Background: In Sweden, registered nurses have a key role in initial patient assessments and prioritization in primary care. This assessment is a complex and demanding process. To meet patient and public needs, insight is needed into nurses’ communication and decision-making during these consultations. Therefore, the aim of this PhD project is to explore clinical reasoning and decision-making in patient-nurse consultations in primary care.

Methods: A prospective multicentre study was designed and data were gathered with a purposive sample of audio recorded observations of real-life communication during 150 patient‒nurse consultations, patient reported health status and stimulated recall interviews with nurses.

Findings: This PhD project will investigate communication and decision-making in 150 nurse-patient consultations with a focus on:

1.Patients’ reason-for-encounter and health problems as assessed by patients’ self-reported health concerns and functional health status (COOP-WONCA).

2.Communication of health concerns and needs as observed with the VR-CoDES (Verona Coding Definitions of Emotional Sequences) using the audio recorded consultations

3.Nurses’ clinical reasoning and decision-making using data gathered with stimulated recall interviews and analysed with a qualitative method for thematic analysis.

This project is presented as an example on how to design and gather data in communication research to investigate nurses’ communication and their exploration of health concerns during nurse-patient consultations in primary care.

Discussion: Results from this research are aimed to support nurses in their assessments, communication and clinical decision-making in primary care. In the long term, this research can contribute to increased knowledge on how the competence of registered nurses can be used and enhanced to make the best use of the primary care resources.

Background: Good access to primary care is central to health and treatment of illnesses in old age. The older population, adults aged 65 years or older, is a diverse group of individuals who exhibit significant variations in their health conditions and longevity. Hence, it is essential to tailor primary care practice to their individual needs. For most elderly in Sweden, registered nurses in primary care are their first point of contact with healthcare services. Therefore, we will explore elderly patients’ expectations and experiences in primary care consultations with nurses.

Methods: An observational study with older adults in primary care will be performed by recording and analysing real-life nurse-patient consultations.

Findings:  From 150 audio-recorded nurse-patient consultations, collected in 2023/2024, the consultations with older patients will be further investigated in this PhD project with a focus on:

1.

What communication aspects do older patients report as important based on their expectations and experiences of primary care nurse consultations assessed with the QUOTE-COMM (Quality Of communication Through the patients' Eyes) questionnaire.

2.

Older adults’ involvement in primary care consultations with nurses by coding the audio recordings with the OPTION 5.

3.

Health information and advice to older adults in primary care nurse visits by analysing the audio qualitatively.

The methods used for this communication research on older adults-nurse consultations will be further discussed.

Discussion: The number of studies on real-life nurse-patient consultations in primary care, specifically with older adults, is limited. This points to a scarcity of insights in the field of communication in older nurse-patient consultations in primary care. There is a need for research to gain a deeper understanding of nurses’ communication strategies and the way they involve older patients in their care. Such insight is needed to continue to provide person-centered care for the steadily increasing numbers of older patients who seek primary care.

Introduction

Communication between older persons and nursing assistants is important in providing high-quality, person-centred home care. While previous research has reported on older persons' emotional concerns during home care conversations, there is a need to gain an in-depth understanding of emotional concerns' role in such conversations and how to support the older persons' comfort and well-being. Therefore, this study aimed to explore the nature and focus of emotional communication between older persons and nursing assistants in home care.

Methods

A descriptive qualitative design using observational data from 83 audio-recorded home care visits was used to identify and analyse sequences of distressing emotional communication, analysed through thematic analysis.

Results

In this study, four themes were described illustrating how emotional communication between older persons and nursing assistants during home care visits creates opportunities for empathy: (1) recognising empathic opportunities, (2) identifying subtle and vague signs of emotional distress, (3) expressing needs for emotional support, and (4) striving to restore comfort in challenging conversations.

Conclusions

Conversations about older persons' emotions and worries can be complex. The findings indicate a fine line between meaningfulness and discomfort in emotional sequences. Expressions of emotional distress provide empathic opportunities that call for attentiveness and sensitivity from nursing assistants, implying a need for education and training in person-centred communication.

Implications for Practice

Emotional communication acknowledging empathic opportunities enhances person-centred care by promoting trust, comfort, and well-being. Ultimately, emotional communication reinforces the importance of empathy in home care and creates space for emotional interactions, leading to more supportive relationships.

Aim

To evaluate child-nurse emotional communication during needle procedures using a child-centered intervention versus a control group.

Methods

A controlled, video-observational study, incorporating 66 children and seven nurses was conducted. Data were collected using video-recordings of child-nurse communication during needle procedures when receiving standard care (control group) or standard care plus the i Can Choose intervention (intervention group).

Findings

Children expressed their unpleasant emotions mostly non-verbally. Compared to children in the intervention group, those in the control group more often expressed vague or unspecified words to describe an emotion (χ2(1) = 14.4, p < 0.001). The nurses' focus and overall communication style varied between the groups. When using i Can Choose, nurses provided more space to children's communication preferences. This seemed to increase children's involvement during the needle procedure.

Conclusion

Communicating with the child, the so-called communicative interaction, instead of to the child, can play a critical role in children's handling of fear and pain related to needle procedures.

Aim

This paper examines a theory and practice developed framework aimed at guiding person-centred communication in registered nurse–patient encounters. The primary objective is to refine and present a data- and theory-driven framework tailored to the demands of nursing practice and those receiving care. To achieve this, the COMCARE model is introduced, providing practical guidance for understanding and implementing strategies for nurses' communication and caring behaviours.

Design

This theoretical paper addresses theory and research on communication strategies during registered nurse–patient encounters based on the principles of caring and person-centredness.

Results

The COMCARE model outlines communication strategies to guide registered nurses to ensure caring and supportive interactions, aligning with the principles of person-centred care. COMCARE builds on the necessary communication skills for person-centred registered nurses–patient encounters and clarifies key components of such communication, with related goals. The key components proposed are related to empathic listening and asking questions, responding and acknowledging, guiding and using clear communication, supportive communication, and appraising and confirming communication. Person-centred communication requires a broad repertoire of skills to be applied and tailored to individuals in various situations and practices.

Conclusion

The COMCARE model provides an overview of the communication skills essential for person-centred care, emphasising guidance for nursing practice to support patients' optimal well-being and health. This framework highlights the importance of communication skills in shaping patient experiences and outcomes and underscores the need for their application and implementation in caring and nursing practice. Effective communication by registered nurses and other healthcare professionals is vital for delivering high-quality care. The COMCARE framework offers practical guidance and serves as a foundation for future training and education for nursing students, as well as informing policy and research in this area. Further research is needed to test and validate the COMCARE model in clinical settings.

Purpose

The number of people living and ageing with HIV is increasing. Insight into their well-being is lacking. The present study was conducted to explore needs, psychosocial issues and experiences of ageing in older adults living with human immunodeficiency virus (HIV) in Sweden.

Methods

A qualitative approach was employed. Semi-structured interviews were conducted with a convenience sample of 22 participants aged 65 years or older living with HIV in Sweden. Thematic analysis based on descriptive phenomenology was used.

Results

Being an older adult living with HIV emerged as a multifaceted experience. The meaning and impact of HIV varied from minimal to substantial, and ageing could overshadow the significance of HIV in everyday life. Three themes emerged: 1) increasing age in the foreground, 2) internalizing HIV in everyday life, and 3) socioemotional impact on everyday life.

Conclusions

The findings suggest a need for a more holistic approach to care of older adults living with HIV, recognizing the broader context of healthy ageing. While participants experienced good health, challenges related to ageing persist, and experiencing HIV-related stigma. The findings highlight the importance of empowering older adults living with HIV.