Margareta Asp

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.

Patient participation in the emergency department: an evaluation using a specific instrument to measure patient participation (PPED).

AIM This study aimed at evaluating patient participation from the perspective of patients who received care in emergency departments, with a separate examination of the relationship between participation and age, gender, education and priority level. BACKGROUND International and national guidelines encourage patient participation. High patient participation is required to ensure a high quality of care. No studies evaluating patient participation at an emergency department have been published. METHODS An evaluating study, with the Patient Participation Emergency Department questionnaire, was conducted at emergency departments in Sweden. A consecutive sample of 356 patients participated. Data were collected in 2008: participants were 49% women and with an average age of 56 years. The statistical methods used were Students t-test, one-way ANOVA and Spearman correlation. RESULTS The results revealed that patients experienced good requirement for participation such as time and information. Mutual participation demonstrated a reasonable level, but patient participation is low in two dimensions (Fight for participation, Participation in getting basic needs satisfied). Young and well-educated patients fought more to participate in their care and gained less attention for basic needs than older and less well-educated patients. CONCLUSIONS Patient participation in a mutual care situation between patients and healthcare professionals requires further improvement to ensure that patients are satisfied and do not have to struggle and fight to participate in their care.

Questionnaire for patient participation in emergency departments : development and psychometric testing

AIM The aim of the study was to develop and test the psychometric properties of a patient participation questionnaire in emergency departments. BACKGROUND Patient participation is an important indicator of the quality of healthcare. International and national healthcare policy guidelines promote patient participation. While patients cared for in emergency departments generally express dissatisfaction with their care, a review of the literature fails to reveal any scientifically tested instruments for assessing patient participation from the perspective of patients. METHODS A methodological study was conducted involving a convenience sample of 356 patients recently cared for in emergency departments in Sweden. Data were collected in 2008 and analysed for construct and criterion validity, also homogeneity and stability reliability. RESULTS A 17-item questionnaire was developed. Two separate factor analyses revealed a distinct 4-factor solution which was labelled: Fight for participation, Requirement for participation, Mutual participation and Participating in getting basic needs satisfied. Criterion validity testing showed 9 out of 20 correlations above 0.30 and, of these, three were moderate correlations of 0.62, 0.63 and 0.70. Cronbachs alpha coefficient ranged from 0.63 to 0.84 and test-retest varied between 0.59 and 0.93. CONCLUSION The results signify evidence of acceptable validity and reliability, and the questionnaire makes it possible to evaluate patient participation in emergency department caring situations. In addition, it produces data which are usable by a diverse range of healthcare professionals.

Safety and understanding : Support as experienced by women living with heart failure in middle age

To reformulate and adjust to their life-situation, women living with heart failure (HF) need help and support. However, the actual meaning of the phenomenon of support is not yet well described. The aim of the study was to uncover the meaning of the phenomenon of support as experienced by women living with HF in middle age. A reflective lifeworld approach within the perspective of caring science was used. Six women (aged 33–61 years) were interviewed. The findings show that the essence of support can be understood as safety, depicted by understanding. However, there is tension between what is supportive and what is not, meaning that even though intentions are good, intended support may involve limitations, uncertainties or insecurity. The meaning of support is further illuminated in the following constituents: “knowledge and understanding”, “finding balance”, “ambiguity of relationships” and “support and formal care—a matter of trust and mistrust”. Findings demonstrate the need for carers to find an approach that ensures both good quality medical care and, at the same time, acknowledges the uniqueness of each individual.

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.

The use of qualitative evidence in clinical care

The article discusses the importance of applying the results of qualitative research to clinical care. It explains the approaches to evaluating the generalisation of such research. It cites the nee ...

Healthy ageing in Isan-Thai culture—A phenomenographic study based on older persons’ lived experiences

