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Gustafsson, T., Sundler, A. J., Hedén, L., Lindberg, E. & Maurin Söderholm, H. (2023). Communication in home care—A feasibility study of an educational intervention in self‐efficacy and job satisfaction. Nursing Open, 10(3), 1375-1382
Open this publication in new window or tab >>Communication in home care—A feasibility study of an educational intervention in self‐efficacy and job satisfaction
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2023 (English)In: Nursing Open, E-ISSN 2054-1058, Vol. 10, no 3, p. 1375-1382Article in journal (Refereed) Published
Abstract [en]

Aim

To explore the feasibility of evaluating a novel educational intervention on person-centered communication for nursing assistants (NAs) in home care.

Design

A feasibility study with pre- and post-assessments.

Methods

Feasibility was assessed pre- and post-intervention, including evaluation of data collection procedures, completion rates and missing data in two questionnaires: Self-efficacy Questionnaire measuring communication skills and Measure of Job Satisfaction, analysed descriptively and statistically.

Results

The questionnaires were feasible and acceptable for the NAs to complete and understand. The pre- and post-assessments showed 83% and 61% completion rates, respectively, and a low proportion of missing data. Barriers for not participating in data collection were stress caused by staff shortages and high workload. Preliminary analysis of the questionnaires showed no significant difference pre- and post-intervention, even though an overall tendency of increased communication self-efficacy was observed. The NAs' self-efficacy ratings also revealed a ceiling effect.

 

Place, publisher, year, edition, pages
John Wiley & Sons, 2023
Keywords
communication, evaluation, feasibility, home care, intervention, job satisfaction, self-efficacy
National Category
Didactics
Research subject
The Human Perspective in Care
Identifiers
urn:nbn:se:hb:diva-28722 (URN)10.1002/nop2.1387 (DOI)000860296700001 ()2-s2.0-85138725712 (Scopus ID)
Funder
University of Borås
Note

Forskningsfinansering: Agneta Prytz-Folkes och Gösta Folkes Stiftelse

Available from: 2022-10-11 Created: 2022-10-11 Last updated: 2023-08-24Bibliographically approved
Höglander, J., Holmström, I. K., Gustafsson, T., Lindberg, E., Maurin Söderholm, H., Hedén, L., . . . Sundler, A. J. (2023). Implementing A person-centred CommunicaTION (ACTION) educational intervention for in-home nursing assistants – a study protocol. BMC Geriatrics, 23(1), Article ID 112.
Open this publication in new window or tab >>Implementing A person-centred CommunicaTION (ACTION) educational intervention for in-home nursing assistants – a study protocol
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2023 (English)In: BMC Geriatrics, ISSN 1471-2318, E-ISSN 1471-2318, Vol. 23, no 1, article id 112Article in journal (Refereed) Published
Abstract [en]

Background: In this study, the focus is on how to support the competence development needed for nursing assistants in home care. Home care services for older persons can be challenging concerning the nature of the interpersonal interaction and communication needed to care for and respond to the diverse needs of older people who seek to live well in our communities. This implies a need to offer more person-centred care (PCC) to older persons. However, there is a lack of knowledge on how to develop such competence. We, therefore, developed A Person-centred CommunicaTION (ACTION) programme, which is a web-based educational intervention aimed at supporting competence development for nursing assistants. The research objective is to evaluate the ACTION programme with respect to participants’ responses to and the effect of the intervention. Methods: A multicentre case–control study with pre- and post-assessments was designed. The ACTION programme will be implemented at home care units, in two different geographic areas in Sweden. A total of 300 nursing assistants will be recruited: 150 for the intervention group and 150 for the control group. We will evaluate the impact measures and the process. Pre- and post-assessments will be performed with data collected via a) audio recordings of communication, b) a questionnaire on self-efficacy communication skills, PCC, empathy and job satisfaction, c) user data, evaluation forms, field notes and observations, and d) interviews. The data will be analysed with descriptive and analytic statistics and/or qualitative methods for meanings. Discussion: This study has the potential to contribute to the evidence supporting competence development required to offer person-centred and quality home care to older persons and to meet upcoming needs for flexible and easily accessible competence development. Trial registration: ISRCTN64890826. Registered 10 January 2022, https://www.isrctn.com/ISRCTN64890826 

