Scandinavian Journal of Caring Sciences最新文献

Background: Critical care nurses who work in intensive or intermediate care units could be exposed to violence and threats in their workplace from patients admitted with intoxication. Despite extensive research on intoxication, research on critical care nurses' experiences with violence and threats from these patients is limited.

Aim: This study explored critical care nurses' experiences with workplace violence when caring for patients with intoxication in an intensive or intermediate care unit setting.

Design: This study employed an exploratory-descriptive qualitative design. The COREQ checklist guided the study's reporting.

Methods: Twelve critical care nurses at four intensive and/or intermediate care units in Norway were interviewed. The data were analysed using reflexive thematic analysis.

Results: Four themes were created in the data analysis: being one step ahead when facing unpredictability, tailoring care to the patient's needs to prevent workplace violence, feeling drained when insufficient nursing care is provided, and wanting more competence and support.

Conclusion: Workplace violence poses a significant challenge to critical care nurses. To mitigate risks and improve patient safety, it is crucial to equip critical care nurses with the necessary knowledge and skills to foster predictability and support the implementation of structured plans.

Implications for the profession: The findings underscore the need to integrate education about drugs, psychiatric diagnoses, and strategies for managing workplace violence into the curriculum for critical care nursing students and in clinical settings. Ward managers should promote education on workplace violence and organise debriefing sessions following incidents of workplace violence.

Patient or public contribution: This study had no patient or public contributions.

Background: Nurses are among the most interactive professionals in society, providing both care and psychosocial and psychotherapeutic interventions for individuals with mental health issues. Nurse-centred approaches have demonstrated a positive impact on addressing mental health issues.

Aim: This study aimed to evaluate the effectiveness of psychosocial and psychotherapeutic interventions administered by nurses in managing mental health issues.

Methods: For this meta-analysis, data were gathered through a comprehensive search of databases, including PubMed, Web of Science, EBSCOhost, Google Scholar and the YÖK Thesis Center, with no restrictions on publication year. Following the review process, a total of 25 studies were included in the analysis. The PRISMA checklist was employed to guide our study.

Results: The meta-analysis revealed that interventions implemented by nurses in the context of mental health were effective. Specifically, the psychosocial and psychotherapeutic interventions significantly reduced depression levels in individuals (SMD: -0.918, 95% CI: -1.350 to -0.486; Z = -4.161; p < 0.05) and anxiety levels (SMD: -0.61, 95% CI: -1.190 to -0.029; Z = -2.59; p < 0.05). Additionally, these interventions were associated with an improvement in individuals' quality of life (SMD: 0.673, 95% CI: 0.303-1.403; Z = 3.56; p < 0.05).

Conclusion: Nurses can play a pivotal role in addressing mental health issues, effectively contributing to the reduction of anxiety and depression levels while enhancing the overall quality of life for individuals.

Background: Previous reviews have indicated a high burden of physical, emotional and sexual symptoms in women who have undergone surgery for vulvar cancer. Numerous surgical modifications have been made over the past few decades to limit post-operative symptoms. However, few reviews have investigated a wide range of symptoms in women with vulvar cancer. A comprehensive review of the literature examining these symptoms following advanced surgical treatment for vulvar cancer could contribute to an updated understanding of symptom experiences in these women.

Aim: To map the literature on women's symptom experiences after surgical treatment for vulvar cancer.

Methods: A scoping review was conducted, following the Preferred Reporting Items for Systematic reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR). The included studies provided independent analyses of women with vulvar cancer, utilised patient-reported outcome measures or qualitative data, were published between 2008 and 2024 and were in English, Danish, Norwegian or Swedish. Searches were conducted on February 20, 2024, in Embase, MEDLINE, CINAHL and PsycINFO. Data were thematically analysed as described by Braun and Clarke.

Results: The following themes were identified in the 20 studies: lymphedema, sexuality and body image, pain, physical functioning, fatigue, urinary symptoms, emotional symptoms and support from relatives and healthcare professionals.

Conclusion: Women who have undergone surgery for vulvar cancer experience several physical and emotional symptoms. However, there is a shortage of qualitative studies that thoroughly explore the concept of symptom experience and quantitative studies that include vulvar-specific patient-reported outcome measures.

Trial and protocol registration: The protocol was preregistered on Open Science Framework on April 9, 2024, registration https://doi.org/10.17605/OSF.IO/429JW.

Background: As a component of goal-oriented care, goal-setting is an important strategy to improve self-management and reduce the economic and personal burden of chronic illness. Primary care nurses, as integral members of the healthcare team, play a pivotal role in providing self-management support to patients with multiple chronic illnesses. Yet, little is known about their perspectives on partnering with patients to set meaningful goals within self-management support programmes.

Aim: To explore perspectives of primary care nurses about their practice of goal-setting with patients to improve self-management.