Healthy ageing is a concept that concerns older persons’ quality of life and is a key factor in promoting well-being. The older population in Thailand is growing. Isan (a region of north-eastern Thailand) has been reported as having one of the most rapidly increasing older populations in the country. In order to care for and promote the health of older people, healthcare providers should understand how healthy ageing is perceived by this target group. Although healthy ageing has been studied in different contexts as well as perspectives, no studies have previously focused on older persons’ experiences of healthy ageing from a lifeworld perspective in Isan-Thai. Therefore, the aim of this study is to describe older persons’ qualitatively different conceptions of healthy ageing in Isan-Thai culture. A phenomenographic approach with an epistemological base in lifeworld theory was used to disclose the various ways to conceptualize healthy ageing. Individual, qualitative interviews were conducted with 17 people aged 60 and above who live in Isan-Thai. The findings of this study revealed three categories of descriptions: “being independent in dependence,” “being at peace,” and “being a valuable person.” This study also found family members, friends, healthcare providers, and religion important to healthy ageing in the Isan-Thai culture. Understanding how older people conceptualize healthy ageing is valuable for healthcare providers. They can apply these findings regarding healthy ageing in their fieldwork when caring for older people.Healthy ageing is a concept that concerns older persons’ quality of life and is a key factor in promoting well-being. The older population in Thailand is growing. Isan (a region of north-eastern Thailand) has been reported as having one of the most rapidly increasing older populations in the country. In order to care for and promote the health of older people, healthcare providers should understand how healthy ageing is perceived by this target group. Although healthy ageing has been studied in different contexts as well as perspectives, no studies have previously focused on older persons’ experiences of healthy ageing from a lifeworld perspective in Isan-Thai. Therefore, the aim of this study is to describe older persons’ qualitatively different conceptions of healthy ageing in Isan-Thai culture. A phenomenographic approach with an epistemological base in lifeworld theory was used to disclose the various ways to conceptualize healthy ageing. Individual, qualitative interviews were conducted with 17 people aged 60 and above who live in Isan-Thai. The findings of this study revealed three categories of descriptions: “being independent in dependence,” “being at peace,” and “being a valuable person.” This study also found family members, friends, healthcare providers, and religion important to healthy ageing in the Isan-Thai culture. Understanding how older people conceptualize healthy ageing is valuable for healthcare providers. They can apply these findings regarding healthy ageing in their fieldwork when caring for older people.

Rest A Health-Related Phenomenon and Concept in Caring Science

Rest is a health-related phenomenon. Researchers have explored the phenomenon of rest, but further concept development is recommended. The aim of my study was to develop and describe a concept of rest, from interviews with a total of 63 participants about their lived experiences of rest. I performed the developing process in two stages: first with descriptive phenomenology and second with a hermeneutic approach. The concept of rest is comprised of the essences of both rest and “non-rest,” and there is a current movement between these two conditions in peoples’ lives. The essence of rest is being in harmony in motivation, feeling, and action. The essence of non-rest is being in disharmony in motivation, feeling, and action. The essences reveal some meaning constituents. Health care professionals and researchers can use the concept as a frame of reference in health care praxis and in applied research.

Community nurses’ experiences regarding the meaning and promotion of healthy aging in northeastern Thailand

Purpose: Describe community nurses’ experiences regarding the meaning and promotion of healthy aging in northeastern Thailand. Method: Data were collected through five focus group interviews with 36 community nurses in northeastern Thailand. Latent content analysis was conducted to analyze the data. Findings: Healthy aging was characterized by the interconnection of older persons, older persons’ family members, and the community. Healthy aging was associated with two themes: “being strong” and “being a supporter and feeling supported.” The nurses’ experiences in promoting healthy aging were described by the themes “providing health assessment,” “sharing knowledge,” and “having limited resources.” Conclusions: The findings of this study provide a deeper understanding of the meaning of healthy aging from a holistic viewpoint. Community nurses must pay attention to older persons and their surroundings when planning how to promote healthy aging. Person-centeredness should be applied in practice to promote healthy aging. The current findings contribute useful information that should help policy makers develop healthy aging strategies in Thailand.

Experiences and perceptions about undergoing mammographic screening: a qualitative study involving women from a county in Sweden

ABSTRACT Purpose: An organized population-based mammographic screening programme aims for an early detection of potential breast abnormalities so that treatment can commence. Continuous participation and a high attendance rate are vital for an effective programme. It is important to understand the underlying reasons for participation in mammographic screening, should there be factors that are amendable within reason and could be adjusted. Therefore, the invited women are valuable sources of information. This study aimed at describing the experiences and perceptions about mammographic screening of women from three municipalities in a Swedish county. Method: Six semi-structured focus-group discussions, each with four to five participants, were held. Content analysis was then conducted. Results: The screening procedure, such as staff professionalism, was covered. Other people’s opinions and the woman’s own understanding affected the women’s decisions on whether or not to undergo the procedure. Structural conditions, such as travel time and financial issues, were sources of concern. However, the offer to perform mammographic screening was perceived with gratitude. Conclusions: Structural conditions, risk and time perceptions, the screening procedure, attitudes towards undergoing it and appreciation of its benefit may influence the women’s continuous willingness to be screened, which in turn may affect public and individual health.