Scandinavian Journal of Caring Sciences最新文献

Aim: This study was conducted to investigate the effects of self-compassion training given to the relatives of patients hospitalised in the palliative care unit on the care burden and self-compassion of patient relatives.

Method: The study is a randomised, controlled experimental study in pretest-posttest design. The study was conducted between February 2024 and June 2024 with the relatives of the patients who received care and treatment in the palliative care unit of a hospital in eastern Turkey. The study was completed with 30 patient relatives in the intervention group and 32 patient relatives in the control group. The patient relatives in the intervention group received 40-50 min of self-compassion training for 8 weeks. No intervention was given to the control group. Personal Information Form, Self-Compassion Scale, and Caregiver Burden Scale were used to collect the data.

Results: While there was no significant difference in the total mean scores of the caregiver burden scale and self-compassion scale of the intervention group before the intervention compared to the control group (p > 0.05), a significant difference was found after the intervention (p < 0.05). When the regression coefficients were analysed, it was found that self-compassion training negatively affected the total mean score of the caregiver burden scale and explained 55% of its variance, while it positively affected the total mean score of the self-compassion scale and explained 55% of its variance.

Conclusion: This study shows that self-compassion training given to the relatives of patients hospitalised in the palliative care unit is effective in terms of reducing the burden of care and increasing their self-compassion. Relatives of patients who received self-compassion training experienced a decrease in their care burden and an increase in their self-compassion. These findings emphasise the importance of self-compassion training in supporting the relatives of patients in palliative care.

Aim: This study aims to describe the existential reflections of patients in need of hospital care. Illness that requires hospitalisation can evoke existential reflections-such as uncertainty and altered self-perception-which confront patients with their vulnerability. This study seeks to provide insights into how patients experience and navigate these reflections, highlighting the importance of including existential reflections in caring.

Design: A phenomenological study using a reflective lifeworld research approach was conducted, following the consolidated criteria for reporting qualitative research checklist.

Method: Twelve patients were interviewed, and data were analysed using the reflective lifeworld research approach.

Ethics: The study was approved by the Swedish Ethical Review Authority and adhered to the Helsinki Declaration.

Findings: The essence is described as being in a vulnerable state while navigating towards existential security, as patients confront mortality and shifting roles. Feeling alone, waiting alone in a hospital room heightens emotional processing, amplifying reflections on illness and personal responsibility. Despite uncertainty, patients draw strength from past experiences, guiding them towards a new reality. Existential reflections emerge both indirectly and through direct contemplation.

Conclusions: A caring relationship that acknowledges existential reflections is crucial for the patient's possibility to adapt and live authentically. Prioritising existential reflections in health care enhances patients' well-being, resilience and purpose.

Background: Loneliness and depression in the elderly population are a worldwide challenge. Elderly people receiving home care are very vulnerable, as they often suffer from comorbidity and various other challenges.

Aim: The study aim was to explore how care assessment teams experience assessing loneliness and symptoms of depression among home care recipients aged 65 years and older in planned home visits.

Method: This study has a qualitative design. Data were collected during two phases. First, data from documents were collected in seven municipalities on 168 home care decisions made by assessment units during 1 month. Second, 10 caseworkers and 10 case managers from different care assessment teams in 20 municipalities located in four different regions in Norway were individually interviewed. Both data sources were analysed using qualitative content analysis.

Results: Analysis of the documents revealed that only three of the 168 home care decisions described support for mental health. The analysis of the interviews resulted in three themes: (i) 'Physical health has higher priority than mental health in home care', (ii) 'Being diagnosed is essential to receive support from home care', (iii) 'Major differences in mental health support between municipalities'.

Conclusion: Caseworkers in care assessment teams find that many home-dwelling elderly are struggling with loneliness and depression, but barriers on both organisational and administrative levels prevent them from providing appropriate interventions. Mental health is thus not systematically recorded in assessments, which may lead to loneliness and depression being overlooked. There are significant differences between municipalities regarding service offerings and follow-up procedures for loneliness and depression, and both caseworkers and municipal leadership must ensure a system that provides comprehensive patient care.

Background: Women may find it difficult to seek face-to-face support, as topics related to sexuality are often considered taboo. The online environment makes it easier to interact with others and share stories while using an anonymous username.

Aim: This study aimed to explore the lived experiences of women with vaginismus by analysing online forum posts. By examining unfiltered personal narratives, we sought to gain insights into their challenges, coping mechanisms, and the factors influencing their help-seeking behaviours without the constraints of predefined research questions.

Methods: Qualitative content analysis was used to explore the lived experiences of women with vaginismus. For this study, we used a simple search phrase, such as 'vaginismus forum', on Google, the most widely used online search engine. In this context, we chose an online forum with different topics to collect data to explore different perspectives of vaginismus patients. Posts from this topic were collected between November 2020 and November 2023. A total of 17,900 posts from the relevant dates were reviewed for analysis. The data was coded and analysed using qualitative content analysis.

