Participation and chronic illness: Nurses’ perceptions in primary care in Brazil, Germany, and Spain

Heumann M, Röhnsch G, Zabaleta-del-Olmo E, Toso BRGO, Giovanella L, Hämel K. Participation and chronic illness: Nurses’ perceptions in primary care in Brazil, Germany, and Spain. European Journal of Public Health. 2022;32(Suppl. 3): ckac129.721.**Background** Many chronically ill persons are challenged by integrating the illness in everyday life and making ‘competent’ decisions on their life and care. In multiprofessional primary care, promoting clients’ self-management and strengthening their abilities to participate in everyday life is increasingly recognized as a nursing task. This study investigates facilitating and inhibiting conditions that nurses experience when exercising this task. **Methods** Drawing upon a phenomenological approach, we conducted guided interviews with 34 practicing nurses and 23 key informants with advanced knowledge of primary health care nursing practice in Brazil, Germany, and Spain. The interviews were analysed using structuring content analysis. **Results** The interviewees see competencies of nurses to establish trusting relationships with chronically ill clients as key to greater client participation. Nurses, however, state that bonding with clients can be time-consuming and exhausting. They consider it fundamental that physicians and other professionals value nurses’ efforts towards stronger client participation as a way forward to reach for person-oriented primary care. They criticize that especially physicians value biomedical tasks more than enabling participation. Referring to primary health care organisation, nurses experience that pressure of time through a growing number of routine and administrative tasks inhibits their efforts to strengthen clients’ participation. **Conclusions** To promote the participation of clients with chronic illnesses in their everyday life and in care, relationship building with clients and self-management support needs to be acknowledged as an important scope of practice approached by nurses. To be able to unfold the potentials nurses need to be equipped with sufficient time and skills

Prospects and constraints of nursing home-based integrated adult day care : Viewpoints of experts

Hämel K, Röhnsch G. Möglichkeiten und Grenzen integrierter Tagespflege in Pflegeheimen: Sichtweisen von ExpertInnen. Zeitschrift fur Gerontologie und Geriatrie. 2019;52(2): 148–156.BACKGROUND: Even when they are in need of care, old people prefer to stay in their community. An appropriate design of nonresidential and residential care services close to people's home is crucial for supporting them. In the model project "Pflege stationar-Weiterdenken!" (Nursing home care-think ahead!) nursing homes offer extended services to old people in the community. This includes integrated day care (ITP), which entails day guests spending the day with residents of the facilities. This article examines the opportunities and challenges arising when designing and implementing this type of cross-sectoral care model.; METHOD: Guided interviews were carried out with 20experts who were either professionals working at the model institutions or involved in the project at the planning and cooperation levels. The data collected were evaluated using thematic coding.; RESULTS: The opportunities and challenges lie at two levels. (1)At the institutional level advantages are greater individual and flexible timeframes of usage and better accessibility of day care for care-dependent people through the integration into residential care settings. The challenges involve administrative and management issues as well as apprehensions among the employees concerning the increased workload. (2)At the level of interaction and social integration experts emphasized the importance of making allowances for the interests and needs of day guests and residents. Furthermore, they confirmed that if this is achieved then integrated day care can improve the social participation of both user groups.; CONCLUSION: From the experts' point of view, the ITP holds the potential for cross-sectoral care for old people in need of care close to their homes. Afinal assessment will require further analysis, especially on users' views