Christine Gustafsson

Municipal Night Nurses’ Experience of the Meaning of Caring

The aim of this study was to elucidate municipal night registered nurses’ (RNs) experiences of the meaning of caring in nursing. The research context involved all night duty RNs working in municipal care of older people in a medium-sized municipality located in central Sweden. The meaning of caring in nursing was experienced as: caring for by advocacy, superior responsibility in caring, and consultative nursing service. The municipal night RNs’ experience of caring is interpreted as meanings in paradoxes: ‘being close at distance’, the condition of ‘being responsible with insignificant control’, and ‘being interdependently independent’. The RNs’ experience of the meaning of caring involves focusing on the care recipient by advocating their perspectives. The meaning of caring in this context is an endeavour to grasp an overall caring responsibility by responding to vocational and personal demands regarding the issue of being a RN, in guaranteeing ethical, qualitative and competent care for older people.

Different Cultures but Similar Positive Attitudes: A Comparison between Thai and Swedish Nursing Students' Attitudes toward Older People

The proportion of elderly people in the worlds population is growing. Thailand and Sweden have disparate cultural traditions of caring for older people, though both countries are facing a larger population of older people. Sweden and Thailand are involved in several cooperative projects and exchange programs for nursing students in this area, raising the questions of if and how the different cultures of gerontological care influence students’ attitudes in the issue. The aim of the study was to compare Swedish and Thai nursing students’ attitudes towards older people. A convenience sample of 241 Thai nursing students and 299 Swedish nursing students participated in the study. The Kogans Old People Scale, a 34-item questionnaire, was used in this research. The questionnaire consists of 17 positive (OP+) statements and 17 negative (OP-) statements and uses a Likert scale. Concerning attitudes towards older people, there was no significant difference in Swedish and Thai students’ positive scores in the distribution across the groups. In contrast, these students did differ on negative scores across countries (p = .001). This was understood to be related to age; the Swedish students’ higher age was positively associated with their positive attitudes; as the age increased, the students’ scores were also higher. Attitudes towards older people are not only influenced by cultural values, norms, and social structures, they also have a foundation in gerontological knowledge and experiences. Education addressing cultural awareness of negative ageism should be incorporated into all aspects of education, not just gerontological courses.

The meaningful encounter: patient and next-of-kin stories about their experience of meaningful encounters in health-care

This study focuses on the meaningful encounters of patients and next of kin, as seen from their perspective. Identifying the attributes within meaningful encounters is important for increased understanding of caring and to expand and develop earlier formulated knowledge about caring relationships. Caring theory about the caring relationship provided a point of departure to illuminate the meaningful encounter in healthcare contexts. A qualitative explorative design with a hermeneutic narrative approach was used to analyze and interpret written narratives. The phases of the analysis were naïve interpretation, structure analysis on two different levels (narrative structure, and deep structure through metaphors) and finally a dialectic interpretation. The narratives revealed the meaning of the meaningful encounter as sharing, a nourishing fellowship, common responsibility and coming together, experienced as safety and warmth, that gives, by extension, life-changing moments, a healing force and dissipated insight. The meaningful encounter can be seen as a complex phenomenon with various attributes. Understanding the meaningful encounter will enable nurses to plan and provide professional care, based on caring science, focusing on patient and next-of-kin experiences.

Supportive leadership in Swedish community night nursing

gustafsson c., fagerberg i. & asp m. (2010) Journal of Nursing Management18, 822–831 Supportive leadership in Swedish community night nursing Aim  The aim of the present study was to examine the support night nurses’ give to staff in community night nursing. Background  Studies have shown that support given to staff is one of night registered nurses’ (RNs’) experiences of the meaning of caring. This support, that community RNs display for staff in night-time care, is sparsely described. Methods  All community night-duty nurses in a medium-sized municipal in Sweden participated in the present study. Thematic content analysis was used to analyse data from observations. Results  The support given by RNs to staff is described using three themes: (1) a conditional supporting stance, (2) preparing propitious conditions for caring and (3) confidence in the abilities of individual staff members and adaptation to their individual needs. The results reveal that RNs consider support to staff in terms of nursing leadership. Conclusions  Out of ‘concern for the staff’ the RNs try to be there for them, which corresponds to nursing leadership. Such concern also arises from the RNs’ awareness that by giving support to staff this affects the staffs’ caring for older people. Implications for nursing management  The current municipal social care organization of community nursing of older people in which RNs have extensive responsibilities with insufficient control, is a working condition with a risk for decreased quality of care and a high risk for work-related stress syndrome.

