Forgotten resources of older home care clients: Focus group study in Finland

In this qualitative focus group study, the resources available to older home‐dwelling people, particularly incoming and existing home care clients, are described from the viewpoint of home care professionals (n = 32). The data were analyzed using inductive content analysis. There were three categories of older people requiring resources from the viewpoint of interviewers: home‐dwelling people, incoming home care clients, and existing home care clients. Based on the analysis, the resources of older home‐dwelling people were categorized in terms of support, meaningful life, everyday activities, and environment. Incoming home care client resources were support, out‐of‐home activities, in‐home activities, and environment. Existing client resources were described in terms of support, everyday activities, and environment. Home care professionals described the resources of the older home‐dwelling people in diverse ways, but those of the perspective of existing clients were reduced. The biggest difference was in everyday activities. Psychological and social resources, including meaningful life and social relationships, seemed to be forgotten. All available resources must be taken into account, especially in the everyday home care services for existing home care clients.     

Close relatives in intensive care from the perspective of critical care nurses

Aim. The aim was to describe critical care nurses’ experiences of close relatives within intensive care. Background. There is a lack of research describing critical care nurses' experiences of the significance of close relatives in intensive care. Knowledge in this area will support critical care nurses to develop good nursing care for the critically ill person and their close relatives. Design and method. The design of the study was qualitative. Data collection was carried out through focus group discussions with 24 critical care nurses in four focus groups during spring 2004. The data were subjected to qualitative thematic content analysis. Results. The focus groups discussions showed that the presence of close relatives was taken for granted by critical care nurses and it was frustrating if the critically ill person did not have any. Information from close relatives made it possible for critical care nurses to create individual care for the critically ill person. They supported close relatives by giving them information, being near and trying to establish good relations with them. Close relatives were important. Critical care nurses lacked forums for reflection and discussion about the care given. Relevance to clinical practice. This study indicates that close relatives are a prerequisite for critical care nurses to give good nursing care to meet the needs of the critically ill person. A communication based on mutual understanding is necessary if critical care nurses are to be able to support close relatives. Dealing constantly with situations that were ethically difficult without any chance to reflect was an obstacle for critical care nurses to improve their work with close relatives.     

Ethical issues in practice: A survey of home‐visiting nurses in Japan

Aim: The purposes of this study were to identify specific components and frequencies of ethical issues that home‐visiting nurses encountered in their practice, relationships between ethical issues and demographic data, and experience of ethics education and workplace environment. Methods: A self‐administered questionnaire was distributed to home‐visiting nurses in Japan. Usable data (1961) were analyzed. Results: Item and exploratory factor analysis for the frequency of encountering ethical issues revealed: (i) concern about respecting client or relationships with relevant professionals; (ii) differences in treatment or care‐taking views among home‐visiting nurse and client and family, or relevant professionals; and (iii) discrepancy of intention between family and client or home‐visiting nurse. All factors were significantly positively related to the current position, duration of working experience as a home‐visiting nurse, and type of nursing education; age was significantly negatively related. Home‐visiting nurses noted that programmed continuing education systems and staff‐training programs were not sufficiently available. Conclusion: The findings of this study indicated the characteristics of ethical issues that home‐visiting nurses encountered in their practice and insufficient continuing education system including ethics education. Ethics education programs tailored to home‐visiting nurses ethical concerns and traits and continuing education systems are needed.     

Nursing from the casual pool: focus group study to explore the experiences of casual nurses

The use of flexible non-contract nursing staff is increasing in Australia and in other countries where there is currently a nursing shortage. There is sparse empirical evidence relating to the experience of these nurses. This focus group study with six groups of enrolled and registered nurses in one regional health authority in New South Wales reports on the challenges and rewards of working through the casual pool. The textual data were coded and reported in themes and subthemes; the overarching theme is balance of social and professional life, while subthemes are social politics, nursing work and professional performance. The results reveal that nurses who work from the casual pool have insight into the work environment and culture of clinical teams that is untapped formally. They have little or no chance to provide clinical teams with feedback or receive feedback on their own performance. The consequence of this study has been the development of a two-way performance intervention to promote high standards of care from nurses who work from the casual pool and the promotion of safe clinical environments and cultures.     

