Scandinavian Journal of Caring Sciences最新文献

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.

Aims and objectives: Initiation of palliative care early in the disease trajectory is beneficial for patients with a life-limiting disease. However, palliative care is still introduced rather late or not at all. Therefore, this study aims to explore barriers and facilitators to early initiation of palliative care as perceived by nurses working on pneumology and nephrology.

Methods: A descriptive interview-based study was conducted from a critical realist perspective until data sufficiency was reached. Fifteen nurses presented and discussed a patient for whom palliative care was initiated too late. Template analysis was conducted to develop themes and subthemes.

Results: Five key themes were extracted: (1) communication, (2) fear, (3) personal beliefs about life and death, (4) ambiguity in terminology and (5) workload and time pressure. Barriers related to poor interdisciplinary communication were therapeutic obstinance, hierarchy, unawareness of the patient's wishes and fear of saying something inappropriate. Other barriers were patients' religious beliefs which often hindered the use of sedatives or morphine and led to discomfort and time restraints. A palliative support team in hospital and advance care planning (ACP) were enablers for early palliative care.

Study limitations: This study started from a negative experience, leading to identification of a lot of barriers and only a few facilitators. The limited sample size and the restriction to two wards within one single hospital limit the diversity of perspectives and the generalisability of the findings.

Conclusion: More attention is needed for ACP and interdisciplinary communication. Palliative care, including ACP, and interdisciplinary communication should be included in the basic curricula of all healthcare professional courses. Further research is needed to explore barriers and facilitators to early initiation of palliative care in other healthcare settings and patient populations. This is crucial in order to develop and implement sustainable interventions for specific groups of patients.

Background: Serious illnesses, such as cancer, bring the threat of loss of health and life closer. This may compromise spiritual well-being. Addressing patients' spirituality is essential in nursing care. Therefore, nursing records should reflect, clarify, and enable spiritual-care follow-up.

Aim: The aim of this study is to explore how spiritual care is expressed in nursing records in cancer care.

Method: This study adopted a hermeneutic approach, and a qualitative content analysis was used to explore the nursing records of 43 inpatients with cancer from Norway. Ethical approval was obtained, and the privacy of the patients and healthcare professionals was safeguarded in line with the applicable legislation.

Results: Spiritual care was rarely reported in the nursing records (i.e., the nursing care plans and the progress notes). However, traces of spiritual care appeared in the records of everyday nursing. Four themes emerged from the analysis: (1) relieving life pain and mitigating loss, (2) facilitating faith support, (3) welcoming family and friends, and (4) sustaining normality and sharing joy.

Conclusions: This study showed that the nursing records of cancer care seldom expressed spiritual care concerning patients' life pain, loss, or faith support. Increasing nurses' competencies in mapping, documenting, and attending to spiritual care, as well as overcoming the limitations of documentation systems, could help address the spiritual needs of cancer patients.

Background: Preterm newborns face many health problems due to their incomplete intrauterine development and the immaturity of their systems. One of these problems concerns nutrition. This study aimed to determine the effect of online kangaroo care (KC) training provided post-discharge on breastfeeding self-efficacy in mothers with preterm infants.

Methods: This research was conducted as an experimental study with a randomised control group. Two groups were formed: kangaroo care and control. The sample of the study consisted of 68 mothers of preterm infants. The mothers in the KC group were given online KC training after discharge from the hospital. The mothers were asked to perform KC regularly, at least once a day, for 20 min, 7 days a week. The Breastfeeding Self-Efficacy Scale was administered to the mothers before and after training.

Results: The results of the study revealed that the difference between the pre-test and post-test breastfeeding self-efficacy scores was statistically significantly higher among the mothers who received online KC training compared with the controls (p < 0.001).

Conclusion: According to the results of our research carried out in this context, the mothers who received online KC training had increased breastfeeding self-efficacy compared to those in the control group.

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.

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.

Objective: This study explores the process through which informal caregivers, particularly spouses, construct their identity within the context of caregiving for individuals with dementia. Despite extensive research in psychology aimed at defining caregiving (e.g. tasks, consequences), few informal caregivers identify themselves as such. For instance, the affective bond shared between caregivers and care-recipients often imbues caregiving responsibilities with a sense of "naturalness," especially if the care-recipient is a spouse.

Methods: To investigate the nature of caregiver identity construction, eight semi-structured interviews were conducted with spouse caregivers of dementia patients. The collected data underwent interpretative phenomenological analysis (IPA).

Results: Three interconnected themes emerged from the analysis: (1) Perceiving changes in my partner, which involves recognising alterations in the care-receiver's characteristics due to dementia; (2) Processing changes, encompassing the experience of grieving losses and reminiscing about the past; and (3) Perceiving changes in myself, referring to the acknowledgement of personal changes due to caregiving.

Conclusion: The study emphasises the dynamic and ongoing nature of caregiver identity construction, which begins with the early recognition of changes in the care-receiver. Interestingly, spouse caregivers oscillate between their identity as a spouse and caregiver, influenced by how they process changes undergone by their partner. Contrasting with previous theories on caregivers' identity, our results focus of caregivers' perceptions rather than their relationship with the care-recipient or caregiving tasks.

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: 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.