Results: Three main themes and 12 subthemes were identified: (1) Facing the reality of vaginismus, (2) Obstacles for women with vaginismus to get help, (3) Facilitators to fight vaginismus.

Conclusions: This study provides qualitative evidence on the experiences of women with vaginismus, shedding light on the challenges they face. The findings highlight that while stigma, emotional distress, and unsupportive environments create barriers, supportive partners, professional guidance, and online communities play a crucial role in their recovery process. These insights emphasise the need to improve awareness and support mechanisms within healthcare and society.

Background: Caring is fundamental in nursing practice, highlighted by theorists as essential to the nurse's role. Among various care approaches, routine care (RC) stands out as critical and complex. Despite its widespread application, the dimensions of RC remain incompletely defined. This study aims to comprehensively analyse the concept of RC.

Method: This study utilised a conceptual analysis approach to delve into 'routine care,' employing the Walker and Avant Model (2019) as its framework. The analysis meticulously followed the eight systematic steps delineated by Walker and Avant. Comprehensive searches were conducted across diverse databases, including Ovid, Scopus, Web of Science, ProQuest, PsycINFO, MEDLINE, CINAHL (Cumulative Index to Nursing and Allied Health Literature), Cochrane Database of Systematic Reviews, Nursing and Allied Health, EMBASE and ABI Inform Collection, using pertinent keywords. Notably, the search was not constrained by publication date but focused on articles congruent with the study's objectives. Subsequently, a thorough review of 347 pertinent articles was undertaken to augment the conceptual analysis.

Findings: The study clarifies the multifaceted nature of RC, emphasising its impact on enhancing patient outcomes and healthcare quality. It discusses both the positive and negative implications of RC for patients, healthcare providers and healthcare settings. Antecedents such as proper planning and education are crucial for successful implementation, with emphasis on continuous updating and adherence to established recommendations.

Conclusion: This study reveals the diverse dimensions of RC. Using these insights, future research can advance the development of practical tools and theoretical frameworks in nursing.

Objective: This study aims to examine the risk of psychological symptoms in spouses of cancer patients and the barriers to and determinants of seeking mental health counselling.

Methods: The study was conducted with a descriptive and correlational design. The data were obtained from spouses (n = 201) of cancer patients. Data collection involved the Participant Information Form (PIF), Psychological Symptom Screening Test (SCL 90-R) and Barriers to Seeking Mental Health Counselling Scale (BMHC). Descriptive statistics and regression analysis were used to analyse the data.

Results: Participants exhibited high levels of risk in somatization (1.67 ± 0.86), depression (1.94 ± 0.92), anxiety (1.72 ± 0.68) and additional items (1.55 ± 0.53). In multiple linear regression analysis, the longest place of residence (β = -0.137), gender (β = -0.144), income level (β = 1.152) and depression were associated with BMHC. Additionally, the longest place of residence (β = -1.007), gender (β = -0.368), income level (β = -0.674), somatization (β = 0.056), depression (β = 0.251) and additional items (β = 1.108) were associated with BMHC.

Conclusions: The results showed that despite spouses of cancer patients being at risk of psychological symptoms, they do not seek psychological help due to stigma and lack of knowledge. In addition, the study revealed an important clinical implication that the focus of health services should not only be on the diagnosed cancer patient but also on their spouse.

Background: Chronic Obstructive Pulmonary Disease (COPD) significantly impacts an individual's daily life. Inhaled medications form the cornerstone of COPD treatment. To ensure the efficacy of these treatments, individuals must use their inhalers correctly. It is crucial for nurses to identify the learning needs of individuals with COPD and relate these needs to their level of care dependency, ultimately improving their quality of life.

Objective: This study aimed to assess the learning needs of individuals with COPD concerning inhaler drug use and to determine their level of care dependency.

Material and methods: The study population comprised 400 individuals diagnosed with COPD who were treated at a chest diseases hospital between May 2019 and December 2019. Data were collected through a patient information form designed by the researcher, an inhaler medication use skill assessment form, the Katz Activities of Daily Living Scale (ADLS), the Lawton and Brody Instrumental Activities of Daily Living Scale (LADL) the Care Dependency Scale (CDS), and the Patient Learning Needs Scale (PLNS). Data normality was assessed using the Kolmogorov-Smirnov test. The independent samples t-test was employed for normally distributed data, while the Mann-Whitney U-test was used for non-normally distributed data. For comparisons between multiple groups, one-way ANOVA was used for normally distributed data and the Kruskal-Wallis test for non-normally distributed data. Dependent sample t-tests were utilised to analyse within-group changes in normally distributed variables. Pearson's correlation coefficient was employed to assess the relationships between normally distributed quantitative variables.

