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Lindberg H, Vaktnäs J, Rasmussen M, Larsson I. Treating the disease and meeting the person with the illness-patient perspectives of needs during infective endocarditis, a qualitative study. PLoS One 2024; 19:e0309373. [PMID: 39190763 DOI: 10.1371/journal.pone.0309373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 08/10/2024] [Indexed: 08/29/2024] Open
Abstract
BACKGROUND Infective endocarditis (IE) is a rare but severe infectious disease. Patients with IE are treated for weeks in the hospital and have profound impairments to their health. New treatment modalities increase options for outpatient care. Little is known about how patients perceive their disease and hospitalisation. We aimed to explore the needs of patients with IE during hospitalisation and the first few months after discharge. METHODS In this qualitative study, 20 patients (45-86 years of age) hospitalised due to IE in Swedish hospitals were interviewed a median of 112 (67-221) days after hospitalisation. Data were analysed with qualitative content analysis, identifying eight subcategories, two categories, and an overall theme. RESULTS The overall theme illuminated a spectrum of needs of patients suffering from IE, between treating the disease and meeting the person with the illness. The needs encompassed eight axes with dual focus on both medical excellence and person-centred care. Medical excellence was needed to optimally treat, supervise, and offer follow-up on this rare and severe disease; patients longed to come home, and there were issues of reliability in the healthcare system. Person-centred care was requested, including individualised information leading to knowledge, reorientation, the beginning of health restoration, and being met as a unique person. Symptoms of fatigue, wasting, and cognitive and mental distress were often neglected by the caregiver. CONCLUSIONS This explorative study shows the patient's needs as important areas in a spectrum between medical excellence and person-centred care. Care in specialised units secure quality. Early discharge is requested by patients. Multiprofessional individualizing outpatient care needs to develop with preserved safety and medical excellence. The disease trajectory after discharge progresses slowly, and the possibility of mitigating its progress is still unclear. Person-centred care, screening for delayed restoration and rehabilitation after endocarditis are important fields for future studies.
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Affiliation(s)
- Helena Lindberg
- Department of Infectious Diseases, Hospital of Halland, Halmstad, Sweden
- Department of Clinical Sciences Lund, Division of Infection Medicine, Lund University, Lund, Sweden
| | - Johan Vaktnäs
- Department of Oncology and Palliative Medicine, Hospital of Halland, Varberg, Sweden
| | - Magnus Rasmussen
- Department of Clinical Sciences Lund, Division of Infection Medicine, Lund University, Lund, Sweden
| | - Ingrid Larsson
- Department of Health and Nursing, School of Health and Welfare, Halmstad University, Halmstad, Sweden
- Spenshult Research and Development Centre, Halmstad, Sweden
- Department of Clinical Sciences, Section of Rheumatology, Lund University, Lund, Sweden
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Kirvalidze M, Boström AM, Liljas A, Doheny M, Hendry A, McCormack B, Fratiglioni L, Ali S, Ebrahimi Z, Elmståhl S, Eriksdotter M, Gläske P, Gustafsson LK, Rundgren ÅH, Hvitfeldt H, Lennartsson C, Hammar LM, Nilsson GH, Nilsson P, Öhlén J, Sandgren A, Söderman A, Swedberg K, Vackerberg N, Vetrano DL, Wijk H, Agerholm J, Calderón-Larrañaga A. Effectiveness of integrated person-centered interventions for older people's care: Review of Swedish experiences and experts' perspective. J Intern Med 2024; 295:804-824. [PMID: 38664991 DOI: 10.1111/joim.13784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/15/2024]
Abstract
Older adults have multiple medical and social care needs, requiring a shift toward an integrated person-centered model of care. Our objective was to describe and summarize Swedish experiences of integrated person-centered care by reviewing studies published between 2000 and 2023, and to identify the main challenges and scientific gaps through expert discussions. Seventy-three publications were identified by searching MEDLINE and contacting experts. Interventions were categorized using two World Health Organization frameworks: (1) Integrated Care for Older People (ICOPE), and (2) Integrated People-Centered Health Services (IPCHS). The included 73 publications were derived from 31 unique and heterogeneous interventions pertaining mainly to the micro- and meso-levels. Among publications measuring mortality, 15% were effective. Subjective health outcomes showed improvement in 24% of publications, morbidity outcomes in 42%, disability outcomes in 48%, and service utilization outcomes in 58%. Workshop discussions in Stockholm (Sweden), March 2023, were recorded, transcribed, and summarized. Experts emphasized: (1) lack of rigorous evaluation methods, (2) need for participatory designs, (3) scarcity of macro-level interventions, and (4) importance of transitioning from person- to people-centered integrated care. These challenges could explain the unexpected weak beneficial effects of the interventions on health outcomes, whereas service utilization outcomes were more positively impacted. Finally, we derived a list of recommendations, including the need to engage care organizations in interventions from their inception and to leverage researchers' scientific expertise. Although this review provides a comprehensive snapshot of interventions in the context of Sweden, the findings offer transferable perspectives on the real-world challenges encountered in this field.
