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Baxter R, Corneliusson L, Björk S, Edvardsson D. Promoting resident thriving in nursing homes: A qualitative study. J Adv Nurs 2024. [PMID: 38661264 DOI: 10.1111/jan.16206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 01/22/2024] [Accepted: 04/06/2024] [Indexed: 04/26/2024]
Abstract
AbstractAimTo explore how staff promote resident thriving in an Australian nursing home.DesignQualitative research design using content analysis.MethodsInterviews were held with 14 nursing staff working in an Australian nursing home in March/April 2018. Data were analysed using qualitative content analysis.ResultsFour themes were revealed: promoting personalized care; promoting opportunities for autonomy; promoting connection and meaning; and promoting a curated environment.ConclusionsStaff promoted resident thriving in relation to everyday care, activities, capabilities, relationships and the lived environment. Interventions that were perceived to promote thriving were described relative to the nurse, the resident, the care team and the wider nursing home context.Implications for the Profession and/or Patient CareThe findings provide novel insight into the understanding and application of the concept of thriving in long‐term care from nursing staffs' perspective.ImpactWhat Problem did the Study Address?Nursing home staff are uniquely positioned to support resident thriving through person‐centred care, yet little is known about how staff support promotion of thriving for nursing home residents in their everyday practice.What were the Main Findings?Nursing home staff perceived that they promoted thriving by personalizing care and supporting autonomy, connection, meaning and pleasure for residents.Where and on Whom will the Research have an Impact?These findings are of interest for the clinicians, educators and researchers who develop, implement and evaluate interventions to improve place‐related well‐being in nursing homes.Reporting MethodCORE‐Q checklist.Patient or Public ContributionNo patient or public contribution occurred for this study as this research focused on exploring staffs' perspectives from the specific viewpoint of their personal experience.
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Affiliation(s)
| | | | - Sabine Björk
- Department of Nursing, Umeå University, Umeå, Sweden
| | - David Edvardsson
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia
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2
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Backman A, Ahnlund P, Lövheim H, Edvardsson D. Nursing home managers' descriptions of multi-level barriers to leading person-centred care: A content analysis. Int J Older People Nurs 2024; 19:e12581. [PMID: 37859588 DOI: 10.1111/opn.12581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 09/12/2023] [Accepted: 10/03/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND Research suggests that person-centred care can be beneficially implemented and sustained, even though barriers remain that prevent uptake in clinical practice. Understanding barriers to person-centred care seems important, as this has an impact on care practices and resident outcomes. Moreover, there is limited knowledge about nursing home managers' descriptions of barriers when leading person-centred care. OBJECTIVES To explore barriers to leading person-centred care as narrated by nursing home managers. METHODS A descriptive qualitative design was used to collect data using individual interviews with 12 nursing home managers in highly person-centred nursing homes. Data were analysed using content analysis. RESULTS Multi-level barriers to leading person-centred care were identified on the (1) person level, (2) team level and (3) organisational level. Placing professional and family considerations ahead of resident considerations was described as a barrier on the personal level (1). Also, staff's divergent care values, processes, and priorities together with turnover and low foundational knowledge were identified as barriers on the team level (2). On an organisational level (3), constrained finances, functional building design and group level rostering were identified as barriers. CONCLUSION Multi-level barriers influence nursing home managers' ability to lead and promote person-centred care. Promoting the development of person-centred practices requires efforts to eliminate barriers on person, team and organisational level. IMPLICATIONS FOR PRACTICE Identifying and overcoming barriers at various levels in nursing home care has the potential to promote person-centred practices. This study can inform stakeholders and policymakers of challenges and complexities in person-centred practices. Multi-level strategies are needed to target challenges at person-, team- and organisational level when striving to develop person-centred care.
