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  • 1.
    Claesson, Maria
    et al.
    Högskolan i Borås, Akademin för vård, arbetsliv och välfärd.
    Josefsson, Karin
    Högskolan i Borås, Akademin för vård, arbetsliv och välfärd.
    Jonasson, Lise-Lotte
    Department of Nursing School of Health and Welfare, Jönköping University, Jönköping, Sweden.
    ‘My registered nurse’: Older people’s experiences of registered nurses’ leadership close to them in community home care in Sweden2021Ingår i: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, artikel-id e12399Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim

    To explore older people's experiences of registered nurses? leadership close to them in community home care.

    Introduction

    In Sweden and throughout the world, the number of people 65 years and older is increasing. While older people are living for more years, living longer can bring more diseases and disabilities, which might lead to the need for home care. Registered nurses are responsible for older people's care needs in their leadership in community home care; this is a part of their professional role as registered nurses, and it implies that they must be multi-artists.

    Design

    An explorative and inductive design was used in two communities in western Sweden.

    Methods

    Individual interviews were conducted with older people (n = 12) with at least one year of experience with community home care. Data were analysed using qualitative content analysis. Results The results are presented in the theme "my registered nurse", including five categories - relationship, professional competence, nursing interventions, coordination and collaboration and organisation - and 15 sub-categories.

    Conclusions

    These findings are based on older people's own experiences. This is specific, as the phenomenon of the RNs leadership is rarely explored from the perspective of older people.

    Implications for practice

    There is a need for organisations to create more opportunities for older people to have their own registered nurses leading close to them. This is because registered nurses have specific competences for meeting older people's individual needs and involving them as competent partners in satisfying their care needs.

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  • 2.
    Jarling, Aleksandra
    et al.
    Högskolan i Borås, Akademin för vård, arbetsliv och välfärd.
    Rydström, Ingela
    Högskolan i Borås, Akademin för vård, arbetsliv och välfärd.
    Ernsth-Bravell, Marie
    Institute of Gerontology, Jönköping University.
    Nyström, Maria
    Högskolan i Borås, Akademin för vård, arbetsliv och välfärd.
    Dalheim Englund, Ann-Charlotte
    Högskolan i Borås, Akademin för vård, arbetsliv och välfärd.
    Becoming a guest in your own home: Home care in Sweden from the perspective of older people with multimorbidities2018Ingår i: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 13, nr 3Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Abstract Background: In line with changing demographics, conditions for older people have also changed. Older people are expected to live and be cared for in their own home for as long as possible. Increasing age also increases the risk of multimorbidity and the need for social services and health care services. Home care, instituted by different laws, is complex and requires cooperation from an older person when his/her home becomes a workplace for service providers.

    Aim: This study aims to illuminate the meaning of being an older person with multimorbidity who lives alone and who is cared for in his/her own home.

    Design: This study uses a qualitative design with a lifeworld approach.

    Methods: Conducted in Sweden in 2016, the researchers interviewed 12 older persons that live alone and receive home care. Data was analysed using qualitative content analysis.

    Results: The findings illustrate four sub-themes: adapting to a caring culture, being exposed, participation with limitations and being dependent on forced relationships. The overall theme reveals that older people experience a life-changing situation when receiving home care and they become a guest in their own home.

    Conclusions: Becoming older with increased needs means to disrupt one’s life when one’s private home becomes a public arena. Caregivers need to be aware of the gap between their rights by law and an older person’s experiences of receiving home care. Only then can care be offered that enables older people to have a sense of control and experience their home as their own.

    Implications for Practice: The findings emphasise the need to view older people as being self-determinant and independent. Older people receiving home care need to be seen as individuals, and their entire life situation should be considered by also acknowledging the important role played by relatives and caregivers.

  • 3.
    Jonasson, Lise-Lotte
    et al.
    [external].
    Berterö, C
    The importance of ‘approaching’ older people: a grounded theory2012Ingår i: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, Vol. 7, nr 1, s. 29-36Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aims and Objectives: The aim of this study was to identify and describe the ethical values in caring encounters as experienced by older patients in their daily interaction with nurses in wards for older people.Background: Ethical values and morals are important aspects that influence the quality of care. Methods: Empirical observational study including follow-up interviews. Twenty-two older patients participated voluntarily in this study. Constant comparative analysis, the core foundation of grounded theory was used. Results: Five categories; Being addressed, receiving respect, desiring to participate, increasing self-determination and gaining self-confidence formed the bases for the core category: Approaching: Approaching concerns how people become closer to each other in a physical space .It also includes how people become closer to each other in a dialogue, involving verbal or bodily communication. Conclusions and Relevance to Clinical Practice: Approaching indicates the ethical values that guide nurses in their caring encounters with older patients. These values are noted by the patient and have an individual value as well as leading to improved quality of their care. The older patient will be confident and satisfied with the caring encounter if the desired components in the nurse’s approaching are exhibited.