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Affiliation(s)
- Mariam Kirvalidze
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Solna, Sweden
| | - Anne-Marie Boström
- Department of Neurobiology, Care Sciences, and Society, Division of Nursing, Karolinska Institutet, Huddinge, Sweden
- Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden
- Research and Development Unit, Stockholms Sjukhem, Stockholm, Sweden
| | - Ann Liljas
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Solna, Sweden
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
| | - Megan Doheny
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Solna, Sweden
| | - Anne Hendry
- International Foundation for Integrated Care (IFIC), Glasgow, Scotland, UK
- School of Health and Life Sciences, University of the West of Scotland, Glasgow, Scotland, UK
| | - Brendan McCormack
- Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, Sydney Nursing School, The University of Sydney, Sydney, Australia
| | - Laura Fratiglioni
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Solna, Sweden
- Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Sulin Ali
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Solna, Sweden
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
- Institute for Sociology, University of Duisburg-Essen, Duisburg, Germany
| | - Zahra Ebrahimi
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg Centre for Person-Centred Care - GPCC, Gothenburg, Sweden
| | - Sölve Elmståhl
- Department of Clinical Sciences, Division of Geriatric Medicine, Lund University, Lund, Sweden
| | - Maria Eriksdotter
- Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden
- Department of Neurobiology, Care Sciences and Society, Division of Clinical Geriatrics, Karolinska Institutet, Huddinge, Sweden
| | - Pascal Gläske
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Solna, Sweden
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
- Institute for Sociology, University of Duisburg-Essen, Duisburg, Germany
| | - Lena-Karin Gustafsson
- School of Health, Care and Social Welfare, Mälardalen University, Eskilstuna, Sweden
| | | | | | - Carin Lennartsson
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Solna, Sweden
- Swedish Institute for Social Research (SOFI), Stockholm University, Stockholm, Sweden
| | - Lena Marmstål Hammar
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
- School of Health and Welfare, Dalarna University, Falun, Sweden
| | - Gunnar H Nilsson
- Department of Neurobiology, Care Sciences, and Society, Division of Family Medicine and Primary Care, Karolinska Institutet, Huddinge, Sweden
| | - Peter Nilsson
- Myndigheten för vård- och omsorgsanalys, Stockholm, Sweden
| | - Joakim Öhlén
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg Centre for Person-Centred Care - GPCC, Gothenburg, Sweden
- Palliative Care Centre, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Anna Sandgren
- Center for Collaborative Palliative Care, Department of Health and Caring Sciences, Linnaeus University, Växjö, Sweden
| | - Annika Söderman
- Faculty of Medicine and Health, School of Health Sciences, Örebro University, Örebro, Sweden
| | - Karl Swedberg
- Department of Molecular and Clinical Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Nicoline Vackerberg
- Jönköping Academy for Improvement of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Davide Liborio Vetrano
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Solna, Sweden
- Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Helle Wijk
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg Centre for Person-Centred Care - GPCC, Gothenburg, Sweden
- Department of Architecture and Civil Engineering, Chalmers University of Technology, Gothenburg, Sweden
- Department of Quality Assurance and Patient Safety, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Janne Agerholm
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Solna, Sweden
- Department of Global Public Health, Karolinska Institutet, Solna, Sweden
| | - Amaia Calderón-Larrañaga
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Solna, Sweden
- Stockholm Gerontology Research Center, Stockholm, Sweden
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3