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Affiliation(s)
| | - Petra Ahnlund
- Department of Social work, Umeå University, Umeå, Sweden
| | - Hugo Lövheim
- Department of Community Medicine and Rehabilitation, Umeå University, Umeå, Sweden
- Wallenberg Centre for Molecular Medicine in Umeå, Umeå, Sweden
| | - David Edvardsson
- School of Nursing and Midwifery, La Trobe University, Melbourne, Australia
- Sahlgrenska Academy, Institute of Health and Care Sciences, University of Gothenburg, Gothenburg, Sweden
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3
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Williams C, Joshi A. The Greenhouse Model of Nursing Home Care: A Scoping Review. J Appl Gerontol 2023:7334648231216005. [PMID: 38029726 DOI: 10.1177/07334648231216005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2023] Open
Abstract
The study aimed to comprehensively review and assess evidence-based outcomes of the Greenhouse model. We systematically reviewed, assessed, and reported on relevant literature using the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines for the scoping review. We identified qualitative or quantitative studies that met our inclusion criteria from PubMed, Medline, CINAHL, and EBSCOhost. The review yielded 41,515 articles published between January 2015 and December 2022; eleven articles met the inclusion criteria and were included in the analysis. The emerging themes were organizational culture, clinical outcomes, and business effects. The Greenhouse model offers a favorable organizational culture with opportunities to enhance clinical and business outcomes. The scoping review was registered in Prospero: CRD42023389048.
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Jansen DA, Sauve JL, Aubart SM. Importance of Variety to the Lives and Wellbeing of Elders. ACTIVITIES, ADAPTATION & AGING 2023. [DOI: 10.1080/01924788.2023.2174732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Debra A. Jansen
- College of Nursing and Health Sciences, University of Wisconsin-Eau Claire, USA
| | - Jennifer L. Sauve
- College of Nursing and Health Sciences, University of Wisconsin-Eau Claire, USA
| | - Stacie M. Aubart
- College of Nursing and Health Sciences, University of Wisconsin-Eau Claire, USA
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Fallahpour M, Nygård L, Asaba E. Communication and engagement as potentiality in everyday life between persons with young onset dementia living in a nursing home and caregivers. Int J Qual Stud Health Well-being 2022; 17:2035305. [PMID: 35133256 PMCID: PMC8925924 DOI: 10.1080/17482631.2022.2035305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objectives To explore communication and engagement in everyday situations between persons with young-onset dementia (YOD) living in a nursing home (NH) and the caregivers. Methods The study draws on ethnographic methods aligned with participatory design. Three residents with YOD living in a NH and eight staff members were recruited. A narrative approach was used for data collection and analysis. Findings Three narrative vignettes were developed representing everyday situations in which communication and engagement was enacted among residents and caregiver staff: (a) waiting for something to happen, (b) tensions about everyday communication, and (c) negotiating a combined living + working environment. The findings stress a paradoxical tension rooted in the NH as residence and workplace as well as place of calm and place of boredom. The everyday situations are interpreted differently from the perspective of the residents and staff. Conclusion The identified paradox of planned and spontaneous situations influences communication and engagement in everyday life, and the potentiality for active engagement embedded in contexts of units for residents with YOD. The degree to which everyday activities and encounters are redefined and renegotiated is an important part of caregiving practices in NH settings for residents with YOD.
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Affiliation(s)
- Mandana Fallahpour
- Department of Neurobiology, Care Sciences and Society (Nvs), Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden
| | - Louise Nygård
- Department of Neurobiology, Care Sciences and Society (Nvs), Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden
| | - Eric Asaba
- Department of Neurobiology, Care Sciences and Society (Nvs), Division of Occupational Therapy, Karolinska Institutet, Stockholm, Sweden
- Unit for Research, Education, Development, & Innovation, Stockholms Sjukhem Foundation, Stockholm, Sweden
- Department of Health Sciences, Occupational Science and Occupational Therapy Research Group, Lund University, Lund, Sweden
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6
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Li M, Ao Y, Deng S, Peng P, Chen S, Wang T, Martek I, Bahmani H. A Scoping Literature Review of Rural Institutional Elder Care. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191610319. [PMID: 36011954 PMCID: PMC9408389 DOI: 10.3390/ijerph191610319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 08/11/2022] [Accepted: 08/15/2022] [Indexed: 05/31/2023]
Abstract
Under circumstances of pervasive global aging combined with weakened traditional family elder care, an incremental demand for institutional elder care is generated. This has led to a surge in research regarding institutional elder care. Rural residents' institutional elder care is receiving more attention as a major theme in social sciences and humanities research. Based on 94 articles related to rural institutional elder care, this study identified the most influential articles, journals and countries in rural institutional elder care research since 1995. This was done using science mapping methods through a three-step workflow consisting of bibliometric retrieval, scoping analysis and qualitative discussion. Keywords revealed five research mainstreams in this field: (1) the cognition and mental state of aged populations, (2) the nursing quality and service supply of aged care institutions, (3) the aged care management systems' establishment and improvements, (4) the risk factors of admission and discharge of aged care institutions, and (5) deathbed matters regarding the aged population. A qualitative discussion is also provided for 39 urban and rural comparative research papers and 55 pure rural research papers, summarizing the current research progress status regarding institutional elder care systems in rural areas. Gaps within existing research are also identified to indicate future research trends (such as the multi-dimensional and in-depth comparative research on institutional elder care, new rural institutional elder care model and technology, and correlative policy planning and development), which provides a multi-disciplinary guide for future research.