Place, publisher, year, edition, pages
BioMed Central (BMC), 2023
Keywords
Competence development, Education intervention, Home care, Nursing assistants, Older persons, Person-centred communication, Study protocol, Aged, Aged, 80 and over, Case-Control Studies, Communication, Empathy, Home Care Services, Humans, article, audio recording, case control study, communication skill, controlled study, education, female, human, human experiment, interview, job satisfaction, male, multicenter study, nursing assistant, qualitative analysis, questionnaire, self concept, Sweden, interpersonal communication, very elderly
National Category
Nursing
Research subject
The Human Perspective in Care; The Human Perspective in Care
Identifiers
urn:nbn:se:hb:diva-30273 (URN)10.1186/s12877-023-03831-3 (DOI)000940262500001 ()2-s2.0-85148998872 (Scopus ID)
Available from: 2023-08-15 Created: 2023-08-15 Last updated: 2024-02-01Bibliographically approved
Kleye, I., Sundler, A. J., Karlsson, K., Darcy, L. & Hedén, L. (2023). Positive effects of a child‐centered intervention on children's fear and pain during needle procedures. Paediatric and Neonatal Pain, 5(1), 23-30
Open this publication in new window or tab >>Positive effects of a child‐centered intervention on children's fear and pain during needle procedures
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2023 (English)In: Paediatric and Neonatal Pain, ISSN 2637-3807, Vol. 5, no 1, p. 23-30Article in journal (Refereed) Published
Abstract [en]

To examine whether children experience less fear or pain using a child-centered intervention and if there were differences between the intervention group and the control group regarding heart rate, time required for the procedure, success rate for the cannula insertion, and patient satisfaction. A controlled single-center case study of observational design, with one control and one intervention group. Child self-reported fear or pain levels did not reveal any differences for those receiving the intervention compared with controls. However, according to a behavioral observation measure with the Procedure Behavior Check List, effects of the intervention were lower distress in relation to fear and pain during the cannula insertion. The time it took to perform the cannula insertion also decreased significantly in the intervention group. More children in the intervention group reported that they were satisfied with the needle procedure compared with the children in the control group. The child-centered intervention provides reduced observed distress related to fear and pain in children undergoing a cannula insertion and reduced total time by more than 50%. This study found that child involvement in care strengthen their ability to manage a needle procedure. 

Keywords
child-centered care, fear, needle procedure, pain
National Category
Nursing
Research subject
The Human Perspective in Care; The Human Perspective in Care
Identifiers
urn:nbn:se:hb:diva-30382 (URN)10.1002/pne2.12095 (DOI)
Available from: 2023-08-24 Created: 2023-08-24 Last updated: 2023-10-19Bibliographically approved
Östman, M., Holmström, I. K., Sundler, A. J. & Hedén, L. (2023). The patient's first point of contact in primary care – registered nurses' communication and initial assessment. In: : . Paper presented at 10th OCHER workshop on Clinical Communication Research, Norway, 11-13 January, 2023..
Open this publication in new window or tab >>The patient's first point of contact in primary care – registered nurses' communication and initial assessment
2023 (English)Conference paper, Oral presentation only (Refereed)
Abstract [en]

Overall information:

This is a postdoc project that includes three work packages (WP). The purpose of this research is to investigate key principles and conflicts of goals in registered nurses’ (RNs) initial assessments and nurse-patient communication related to the priority of patients’ needs and care provision in primary care. This abstract focuses on the first WP.