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Fomicheva AV, Volel BA, Troshina DV, Andreev DA, Simonov AN, Zozulya SA, Klyushnik TP. [Clinical features of asthenic disorders in chronic heart failure]. Zh Nevrol Psikhiatr Im S S Korsakova 2023; 123:104-111. [PMID: 36843466 DOI: 10.17116/jnevro2023123021104] [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: 02/28/2023]
Abstract
OBJECTIVE The aim of the study is to study the clinical features of asthenic disorders in chronic heart failure (CHF) considering the reaction to the disease. MATERIAL AND METHODS 62 inpatients with CHF II-IV functional class (FC) according to NYHA were examined. Research methods included somatic, psychopathological and pathopsychological examination using psychometric scales. RESULTS According to a pathopsychological study using the Multidimensional Fatigue Inventory (MFI-20), asthenic disorders were discovered in all examined patients, realized mainly by «general fatigue» (75.8%) and «physical fatigue» (72.6%), more rarely «mental fatigue» was observed (32.2%). Correlations of «general fatigue» with the age of patients were revealed (p=0.018). There was a relationship between the severity of asthenic disorders and the severity of CHF, as evidenced by the correlation between «general fatigue» and reduced ejection fraction (EF) of the left ventricle (p=0.005), as well as «physical fatigue» and FC according to NYHA (p=0.022). The negative impact of all components of the dimensions of asthenic disorders on the quality of life was determined (p<0.05). According to the concept of the formation of different perceptions of the manifestations of a somatic disease, two types of reactions to asthenic disorders were identified: 1. Dissociative reactions, manifested by a discrepancy between the severity of CHF and a subjective assessment of the condition with an underestimation of the asthenic symptoms denial of its influence on the usual lifestyle and associated with an unfavorable course of CHF and 2. Adaptive reactions, realized by a harmonious perception of asthenia, awareness of the need to change lifestyle considering the presence of CHF symptoms. CONCLUSION In accordance with the results, the described clinical features of asthenic disorders allow to distinguish asthenia in CHF and other pathology, and the identified types of reactions can contribute to the timely verification of asthenia, prevention of further progression of CHF, and the development of appropriate treatment approaches.
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Affiliation(s)
- A V Fomicheva
- Sechenov First Moscow State Medical University, Moscow, Russia
| | - B A Volel
- Sechenov First Moscow State Medical University, Moscow, Russia.,Mental Health Research Centre, Moscow, Russia
| | - D V Troshina
- Sechenov First Moscow State Medical University, Moscow, Russia
| | - D A Andreev
- Sechenov First Moscow State Medical University, Moscow, Russia
| | - A N Simonov
- Mental Health Research Centre, Moscow, Russia
| | - S A Zozulya
- Mental Health Research Centre, Moscow, Russia
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Qin J, Xiong J, Wang X, Gao Y, Gong K. Kinesiophobia and Its Association With Fatigue in CHF Patients. Clin Nurs Res 2022; 31:1316-1324. [PMID: 35249417 DOI: 10.1177/10547738221081230] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Kinesiophobia is related with adverse outcomes in various diseases, but it hasn't been studied in chronic heart failure (CHF). Fatigue often causes movement avoidance in CHF patients by leading to a worse condition and server symptom burden. To explore kinesiophobia and its related factors and the relationship between the kinesiophobia and fatigue in CHF patients. We recruited total of 236 inpatients with CHF from October 2020 to March 2021 and administered a self-designed demographic questionnaire, the Chinese version of the Tampa Scale for Kinesiophobia Heart (TSK-Heart-C), and the Multidimensional Fatigue Inventory (MFI-20), and collected related electronic medical record data. The results showed that the incidence of kinesiophobia was 63.14% in hospitalized patients, and there was a moderate correlation between fatigue and kinesiophobia (r = .49, p < .01). Educational background, monthly family income, disease course, and fatigue explained 41% of the variation in kinesiophobia, of which fatigue independently accounted for 9%.
