n = 9) 3 months post-intervention. The quantitative data were analysed statistically and the qualitative data by deductive-inductive content analysis. The main results were merged into a joint display as mixed-method meta-inferences.

Results: Positive changes were found in occupational well-being, promoting activities and workplace support. Educators experienced improvements in work organisation processes and reflection on occupational well-being issues. The study found no significant change in the overall self-assessed level of occupational well-being. The intervention framework was considered functional, with workload issues as the main barriers.

Study limitations: The main limitations of this study were a small sample size and a long intervention period, which challenged participant engagement and outcome evaluation.

Conclusions: The intervention enables community-level occupational well-being development, and it can be applied in health care educators' work communities. The study suggests refining the intervention in terms of information provision, time resources and community-level orientation and discussion.

Aims and objectives: To explore the experiences of elderly medical patients shortly after an unplanned emergency department readmission and the perceived value of health care encounters.

Background: Elderly medical patients are often frail, have multiple health issues and are at risk for (re)admissions, loss of function, morbidity, and mortality. Elderly people are frequently admitted for a shorter time.

Design: This study employed a qualitative design and was conducted at a 700-bed university hospital in Copenhagen, Denmark.

Methods: A purposeful sampling included 10 readmitted medical patients over 65 years, admitted for less than 72 h. In-depth qualitative study within the phenomenological-hermeneutical research tradition, drawing analytical inspiration from Interpretative Phenomenological Analysis.

Results: The analysis identified three main themes. Patients experience powerlessness and system-dependence in their attempt to navigate the healthcare system and are in need of clarification in relation to the acute readmissions. Patients described being in a life circumstance where they constantly had to balance acute and chronic disease(s).

Conclusions: Elderly readmitted patients are highly dependent on the randomness of support related to acute healthcare encounters and a supportive network. Lack of health clarification can provoke a negative spiral of disempowerment and lower the threshold for acute health care seeking.

Relevance to clinical practice: Identifying and understanding the perceived value of a readmission is essential to prevent unplanned readmission and guide healthcare professionals in enhancing the quality of care.

Reporting method: COREQ checklist.

Patients or public contributing: Elderly readmitted patients were involved in the study as participants providing the research data. WHAT DOES THIS PAPER CONTRIBUTE TO THE WIDER GLOBAL CLINICAL COMMUNITY?: This study illustrates how the organisation and flow culture in the emergency departments are inadequate to meet the multiple health issues of elderly medical patients, where the separation of acute and chronic illness may be blurred. This study describes the experienced consequences of missed care and how patients are having deep trouble connecting value of the acute hospitalisation to their overall health situation, leaving them in a debilitating dilemma in need of clarification. Elderly medical patients exposed to a varying degree of belonging to a personal network may be vulnerable to disempowerment and dependent on a system that does not accommodate their expectations or needs.

Trial registration: The study was approved by the Danish ethical committee protocol number: 17006481 and the regional governance AHH no. 2017028-is-suite no. 05367.

Background: Receiving qualified and safe maternity care enables the early detection and prevention of potential complications in all stages of childbirth for both mother and newborn. Despite ongoing advancements in safe motherhood practices, a standardised instrument to evaluate healthcare professionals' competencies in this domain remains uncharted territory.

Aim: The aim of the study was to develop the Safe Motherhood Scale and to evaluate its validity and reliability.

Methods: This methodological study was conducted online with 341 participants through social media platforms and internet-based channels between March 15 and June 30, 2025. The data collection tools of the study included a Personal Information Form and the Safe Motherhood Scale (for healthcare professionals) were used. An item pool was developed based on a comprehensive literature review, and analyses for content and construct validity were performed. For reliability analyses, Cronbach's alpha, item-total score correlations and the test-retest method were employed. Statistical significance was determined at the p < 0.05 level.

Results: The statistical analyses indicated that the Safe Motherhood Scale, comprising 22-item and four subscales, is a valid and reliable measurement instrument. Exploratory factor analysis yielded a Kaiser-Meyer-Olkin (KMO) value of 0.83. Confirmatory factor analysis results indicated acceptable model fit indices: CMIN/DF = 2.05, GFI = 0.77, TLI = 0.77, CFI = 0.80 and RMSEA = 0.09 (90% CI [0.081, 0.107]). The Cronbach's alpha coefficient for the overall scale was 0.81.

Conclusion: The Safe Motherhood Scale has been established as a valid and reliable instrument for assessing healthcare professionals' competencies in implementing safe motherhood practices. The scale is recommended for use in various areas, including the evaluation of safe motherhood services, identification of areas for improvement and assessment of healthcare professionals' training needs.