Results: Of the study participants, 59.8% were male, 34% were in stage 2 of COPD, and 88.8% had been using inhaler medications since their diagnosis. The mean total score on the ADLS was 15.3 ± 3.6, while the mean total score on the LADL was 18.4 ± 5.2. The mean total CDS score was 67.5 ± 21.1, with a median of 79.5. The mean total importance and fulfilment scores on the PLNS were 187.1 ± 49.1 and 182.8 ± 51.7, respectively.

Conclusion: The study revealed that individuals with COPD have unmet learning needs concerning the correct use of inhaler medications. Additionally, it was found that care dependency levels were moderate, increasing with age, COPD stage, and improper inhaler use.

Background: As open-heart surgery can be stressful for the patient and their family, the objective of this study was to generate knowledge on how to support families in relation to open-heart surgery based on important situations.

Aim: The aim was to explore and describe the experiences and actions of important situations of family involvement as expressed by family members of patients who underwent elective open-heart surgery in Sweden.

Methodological design and justification: The critical incident technique used is a qualitative method appropriate for identifying issues relating to clinical problems.

Ethical issues and approval: Ethical approval was obtained from the Swedish Ethical Review Authority. Allowance was made for the unexpected presence of the patient.

Research methods: Individual interviews with 29 family members of patients who underwent open-heart surgery in Sweden in 2023 were analysed using the critical incidence technique, as applied in nursing and healthcare sciences.

Results: The family members experienced being-or not being-seen as significant and were fearing the loss of normal life in relation to open-heart surgery. Actions taken during important situations were building confidence to relinquish control and relieving burdens to improve well-being.

Conclusions: Family involvement, in terms of being informed and welcomed, led to an improved ability to care for their loved ones. Emotionally supportive interventions targeting families should be considered in relation to a loved one's open-heart surgery.

Aim: An ageing population increases the demand for emergency department (ED) visits and hospitalisations, and people living in nursing homes in particular are impacted by burdensome transfers and hospitalisations. As such, several onsite-provided care services have been developed to reduce hospitalisations, but more evidence of their cost-effectiveness is needed. An outreach service (OS) was thus developed for nursing homes to increase the quality of care and to decrease avoidable transfers of patients to ED examinations and treatments in hospitals by promoting continuity of care. The model consists of a patient-centred care plan followed by a responsible doctor, an easy-to-use patient information system, 24/7 geriatric teleconsultation for acute problems and nurse training. Thus, this mixed-methods study evaluates the system-level effects of the service model.

Methods: The study was conducted in 12 nursing homes, comprising 401 patients in total for both cohorts. The costs and benefits of the OS, including the use of health care services in other institutions, were analysed during the 12-month periods both before and after the implementation. An independent sample Mann-Whitney U-test was used at the patient level, and eight semi-structured interviews were conducted with the healthcare personnel concerning the benefits and challenges of the new model.

Results: The system-level costs decreased in all 12 nursing homes and, in total, 21.7% after the implementation. The biggest monetary savings were accrued from inpatient stays, both in primary and secondary care, as the new OS patients needed remarkably less frequent care in hospital ward units. Ambulance transfers and acute visits at primary care decreased by more than 50%, and patient-level decreases in total costs and in the costs of inpatient care and acute visits were all statistically significant (p < 0.01). Nurses and municipality officials considered the OS to be invariably positive.

Conclusions: The OS was effective, as it led to remarkable decreases in system-level costs for society across nursing homes during the 12-month follow-up. Nurses appreciated the OS, as it improved their ability to maintain control over their work.

Aims and objectives: To explore the allogeneic haematopoietic stem cell transplantation recipients' experiences of outdoor physical activity while admitted to the hospital.

Method: The study is a descriptive, qualitative study. Fourteen first-time allogeneic stem cell transplantation recipients were included. After going through a tailored outdoor physical activity programme, the participants took part in individual in-depth interviews to describe their experiences of the physical activity programme. The interviews were analysed in accordance with the manifest level of content analysis by Graneheim and Lundman.

Results: The participants had different starting points, but the majority experienced taking part in physical activity as positive. The data analysis resulted in five categories: (1) Physical activity is positive; (2) Health condition might challenge activity; (3) Tailored activity; (4) Social aspects and (5) Feeling well. The interest in adherence to the programme seemed to be related to the participants' physical activity prior to admission to the hospital. Furthermore, somatic symptoms were the major challenges to participation.

Conclusions: Our findings suggest that participants viewed the physical outdoor programme as a positive reprieve from the hospital setting. The results demonstrate that an outdoor physical activity programme tailored to patients' health conditions is feasible and can have physical and social benefits.