Background:

Primary care is central to the Swedish healthcare system, for “good quality, local health care”, with focus on accessibility and continuity. In primary care, RNs are usually the patient's first point of contact and those who carry out initial assessments and priorities. The RNs communication and interaction with the patient is important for the initial exploration and understanding about patient’s health concerns, and RNs assessment includes data gathering, the interpretation of these data and decision-making on what action needs to be taken. Communication strategies used can optimize RNs assessment and clinical reasoning. However, assessments and priorities are complex, as health problems and illness severity must be weighed against accessibility and available resources. There is a lack of research on RNs communication strategies used to address individual patients’ need in their initial contact with primary care.

Aim:

To explore nurse-patient communication during initial assessments and RNs’ priorities with focus on expressed needs and concerns.

Methods:

The first WP is based on observational data, subjects for the project are RNs and patients from primary care units in Region Västra Götaland, Sweden. Data will be gathered on real time nursepatient communication using audio recordings with ten RNs doing five recordings each. A purposeful sampling will be made to collect data related to patients with a first point of contact with different disease conditions and illness complexities. The processing and analysis of data collected on audio recordings will be coded with the Verona Coding Definitions on Emotional Sequences (VR-CoDES). The data will allow for both statistical and qualitative analysis.

Expected findings:

This study can contribute to more knowledge about RNs communication strategies in relation to RNs’ assessment in patient’s first point of contact in primary care, but also whether gender differences or other inequalities exist.

Timeplan:

The first WP will start in Spring 2023 and by the end of the year, reporting and dissemination of findings is expected to be possible

Request for feedback:

We have planned to code the data with VR-CoDES. Other methods or approaches that may be suitable?

National Category
Nursing
Research subject
The Human Perspective in Care
Identifiers
urn:nbn:se:hb:diva-29345 (URN)
Conference
10th OCHER workshop on Clinical Communication Research, Norway, 11-13 January, 2023.
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare
Available from: 2023-01-23 Created: 2023-01-23 Last updated: 2023-03-30Bibliographically approved
Sundler, A. J., Hedén, L., Holmström, I. K., van Dulmen, S., Bergman, K., Östensson, S. & Östman, M. (2023). The patient’s first point of contact (PINPOINT) – protocol of a prospective multicenter study of communication and decision-making during patient assessments by primary care registered nurses. BMC Primary Care, 24(1), Article ID 249.
Open this publication in new window or tab >>The patient’s first point of contact (PINPOINT) – protocol of a prospective multicenter study of communication and decision-making during patient assessments by primary care registered nurses
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2023 (English)In: BMC Primary Care, E-ISSN 2731-4553, Vol. 24, no 1, article id 249Article in journal (Refereed) Published
Abstract [en]

Background

A major challenge for primary care is to set priorities and balance demands with available resources. The registered nurses in this study are practice nurses working in primary care offices, playing a large role in initial assessments. The overall objective of this research is to investigate practices of communication and decision-making during nurses’ initial assessment of patients’ health problems in primary care, examine working mechanisms in good practices and develop feasible solutions.

Methods

Project PINPOINT aims for a prospective multicenter study using various methods for data collection and analysis. A purposive sample of 150 patient‒nurse consultations, including 30 nurses and 150 patients, will be recruited at primary care centers in three different geographic areas of southwest Sweden. The study will report on outcomes of communication practices in relation to patient-reported expectations and experiences, communication processes and patient involvement, assessment and decision-making, related priorities and value conflicts with data from patient questionnaires, audio-recorded real-time communication, and reflective interviews with nurses.

Discussion

This research will contribute to the knowledge needed for the guidance of first-line decision-making processes to best meet patient and public health needs. This knowledge is necessary for the development of assessments and decisions to be better aligned to patients and to set priorities. Insights from this research can empower patients and service providers and help understand and enhance feasible person-centered communication strategies tailored to patients’ level of health literacy. More specifically, this research will contribute to knowledge that can strengthen nurses’ communication, assessments, and clinical decision-making in primary care. In the long term, this will contribute to how the competencies of practice nurses and other professionals are organized and carried out to make the best use of the resources within primary care.