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Affiliation(s)
- Jingwen Qin
- Department of Cardiology, Affiliated Hospital of Yangzhou University, Yangzhou University,Jiangsu, China.,School of Nursing, Yangzhou University, Jiangsu, China
| | - Juanjuan Xiong
- Department of Cardiology, Affiliated Hospital of Yangzhou University, Yangzhou University,Jiangsu, China.,School of Nursing, Yangzhou University, Jiangsu, China
| | - Xue Wang
- Department of Cardiology, Affiliated Hospital of Yangzhou University, Yangzhou University,Jiangsu, China
| | - Ya Gao
- Department of Cardiology, Affiliated Hospital of Yangzhou University, Yangzhou University,Jiangsu, China
| | - Kaizheng Gong
- Department of Cardiology, Affiliated Hospital of Yangzhou University, Yangzhou University,Jiangsu, China
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5
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Zhang J, Chai X, Ye Y, Zhao Q, Fan X. Association between sleep and quality of life in heart failure patient-caregiver dyads and mediation of fatigue: An actor-partner interdependence mediation model. J Adv Nurs 2022; 78:2436-2447. [PMID: 35133026 DOI: 10.1111/jan.15174] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 01/02/2022] [Accepted: 01/20/2022] [Indexed: 11/30/2022]
Abstract
AIMS Quality of life is essential to heart failure patients and their family caregivers. This study aimed to examine the mediating role of fatigue in the association between sleep and quality of life in heart failure patient-caregiver dyads. DESIGN A cross-sectional descriptive study was conducted from November 2017 to August 2018. METHODS A total of 269 heart failure patient-caregiver dyads at two hospitals in China were included. The Chinese version of the Pittsburgh Sleep Quality Index, the Chalder Fatigue Scale and the 12-item Short-Form Health Survey were used to collect data on heart failure patients and their family caregivers. The structural equation model was employed in the dyadic analysis based on the actor-partner interdependence mediation model. RESULTS Regarding the actor effects, poor sleep was negatively associated with physical and mental quality of life in heart failure patients and their family caregivers, respectively, and the relationship was mediated by their fatigue. Regarding the partner effects, caregivers' fatigue was positively associated with patients' physical quality of life and mediated the association between caregivers' sleep and patients' physical quality of life. CONCLUSIONS Heart failure patients and their family caregivers experience reduced quality of life when they have poor sleep and fatigue, and caregivers' fatigue is related to patients' improved physical quality of life. Hence, dyadic interventions targeting to improving sleep and fatigue may be beneficial to their quality of life. IMPACT This study highlights the importance of routinely measuring and managing sleep and fatigue for heart failure patients and their family caregivers. Effective dyadic-based interventions that maintain equal attention to family caregivers should be considered by healthcare providers to maximize the improvement of patients' quality of life.
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Affiliation(s)
- Jie Zhang
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Xiaohui Chai
- Department of Anesthesiology and Surgery, Qingdao Municipal Hospital Group, Qingdao, Shandong, China
| | - Yi Ye
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Qiuge Zhao
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Xiuzhen Fan
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
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6
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Roikjaer SG, Gärtner HS, Timm H. Use of narrative methods in rehabilitation and palliative care in Scandinavian countries: A scoping review. Scand J Caring Sci 2021; 36:346-381. [PMID: 34882807 DOI: 10.1111/scs.13050] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2021] [Revised: 10/21/2021] [Accepted: 11/21/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Although narratives-including an ill person's life story, life situation and future perspectives-seem to lie at the core of rehabilitation and palliative care in Scandinavian countries, we lack a scope of how, when and where narrative methods are used. Such a scope could provide knowledge and inspiration on a practical as well as a policy level. The objective of this study is to explore the literature on the use of systematic, narrative methods in rehabilitative and palliative care for people with life-threatening illness in Scandinavian countries. METHOD We conducted a scoping review in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) where applicable. We performed a systematic search in CINAHL, Medline, PsychInfo, SOCIndex and SveMed+using the search terms 'life threatening illness', 'narratives', 'rehabilitation', 'palliative care' and 'Scandinavia', followed by a search for grey literature. We found 42 records to be eligible for this scope and extracted the data via piloted extraction tables. RESULTS We identified 17 narrative methods and present findings concerning four themes: (1) a record of the narrative methods used; (2) an objective and theoretical framework for the narrative methods; (3) the content and form of the narrative methods; and (4) the significance of the narrative methods used. CONCLUSION Narrative methods are used in systematic ways in rehabilitation and palliative care in Scandinavian countries and cover a wide variety of objectives, theoretical frames, forms and outcomes. Further development may benefit from more elaboration on definitions and the relationships between objectives, theoretical frameworks and outcomes.