Aims and objectives: To identify the elements of safety for older individuals living at home and how they describe safety as a lived experience.

Methodological design and justification: The research design was based on a phenomenological inquiry. The narratives were older individuals' own experiences of safety at home.

Ethical issues and approval: The study followed Finnish law and the European Code of Conduct for Research Integrity. The university committee of ethics gave ethical approval, and permission to conduct the study was granted from one wellbeing services county.

Research methods: Ricœur's Hermeneutic Phenomenological Analysis method was used to examine 16 older individuals' life experience of safety at home. The data was collected using a semi-structured interview framework and two structured instruments.

Results: Safety at home was expressed in many ways as being safe, living safely, and having a safe feeling with other people and most often in a positive manner. Older individuals' narratives of safety related to safe living in one's own home; being able to take care of oneself; reminiscing and longing; living at home is meaningful and valuable; changes in physical functioning; getting help from homecare and others.

Study limitations: The selection of participants was approached by homecare professionals and contact persons, who recruited older individuals to participate in the study. Whilst the inclusion criteria were known, the selection time was short, so not all potential participants were reached within this time.

Conclusions: For older individuals, safety at home means prerequisites for their daily life, including their unique perspectives and lived experiences. There is a need to explore diverse cultural contexts and employ longitudinal approaches to investigate how factors such as closeness to nature or social isolation contribute to older individuals' experiences of safety in their living environment.

Objective: This paper aimed at ascertaining whether a Plan-Do-Check-Act (PDCA) nursing model improves treatment adherence and reduces hospital-acquired infections (HAIs) in elderly patients with bronchopneumonia.

Methods: Eighty-eight inpatients with senile bronchopneumonia were randomly assigned to two groups. The control group (n = 44) received standard therapy plus routine nursing; the observation group (n = 44) received the same care augmented by a PDCA-based nursing programme. Outcomes were assessed before and after nursing and included adherence ratings, clinical recovery indicators (length of stay; time to resolution of cough, sputum, pulmonary moist rales and dyspnoea), pulmonary function indices (FEV1, PEER, FVC), ward hygiene compliance metrics and HAI incidence.

Results: Post-nursing, adherence in the observation group improved markedly and exceeded that of controls; patients rated as having good adherence increased from 15.91% to 56.82%, whereas the poor-adherence category fell from 50.00% to 2.27%. Times to disappearance of cough, sputum, moist rales, and dyspnoea, as well as length of stay, were all shorter than in the control group (all p < 0.05). Both groups showed gains in FEV1, PEER, and FVC after nursing (p < 0.05), with the observation group achieving significantly higher values at follow-up (p < 0.001). Ward-level compliance-equipment cleaning, staff hygiene, environmental/air quality, cleaning-disinfection quality and knowledge of infection prevention-was superior in the observation group (all p < 0.05). The HAI rate was lower with PDCA (3/44, 6.82%) than with routine care (11/44, 25.00%; p < 0.05).

Conclusion: Implementation of PDCA-based nursing in older adults with bronchopneumonia led to clinically meaningful benefits-accelerated symptom relief, enhanced adherence, measurable gains in lung function, improved ward hygiene compliance and reduced nosocomial infections.

Background: Enhancing patient safety involves identifying key factors and applying preventive strategies. While clinical competency, professional values and safety culture are recognised as important, the mediating role of patient-centred communication in promoting safety-care activities remains underexplored.

Aim: This study aimed to identify factors influencing safety-care activities among hospital nurses, with patient-centred communication competency as a mediator.

Methods: A correlational survey design was employed, involving 308 nurses with a minimum of 6 months of clinical experience at university hospitals. Data were collected between March and December 2022 and analysed using structural equation modelling with IBM SPSS 26.0 and AMOS 26.0.

Results: Most participants were female (93.8%) and single (84.4%), with an average of 5 years of clinical experience. Clinical competency, professional values, awareness of safety culture and patient-centred communication competency collectively explained 36% of the variance in safety-care activities. Patient-centred communication competency demonstrated a significant indirect effect (β = 0.04, 95% CI [0.01, 0.07]), supporting its mediating role.

Conclusions: Clinical competency, awareness of safety culture and patient-centred communication competency were significant predictors of safety-care activities. The mediating role of communication highlights its importance in translating values into safety-care practice. Future research should examine broader organisational and cultural influences to strengthen the model's applicability across diverse healthcare settings.