Trial registration

ClinicalTrials.gov Identifier: NCT06067672.

 

Keywords
Communication, Decision-making, Nurse, Nurse-patient interaction, Primary care, Study protocol
National Category
Nursing Health Care Service and Management, Health Policy and Services and Health Economy
Research subject
The Human Perspective in Care
Identifiers
urn:nbn:se:hb:diva-31045 (URN)10.1186/s12875-023-02208-0 (DOI)001122635700004 ()2-s2.0-85178183187 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2022 − 00850
Available from: 2023-12-19 Created: 2023-12-19 Last updated: 2024-02-01Bibliographically approved
Östman, M., Hedén, L., van Dulmen, S., Sundler, A. J. & Holmström, I. K. (2023). The patient's first point-of-contact in primary care – registered nurse – patient communication coded by VR-CoDES. In: : . Paper presented at Nordic Conference in Nursing Research in Reykjavík, Iceland, 2 - 4 October 2023..
Open this publication in new window or tab >>The patient's first point-of-contact in primary care – registered nurse – patient communication coded by VR-CoDES
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2023 (English)Conference paper, Oral presentation only (Refereed)
National Category
Nursing
Research subject
The Human Perspective in Care; The Human Perspective in Care
Identifiers
urn:nbn:se:hb:diva-30765 (URN)
Conference
Nordic Conference in Nursing Research in Reykjavík, Iceland, 2 - 4 October 2023.
Available from: 2023-11-15 Created: 2023-11-15 Last updated: 2023-11-28Bibliographically approved
Gustafsson, T., Sundler, A. J., Hedén, L., Lindberg, E. & Maurin Söderholm, H. (2022). An educational intervention to improve communication skills in home care – a feasibility study. In: : . Paper presented at The 4th International NCCS & EACS Conference, Eskilstuna, 26-28 april, 2022..
Open this publication in new window or tab >>An educational intervention to improve communication skills in home care – a feasibility study
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2022 (English)Conference paper, Oral presentation with published abstract (Refereed)
Abstract [en]

An educational intervention to improve communication skills in home care – a feasibility study

Background

An educational intervention focused on person-centred communication with older persons in home care was developed. Twenty-three nursing assistants (NAs) from two home care units were offered the intervention. This feasibility study was conducted to capture benefits and pit falls with study processes before large scale interventions, such as acceptability and appropriateness of evaluation methods.

Aim

To explore the feasibility of proposed methods for evaluating a novel educational intervention on person-centered communication for NAs in home care.

Method

Feasibility study with pre- and post-assessments, including evaluation of data collection procedures, completion rates, and missing data for two questionnaires: Self-efficacy Questionnaire measuring communication skills and Measure of Job Satisfaction. Descriptive and statistical analysis was conducted. 

Results

The results showed a completion rate of 83% and 61% in pre- and post-assessment respectively, and a low proportion of missing data. The questionnaires were feasible and acceptable for NAs to complete and understand. Stress due to staff shortages and high workload negatively affected NAs’ participation in data collection. Overall, NAs rated their communication skills as high with a tendency towards higher communication self-efficacy after the intervention, however, this difference was not statistically significant. Job satisfaction remained unchanged pre- and post-intervention.

Conclusion

Low follow-up rates suggest that the data collection procedures need refinement. Although the outcomes are preliminary at this point, they indicate a ceiling effect in NAs’ self-efficacy ratings. The ceiling effect limits possibilities for improvement and suggests that studies with a larger sample is needed.

Implications for caring in a changing world

In a changing world, where a rapid aging population challenges home care services, there is a need for innovative interventions that support and strengthen health care professionals’ communication skills, aiming at improving older persons’ well-being This study contributes with knowledge to the complexity of developing and evaluating complex interventions on communication in home care.