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Affiliation(s)
- Mingyang Li
- College of Management Science, Chengdu University of Technology, Chengdu 610059, China
| | - Yibin Ao
- College of Management Science, Chengdu University of Technology, Chengdu 610059, China
- College of Environment and Civil Engineering, Chengdu University of Technology, Chengdu 610059, China
| | - Shulin Deng
- College of Environment and Civil Engineering, Chengdu University of Technology, Chengdu 610059, China
| | - Panyu Peng
- College of Environment and Civil Engineering, Chengdu University of Technology, Chengdu 610059, China
| | - Shuangzhou Chen
- Department of Social Work and Social Administration, Faculty of Social Sciences, The University of Hong Kong, Hong Kong, China
| | - Tong Wang
- Faculty of Architecture and Built Environment, Delft University of Technology, 2628 CD Delft, The Netherlands
| | - Igor Martek
- School of Architecture and Built Environment, Deakin University, Geelong 3220, Australia
| | - Homa Bahmani
- College of Environment and Civil Engineering, Chengdu University of Technology, Chengdu 610059, China
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7
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Sjögren K, Bergland Å, Kirkevold M, Lindkvist M, Lood Q, Sandman PO, Vassbø TK, Edvardsson D. Effects of a person-centred and thriving-promoting intervention on nursing home residents' experiences of thriving and person-centredness of the environment. Nurs Open 2022; 9:2117-2129. [PMID: 35485234 PMCID: PMC9190681 DOI: 10.1002/nop2.1222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 02/25/2022] [Accepted: 04/03/2022] [Indexed: 11/09/2022] Open
Abstract
AIM To evaluate the effects of a person-centred and thriving-promoting intervention on nursing home residents´ experiences of thriving and person-centredness of the environment, and to evaluate if the effects varied between female and male residents. DESIGN A multi-centre, non-equivalent controlled group before-after intervention design. METHODS Six nursing homes in Australia, Norway and Sweden were allocated to either intervention or control group. The intervention comprised a staff educational programme. A survey using proxy-ratings by staff was administered before (T0), immediately after (T1) and six months after (T2) the intervention. The sample varied between 205 and 292 residents. Linear regression models were used to explore effects. RESULTS Statistically significant effects were found on experiences of thriving and person-centredness of the environment. These effects were significant for male residents but not for female residents. The results emphasize the importance of individually tailored social and recreational activities.
