Karin Sundin

Perceptions of conscience, stress of conscience and burnout among nursing staff in residential elder care

AIM This paper is a report of a study of patterns of perceptions of conscience, stress of conscience and burnout in relation to occupational belonging among Registered Nurses and nursing assistants in municipal residential care of older people. BACKGROUND Stress and burnout among healthcare personnel and experiences of ethical difficulties are associated with troubled conscience. In elder care the experience of a troubled conscience seems to be connected to occupational role, but little is known about how Registered Nurses and nursing assistants perceive their conscience, stress of conscience and burnout. METHOD Results of previous analyses of data collected in 2003, where 50 Registered Nurses and 96 nursing assistants completed the Perceptions of Conscience Questionnaire, Stress of Conscience Questionnaire and Maslach Burnout Inventory, led to a request for further analysis. In this study Partial Least Square Regression was used to detect statistical predictive patterns. RESULT Perceptions of conscience and stress of conscience explained 41.9% of the variance in occupational belonging. A statistical predictive pattern for Registered Nurses was stress of conscience in relation to falling short of expectations and demands and to perception of conscience as demanding sensitivity. A statistical predictive pattern for nursing assistants was perceptions that conscience is an authority and an asset in their work. Burnout did not contribute to the explained variance in occupational belonging. CONCLUSION Both occupational groups viewed conscience as an asset and not a burden. Registered Nurses seemed to exhibit sensitivity to expectations and demands and nursing assistants used their conscience as a source of guidance in their work. Structured group supervision with personnel from different occupations is needed so that staff can gain better understanding about their own occupational situation as well as the situation of other occupational groups.

The Meaning of Skilled Care Providers’ Relationships with Stroke and Aphasia Patients

Little is known about the reciprocal influence of communication difficulties on the care relationship. To illuminate care providers’ lived experiences of relationships with stroke and aphasia patients, narrative interviews were conducted with providers particularly successful at communicating with patients. A phenomenological hermeneutic analysis of the narratives revealed three themes: Calling forth responsibility through fragility, restoring the patient’s dignity, and being in a state of understanding. The analysis disclosed caring with regard to the patient’s desire, which has its starting point in intersubjective relationship and interplay, in which nonverbal communication is essential—that is, open participation while meeting the patient as a presence. Thus, care providers prepare for deep fellowship, or communion, by being available. They described an equality with patients, interpreted as fraternity and reciprocity, that is a necessary element in presence as communion. The works of Marcel, Hegel, Stern, and Ricoeur provided the theoretical framework for the interpretation.

Perceptions of conscience, stress of conscience and burnout among registered nurses and nurse assistants in municipal residential care of older people

AIM This paper is a report of a study of patterns of perceptions of conscience, stress of conscience and burnout in relation to occupational belonging among Registered Nurses and nursing assistants in municipal residential care of older people. BACKGROUND Stress and burnout among healthcare personnel and experiences of ethical difficulties are associated with troubled conscience. In elder care the experience of a troubled conscience seems to be connected to occupational role, but little is known about how Registered Nurses and nursing assistants perceive their conscience, stress of conscience and burnout. METHOD Results of previous analyses of data collected in 2003, where 50 Registered Nurses and 96 nursing assistants completed the Perceptions of Conscience Questionnaire, Stress of Conscience Questionnaire and Maslach Burnout Inventory, led to a request for further analysis. In this study Partial Least Square Regression was used to detect statistical predictive patterns. RESULT Perceptions of conscience and stress of conscience explained 41.9% of the variance in occupational belonging. A statistical predictive pattern for Registered Nurses was stress of conscience in relation to falling short of expectations and demands and to perception of conscience as demanding sensitivity. A statistical predictive pattern for nursing assistants was perceptions that conscience is an authority and an asset in their work. Burnout did not contribute to the explained variance in occupational belonging. CONCLUSION Both occupational groups viewed conscience as an asset and not a burden. Registered Nurses seemed to exhibit sensitivity to expectations and demands and nursing assistants used their conscience as a source of guidance in their work. Structured group supervision with personnel from different occupations is needed so that staff can gain better understanding about their own occupational situation as well as the situation of other occupational groups.

Elderly women’s experiences of support when living with congestive heart failure

Heart failure is a chronic syndrome that has physiological, psychological and social effects. The aim of the study was to illuminate the meanings of support as experienced by elderly women with chronic heart failure. Narrative interviews were conducted with five elderly women with chronic heart failure. A phenomenological hermeneutic method of interpretation was used. The meanings of support were experienced by the women out of two perspectives, that is, when support is present and when there is a lack of support. The findings were revealed in two themes: “Feeling confident means support” and “Feeling abandoned”. The women do not wish to be a burden. They want to be independent as much as possible to defend their dignity. An important support to the women is that they are understood and confirmed in their illness. Supportive relations are most valuable, that is, a relationship that supports the womens independence. If there is no supportive relationship, they feel like a burden to others and they feel lonely; this loneliness creates suffering and counteracts wellbeing and health.