National Category
Nursing
Identifiers
urn:nbn:se:hb:diva-29100 (URN)
Conference
The 4th International NCCS & EACS Conference, Eskilstuna, 26-28 april, 2022.
Available from: 2022-12-11 Created: 2022-12-11 Last updated: 2023-01-04Bibliographically approved
Kleye, I., Sundler, A. J., Darcy, L., Karlsson, K. & Hedén, L. E. (2022). Children's communication of emotional cues and concerns during a preoperative needle procedure. Patient Education and Counseling, 105(6), 1518-1523
Open this publication in new window or tab >>Children's communication of emotional cues and concerns during a preoperative needle procedure
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2022 (English)In: Patient Education and Counseling, ISSN 0738-3991, E-ISSN 1873-5134, Vol. 105, no 6, p. 1518-1523Article in journal (Refereed) Published
Abstract [en]

Objective

This study explores children’s expressions of emotional cues and concerns during needle procedures, nurses’ responses and findings in relation to children’s age and sex.

Methods

Twenty-six children aged 6–12 years were video recorded during a preoperative needle procedure. Emotional communication was analyzed using Verona Coding Definitions of Emotional Sequences.

Results

A total of 111 cues or concerns were identified in the observed needle procedures, with a distribution of 77 cues and 34 concerns. A majority of children (85%) expressed emotional cues through non-verbal communication. No differences between child age or sex related to expressed emotion were found. The child elicited the communicated emotion in 98% of sequences. Nurses' responses were coded as not providing space for communication in 75% of sequences.

Conclusion

Children are capable of expressing their emotional distress, primarily non-verbally, during needle procedures. A child showing less overt expressions during a needle procedure does not necessarily experience less fear or pain. The nurses’ communication focused on practical information during the needle procedure, with less attention to the child’s distress.

Practice implications

Nurses need to develop strategies to be aware of emotions the child communicates before, during and after a needle procedure.

Keywords
pediatrics, needle-procedure, communicate unpleasant emotions, fear, pain
National Category
Nursing
Research subject
The Human Perspective in Care; The Human Perspective in Care
Identifiers
urn:nbn:se:hb:diva-26789 (URN)10.1016/j.pec.2021.09.035 (DOI)000809718300017 ()2-s2.0-85116686249 (Scopus ID)
Available from: 2021-10-22 Created: 2021-10-22 Last updated: 2023-10-19
Ahlstrand, I., Larsson, I., Larsson, M., Ekman, A., Hedén, L., Laakso, K., . . . Hallgren, J. (2022). Health-promoting factors among students in higher education within health care and social work: a cross-sectional analysis of baseline data in a multicentre longitudinal study. BMC Public Health, 22(1), Article ID 1314.
Open this publication in new window or tab >>Health-promoting factors among students in higher education within health care and social work: a cross-sectional analysis of baseline data in a multicentre longitudinal study
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2022 (English)In: BMC Public Health, E-ISSN 1471-2458, Vol. 22, no 1, article id 1314Article in journal (Refereed) Published
Abstract [en]

Background

Educational environments are considered important in strengthening students’ health status and knowledge, which are associated with good educational outcomes. It has been suggested to establish healthy universities based on a salutogenic approach – namely, health promotion. The aim of this study was to describe health-promoting resources and factors among first-semester students in higher education in healthcare and social work.

Methods

This cross-sectional study is based on a survey distributed among all students in seven healthcare and social work programmes at six universities in southern Sweden. The survey was carried out in 2018 using a self-reported, web-based questionnaire focussing on general health and well-being, lifestyle factors together with three validated instruments measuring health-promoting factors and processes: the Sense of Coherence (SOC) scale, Salutogenic Health Indicator Scale (SHIS) and Occupational Balance Questionnaire (OBQ).

Results

Of 2283 students, 851 (37.3%) completed the survey, of whom 742 (87.1%) were women; 722 (84.8%) were enrolled on healthcare programmes, and 129 (15.2%) were enrolled on social work programmes. Most reported good general health and well-being (88.1% and 83.7%, respectively). The total mean scores for the SOC scale, SHIS and OBQ were, respectively, 59.09 (SD = 11.78), 44.04 (SD = 9.38) and 26.40 (SD = 7.07). Well-being and several healthy lifestyles were related to better general health and higher SOC, SHIS and OBQ scores. Multiple linear and logistic regressions showed that perceived well-being and no sleeping problems significantly predicted higher general health and higher SOC, SHIS and OBQ scores. Being less sedentary and non-smoking habits were significant predictors of higher SOC.