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Affiliation(s)
- Karin Sjögren
- Department of Nursing, Umeå University, Umeå, Sweden
| | - Ådel Bergland
- Lovisenberg Diaconal University College, Oslo, Norway
| | - Marit Kirkevold
- Department of Nursing Science, Faculty of Medicine, Institute of Health and Society, Oslo University, Oslo, Norway.,Institute of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway
| | - Marie Lindkvist
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Qarin Lood
- Department of Nursing, Umeå University, Umeå, Sweden.,Department of Health and Rehabilitation, Centre for Ageing and Health - AgeCap, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia
| | | | - Tove Karin Vassbø
- Lovisenberg Diaconal University College, Oslo, Norway.,Faculty of Medicine, Institute of Health and Society, Oslo University, Oslo, Norway
| | - David Edvardsson
- Department of Nursing, Umeå University, Umeå, Sweden.,School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia
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Davies M, Zúñiga F, Verbeek H, Simon M, Staudacher S. Exploring Interrelations Between Person-Centred Care and Quality of Life Following a Transition into Long-Term Residential Care: A Meta-Ethnography. THE GERONTOLOGIST 2022; 63:660-673. [PMID: 35176167 PMCID: PMC10167765 DOI: 10.1093/geront/gnac027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Globally, a culture change in long-term residential care (LTRC) moving towards person-centred care (PCC) has occurred in an attempt to improve resident quality of life (QoL). However, a clear understanding of how different aspects contributing to a PCC approach are interrelated with resident QoL is still lacking. This review explores interrelating aspects between PCC and QoL in LTRC using qualitative synthesis. RESEARCH DESIGN AND METHODS Ten relevant primary studies were identified from a search of interdisciplinary research databases providing qualitative information. Studies were critically reviewed for key themes and concepts by the research team. We used a meta-ethnography approach to inductively interpret findings across multiple studies and reinterpreted the information using a constructivist approach. RESULTS We identified 5 second order constructs sharing commonalities suggesting interrelations between PCC and QoL: (1) Maintaining dignity, autonomy and independence. (2) Knowing the whole person. (3) Creating a 'homelike' environment. (4) Establishing a caring culture. (5) Integrating families and nurturing internal and external relationships. Synthesis translation led to the following third order constructs: (1) Personalising care within routines (2) Optimising resident environments (3) Giving residents a voice. DISCUSSION AND IMPLICATIONS There are many interrelating aspects of PCC and QoL following a permanent transition into LTRC, but successful implementation of PCC, which enhances QoL presents challenges due to organisational routines and constraints. However, by prioritising resident voices to include their needs and preferences in care, QoL can be supported following a transition into LTRC.
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Affiliation(s)
- Megan Davies
- Institute of Nursing Science, Department of Public Health, University of Basel, Basel, Switzerland.,Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Franziska Zúñiga
- Institute of Nursing Science, Department of Public Health, University of Basel, Basel, Switzerland
| | - Hilde Verbeek
- Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Michael Simon
- Institute of Nursing Science, Department of Public Health, University of Basel, Basel, Switzerland
| | - Sandra Staudacher
- Institute of Nursing Science, Department of Public Health, University of Basel, Basel, Switzerland.,Department of Health Services Research, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
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Siette J, Knaggs GT, Zurynski Y, Ratcliffe J, Dodds L, Westbrook J. Systematic review of 29 self-report instruments for assessing quality of life in older adults receiving aged care services. BMJ Open 2021; 11:e050892. [PMID: 34794991 PMCID: PMC8603300 DOI: 10.1136/bmjopen-2021-050892] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Quality of life (QoL) outcomes are used to monitor quality of care for older adults accessing aged care services, yet it remains unclear which QoL instruments best meet older adults', providers' and policymakers' needs. This review aimed to (1) identify QoL instruments used in aged care and describe them in terms of QoL domains measured and logistical details; (2) summarise in which aged care settings the instruments have been used and (3) discuss factors to consider in deciding on the suitability of QoL instruments for use in aged care services. DESIGN Systematic review. DATA SOURCES MEDLINE, EMBASE, PsycINFO, Cochrane Library and CINAHL from inception to 2021. ELIGIBILITY CRITERIA Instruments were included if they were designed for adults (>18 years), available in English, been applied in a peer-reviewed research study examining QoL outcomes in adults >65 years accessing aged care (including home/social care, residential/long-term care) and had reported psychometrics. DATA EXTRACTION AND SYNTHESIS Two researchers independently reviewed the measures and extracted the data. Data synthesis was performed via narrative review of eligible instruments. RESULTS 292 articles reporting on 29 QoL instruments were included. Eight domains of QoL were addressed: physical health, mental health, emotional state, social connection, environment, autonomy and overall QoL. The period between 1990 and 2000 produced the greatest number of newly developed instruments. The EuroQoL-5 Dimensions (EQ-5D) and Short Form-series were used across multiple aged care contexts including home and residential care. More recent instruments (eg, ICEpop CAPability measure for Older people (ICECAP-O) and Adult Social Care Outcomes Toolkit (ASCOT)) tend to capture emotional sentiment towards personal circumstances and higher order care needs, in comparison with more established instruments (eg, EQ-5D) which are largely focused on health status. CONCLUSIONS A comprehensive list of QoL instruments and their characteristics is provided to inform instrument choice for use in research or for care quality assurance in aged care settings, depending on needs and interests of users.