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Affiliation(s)
- Stine Gundtoft Roikjaer
- REHPA, The Danish Knowledge Center for Rehabilitation and Palliative Care, Nyborg, Denmark.,Naestved, Slagelse, Ringsted Hospitals Department of Neurology, and Department of Physiotherapy and occupational therapy, Region Zealand, Slagelse, Denmark
| | - Henriette Søby Gärtner
- REHPA, The Danish Knowledge Center for Rehabilitation and Palliative Care, Nyborg, Denmark.,SIF, The National Institute of Public Health, University of Southern Denmark, Nyborg, Denmark
| | - Helle Timm
- REHPA, The Danish Knowledge Center for Rehabilitation and Palliative Care, Nyborg, Denmark.,SIF, The National Institute of Public Health, University of Southern Denmark, Nyborg, Denmark
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Straiton N, Gallagher R. Prioritizing what matters most in digital health research. Eur J Cardiovasc Nurs 2021; 21:519-520. [PMID: 34791176 DOI: 10.1093/eurjcn/zvab103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 10/19/2021] [Indexed: 11/13/2022]
Affiliation(s)
- Nicola Straiton
- Sydney Nursing School, University of Sydney, Sydney, New South Wales, Australia
| | - Robyn Gallagher
- Sydney Nursing School, University of Sydney, Sydney, New South Wales, Australia
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Ekman I, Ebrahimi Z, Olaya Contreras P. Person-centred care: looking back, looking forward. Eur J Cardiovasc Nurs 2021; 20:93-95. [PMID: 33693738 DOI: 10.1093/eurjcn/zvaa025] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 11/11/2020] [Indexed: 11/12/2022]
Abstract
An interdisciplinary group of clinical and non-clinical academics in Sweden created a research centre for the study of person-centred care (PCC) in long-term illness: the University of Gothenburg Centre for Person-Centred Care (GPCC). The GPCC steering committee formulated a position paper with three 'simple routines' to initiate, implement, and safeguard PCC in daily clinical practice. The EJCN accepted this position paper for publication in 2011. This brief review seeks to present how PCC, as defined in the position paper, has been used in research and published in EJCN during the past 5 years (2016-20). Clinical implications and future research in PCC are also suggested.
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Affiliation(s)
- Inger Ekman
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Centre for Person-Centred Care, University of Gothenburg (GPCC), Gothenburg, Sweden
| | - Zahra Ebrahimi
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Centre for Person-Centred Care, University of Gothenburg (GPCC), Gothenburg, Sweden
| | - Patricia Olaya Contreras
- Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Centre for Person-Centred Care, University of Gothenburg (GPCC), Gothenburg, Sweden
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Thorarinsdottir K, Kristjansson K. Meaningful Text: Total Hip Replacement Patients’ Lived Experience of a Nursing Care Plan Written in Lay Language. Open Nurs J 2020. [DOI: 10.2174/1874434602014010325] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Person-centred care involves respecting patients’ experiences, preferences, and needs, as well as sharing information with them and involving them in care planning. Scant research has been conducted on how it influences patients to have direct access to their care planning when it has been established through the use of standardised care plans or pathways. In the orthopaedic ward in which this study was conducted, a standardised nursing care plan for total hip replacement patients (THR), which was originally written in professional language, was rewritten in lay language and used as peri-operative teaching material for this patient group.
Study Aim:
To explore the meaning THR patients ascribe to the lived experience of reading and retaining their standardised nursing care plan in lay language during their hospital stay.
Methods:
The data collection and analysis followed a method adapted by the Vancouver School of Doing Phenomenology. Data were collected through 12 in-depth interviews with six THR patients.
Results:
The main finding was that the participants acquired knowledge from the text of the care plan that was understandable and meaningful, as evidenced by the empowering impact it had on them. This impact included improved psychological wellbeing, more open communication, and the provision of a tool to keep track of care. Some revisions of the care plan were recommended.
Conclusion:
The study suggests that a patient version of standardised care plans can act as an important educational tool for THR patients that can empower them to manage their health situations.
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Tools to Support Self-Care Monitoring at Home: Perspectives of Patients with Heart Failure. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17238916. [PMID: 33266245 PMCID: PMC7731418 DOI: 10.3390/ijerph17238916] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 11/04/2020] [Accepted: 11/25/2020] [Indexed: 12/15/2022]
Abstract
Self-care monitoring at home can be a challenge for patients with heart failure (HF). Tools that leverage information and communication technology (ICT), comprise medical devices, or have written material may support their efforts at home. The aim of this study was to describe HF patients’ experiences and their prioritization of tools that support, or could support, self-care monitoring at home. A descriptive qualitative design employing semi-structured interviews was used with HF patients living at home and attending an HF outpatient clinic in Norway. We used a deductive analysis approach, using the concept of self-care monitoring with ICT tools, paper-based tools, medical devices, and tools to consult with healthcare professionals (HCPs) as the categorization matrix. Nineteen HF patients with a mean age of 64 years participated. ICT tools are used by individual participants to identify changes in their HF symptoms, but are not available by healthcare services. Paper-based tools, medical devices, and face-to-face consultation with healthcare professionals are traditional tools that are available and used by individual participants. HF patients use traditional and ICT tools to support recognizing, identifying, and responding to HF symptoms at home, suggesting that they could be used if they are available and supplemented by in-person consultation with HCPs.
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