Methods: For this qualitative exploratory study, we conducted semi-structured interviews with 28 primary care nurses who provided self-management support to patients with multiple chronic illnesses. Data were analysed using inductive thematic analysis. This research was approved by the Mayo Clinic Institutional Review Board.

Results: Key themes from interviews focused on: (1) goal-setting practices; (2) challenges encountered in goal-setting; and (3) the perceived value-add of using a patient-centred goal-setting approach. Nurses described practices that empower patients to take charge of goal-setting, emphasising that the opportunity to create personal goals enhances motivation and enables the development of realistic action plans. Key challenges faced were patients' lack of familiarity with personal goal-setting, competing life stressors and patients' reluctance to change.

Conclusion: Our findings contribute valuable insights about how primary care nurses approach goal-setting within a self-management support program. Notably, unlike previous studies where clinicians reported that time-limited appointments and institutional expectations hindered patient-centred goal-setting, our participants practicing in an institutionally supported goal-oriented patient-centred model of care did not report time constraints or pressures to prioritise clinical goals over patient goals. Instead, they described patient-centred goal-setting practices that are associated with positive patient and clinical outcomes. To potentially corroborate and expand upon our findings and inform practice and training, future research should include qualitative and survey studies to explore primary care RNs perspectives about goal-setting and observational research to evaluate nurse-patient goal-setting interactions.

Background and aim: Due to ageing, physical changes can affect one's ability to actively engage with others, resulting in limitations in social connections comparable to loneliness. Hence, there is a need for research on how older adults avoid experiencing loneliness and thus promote health through social connections. The aim of this study was to describe the significance of social connections and health in relation to loneliness experienced by older adults living at home.

Methods: Older adults aged 65 years and older (n = 16) purposively selected from a longitudinal population-based multicentre study participated in semi-structured interviews. The interviews were conducted in January 2024, transcribed verbatim and analysed using inductive content analysis.

Findings: The findings illustrated one main category, Preventing loneliness, and three associated generic categories: The silver lining of connecting with oneself, Being surrounded by meaningful connections and Striving to maintain an active and healthy life.

Conclusion: Preventing loneliness may be one important aspect of healthy ageing. However, for some older adults, time alone offers enrichment and well-being, with routines playing a key role. Meaningful connections and feeling needed are crucial in preventing loneliness, especially as social networks may decline with age. An active and healthy life also prevents loneliness, though barriers like age-related limitations must be addressed. It is, therefore, important to address loneliness in society. Furthermore, it is essential that healthcare education incorporates the impact of loneliness on older adults to promote healthy ageing.

Background: Futile treatments waste health resources and may conflict with nurses' ethical attitudes, causing moral distress. Nurses frequently administer such treatments due to external pressures.

Desing and methods: This cross-sectional study involved 205 nurses in a public hospital in Turkey (June-August 2024). Data were collected using the "Nurse Descriptive Information Form," "Nurses' Attitudes Towards Futile Treatment Scale (NAFTS)," and "Ethical Attıtude Scale in Nursıng Care (EASNC)."

Results: The mean age of participants was 33.62 ± 7.37 years; 69.8% were female, and 37.1% worked in intensive care. While 90.7% received ethics training, 54.6% lacked knowledge about futile treatments. Over half (54.1%) had administered care they considered futile, with 82.9% citing physician orders as the main reason. Most (70.7%) saw futile treatments as an ethical issue. The NAFTS mean score was 40 ± 7.67 (medium level), and the EASNC score was 158.60 ± 14.85 (high level). A moderate negative correlation (r = -0.394, p < 0.05) indicated that stronger ethical attitudes reduced acceptance of futile treatments.

Conclusion: As nurses' ethical attitudes strengthened, their tendency to administer futile treatments decreased. Setting realistic, patient-specific care goals can prevent ethical conflicts and unhelpful care.

Implications for the profession: Providing ethical training is essential to help nurses avoid futile treatments and make better decisions in challenging situations. Developing supportive policies in healthcare institutions can guide ethical practices and reduce unnecessary treatments. Improving work conditions, such as adjusting hours and reducing workloads, enhances nurses' ability to focus on ethical and patient-centered care. Encouraging teamwork between nurses and doctors strengthens communication and shared decision-making, minimising conflicts. Additionally, reducing futile treatments not only saves healthcare resources but also improves the quality of patient care and professional satisfaction for nurses. These measures collectively support the nursing profession and contribute to better healthcare outcomes.

Reporting method: We adhered to the STROBE.

No patient or public contribution: Given that this study is based on the literature, namely the codes of ethics, there is no direct/indirect involvement of patients or the public.

Background: Being admitted to a paediatric intensive care unit is a stressful situation for the minor and their family, causing emotional alterations that generate changes in psychological, physical and social aspects, as well as on how to take care of the minor.

Aim: The objective of this study was to explore the coping strategies experienced by families who have a minor admitted to the paediatric intensive care unit.