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Affiliation(s)
- Joyce Siette
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
- Centre for Ageing, Cognition and Wellbeing, Macquarie University, Sydney, New South Wales, Australia
| | - Gilbert Thomas Knaggs
- NHMRC Partnership Centre for Health Systems Sustainability, Macquarie University, Sydney, New South Wales, Australia
| | - Yvonne Zurynski
- NHMRC Partnership Centre for Health Systems Sustainability, Macquarie University, Sydney, New South Wales, Australia
| | - Julie Ratcliffe
- Health and Social Care Economics Group, Caring Futures Institute, Flinders University of South Australia, Adelaide, South Australia, Australia
| | - Laura Dodds
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Johanna Westbrook
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
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Basinska K, Künzler-Heule P, Guerbaai RA, Zúñiga F, Simon M, Wellens NIH, Serdaly C, Nicca D. Residents' and Relatives' Experiences of Acute Situations: A Qualitative Study to Inform a Care Model. THE GERONTOLOGIST 2021; 61:1041-1052. [PMID: 33624766 PMCID: PMC8437505 DOI: 10.1093/geront/gnab027] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Indexed: 11/24/2022] Open
Abstract
Background and Objectives As new models of care aiming to reduce hospitalizations from nursing homes emerge, their implementers must consider residents’ and relatives’ needs and experiences with acute changes in the residents’ health situations. As part of the larger INTERCARE implementation study, we explored these persons’ experiences of acute situations in Swiss nursing homes. Research Design and Methods 3 focus groups were conducted with residents and their relatives and analyzed via reflexive thematic analysis. Results The first theme, the orchestra plays its standards, describes experiences of structured everyday care in nursing homes, which functions well despite limited professional and competency resources. The second theme, the orchestra reaches its limits, illustrates accounts of acute situations in which resources were insufficient to meet residents’ needs. Interestingly, participants’ perceptions of acute situations went well beyond our own professional view, that is, changes in health situations, and included situations best summarized as “changes that might have negative consequences for residents if not handled adequately by care workers.” Within the third theme, the audience compensates for the orchestra’s limitations, participants’ strategies to cope with resource limitations in acute situations are summarized. Discussion and Implications Our findings suggest differences between care providers’ and participants’ perspectives regarding acute situations and care priority setting. Alongside efforts to promote staff awareness of and responsiveness to acute situations, care staff must commit to learning and meeting individual residents’ and relatives’ needs. Implications for the development and implementation of a new nurse-led model of care are discussed.
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Affiliation(s)
- Kornelia Basinska
- Nursing Science (INS), Department of Public Health, Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Patrizia Künzler-Heule
- Nursing Science (INS), Department of Public Health, Faculty of Medicine, University of Basel, Basel, Switzerland.,Department of Gastroenterology/Hepatology, Cantonal Hospital St. Gallen, Switzerland.,Department of Nursing Development, Cantonal Hospital St. Gallen, Switzerland
| | - Raphaëlle Ashley Guerbaai
- Nursing Science (INS), Department of Public Health, Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Franziska Zúñiga
- Nursing Science (INS), Department of Public Health, Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Michael Simon
- Nursing Science (INS), Department of Public Health, Faculty of Medicine, University of Basel, Basel, Switzerland.,Inselspital Bern University Hospital, Nursing Research Unit, Switzerland
| | - Nathalie I H Wellens
- Department of Public Health and Social Affairs of the Canton of Vaud, Lausanne, Switzerland
| | | | - Dunja Nicca
- Nursing Science (INS), Department of Public Health, Faculty of Medicine, University of Basel, Basel, Switzerland.,Department of Public & Global Health, Epidemiology, Biostatistics and Prevention Institute, University of Zürich, Switzerland
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Why do patients struggle with their medicines?-A phenomenological hermeneutical study of how patients experience medicines in their everyday lives. PLoS One 2021; 16:e0255478. [PMID: 34358258 PMCID: PMC8345846 DOI: 10.1371/journal.pone.0255478] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 07/16/2021] [Indexed: 11/19/2022] Open
Abstract
Why do so many people struggle with their medicines despite decades of research on medicines taking? Research into how people experience medicines in their everyday life remains scarce with the majority of research in this area of focusing on whether or not people take their medicines as prescribed. Hence, this study used a phenomenological hermeneutical qualitative design to gain a deeper understanding of individuals’ perspectives on the lived experience of medicine-taking. Findings from this study highlight five main themes where participants experience medicines as: 1) life-saving and indispensable, 2) normal and a daily routine, 3) confusing and concerning, 4) unsuitable without adjustment, and 5) intrusive and unwelcome. These results can be the basis for mutually agreed prescribing through a co-creative approach that aims at enhancing open and honest dialogues between patients and healthcare professionals in partnership about medicines.
