Dorthe Boe Danbjørg

Parental experiences of early postnatal discharge: A meta-synthesis

OBJECTIVE the aim of this study was to investigate new parents׳ experiences of early postnatal discharge. DESIGN a meta-synthesis including 10 qualitative studies was conducted using Noblit and Hare׳s method of meta-synthesis development. SETTING qualitative studies performed in western countries from 2003-2013 were included. PARTICIPANTS the 10 included studies involved 237 mothers and fathers, first time parents as well as multiparous. FINDINGS we identified four overlapping and mutually dependent themes reflecting the new parents׳ experiences of early postnatal discharge: Feeling and taking responsibility; A time of insecurity; Being together as a family; and Striving to be confident. The mothers׳ and fathers׳ experiences of responsibility, security and confidence in their parental role, were positively influenced by having the opportunity to be together as a family, receiving postnatal care that included both parents, having influence on time of discharge, and getting individualised and available support focused on developing and recognising their own experiences of taking care of the baby. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE the new parents׳ experiences of early discharge and becoming a parent were closely related. Feeling secure and confident in the parental role was positively or negatively influenced by the organisation of early discharge. This underscores the importance of the way health professionals support new mothers and fathers at early postnatal discharge.

The practical skills of newly qualified nurses

This paper reports the findings from a study of newly qualified nurses and which subjects the nurses regarded as the most important in order to be able to live up to the requirements of clinical practice, and how they experience their potential for developing practical and moral skills, after the decrease in practical training. A qualitative approach guided the research process and the analysis of the data. The data was collected by participant observation and qualitative interviews with four nurses as informants. The conclusions made in this study are based on the statements and the observations of the newly qualified nurses. Our findings are discussed in relation to the Aristotelian concept and other relevant literature. The main message is that the newly qualified nurses did not feel equipped when they finished their training. This could be interpreted as a direct consequence of the decrease in practical training. Our study also underlines that the way nursing theory is perceived and taught is problematic. The interviews revealed that the nurses think that nursing theories should be applied directly in practice. This misunderstanding is probably also applicable to the teachers of the theories.

Participatory design methods in telemedicine research

Healthcare systems require a paradigm shift in the way healthcare services are delivered to counteract demographic changes in patient populations, expanding technological developments and the increasing complexity of healthcare. Participatory design (PD) is a methodology that promotes the participation of users in the design process of potential telehealth applications. A PD project can be divided into four phases including: the identification and analysis of participant needs; the generation of ideas and development of prototypes; testing and further development of prototypes; and evaluation. PD is an iterative process where each phase is planned by reflecting on the results from the previous phase with respect to the participants’ contribution. Key activities of a PD project include: fieldwork; literature reviewing; and development and testing. All activities must be applied with a participatory mindset that will ensure genuine participation throughout the project. Challenges associated with the use of PD include: the time required to properly engage with participants; language and culture barriers amongst participants; the selection of participants to ensure good representation of the user group; and empowerment. PD is an important process, which is complemented by other evaluation strategies that assess organisational requirements, clinical safety, and clinical and cost effectiveness. PD is a methodology which encourages genuine involvement, where participants have an opportunity to identify practical problems and to design and test technology. The process engages participants in storytelling, future planning and design. PD is a multifaceted assessment tool that helps explore more accurately clinical requirements and patient perspectives in telehealth.

Usage of an Exercise App in the Care for People With Osteoarthritis: User-Driven Exploratory Study

Background Exercise has proven to reduce pain and increase quality of life among people living with osteoarthritis (OA). However, one major challenge is adherence to exercise once supervision ends. Objective This study aimed to identify mental and physical barriers and motivational and social aspects of training at home, and to test or further develop an exercise app. Methods The study was inspired from participatory design, engaging users in the research process. Data were collected through focus groups and workshops, and analyzed by systematic text condensation. Results Three main themes were found: competition as motivation, training together, and barriers. The results revealed that the participants wanted to do their training and had knowledge on exercise and pain but found it hard to motivate themselves. They missed the observation, comments, and encouragement by the supervising physiotherapist as well as their peers. Ways to optimize the training app were identified during the workshops as participants shared their experience. Conclusions This study concludes that the long-term continuation of exercising for patients with OA could be improved with the use of a technology tailored to users’ needs, including motivational and other behavioral factors.

Blogs - Læringsfællesskab med rum til refleksion

Anvendelse af blogs i laeringssituationer kan give studerende mulighed for at reflektere i faellesskab. Derfor blev blogs afprovet blandt universitetsstuderende med det formal at undersoge, hvordan studerende oplever anvendelsen af blogmediet, samt undersoge hvilke former for refleksion, som blogs kan understotte. Undersogelsen var baseret pa en sociokulturel forstaelse af laering, hvor laering ses som en proces, der konstrueres gennem interaktioner. Blogs blev afprovet som en del af et undervisningsforlob for 24 studerende. Blogindlaeggene blev analyseret mhp at identificere refleksionsniveauet, og der blev gennemfort et fokusgruppeinterview med fem studerende for at afdaekke de studerendes oplevelser med at blogge. Konklusionen er at blogmediet tilbyder et laeringsfaelleskab, som giver de studerende mulighed for refleksion. Desuden tyder det pa, at muligheden for refleksion forringes ved uklarhed over opgaven og usikkerhed pa hvordan blogmediet anvendes. Endelig kan anvendelsen af blogs i laeringssituationer udfordre de gaengse opfattelser af laering, hvilket kan skabe forvirring hos de studerende.

“Dad – a practical guy in the shadow”: Fathers’ experiences of their paternal role as a father during early discharge after birth and readmission of their newborns

OBJECTIVES The aim is to explore how new fathers experience early discharge after birth and readmission of their newborn in relation to their role and involvement as a father. Fathers of today are active participants during pregnancy, birth and in the care of the newborn. Still studies demonstrate that health care professionals are unsuccessful at involving fathers in ante- and postnatal care. How fathers experience their paternal role in the early postnatal period may affect the well-being of the new family. STUDY DESIGN A qualitative study inspired by the hermeneutic approach. Data was collected through telephone interviews. The study was conducted in the Region of Southern Denmark in a University Hospital setting. Convenience sampling was applied. Eight fathers were included from November 2015 till February 2016 and six were interviewed. RESULTS The data analysis revealed three categories: Early discharge - ups and downs, Readmission -waiting but being in good hands, and Practical guy in the shadow. CONCLUSIONS Our study points at fathers being comfortable with being discharged early, but experienced insecurity when at home. The fathers experienced to be categorized by health care professionals as the practical guy, who had to assist the mother. Yet fathers saw themselves as equal to the mothers. Fathers also saw themselves in the shadow of the mother and showed greater considerations for the mothers feelings than their own. Fathers can be insecure in their paternal role when being met as just the practical guy.