Methods: Phenomenological qualitative research study. A sample of 12 participants was obtained from families who had a prolonged admission to the paediatric intensive care unit of a minimum duration of 3 months and who were not in an end-of-life situation. The data analysis was carried out by deepening the study theme during the data collection of the three group interviews conducted.

Ethics statement: This study is part of a predoctoral research project approved by the Ethics Committee of the Vall d'Hebrón University Hospital in Barcelona (approval code: PRAMI-273/2015).

Results: Two main categories were identified that emerged from the families' perceptions related admission of their minors to the paediatric intensive care unit and their subsequent adaptation to the new situation: (1) Family self-perception: the families' own perceptions of different feelings and emotions experienced during admission and their interpretations are collected. (2) Role of the caregiver: understood as the families' perceptions of the capacity and willingness to face the new situation in the child's health-disease process; and 10 subcategories: training, comfort, confidence, fear, anxiety, impotence, loneliness, will, adaptability and reference family group.

Conclusions: The findings show the need to carry out an integrative approach to families which coexist in a paediatric intensive care unit; through the training of these families to be able to cope with health changes.

Background: This study takes as its starting-point the assumption highlighted in previous research and theory that human beings can experience health despite chronic or severe illness. An individual's perceptions of health often change when being is faced with long-term illness, the meaning of health takes new dimensions and sets health in motion. Previous studies have focused on health related to specific diseases grounded in coping strategies or experiences of meaning in life.

Aim: This study aims to gain a deeper understanding of health, what it means for human beings with long-term illness to be in the movement between suffering and health and their motives and resources to promote and maintain health.

Methodology and method: This study has an inductive qualitative research design with a hermeneutic approach. The data collection was carried out via in-depth interviews with seven people with long-term illnesses. The interviews were analysed inductively using reflexive thematic analysis.

Results: Three main themes emerged in the thematic analysis: Moving between letting go and holding on, a changed attitude towards health and trusting life to carry you. The results demonstrate that for a human being with a long-term illness, the movement between suffering and health is the reality in which they live and as a movement between giving up and holding on, between grief and gratitude, and between vulnerability and nearness.

Conclusion: When human beings face suffering in the form of long-term illnesses, they can experience health in the ways they choose to act, relate and view their value as a human being, without any requirement for performance. The task of healthcare is to recognise the resource that people themselves possess. Healthcare professionals need a dialectical view of health and suffering to provide care that not only aims to eradicate disease but also to see what health is in times of illness.

Background and aim: Yoga has gained significant attention worldwide as a holistic approach to physical fitness and mental health self-care. Despite its popularity, gaps persist in understanding its prevalence, drivers for initiation, health advantages and determinants of participation. This study seeks to explore these aspects by examining the prevalence, initial motivations, predictors of engagement and perceived impacts on health and well-being among a representative sample of Polish adults.

Methods: A cross-sectional online survey was conducted in 2022 with 1065 participants, using quota sampling to approximate a representative sample of the Polish adult population. The study received ethics approval from the University of Warsaw. After data collection, between-group comparisons and regression analyses were conducted.

Results: Findings reveal that approximately 12.2% of Polish adults (4.27 million individuals aged 20 and older) have practised yoga during their lifetime. Female gender and having a higher education were positive predictors of lifetime yoga practice, whereas being aged 45-54 was a negative predictor. The most reported reasons for practising yoga were to improve general well-being (71.3%), to relax (53.2%) and to improve energy levels (33.9%). Most yoga practitioners perceived enhancements in energy levels, happiness and health (55.0%, 55.0% and 51.4%, respectively).

Conclusion: This research highlights the growing interest in yoga among a representative sample of Polish individuals similar to other Western nations, emphasising its perceived benefits for personal well-being and health enhancement. Future research should investigate these effects using longitudinal and experimental study designs.

Introduction: Early in 2020, the World Health Organisation (WHO) declared COVID-19 to be a pandemic. Older people were especially vulnerable to illness and death from the virus. For care staff, including assistant nurses (ANs) working in residential care facilities (RCFs), many circumstances related to the pandemic caused ethical challenges.

Aim: The aim of this study was to explore ANs' experiences of ethical challenges during the pandemic, while working in RCFs for older people in Sweden.

Methods: This study used an explorative qualitative design based on focus group interviews with 19 ANs. The interviews were analysed using thematic analysis.

Results: Ethical challenges faced by ANs in RCFs during the pandemic included (a) being unable to give dignified care, depriving older people of their human rights; (b) being duty-bound to follow restrictions despite the suffering of relatives, witnessing injustice; (c) facing the deprioritisation of older people, being part of providing care on unequal terms; (d) being restricted and devalued, feeling abandoned; (e) being forced to adhere to personal constraints, having integrity and autonomy severely violated; and (f) fulfilling duty with life at stake, sensing the fear.

Conclusion: During the pandemic, ANs in Sweden experienced ethical challenges in the care of older people in RCFs, as well as personal ethical challenges. Such challenges arose in various situations, and their consequences entailed undignified and compromised care.