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12
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Lundin A, Bülow PH, Stier J. Assistant Nurses' Positioned Accounts for Prioritizations in Residential Care for Older People. THE GERONTOLOGIST 2021; 61:573-581. [PMID: 33063827 DOI: 10.1093/geront/gnaa154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Swedish eldercare is strained by an increased administrative workload, which draws time away from individual care of and interaction with older people. This study explores how eldercare staff, working closely with residents in Swedish special housing (nursing homes), make accounts for how they prioritize work tasks. RESEARCH DESIGN AND METHODS Openly structured, thematic interviews were conducted with 12 permanently employed, female assistant nurses, including a group interview with 3 of them. Positioned accounts (small stories) concerning prioritizations due to insufficient resources were analyzed, using Bamberg's three-level positioning analysis. RESULTS The analysis shows that the staff take a favorable position toward the older people by distinguishing between care and "the other things." They also justify prioritizations at odds with their care values. The assistant nurses present themselves as doing the best they can in organizationally restricted situations. Organizational demands limit the space for care, giving rise to an idealization of "icing on the cake." Morale is complex in residential care. A narration of "the torn carer" was found as a co-constructed storyline explaining why the staff did not perform eldercare consistent their care values. DISCUSSION AND IMPLICATIONS When ideals and practice differ, interaction in the peer group becomes important in order to maintain a positive professional identity. "The torn carer" is a way for the staff to escape blame for not living up to care values, but it also victimizes them. Staff could be empowered by a working environment characterized by a reflective practice.
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Affiliation(s)
- Anette Lundin
- Department of Social Work, Linnaeus University, Kalmar, Sweden
| | - Pia H Bülow
- School of Health and Welfare, Jönköping University, Sweden.,Department of Social Work, University of the Free State, Bloemfontein, South Africa
| | - Jonas Stier
- Department of Social Work, Mälardalen University, Västerås, Sweden
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13
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Baxter R, Corneliusson L, Björk S, Kloos N, Edvardsson D. A recipe for thriving in nursing homes: A meta-ethnography. J Adv Nurs 2021; 77:2680-2688. [PMID: 33608981 DOI: 10.1111/jan.14775] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 11/20/2020] [Accepted: 01/18/2021] [Indexed: 11/28/2022]
Abstract
AIM To explore contributors for thriving in nursing homes by evaluating, analysing and synthesizing peer-reviewed qualitative literature on the topic. BACKGROUND Thriving is a positive life-world concept that has been explored by several qualitative studies; however, descriptions of thriving and contributors to thriving have not been compared or contrasted among different studies and contexts, nor have they been reviewed and synthesized. DESIGN Qualitative meta-ethnography. DATA SOURCES Four electronic databases were searched in October 2019, with sources published between 2000 and 2019 included. REVIEW METHODS Sources of peer-reviewed literature that employed qualitative methods to explore thriving in nursing homes were evaluated. In total, 1,017 sources were screened at title-level, 95 advanced to abstract-level review and 11 were assessed at full-text level. Each source was evaluated by two researchers independently in relation to methodological quality and relevance to the study aim. Themes pertaining to thriving in nursing homes were extracted, interpreted and synthesized. RESULTS In total, seven sources of peer-reviewed literature were included. Two main themes illustrating the contributors to thriving were identified: ingredients for thriving (subthemes: personal contributors and social contributors) and environment for thriving (subthemes: spacial contributors and societal contributors). CONCLUSION Contributors to thriving in nursing homes include personal attributes, relationships with others, the lived environment and societal structures. Thriving for older people could thereby be defined as a holistic concept denoting lived experiences of situated contentment. Future studies should explore different temporal facets of thriving in the nursing home setting. IMPACT This meta-synthesis proposes a 'recipe' for thriving as comprising the right ingredients and the right environment, determined by the preferred 'taste' of the individual person. The proposed definition and contributors illuminate thriving as a positive life-world concept that is based on one's lived experiences and context.