A Family Systems Nursing Approach for Families Following a Stroke Family Health Conversations

Stroke in midlife is a life altering, challenging experience for the whole family thereby necessitating a family approach to intervention. The aim of this study was to describe the experiences of 17 family members living in Sweden, including seven adult stroke patients (six males; one female) under the age of 65 who participated in a series of three nurse-led family conversations that were offered in each family’s home. These Family Health Conversations (FamHC) were guided by the conceptual lens of Family System Nursing. Individual, semi-structured, evaluative interviews conducted with each participant one month after the FamHC were analyzed by qualitative content analysis. The FamHC were described by family members as a unique conversation that they had not previously experienced in health care contexts. Family members described possibilities for relational sharing and meaningful conversations as well as changes in family functioning that support the suitability of FamHC for family stroke care.

Experiences With Family Health Conversations at Residential Homes for Older People

The aim of this study was to highlight family members’ experiences of participating in Family Health Conversation (FamHC), based on families in which a family member was living in a residential home for older people. A total of 10 families and 22 family members participated in evaluating family interviews 1 month after participating in FamHC. The interviews were analyzed by qualitative content analysis. The main finding was being a part of FamHC increased family members’ insights, understanding, and communication within the family. Getting confirmation from nurses was essential to cope with the new life situation, which also meant that they felt comfortable to partly hand over the responsibility for the older person who moved to the residential home. By being open and expressing their feelings, a bad conscience could be relieved. These findings showed that FamHC could be helpful for family members in adapting to this novel situation.

What Couples Choose to Focus on During Nurse-led Family Health Conversations When Suffering Stroke

The aim of this study was to illuminate which topics 2 couples, ages younger than 65 years old, where 1 partner has suffered a stroke, choose to focus on when participating in nurse-led family heal ...

Experience of Support for Parents of Adolescents With Heart Defects—Supported to be Supportive

The purpose of this study was to illuminate the meanings of the lived experience of support for parents of adolescents with heart defects. Narrative interviews were conducted with four mothers and two fathers of adolescents with heart defects. Interviews were interpreted using a phenomenological-hermeneutic method. The interpretation revealed that parents, themselves, attempt to be very supportive. They support their adolescent children, the rest of their families, the staffs of their childrens schools, and others around their children. The sense of gratification and contentment that parents receive from fulfilling supportive functions is, in turn, influenced by the support that they, themselves, receive from care providers.

Family Health Conversations have Positive Outcomes on Families - A Mixed Method Research Study

Background: Having a family member living in a residential home affects the entire family and can be hard to handle. Family members require encouraging and open communication support from nurses during and after relocation to a residential home. A Family Systems Nursing intervention, “Family Health Conversations” (FamHC) was conducted in order to strengthen the health of families having relatives at residential home for older people. Objectives: The aims of this study were to evaluate the responses to the Family Health Conversations in families with a member living at a residential home for older people and to integrate the empirical results with a theoretical assumption upon which the intervention was based. Methods: A mixed methods research design was used. The Swedish Health-Related Quality of Life Survey and the Family Hardiness Index were administered before and 6 months after the intervention. Qualitative data was collected by semi-structured interviews with each family 6 months post-intervention. The sample included 10 families comprising 22 family members. Result: Main finding was that FamHCs helped family members process their feelings about having a member living at a residential home and made it easier for them to deal with their own situations. FamHCs helped to ease their consciences, improve their emotional well-being, and change their beliefs about their own insufficiency and guilt. Seeing problems from a different perspective facilitated the families’ thinking in a new way. Conclusion: These findings showed that FamHC could be an important type of intervention to improve family functioning and enhance the emotional well-being.

Support for Fathers of Children With Heart Defects

The purpose of the study was to illuminate the meanings of the lived experiences of support as disclosed by fathers of children with congenital heart defect (CHD). Narrative interviews were conducted individually with five fathers of children diagnosed with CHD. A phenomenological-hermeneutic method was used to interpret the verbatim transcribed narrative interviews. The meanings of the lived experiences of support for the fathers were identified in two themes and illustrate the fathers’ feelings of being supported when being in a mutual relationship with others. A third theme illustrates the situation when support is absent. Our findings indicate that support for fathers of children with CHD might be best promoted by the philosophy of family-centered care.