Conclusions

Swedish students in higher education within the healthcare and social work sector report good general health and well-being in the first semester, as well as health-promoting resources (i.e. SOC, SHIS and OBQ), and in some aspects, a healthy lifestyle. High-intensity exercise, no sleeping problems and non-smoking seem to be of importance to both general health and health-promotive resources. This study contributes to knowledge about the health promotive characteristics of students in the healthcare and social work fields, which is of importance for planning universities with a salutogenic approach.

Place, publisher, year, edition, pages
Springer Nature, 2022
Keywords
Health and health-promoting resources, Health behavior, Healthy lifestyles, Higher education, Occupational Balance Questionnaire, Salutogenesis, Salutogenic Health Indicator Scale, Sense of coherence, Students’ health
National Category
Nursing
Research subject
The Human Perspective in Care
Identifiers
urn:nbn:se:hb:diva-28369 (URN)10.1186/s12889-022-13690-z (DOI)000823651600001 ()2-s2.0-85133710137 (Scopus ID)
Note

Open access funding provided by Halmstad University. The six universities in the Swedish framework for ‘Health Research in Collaboration’ and Region Västra Götaland jointly financed the cost of project management. All authors receive regular research support from their respective universities. This research project has not received external funding and has not undergone peer review by the funding body.

Available from: 2022-08-12 Created: 2022-08-12 Last updated: 2023-08-28Bibliographically approved
Gustafsson, T., Lindberg, E., Hedén, L., Maurin Söderholm, H. & Sundler, A. J. (2022). Walk a fine line between meaningfulness or discomfort: the complexity of emotional communication. In: : . Paper presented at The 2022 International Conference on Communication in Healthcare in Glasgow, 6-9 September 2022..
Open this publication in new window or tab >>Walk a fine line between meaningfulness or discomfort: the complexity of emotional communication
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2022 (English)Conference paper, Oral presentation with published abstract (Refereed)
Abstract [en]

Background: 

The home care of older persons includes inter-personal interactions and communication needed to care for and respond to diverse needs of older people. Previous research has focused on emotional expressions of older persons and responses by nursing staff. Research on the meaning of the interaction in these sequences is sparse. Therefore, the aim of this study was to illuminate the meaning attached to sequences of emotional communication and the interaction during these sequences between older persons and nursing assistants during home care visits.

Methods: 

A descriptive observational design was used. The data consisted of 44 audio recordings of real-life conversations between older persons and nursing assistants during home care visits. A hermeneutic phenomenological analysis was conducted.

Findings: 

Preliminary results indicate sequences of emotional communication being a window of opportunities. The interaction that followed were linked to dual and sometimes incongruent meanings. Expressions being actively blocked or ignored could cause an increase of unpleasant emotions or distract away from negative feelings. Simultaneously, such conversations could both ease or add to the complexity of the interaction and communication. Conversations elaborating on the older persons’ emotions seemed to instill trust and create meaningfulness, at the same time as these situations contained unpleasant moments with sad or angry feelings. The risk for discomfort in these sequences could threaten the trust in the relationship.

Discussion: 

Conversations on older persons worries can be complex: the findings point to a fine line between meaningfulness and distress in these sequences. Unpleasant emotions call for attention and caution, these may need to be noticed at the same time as they cannot be forced out. 

National Category
Nursing
Identifiers
urn:nbn:se:hb:diva-29336 (URN)
Conference
The 2022 International Conference on Communication in Healthcare in Glasgow, 6-9 September 2022.
Available from: 2023-01-18 Created: 2023-01-18 Last updated: 2023-01-19Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-7067-2687

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