Staffs’ documentation of participation for adults with profound intellectual disability or profound intellectual and multiple disabilities

Abstract Purpose: This study investigated what areas of International Classification of Functioning, Disability and Health were documented in implementation plans for adults with profound intellectual disability or profound intellectual and multiple disabilities with focus on participation. Methods: A document analysis of 17 implementation plans was performed and International Classification of Functioning, Disability and Health was used as an analytic tool. Results: One hundred and sixty-three different codes were identified, especially in the components Activities and participation and Environmental factors. Participation was most frequently coded in the chapters Community, social and civic life and Self-care. Overall, the results showed that focus in the implementation plans concerned Self-care and Community, social and civic life. The other life areas in Activities and participation were seldom, or not at all, documented. Conclusions: A deeper focus on participation in the implementation plans and all life areas in the component Activities and participation is needed. It is important that the documentation clearly shows what the adult wants, wishes, and likes in everyday life. It is also important to ensure that the job description for staff contains both life areas and individual preferences so that staff have the possibility to work to fulfill social and individual participation for the target group. Implications for rehabilitation There is a need for functioning working models to increase participation significantly for adults with profound intellectual disability or profound intellectual and multiple disabilities. For these adults, participation is achieved through the assistance of others and support and services carried out must be documented in an implementation plan. The International Classification of Functioning, Disability and Health can be used to support staff and ensure that information about the most important factors in an individual’s functioning in their environment is not omitted in documentation.

Experiences of using Bestic, an eating aid for people with intellectual disabilities

This article reports on the results of a pilot study exploring whether and how the meal situations of persons with intellectual disabilities (PWIDs) in need of help and support during meal situations were affected by an eating aid. This article also analyzes how PWIDs and their assistants perceived their experiences of using an eating aid during meal situations. Data for the study were collected in interviews with PWIDs and their assistants. The results are presented in five themes: independence in the meal situation, motivation to use the eating aid, functions of the eating aid, social aspects of using the eating aid, and design corresponding to intellectual disability. The eating aid’s function, user-friendliness, and the assistants’ attitudes appear to be crucial for using the eating aid. Another important aspect is the introductory and training phase, which must be fundamentally adapted to suit the PWIDs ability to learn and understand. When these aspects are controlled, the eating aid can be a tool for increased independence during meal situations for PWIDs who are unable to move their arms or hands.

Care managers’ perceptions of eHomecare: a qualitative interview study

ABSTRACT To implement information and communication technology (ICT) in elderly care can be a challenge for healthcare organisations. In Sweden, care managers (CMs) are responsible for offering ICT as a new part of homecare, i.e. eHomecare. The aim of this study was to focus on CMs’ perspectives and describe their perceptions of eHomecare. The study has a qualitative approach. Semi-structured interviews based on vignettes were conducted with 12 CMs in a medium-sized municipality in central Sweden. Data were analysed using qualitative analysis. The findings showed that CMs are influenced by surrounding organisations and relatives in their decision to grant eHomecare. There were also difficulties in CMs’ management of eHomecare. Furthermore, eHomecare was perceived to improve the quality of everyday life for older. It is understood that the management of eHomecare is a challenging task for CMs and a complex mission. Interactions among CMs, relatives, care providers, and other factors as for example CMs’ own attitudes have an impact on CMs’ decisions.

eHomecare and safety: The experiences of older patients and their relatives

ABSTRACT The studys aim was to extend descriptions of how older patients with granted eHomecare and their relatives understand safety, and further to describe how they experience safety in everyday life. The study was conducted in Sweden. The participants were 12 older patients who had been provided with eHomecare and 8 relatives. Data were collected by semi‐structured individual interviews. A conceptual framework of safety was used and a qualitative content analysis was conducted in a deductive and an inductive phase. The deductive results are presented in predefined categories: perceived sense of safety, disturbance and threats, re‐establishing safety, and new safety. The inductive analysis resulted in two main categories: safety as part of everyday life and eHomecare as safety. The results show that eHomecare can promote safety for older patients and their relatives. Existing doubts and ethical concerns about the service can be minimized by providing adequate information.