  • 4.
    Sundler, Annelie Johansson
    et al.
    Högskolan i Borås, Akademin för vård, arbetsliv och välfärd.
    Hjertberg, Frida
    Home healthcare, Marks municipality, Mark.
    Keri, Helena
    Home healthcare, Jönköping municipality.
    Holmström, Inger K
    School of Health Care and Social Welfare, Mälardalen University.
    Attributes of person-centred communication: A qualitative exploration of communication with older persons in home health care.2019Ingår i: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743, artikel-id e12284Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: Previous research points to challenges related to the home healthcare of older persons and to the complexity of communication. Although person-centred care has been advocated widely, there remains a need for in-depth knowledge on how to enable person-centred and supportive communication in the care of older persons.

    AIM: The aim of this study was to explore attributes of person-centred communication between nurses and older persons being cared for in their home.

    METHODS: A descriptive study with a qualitative approach was conducted. A data set from the COMHOME-study consisting of 77 audio-recorded home healthcare visits between registered nurses and older persons was analysed with a method for qualitative thematic analysis.

    RESULTS: The findings indicate that the attributes of person-centred communication comprise recognising, inviting and involving older persons. To facilitate this form of communication, attentiveness and responsiveness on the part of RNs seemed significant. Person-centred communication was facilitated when the RNs used verbal expressions to emphasise and acknowledge the older persons' views and were attentive to their emotions and expressions.

    CONCLUSION: The nurses' attentiveness and responsiveness seems important for person-centred communication with older persons. Communication skills are needed to recognise, invite and involve older persons in their care and to support their health and well-being. Implication for practice The importance of communication which facilitate a person-centred approach by nurses should be acknowledged when caring for older persons and included in education and training.

  • 5.
    Svensson, Anders
    et al.
    Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden.
    Bremer, Anders
    Högskolan i Borås, Akademin för vård, arbetsliv och välfärd. Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden.
    Rantala, Andreas
    Centre of Interprofessional Collaboration within Emergency care (CICE), Linnaeus University, Växjö, Sweden.
    Andersson, Henrik
    Högskolan i Borås, Akademin för vård, arbetsliv och välfärd. Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden.
    Devenish, Scott
    Faculty of Health, Queensland University of Technology, Brisbane, QLD, Australia.
    Williams, Julia
    Paramedic Clinical Research Unit (ParaCRU), University of Hertfordshire, Hatfield, UK.
    Holmberg, Mats
    Faculty of Health and Life Sciences, Linnaeus University, Växjö, Sweden.
    Ambulance clinicians’ attitudes to older patients’ self-determination when the patient has impaired decision-making ability: A Delphi study2021Ingår i: International Journal of Older People Nursing, ISSN 1748-3735, E-ISSN 1748-3743Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Objective

    The proportion of older people is increasing and reflects in the demand on ambulance services (AS). Patients can be more vulnerable and increasingly dependent, especially when their decision-making ability is impaired. Self-determination in older people has a positive relation to quality of life and can raise ethical conflicts in AS. Hence, the aim of this study was to empirically explore attitudes among Swedish ambulance clinicians (ACs) regarding older patients’ self-determination in cases where patients have impaired decision-making ability, and who are in urgent need of care.

    Materials and methods

    An explorative design was adopted. A Delphi technique was used, comprising four rounds, involving a group (N = 31) of prehospital emergency nurses (n = 14), registered nurses (n = 10) and emergency medical technicians (n = 7). Focus group conversations (Round 1) and questionnaires (Rounds 2–4) generated data. Round 1 was analysed using manifest content analysis, which ultimately resulted in the creation of discrete items. Each item was rated with a five-point Likert scale together with free-text answers. Consensus (≥70%) was calculated by trichotomising the Likert scale.

    Results

    Round 1 identified 108 items which were divided into four categories: (1) attitudes regarding the patient (n = 35), (2) attitudes regarding the patient relationship (n = 8), (3) attitudes regarding oneself and one's colleagues (n = 45), and (4) attitudes regarding other involved factors (n = 20). In Rounds 2–4, one item was identified in the free text from Round 2, generating a total of 109 items. After four rounds, 72 items (62%) reached consensus.

    Conclusions

    The findings highlight the complexity of ACs’ attitudes towards older patients’ self-determination. The respect of older patients’ self-determination is challenged by the patient, other healthcare personnel, significant others and/or colleagues. The study provided a unique opportunity to explore self-determination and shared decision-making. AS have to provide continued ethical training, for example to increase the use of simulation-based training or moral case deliberations in order to strengthen the ACs’ moral abilities within their professional practice.

    Implications for practice

    Ambulance services must develop opportunities to provide continued training within this topic. One option would be to increase the use of simulation-based training, focusing on ethical aspects of the care. Another option might be to facilitate moral case deliberations to strengthen the ACs’ abilities to manage these issues while being able to share experiences with peers. These types of interventions should illuminate the importance of the topic for the individual AC, which, in turn, may strengthen and develop the caring abilities within an integrated care team.

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