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Affiliation(s)
| | | | - Sabine Björk
- Department of Nursing, Umeå University, Umeå, Sweden
| | - Noortje Kloos
- Department of Psychology, Health and Technology, Centre for eHealth and Wellbeing Research, University of Twente, Enschede, Netherlands
| | - David Edvardsson
- Department of Nursing, Umeå University, Umeå, Sweden.,School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia
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Baxter R, Sandman PO, Björk S, Sköldunger A, Edvardsson D. Recognizing expressions of thriving among persons living in nursing homes: a qualitative study. BMC Nurs 2021; 20:8. [PMID: 33402189 PMCID: PMC7786504 DOI: 10.1186/s12912-020-00526-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 12/20/2020] [Indexed: 11/24/2022] Open
Abstract
Background Thriving has emerged as a contemporary and health-promoting concept for older people living in nursing homes; however, there has been limited research to explore how nursing home staff identify thriving in their everyday practice. The aim of this study was to explore how staff recognize expressions of thriving among persons living in nursing homes. Methods Semi-structured interviews were conducted with 14 nurses working at a nursing home in Victoria, Australia. The interviews were audio-recorded, transcribed and analyzed using qualitative content analysis. Results The analysis resulted in six sub-categories and three main categories. Expressions of thriving were recognized in relation to how staff understood thriving, observed thriving and sensed thriving. Staff described comparing and contrasting clinical assessment indicators with their own personal and professional understandings of thriving, as well as their overall sense of the individual person within the wider situational and environmental context. Conclusions Our results illuminate how staff recognize everyday expressions of thriving for people living in nursing homes and emphasizes the importance of utilizing person-centred care principles in clinical assessments. These findings have practical implications with regards to how thriving is identified and assessed in long-term care, and could be used to inform and guide staff education, person-centred care strategies, and organizational policies to better support and promote thriving in nursing homes. Supplementary Information The online version contains supplementary material available at 10.1186/s12912-020-00526-7.
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Affiliation(s)
| | - Per-Olof Sandman
- Department of Nursing, Umeå University, Umeå, Sweden.,Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Huddinge, Sweden
| | - Sabine Björk
- Department of Nursing, Umeå University, Umeå, Sweden.,Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden
| | - Anders Sköldunger
- Department of Nursing, Umeå University, Umeå, Sweden.,Department of Neurobiology, Division of Neurogeriatrics, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - David Edvardsson
- Department of Nursing, Umeå University, Umeå, Sweden.,School of Nursing and Midwifery, La Trobe University, Melbourne, Australia
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Abstract
INTRODUCTION Mental illness is a major concern in many countries. In Sweden, stress-related mental illness is currently the most frequent reason for sick leave. OBJECTIVE This study aimed to explore patients' experiences of stress-related exhaustion. DESIGN A qualitative study with interview data analysed using a phenomenological hermeneutic method. SETTING Participants were selected from public primary healthcare centres in a larger city in western Sweden. PARTICIPANTS Seven women and five men on sick leave from work due to stress-related exhaustion were included in the study. FINDINGS Stress-related exhaustion was experienced as a loss of access to oneself and one's context and feelings of being trapped and lost in life. The condition had a significant impact on personal identity, raised existential issues and was interpreted as facing a blind alley. Participants described a mistaken direction in life, being forced to stop, change direction and act differently. CONCLUSION Stress-related exhaustion is a challenging, life-changing existential experience that involves a crisis with an opportunity for new insights. Careful consideration of patients' narratives together with the expertise of healthcare professionals can be combined to improve health and optimise recovery based on individual's situation.
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Affiliation(s)
- Sara Alsén
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
| | - Lilas Ali
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
- Psychiatric department, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Inger Ekman
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
| | - Andreas Fors
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Centre for Person-Centred Care (GPCC), University of Gothenburg, Gothenburg, Sweden
- Research and Development Primary Health Care, Region Västra Götaland, Gothenburg, Sweden
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