Co-bedding of multiples in the neonatal unit: Assessing nurses and midwives attitude and level of understanding

AimThe purpose of this project was to explore the existing attitudes and level of understanding of nurses and midwives towards co-bedding multiples (twins and higher order multiples) in a large Australian, tertiary level, Neonatal Unit.MethodA purposefully designed anonymous survey was first piloted and then distributed to nurses and midwives working in the neonatal unit. Respondents were required to answer eight multiple choice questions to assess their level of understanding of co-bedding and rate eight statements, using a 5-point Likert scale, to assess their attitude towards the practice.FindingsA total of 201 surveys were distributed and 148 surveys were returned, resulting in a response rate of 74%. A mean of 85% of respondents answered the multiple choice questions correctly. Seventy four percent of the respondents agreed with the eight statements that described potential benefits of co-bedding (47% agreed and 27% strongly agreed), 16% were undecided and 10% disagreed.ConclusionThis project has demonstrated that the nurses and midwives understood and held positive attitudes towards the practice of co-bedding of multiples. It appears that there is sufficient support to move forward to implement this aspect of family centred care best practice for neonates who are medically stable.     

Experiences and learning during a graduate nurse program: an examination using a focus group approach

The graduate nurse year requires individuals to make a huge transition from university student to registered nurse as part of the health care workforce. New graduates experience steep learning curves throughout the first year of professional practice. This study sought to explore experiences and learning occurring throughout the graduate nurse program for a group of seven new nurse graduates. Focus group interviews were conducted at six months and 12 months into the program using the same set of guiding questions. The first interview highlighted that graduates early in the graduate year were internalised, concentrating on their own survival in managing workloads, facing practice realities and coming to terms with themselves as nurses. Learning was primarily about survival strategies and performing tasks. By the second interview, graduates were much less focussed on themselves. They understood their place in the health care team, had gained confidence in their relationships, and were showing concern for the next graduates arriving. Learning at this stage involved more higher order skills, including critical thinking.     

Critical care nurses' perception of patient involvement in care: A qualitative focus group

Background

Patient involvement in care in the intensive care unit (ICU) is complex. Knowledge about the nature and extent of patient involvement in the Intensive care unit is scarce.

Aim

The aim of the study was to explore the critical care nursing staff's perception of patient involvement in their care in the ICU.

Study Design

A phenomenological, hermeneutic research study was carried out using qualitative data. Data were collected in two focus group interviews analysed using Ricoeur's theory of interpretation. The study was conducted in a level 2 medical-surgical 8-bed ICU in a regional hospital in Southern Denmark.

Results

Critical care nurses found it important to maintain involvement in intensive care. Depending on the patient's ability to partake in care, approaches for patient involvement ranged from (1) continually adjusting care activities according to the patient's bodily responses, (2) formation of a relationship with the patient to enable personalized care and (3) making room for self-determined care progressing with the patient's recovery.

Conclusion

Critical care nurses' perception of patient involvement depended on the patient's level of consciousness. When unconscious, patient involvement was possible but took a physical approach. However, the power inequality in the nurse–patient relationship must be expressed if patient involvement in the ICU is to take place.

Relevance to Clinical Practice

Results suggest that nurses' perception of patient involvement in the ICU depends on the patient's level of consciousness. Patient involvement may be possible even when the patient is unconscious but it takes a more physical approach. It is essential that the power inequality in the nurse–patient relationship must be expressed if patient involvement in the ICU is to take place.     

Nurses' first encounters with parents of new-born children--public health nurses' views of a good meeting

? The nurse’s view of the first meeting with parents of new‐born children may have consequences for the quality of future contact. A good start will lay a solid foundation for a lasting relationship, and have an affect on the nurse’s work to support parents and children and to promote health. We do not know what nurses mean by a ‘good meeting’. ? The aim of this study was to discover how nurses view the first meeting as a general preventive measure aimed at all parents and their new‐born children. ? Four focus groups interviews were held with nurses from different primary health care areas in the county of Skåne, southernmost Sweden. ? Analysis of the content in the transcribed interview texts disclosed eight subcategories: good contact/reciprocal relationship; willingness to listen; guest/equal roles; time/peace and quiet; the family in its environment; socio‐cultural aspects; confirmation/support; and individual advice. ? Three categories were established: creating trust; creating a supportive climate; and creating a picture of the family’s life situation. ? The home visit was seen as an important way to establish trust and obtain a picture of the family’s life situation, which was in turn essential for creating a supportive climate.